How to heal a gluteus medius running injury (and keep it from returning)

By Henry Howard

As a masters athlete, running coach and Chief Running Officer for RunSpirited, sometimes I find inspiration to write about something occurring in my journey.

Today, that’s the case when I had to diagnose a new running-related pain that arose.

If you’ve ever felt a nagging ache on the outside of your hip that flares up early in a run and lingers long after you finished, there’s a good chance your gluteus medius is trying to tell you something. It’s one of the sneakier injuries because it rarely announces itself with a dramatic pop or tear. It just shows up as stiffness, then soreness, then eventually it starts dictating your training.

Let’s break down what this muscle actually does, why it gets cranky, and — most importantly — how to heal it and keep it from halting your training and racing.

(Disclaimer: This article is for general educational purposes and isn’t a substitute for individualized medical advice. If you are experiencing hip pain, see a physical therapist or physician for a proper evaluation.)

What is the gluteus medius, and why should runners care?

Sandwiched between your glute max and glute min, the gluteus medius sits on the outer side of your pelvis, running from the top of your hip bone down to the top of your thigh bone. Despite being the “middle child” of the glute family, it does heavy lifting on every single stride. The gluteus medius keeps your pelvis level when you’re balanced on one leg, helps control how your thigh rotates and pulls your leg out to the side (hip abduction).

Since running is essentially a series of single-leg hops, the glute medius works overtime on every stride to keep your hips from dropping and your knees from caving inward. When it’s doing its job well, you barely notice it. When it’s weak, fatigued, or irritated, you’ll usually feel it as pain on the outer hip. Sometimes it radiates down toward the knee or up into the lower back.

A simple self-check: stand in front of a mirror, hands on hips, and lift one knee to waist height while balancing on the other leg. Watch your opposite hip. If it drops noticeably instead of staying level, that’s often a sign the standing-leg glute medius isn’t stabilizing the way it should.

What causes a gluteus medius running injury

Most gluteus medius running injuries aren’t the result of one bad step. They build up over weeks or months. Common culprits include:

• Ramping up mileage too quickly. Repeated stress without enough recovery time is one of the most common triggers for gluteal tendon irritation.

• Poor running mechanics, especially excessive pelvic drop or hip adduction, where the knee drifts inward with every stride.

• Muscle imbalances, where the glute max or quads take over work the glute medius should be doing.

• Too much sitting. Long hours at a desk can leave this muscle underused and slow to activate when you actually need it.

• Skipping strength work. Runners who only run, and never load the hips laterally, are more likely to develop this weak link.

In its more advanced form, this shows up as gluteal tendinopathy — irritation where the glute medius and minimus tendons attach to the femur — and it’s one of the most common sources of outer-hip pain in the running community.

How to treat and heal a gluteus medius injury

The encouraging news is that gluteus medius injuries generally respond well to a structured approach:

1. Back off the aggravating load but don’t stop moving entirely. Cutting mileage or swapping in cross-training for a stretch gives the tendon room to calm down without torching your fitness. For example, I switched to a long bike ride (in fact, my longest ever) instead of my prescribed long weekend run when the gluteus medius didn’t respond after after a few days off.

2. Calm things down early. Ice, anti-inflammatory measures if appropriate for you, and simply avoiding positions that compress the area — like sitting cross-legged or standing with your hip “hanging” to one side — take pressure off an irritated tendon.

3. Start with isometrics. Gentle, sustained holds, such as a wall-press hip abduction hold, can ease pain and begin reactivating the muscle without provoking it further.

4. Progress to controlled strengthening. Once pain settles, move into slow, controlled strength work to rebuild capacity.

5. Loop in a physical therapist if things stall. A PT can rule out a full tear, confirm what’s actually going on and build a progression suited to your case. This is especially worthwhile if pain hasn’t eased after a few weeks of modified training.

Stretching alone can feel good in the moment, but it rarely fixes the underlying issue, since most gluteus medius injuries come from the muscle being weak or under-recruited rather than simply tight.

Strength work to prevent a recurrence

Once you’re through the acute phase, the real work of injury-proofing your hips begins. Below I listed some of the moves I would generally recommend for building durable glute medius strength. But be sure to consult your doctor and/or physical therapist so they can properly address your specific condition and appropriate rehab plan.

• Side-lying hip abduction. Lie on your side, bottom leg bent for stability, and lift the top leg straight up without rocking your hip backward. Keep the movement slow and controlled.

• Clamshells. Same starting position, knees bent, feet together — open your top knee like a clamshell while keeping your pelvis still.

• Hip hitches (pelvic drops). Stand on a step with one leg hanging off the edge, and practice dropping and lifting your pelvis using only the standing-leg glute, keeping that knee straight. This one directly mimics the stabilizing job the muscle does while you run.

• Single-leg deadlifts. Build balance and posterior-chain strength while forcing the standing hip to stabilize.

• Bulgarian split squats. A single-leg strength staple that loads the hip in a running-specific pattern.

• Lateral band walks. Monster walks and side steps with a resistance band around your ankles or knees are a simple, effective way to build endurance in the hip abductors.

  
  

Aim for two to three sessions a week of this kind of work, even after you’re pain-free. The tendency for runners is to drop strength training the moment symptoms disappear, and that’s exactly how this injury becomes a repeat offender.

The bottom line

Your gluteus medius may be small compared to its “maximus” neighbor, but for runners it’s doing outsized work on every stride. Treat the irritation, then build the strength that keeps it from flaring up again and this is one injury you can put behind you for good.

Frequently Asked Questions: Gluteus medius injury

Question: What does gluteus medius pain feel like in runners?

Answer: Most runners describe it as an ache or sharp twinge on the outer side of the hip, often near the bony point you can feel when you press on the side of your hip. It typically worsens with running, climbing stairs, or lying on the affected side at night, and can sometimes radiate down toward the knee.

Question: How long does it take to heal a gluteus medius injury?

Answer: Mild irritation can improve within a few weeks of load management and targeted strengthening. More established tendinopathy often takes 8 to 12 weeks of consistent rehab to fully resolve, and a true muscle tear can take considerably longer, sometimes requiring surgical evaluation. See your doctor and/or a physical therapist to get your specific injury properly diagnosed.

Question: Can I keep running with a gluteus medius injury?

Answer: It depends on severity and the recommendation of your PT and/or doctor. Mild cases may tolerate reduced mileage and easier paces as long as pain stays low during and after the run. If pain changes your gait, lingers for hours afterward, or gets progressively worse, it’s a sign to back off running and cross-train while you rehab.

Question: What’s the difference between gluteus medius tendinopathy and a tear?

Answer: Tendinopathy is irritation and breakdown of the tendon fibers from repetitive overload. That is pretty common and usually responds well to a strengthening program. A tear is a structural disruption of the muscle or tendon, often causing more sudden or severe pain and weakness, and it may require imaging and a specialist’s evaluation to rule out.

Question: What’s the best exercise for gluteus medius weakness?

Answer: There isn’t a single “best” move, but hip hitches and side-lying hip abduction are two of the most direct ways to isolate and strengthen the muscle in a pattern that closely mirrors what it does while running.

Question: Should I stretch or strengthen a tight-feeling gluteus medius?

Answer: Both have a place, but strengthening is usually the priority. A “tight” feeling on the outer hip is frequently a sign of an overworked or weak muscle rather than a genuinely short one, so leaning too heavily on stretching without addressing strength can leave the underlying issue unresolved.