Hip Pain & Injury
Article by John Miller
What Causes Hip Pain?
Hip pain is common and spread across all age groups. The hip joint and its integration with your pelvis, SIJ and lumbar spine (lower back) make it a complex region to correctly analyse and assess any dysfunction.
The Older Hip
If you are in the older population group, you will be more vulnerable to age-related hip issues such as hip arthritis, trochanteric bursitis and GTPS (Greater Trochanteric Pain Syndrome). Functional limitations could include simply walking, sit to stand, single leg standing, stairs or even sleeping in severe cases.
Hip pain can also be associated with reduced balance. A thorough balance assessment may be required to predict a falls risk. Falls prevention exercises may be prescribed by your physiotherapist to address any individual deficits. They may even advise you to utilise a walking assistance device such as a walking stick, crutches or a walking frame.
The Sporting Hip
Younger sports-related hip issues may come on after prolonged running, jumping or landing activities. Specific sporting hip conditions should be discussed and thoroughly assessed by your hip physiotherapist. Biomechanical deficits and subtle hip weakness that may only show on a slow-motion video are just two of the potential causes of sporting hip injuries.
Groin pain is one of the most common symptoms associated with hip joint pathologies such as hip osteoarthritis and hip labral injury. There are also many other causes of groin pain that need to be excluded by a health professional. More info: Groin Pain.
Only after a thorough hip assessment will your hip pain be effectively rehabilitated to relieve your current hip pain and joint dysfunction, plus prevent the return of any future hip pain.
Hip Pain Assessment
The successful treatment of your hip pain requires a thorough and accurate assessment of your:
- entire lower limb (foot, ankle, knee, hip, groin)
- lumbar spine
- pelvis and SIJ function and alignment
- deep hip muscle control and activation patterns
- middle and superficial hip muscle control, strength and function
- deep abdominal, core and pelvic floor muscle control
- upper thigh muscle length and strength (e.g. quadriceps, adductors, hamstrings, and ITB)
- neural tissue extensibility e.g. sciatic and femoral nerve
- hip joint biomechanics.
Your hip pain can and often is related to your whole lower limb
Common Sources of Hip Pain
Hip Joint Pain
- Hip Arthritis - Osteoarthritis
- Hip Labral Tear
- Hip Pointer
- Femoroacetabular Impingement - FAI
- Perthes Disease
- Slipped Femoral Capital Epiphysis
- Stress Fracture
- Avascular Necrosis of the Femoral Head
Lateral Hip Pain
- Inguinal hernia
- Sportsman's hernia
- Hip Flexor Strain
Other Muscle-related Pain
- Piriformis Syndrome
- Muscle Pain -Muscle Strain
- Poor Hip Core
- DOMS -Delayed Onset Muscle Soreness
- Core Stability Deficiency
What is the Best Treatment for Hip Pain?
A thorough analysis of WHY you actually suffering hip pain from a movement, posture, or a control aspect, is vital to solving your hip pain.
Only an accurate diagnosis of the source of your hip pain can solve the pain, quickly improve your day to day function, prevent a future recurrence, or improve your athletic performance.
Symptomatic treatment has traditionally been the first choice of short-term treatment. This could include local chemical modalities such as cortisone injections or painkillers. Ice or heat could also assist along with some gentle stretching or exercise.
However, persisting hip problems will require additional investigations to assess your joint integrity or range of motion, muscle length, strength, endurance, power, contraction timing and dynamic stability control.
Your healthcare practitioner who has a special interest in hip pain and injury management should be consulted to thoroughly assess your hip, groin, pelvis, lower limb and spine. Due to the kinetic chain, they all have an impact, especially at the high athletic performance end. A quality practitioner will specifically educate you regarding your condition and combine with exercise and/or manual therapy as per the Clinical Practice Guidelines. (Cibulka et al., 2017) Hip pain education should also include teaching you specific activity modification, individualised exercises, weight-loss advice (if required), and methods to unload any arthritic joints.
Recent research evidence-backed approaches have modernised physiotherapy treatment approaches to effectively managing hip pain. Together with a thorough hip assessment, your hip treatment can progress quickly to restore you to a pain-free hip and perform your normal sport or daily activities in the shortest time possible.
For specific rehabilitation advice regarding your hip pain, seek the professional advice of a high quality and up-to-date physiotherapist, who is experienced in the assessment, treatment, prevention and optimisation of hip pain and related conditions. After assessing you they will individually prescribe therapeutic activities based on your specific needs for daily living, values, and functional activities or point you in the direction of the most suitable healthcare practitioner for you and your hip condition.
Buy Helpful Products for Hip Pain
Hip Pain Treatment Options
Your hip physiotherapist may consider an extensive range of treatment options including manual joint therapy to improve your joint mobility, muscle stretches or supportive taping. Your physiotherapist is also likely to add strengthening and joint control exercises as they deem appropriate for your specific functional and sporting needs.
Please click the links below for more information about some of the common hip treatments that your physiotherapist may recommend or utilise for your hip pain.
Hip Pain FAQs
Cibulka, M., Bloom, N., Enseki, K., Macdonald, C., Woehrle, J. and McDonough, C. (2017). Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2017. Journal of Orthopaedic & Sports Physical Therapy, 47(6), pp.A1-A37.
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