Gluteal TendinopathyOuter Hip Pain After Total Hip Replacement: Why It May Not Be Your Implant Posted on March 4, 2026 by Physiofit Outer Hip Pain After Total Hip Replacement Outer Hip Pain After Total Hip Replacement: Why It May Not Be Your Implant If you’ve had a total hip replacement but still feel pain on the outside of your hip, you’re not alone. Many patients — especially men — assume that lingering outer hip pain means something is wrong with the implant. In most cases, the replacement is functioning well. The pain is often coming from something else: Gluteal tendinopathy. First, The Reassuring Part If your surgeon has confirmed: The implant is stable Imaging looks normal There are no signs of infection or loosening Then the issue is often soft tissue — not the joint itself. The most common source of persistent outer hip pain after total hip replacement is irritation of the gluteus medius and gluteus minimus tendons. These are the primary stabilizers of your hip. Why Does This Happen After Hip Replacement? Pre-operative inhibition and disuse Many individuals undergo total hip replacement after a prolonged period of hip pain due to osteoarthritis. Chronic pain and altered gait mechanics often lead to reduced loading of the involved limb, resulting in pre-surgical muscle inhibition and atrophy—especially in the lateral hip stabilizers. Your surgeon replaced the joint, not the muscles. When those tendons are weak but repeatedly stressed, they become irritated. This is called gluteal tendinopathy. Why We See This Often in Males While outer hip pain is common in both men and women, we frequently see persistent post-hip replacement tendon issues in males for a few reasons: Men often return to activity quickly Higher body mass can increase tendon load Tight lateral hip structures create compression Less emphasis on post-op glute strengthening Greater participation in golf, yard work, or recreational sports Many men assume strength will “just come back” naturally — but hip stability requires targeted loading. Common Symptoms of Gluteal Tendinopathy After Hip Replacement Pain on the outside of the hip Pain when lying on that side Discomfort walking longer distances Pain with stairs or single-leg standing Tenderness to touch over the lateral hip Importantly, the pain is typically not deep in the groin (which would suggest joint involvement). Why Rest Alone Doesn’t Fix It Many patients try: Cutting back activity Stretching the IT band Anti-inflammatories Another injection While symptoms may calm temporarily, the tendon still lacks strength. Tendons need progressive load to adapt. Without strengthening, the irritation often returns. The Solution: Rebuilding Hip Strength the Right Way At PhysioFit of NC, we treat outer hip pain after total hip replacement with a structured, progressive strengthening approach. Treatment focuses on: ✔ Pain-calming isometric exercises✔ Gradual hip abductor strengthening✔ Pelvic control during walking✔ Single-leg stability training✔ Functional progression for daily tasks Every session is one-on-one with a Doctor of Physical Therapy, so we can safely progress strength while respecting your surgical history. The Goal Is Confidence — Not Just Pain Relief Our objective isn’t just to reduce discomfort. We want you to: Walk longer distances without pain Climb stairs confidently Sleep on either side Return to golf or recreational activity Trust your hip again And that requires rebuilding tendon capacity — not just managing symptoms. When Should You Seek Help? If: Your hip replacement was more than 3–6 months ago Your surgeon says the implant looks good You still have persistent outer hip pain It may be time to evaluate the gluteal tendons. Final Thoughts Persistent outer hip pain after total hip replacement does not automatically mean something is wrong with the implant. Often, it means the stabilizing muscles need attention. With the right strengthening progression, gluteal tendinopathy can improve significantly — even months or years after surgery. If you’re in Wake Forest and dealing with outer hip pain after hip replacement, we’re here to help guide you back to confident movement. Schedule an evaluation today to start your program! Physiofit The Right Way to Strengthen for Gluteal Tendinopathy: Why Random Exercises Don’t Work Achilles Tendinopathy: Why It’s Not Just “Tight Calves”
