Red Light Therapy for Gluteal Tendinopathy: Reducing Lateral Hip Pain

Gluteal tendinopathy — formerly mislabelled as "trochanteric bursitis" — is the most common cause of lateral hip pain in adults over 40. It's a tendon problem, not a bursa problem, and tendinopathy responds well to photobiomodulation.

What Is Gluteal Tendinopathy?

The gluteus medius and gluteus minimus are two of the deeper hip stabilising muscles. Both attach to the greater trochanter — the bony prominence on the outside of the hip. These tendons take huge cumulative load: every step you take, every time you stand on one leg, the gluteal tendons fire to keep the pelvis level.

Tendinopathy is what happens when the tendon's normal repair processes fall behind the load being placed on it. The tendon develops microdamage, the collagen architecture gets disorganised, neurovascular ingrowth occurs, and pain becomes chronic. The condition is most common in middle-aged and older women — partly due to hormonal changes affecting tendon collagen, partly due to hip biomechanics that load the lateral tendons more in women than men.

The classic presentation: pain on the outside of the hip, worse when you lie on the affected side at night, worse with stairs and prolonged standing, often radiating into the lateral thigh. There's almost always tenderness directly over the greater trochanter when pressed.

Why It's Often Misdiagnosed as Bursitis

For decades, lateral hip pain was treated as "trochanteric bursitis" — an inflammation of the bursa sitting over the greater trochanter. Patients were given corticosteroid injections aimed at the bursa, with mixed results. Modern ultrasound and MRI imaging has shown that in the vast majority of cases, the bursa is normal or only mildly involved. The actual problem is in the tendons.

This is why corticosteroid injection results are inconsistent — they're sometimes hitting the wrong tissue. It's also why the condition is now formally called "greater trochanteric pain syndrome" (GTPS) or "gluteal tendinopathy" in physiotherapy and sports medicine literature, not bursitis.

For photobiomodulation, the distinction matters because tendinopathy has a much better evidence base for LLLT than bursitis does. The mechanism — reducing inflammatory signalling, supporting collagen organisation, addressing the cellular environment around chronic tendon damage — maps directly onto what tendinopathy actually is.

What the Research Shows

The strongest LLLT evidence in tendinopathy comes from Achilles, patellar, rotator cuff, and elbow studies — the gluteal tendons specifically have less direct evidence, but the mechanism is the same. A 2024 meta-analysis of tendon outcomes found that LLLT reduces pain intensity and may improve function in tendon conditions when applied at clinically meaningful doses.

For lateral hip pain specifically, current best practice combines load management (avoiding sleeping on the affected side, modifying stair use, single-leg stance work) with progressive isometric and isotonic strengthening of the hip abductors. Photobiomodulation is increasingly used as an adjunct to support tendon recovery between exercise sessions, particularly during the first 8–12 weeks when symptoms are most active.

A 2021 review of LLLT in soft-tissue rehabilitation concluded that LLLT is a beneficial adjunct to rehabilitation exercise — the same pattern that holds for knee OA holds for tendinopathy.

How to Use the MOVE+ for Gluteal Pain

Application is straightforward — the gluteal tendons are surface-accessible at the greater trochanter, and 808 nm penetrates easily to the tendon depth.

Suggested protocol:

• Placement: wrap directly over the greater trochanter (the bony point on the outside of the hip — you'll feel it easily) and the area immediately above and behind it.
• Wavelength: 660 nm + 808 nm (MOVE+ standard).
• Session duration: 10–15 minutes per session.
• Frequency: 5 sessions per week for the first 8 weeks, then taper to 3 sessions per week.
• Combine with: isometric hip abductor work (side-lying clamshells, side-lying leg lifts at low load), single-leg balance work, and load management (avoid sleeping on the affected side; use a pillow between knees if you do).
• Avoid: aggressive stretching of the iliotibial band — for gluteal tendinopathy, ITB stretching often makes the condition worse.

When to Combine With PT vs. When to Consider Injection

Most cases of gluteal tendinopathy improve with 8–12 weeks of structured exercise rehabilitation plus daily photobiomodulation. If symptoms are severe at presentation or aren't improving after 12 weeks of disciplined conservative care, options include image-guided high-volume injection (saline + small steroid dose), platelet-rich plasma (PRP), or — in refractory cases — surgical tendon repair.

Photobiomodulation pairs particularly well with PT because it reduces the post-exercise inflammatory load that often causes tendinopathy patients to flare up after rehab sessions. Many physiotherapists now incorporate LLLT into clinic visits for exactly this reason.

Safety and Contraindications

• Do not apply directly over recent injection sites for at least 48 hours.
• Avoid use over active infection or open skin lesions.
• Pregnancy: see our pregnancy guide.
• Photosensitising medications (tetracyclines, isotretinoin, some NSAIDs at high doses): consult your prescriber.
• Hip implants: photobiomodulation is non-thermal and does not interact with metal hardware, but always confirm with your orthopaedic surgeon.

Frequently Asked Questions