Hip bursitis, more accurately called greater trochanteric pain syndrome (GTPS), causes pain on the outside of your hip at the bony prominence called the greater trochanter. While traditionally blamed on inflammation of the bursa (a fluid-filled cushion), research now shows that most cases involve degeneration of the gluteal tendons (gluteus medius and minimus) that attach at the trochanter, with bursitis as a secondary finding. Understanding this matters because it changes the treatment approach entirely.
In Boulder, hip bursitis is extremely common in runners, hikers, and active adults, particularly women over 40. It disrupts sleep because lying on the affected side is painful. It makes walking painful, limits your ability to hike and run, and progressively worsens without treatment. Many patients I see have received multiple cortisone injections with temporary relief that keeps wearing off. The cortisone is treating inflammation in the bursa while the actual problem, the gluteal tendon degeneration, continues to progress underneath.
The conventional approach to hip bursitis has been cortisone injections into the trochanteric bursa, physical therapy focusing on hip strengthening, and anti-inflammatory medication. When those fail, surgical bursectomy (removal of the bursa) is sometimes offered. This treatment model is based on the outdated assumption that the bursa is the primary problem.
Current research has shifted the understanding. Greater trochanteric pain syndrome is primarily a tendon problem (gluteus medius and minimus tendinopathy), not a bursa problem. Cortisone reduces inflammation temporarily but does not repair the degenerated tendons, and repeated injections can further weaken tendon tissue. Surgical bursectomy removes the bursa but leaves the underlying tendon degeneration untreated. A Level I double-blind randomized controlled trial with two-year follow-up demonstrated that PRP for gluteal tendinopathy outperforms cortisone injection, marking a shift in the evidence base for treating this condition.
At Dynamic Athlete, hip bursitis treatment targets the actual source of the problem: the gluteal tendons, not just the inflamed bursa.
Dynamic PRP+ concentrates your own blood platelets and growth factors, then delivers them directly into the damaged gluteal tendons under ultrasound guidance. A Level I double-blind RCT with two-year follow-up demonstrated that PRP for gluteus medius and minimus tendinopathy produces significantly better outcomes than cortisone injection. This is the strongest clinical evidence supporting PRP over cortisone for any tendon condition in the hip.
Dynamic Shockwave+ combines focused shockwave therapy with EMTT (Extracorporeal Magnetotransduction Therapy) using Storz Medical devices. For hip bursitis, focused shockwave stimulates new blood vessel formation in the gluteal tendons, reduces chronic pain signaling, and breaks down calcification and scar tissue. EMTT penetrates deeper to accelerate cellular metabolism. This combination addresses both the tendon damage and the secondary bursitis simultaneously.
I founded the American Shockwave Training Institute (ASTI) and train clinicians nationally on shockwave protocols for tendon and periarticular conditions. The device and protocol design determine outcomes.
For patients whose hip bursitis is connected to biomechanical factors, Dynamic Core+ (EMSELLA/HIFEM) strengthens the pelvic floor and deep core muscles that support hip mechanics. Weak core and pelvic floor muscles alter gait patterns and increase lateral hip loading, perpetuating the tendinopathy. For neurological healing optimization, Dynamic Mind+ (EXOMIND/ExoTMS) can enhance the body’s recovery response and pain modulation throughout the treatment process.
Dynamic Athlete is the only practice in the country offering all five proprietary modalities under one roof. For hip bursitis specifically, this means we can address the gluteal tendon damage with Dynamic PRP+ and Dynamic Shockwave+, strengthen the core and pelvic floor stability with Dynamic Core+, optimize neurological recovery with Dynamic Mind+, and manage the treatment process with diagnostic precision that targets the actual source of your lateral hip pain rather than simply injecting the bursa and hoping for the best.
Your hip bursitis is probably not a bursa problem. It is a tendon problem. Most physicians miss this. Aneesh Garg, DO, CAQ does not, because his Yale residency and Andrews Sports Medicine fellowship trained him to evaluate what is actually generating your pain, not just where you feel it. He is double board-certified in Sports Medicine and Internal Medicine and serves as Team Physician for USA Hockey and U.S. Soccer. That diagnostic precision changes everything about how your lateral hip pain gets treated.
For hip bursitis, his sports medicine training means he evaluates the condition as greater trochanteric pain syndrome rather than simply injecting the bursa. He assesses gluteal tendon integrity, hip biomechanics, and core stability to build a treatment plan that addresses the actual source.
Our patients with hip pain and lateral hip conditions report meaningful improvement when the actual source of their symptoms is identified and treated.
One former collegiate athlete who skis and mountain bikes as her full-time job is being treated at Dynamic Athlete for a hip injury. She described being lightyears ahead of where she was and is confident she will return to the activities she loves.
Another patient went to Dynamic Athlete on a primary care referral for hip and knee pain after an exercise injury. Dr. Garg explained the problem in clear terms, laid out treatment options, and built a plan that made sense for her situation.
Published Level I evidence shows PRP for gluteal tendinopathy outperforms cortisone injection at two-year follow-up, supporting the approach we use for every hip bursitis patient.
Yes. A Level I double-blind randomized controlled trial with two-year follow-up demonstrated that PRP for gluteal tendinopathy produces significantly better outcomes than cortisone injection for greater trochanteric pain syndrome. Your own blood is drawn, concentrated, and injected directly into the damaged gluteal tendons under ultrasound guidance. Over 90% of our patients self-report a 75% or greater improvement following treatment. Our Dynamic PRP+ protocol uses precise image-guided placement into the gluteal tendons, not just the bursa. This targets the actual source of the problem rather than masking symptoms. One patient described being lightyears ahead of where she was after treatment.
Focused shockwave therapy stimulates new blood vessel formation in the gluteal tendons, reduces chronic pain signaling, and breaks down calcification and scar tissue contributing to greater trochanteric pain. EMTT, paired with shockwave in our Dynamic Shockwave+ protocol, penetrates deeper to accelerate cellular metabolism. This combination addresses both the tendon degeneration and the secondary bursitis simultaneously. Dr. Garg founded ASTI and trains clinicians nationally on shockwave protocols using Storz Medical devices. This is not the same as radial pressure waves. Radial waves are not true shockwave and cannot target the gluteal tendon insertion with the same precision. One patient received shockwave and EMTT and reported significant improvement within days, with no pain and increased mobility.
Because cortisone treats the inflammation in the bursa without repairing the degenerated gluteal tendons underneath. Current research shows that most cases of hip bursitis are primarily tendon problems (gluteus medius and minimus tendinopathy) with bursitis as a secondary finding. Cortisone reduces inflammation temporarily, but once it wears off, the damaged tendons continue generating pain. Repeated cortisone can also weaken the tendon tissue further. Our approach at Dynamic Athlete targets the gluteal tendons directly with Dynamic PRP+ and Dynamic Shockwave+ to promote actual structural tissue repair rather than temporary symptom suppression. One patient who explored several clinics chose Dynamic Athlete for its honesty and felt remarkably close to normal after PRP and shockwave.
In most cases, yes. Research has shifted the understanding of greater trochanteric pain syndrome from a bursa problem to a tendon problem. The gluteus medius and minimus tendons that attach at the greater trochanter are the primary pain generators in the majority of patients. The bursitis is secondary to the tendon degeneration. At Dynamic Athlete, Dr. Garg evaluates gluteal tendon integrity with ultrasound and clinical exam rather than assuming the bursa is the source. For enhanced recovery, Dynamic Mind+ (EXOMIND) can optimize the neurological healing response. This accurate diagnosis changes the treatment approach entirely and leads to better outcomes.
Most patients respond well to a combination of PRP injection (one or two sessions) and three to six sessions of Dynamic Shockwave+ spaced one week apart. PRP is delivered directly into the gluteal tendons under ultrasound guidance, while shockwave addresses pain signaling and promotes tendon healing across multiple sessions. Some patients notice meaningful improvement after the first few shockwave sessions. Dr. Garg adjusts the protocol based on your response and imaging findings. When biomechanical factors contribute, Dynamic Core+ (EMSELLA) is incorporated for pelvic floor and deep core stability support during rehabilitation. One patient reported that the treatment was precise, efficient, and actually moved the needle fast.
Yes. Weak pelvic floor and deep core muscles alter gait mechanics and increase lateral loading on the hip, which perpetuates gluteal tendinopathy and bursitis. Our Dynamic Core+ (EMSELLA/HIFEM) protocol strengthens these muscles through high-intensity electromagnetic stimulation, addressing the biomechanical factors that contribute to hip bursitis. Most clinics skip this step entirely. At Dynamic Athlete, we incorporate core stability assessment and treatment into hip bursitis protocols because treating the tendons without addressing the stability deficit leads to recurrence. Dr. Garg evaluates core and pelvic floor function as part of every hip pain assessment. One patient described EMSELLA as a surprisingly powerful add-on that activated deep inner muscles more precisely than anything he had experienced in 25 years in the fitness space.
Most clinics inject cortisone into the bursa and send you to PT. We target the actual source, the gluteal tendons, with Dynamic PRP+ backed by Level I evidence showing superiority over cortisone at two years. We layer Dynamic Shockwave+ with EMTT for tendon healing and use Dynamic Core+ to address the biomechanical factors driving the condition. Dr. Garg’s training at Yale and Andrews Sports Medicine, combined with his role as Team Physician for USA Hockey and U.S. Soccer, means your hip gets diagnostic precision and treatment depth no other Boulder provider offers. No other practice in the country offers all five modalities. One former NCAA athlete described this as world-class care worth every penny after chronic pain resolved with treatment here.