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What Causes Hip and Groin Pain?

John Miller Physiotherapist Erin Runge Physiotherapist
Article by John Miller & Erin Runge
hip and groin pain causes assessed with standing hip flexion and rotation

Hip movement checks help guide the next step.

Hip and groin pain causes may include irritation inside the hip joint, a groin strain, tendon overload, bone stress or referred pain from the lower back or pelvis. Symptoms often appear during walking, running, sitting, stairs, squats, kicking or changing direction.

A hip pain physiotherapy assessment can help identify the most likely source. This is especially useful when hip pain overlaps with groin pain or lower back symptoms.

Quick Answer: What Causes Hip and Groin Pain?

Common hip and groin pain causes include hip osteoarthritis, femoroacetabular impingement, hip labral irritation, groin strain, adductor tendon pain, hip flexor pain, gluteal tendon pain and referred pain from the lower back.

Pain location offers clues, but it does not confirm a diagnosis. Stiffness, clicking, weakness, limping, altered sensation and activity triggers help build a clearer clinical pattern.

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What Are the Main Hip and Groin Pain Causes?

Most causes fit within several broad groups: hip joint problems, muscle or tendon overload, outer hip conditions, referred pain, bone stress and inflammatory or medical conditions.

Deep pain at the front of the hip or groin can suggest involvement of the hip joint. Inner-thigh pain may involve the adductor muscles or tendons. Outer hip pain commonly relates to the gluteal tendons or nearby bursa. However, symptoms can overlap, and lower back problems may also refer pain into the hip or groin.

Deep Front Hip or Groin Pain

The hip joint, labrum, FAI or hip arthritis may contribute.

Common clues: stiffness, clicking, catching, reduced rotation, sitting pain, squatting pain or difficulty getting out of a car.

Inner-Thigh or Groin Pain

The adductor muscles or tendons are common sources.

Common clues: pain with squeezing the legs together, sprinting, kicking, cutting, lunging or changing direction.

Outer Hip Pain

Gluteal tendon or trochanteric pain may be involved.

Common clues: pain with side-lying, stairs, hills, walking, standing on one leg or lying directly on the painful side.

Back, Buttock or Leg Symptoms

Lower back referral or nerve irritation may contribute.

Common clues: burning pain, pins and needles, numbness, pain below the knee or symptoms that change with spinal movement.

Important: These patterns provide clues only. More than one structure may contribute, and pain location alone cannot confirm the diagnosis.

What Symptoms Suggest a Hip Joint Problem?

Hip joint pain often feels deep at the front of the hip or within the groin. It may worsen with sitting, stairs, hills, deep squats, twisting or getting in and out of a car.

Several joint-related problems can feel similar during their early stages. Assessment may examine hip movement, strength, walking, single-leg control and how symptoms respond to different positions and loads.

Could the Pain Come From a Muscle or Tendon?

Muscle and tendon overload is common in active people, runners, field-sport athletes and gym users. Symptoms may build gradually or begin after a sprint, kick, lunge or sudden direction change.

Muscle and tendon problems often respond to staged loading. However, the exercise plan should match the likely tissue, symptom level, current capacity and activity goal.

hip and groin pain causes checked with adductor squeeze test

Adductor testing can help identify possible groin-related sources.

What Causes Pain on the Outside of the Hip?

Outer hip pain commonly relates to sensitivity within the gluteal tendons and surrounding tissues. Many people notice pain during side-lying, walking, stairs, hills or prolonged single-leg standing.

Care often focuses on reducing irritating compression, adjusting activity, improving hip strength and gradually rebuilding walking or running tolerance.

Can Back Pain Cause Hip or Groin Pain?

Yes. Lower back pain, sciatica and a pinched nerve may refer symptoms into the front, side or back of the hip.

Back-related symptoms may include burning pain, pins and needles, numbness, leg pain or symptoms that change when you move your spine. By comparison, hip joint symptoms often change more with hip rotation, squatting, stairs, sitting or getting in and out of a car.

What Other Health Conditions Can Cause Hip or Groin Pain?

Less common causes still require consideration. Osteoporosis may increase fracture risk. Rheumatoid arthritis may cause joint pain, swelling and prolonged morning stiffness. A stress fracture may cause deep pain that worsens with impact, running or repeated loading.

Medical review becomes more important when pain is severe, follows trauma, worsens despite rest, affects general health or prevents weight-bearing.

How Does Physiotherapy Help Identify the Cause?

A physiotherapist examines the full symptom pattern rather than relying on pain location alone. Assessment may include hip range, strength, resisted muscle testing, balance, walking, squats, steps, spinal screening and activity-specific loading.

These findings help determine whether symptoms are more likely to involve the hip joint, adductors, hip flexors, gluteal tendons, lower back or another source. They also guide load modification, rehabilitation exercise and return-to-activity planning.

Imaging may help in selected cases. Your physiotherapist may recommend GP review, medical assessment or imaging when your history or examination findings suggest this is appropriate.

Should You Keep Exercising?

You may continue comfortable movement when symptoms remain mild, settle quickly and do not worsen later that day or the next morning.

  • Keep walking if pain does not build or cause limping.
  • Reduce painful sprinting, kicking, cutting or jumping.
  • Modify deep squats if they reproduce hip or groin pain.
  • Restart strength work gradually rather than testing maximum loads.
  • Arrange an assessment if symptoms repeatedly return.

When Should You Seek Help?

Book an assessment when hip or groin pain lasts more than a few days, limits walking, causes limping, stops sport, affects sleep or returns whenever activity increases.

Seek urgent medical care if you cannot bear weight, have major trauma, fever, severe or worsening night pain, unexplained weight loss, sudden testicular pain, significant abdominal pain or severe pain with feeling generally unwell.

hip and groin pain causes managed with lateral step reach rehab

Guided control and progressive loading support a safer return to activity.

What To Do Next

If hip or groin pain limits walking, work, training or sport, consider a physiotherapy assessment. Early guidance can help identify the likely source, reduce repeated flare-ups and support a safer return to normal activity.

For athletes and active adults, assessment may also guide training changes, strength progression and return to running, kicking, cutting or gym exercise.

Related Hip and Groin Information

Hip and Groin Pain FAQs

What causes hip and groin pain?

Hip and groin pain may come from the hip joint, nearby muscles or tendons, bone stress or referred pain from the lower back or pelvis. Common triggers include walking, running, sitting, stairs, squats and twisting.

Can hip pain cause groin pain?

Yes. Hip joint problems may refer pain into the groin. This can occur with hip arthritis, femoroacetabular impingement and hip labral irritation. Symptoms may worsen with sitting, squats, twisting, stairs or getting in and out of a car.

What does adductor-related groin pain feel like?

Adductor-related groin pain often feels like inner-thigh or groin pain. It may worsen with sprinting, kicking, cutting or squeezing the legs together. Symptoms may begin suddenly or build gradually with repeated loading.

When should I see a physiotherapist for hip or groin pain?

Consider an assessment if pain lasts more than a few days, limits daily activity, affects walking, causes limping, stops sport or repeatedly returns after rest.

Can exercise help hip and groin pain?

Exercise may help when it matches the likely cause and stage of pain. Rehabilitation may include hip, groin, trunk and leg strengthening followed by gradual progression of walking, running, stairs or sport tasks.

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References

  1. Reiman MP, Thorborg K, Hölmich P, et al. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018. Br J Sports Med. 2020;54(11):631–641.
  2. Rolph R, Morgan C, Chapman G, Marsh S. Groin pain in athletes. BMJ. 2020;368:m109.
  3. Short SM, Tenforde AS, Lau B, et al. Hip and groin injury prevention in sport. Int J Sports Phys Ther. 2021;16(1):172–183.
  4. Martins TB, Nunes GS, Freitas-Júnior IF, et al. Risk factors associated with groin pain in athletes: a systematic review with meta-analysis. Life (Basel). 2025.

Common Thigh Injuries

John Miller Physiotherapist jack campbell physiotherapist clayfield sandgate
Article by John Miller & Jack Campbell
Common thigh injuries quadriceps assessment after direct sports impact
Physiotherapy assessment helps identify the source and severity of thigh pain.

What Are the Most Common Thigh Injuries?

Common thigh injuries include muscle strains, corked thigh, hamstring strain, ITB syndrome, runner’s knee, and pain referred from the lower back, hip, or knee. The source of pain is not always obvious early, so symptom pattern, injury mechanism, and movement testing all matter.

If you are active, play sport, or have recently increased training, start by checking the main thigh pain patterns. This can help you decide whether your pain sounds like a muscle injury, a bruising injury, an overload problem, or referred pain such as sciatica.

Quick check: a sudden pull, bruising, swelling, limping, tingling, numbness, or pain that keeps returning should be assessed rather than ignored.

Seek urgent medical care: if you cannot weight-bear, have severe swelling, major trauma, spreading numbness, new weakness, or bladder or bowel changes.

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Which Thigh Injuries Are Most Common?

Most common thigh injuries affect the front, back, or outer side of the thigh. However, pain can also refer from the lower back, hip, or knee. That is why a clear history and physical assessment help guide the right treatment plan.

Hamstring Strain

A hamstring strain affects one or more muscles at the back of the thigh. It often happens during sprinting, kicking, jumping, or sudden acceleration. Common signs include a sharp pull, local tenderness, weakness, and pain with fast walking, bending, or sport.

Thigh Strain or Corked Thigh

A thigh strain can follow a forceful stretch, hard sprint, kick, or sudden change of speed. A corked thigh usually follows a direct knock. Pain, bruising, swelling, stiffness, and difficulty lifting the leg are common.

ITB Syndrome

ITB syndrome is an overload problem often linked with running or cycling. Pain usually sits near the outside of the knee, but tightness or irritation can also track along the outer thigh. Training changes, hip control, and load tolerance can all play a role.

Runner’s Knee

Runner’s knee, also called patellofemoral pain, usually causes discomfort around or behind the kneecap. Some people feel pain spreading into the lower thigh, especially with stairs, squats, hills, running, or long sitting.

Sciatica or Referred Nerve Pain

Sciatica may cause thigh pain, burning, tingling, numbness, or weakness. Unlike a simple muscle strain, nerve-related pain may travel down the leg and may change with sitting, bending, coughing, or spinal movement.

What Causes Common Thigh Injuries?

Common thigh injuries often follow sprinting, kicking, sudden acceleration, awkward landing, direct contact, or repeated overload. Other cases relate to poor load progression, reduced strength, limited mobility, running mechanics, or referred symptoms from the back, hip, or knee.

Overuse injuries can build when the thigh muscles and surrounding tissues do not have enough time to adapt. This may happen after a sudden increase in distance, speed, hills, gym loading, sport sessions, or match minutes.

Why Does Thigh Pain Happen During Sport or Exercise?

Thigh pain during sport or exercise often means the tissue load has exceeded what your muscles, tendons, joints, or nerves can currently tolerate. This may follow repeated sprinting, kicking, hills, change-of-direction work, or returning to sport before the thigh has recovered enough.

The pain pattern gives useful clues. A sharp local pain after a sprint may suggest a strain. Bruising after contact may suggest a corked thigh. Burning, tingling, numbness, or pain that travels may suggest nerve involvement.

How Can You Help Prevent Common Thigh Injuries?

Prevention starts with good training habits. A suitable warm-up, gradual workload progression, and a structured exercise program may help improve strength, control, and load tolerance.

Common thigh injuries rehab exercise with supervised lunge strengthening
Controlled strengthening can support graded thigh injury recovery.
  • Warm up well: prepare for speed, kicking, and change-of-direction work.
  • Progress gradually: avoid sudden jumps in distance, intensity, hills, or sprint volume.
  • Build strength: train the hamstrings, quadriceps, gluteals, calves, and trunk.
  • Improve control: work on landing, running, deceleration, and single-leg stability.
  • Respect recovery: sleep, rest days, and lighter sessions still matter.

When Should You Worry About Thigh Pain?

You should seek help if thigh pain is severe, you cannot walk normally, swelling or bruising is significant, symptoms keep returning, or you notice numbness, tingling, or weakness. Ongoing pain that limits work, training, stairs, sitting, or sleep also deserves assessment.

For nerve-related leg pain, Healthdirect provides a useful public overview of sciatica symptoms and causes.

FAQs About Common Thigh Injuries

How do I know if thigh pain is a strain or sciatica?

A muscle strain usually causes local pain, tenderness, and weakness in one part of the thigh after a clear movement or effort. Sciatica more often causes pain that travels, with tingling, numbness, burning, or symptoms that change with back movement or sitting.

How long do common thigh injuries take to heal?

Recovery time depends on the source and severity. A mild muscle issue may settle within days to a few weeks. A larger strain, overload problem, or nerve-related presentation can take longer. Early diagnosis and the right loading plan usually help guide the timeline.

Can I keep exercising with thigh pain?

Sometimes, but it depends on the cause. Mild symptoms may allow modified activity. Sharp pain, limping, bruising, worsening symptoms, numbness, tingling, or weakness usually mean you should stop and get advice. Good management often means modifying load, not pushing through.

What treatment helps common thigh injuries?

Treatment may include load modification, targeted strengthening, mobility work, manual therapy, running or movement advice, and a graded return-to-sport plan. The right option depends on whether the problem is muscular, tendon-related, joint-related, or referred from the back.

Can thigh pain come from the knee, hip, or back?

Yes. Some thigh pain starts outside the thigh. Knee problems can refer pain into the lower thigh, hip problems can affect the upper thigh, and back or nerve irritation can send pain, tingling, or numbness down the leg.

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What to Do Next

If your thigh pain is not settling, keeps coming back, or affects walking, work, training, or sport, a physiotherapist can assess the likely source and guide your next step. Early advice may help you choose the right loading plan and reduce repeated flare-ups.

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Thigh Products

These thigh products are commonly used by our physiotherapists to improve strength, provide comfort, improve flexibility, plus assist home exercise programs.

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References

  1. Jankaew A, Chen JC, Chamnongkich S, Lin CF. Therapeutic Exercises and Modalities in Athletes With Acute Hamstring Injuries: A Systematic Review and Meta-analysis. Sports Health. 2023;15(4):497-511. doi:10.1177/19417381221118085
  2. Pietsch S, Lorenz S, Ueblacker P, Mickschl DJ, Hasler M, Kümmel J, et al. Epidemiology of quadriceps muscle strain injuries in elite track and field athletes. Br J Sports Med. 2024;58(2):95-101.
  3. Pietsch S, Lorenz S, Hasler M, Ueblacker P, Mickschl DJ, Schlegel TF, et al. Risk Factors for Quadriceps Muscle Strain Injuries in Sport: A Systematic Review. Int J Sports Phys Ther. 2022;17(4):536-550.
  4. Sanchez-Alvarado A, Bokil C, Cassel M, Engel T. Effects of conservative treatment strategies for iliotibial band syndrome on pain and function in runners: a systematic review. Front Sports Act Living. 2024;6:1386456. doi:10.3389/fspor.2024.1386456
  5. Neal BS, Lack SD, Bartholomew C, Morrissey D, et al. Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning. Br J Sports Med. 2024;58(24):1486-1495. doi:10.1136/bjsports-2024-108110
  6. Zaina F, Doniselli FM, Andreucci A, et al. Identification of Best Evidence for Rehabilitation in persons with low back pain with radiculopathy. Arch Phys Med Rehabil. 2023;104(6):1209-1218. doi:10.1016/j.apmr.2023.02.013

Hip Impingement

John Miller Physiotherapist Zoe Russell Physiotherapist
Article by
John Miller, Zoe Russell
Hip impingement physiotherapy hip flexion internal rotation assessment during groin pain examination

Hip impingement can cause deep front-of-hip or groin pain. It may feel like a pinch, catch or block during squats, sitting, running, kicking or twisting. It often overlaps with other causes of hip pain and groin pain, so a clear assessment helps guide the right plan.

Clinicians often use the term Femoroacetabular Impingement Syndrome, or FAIS. This means your symptoms, clinical signs and imaging findings fit together. Hip shape alone does not prove FAIS, because some people have cam or pincer shapes without pain.

Quick answer: hip impingement often causes a deep groin or front-of-hip pinch during deep bending, twisting, sport or long sitting.

Next step: assessment checks whether symptoms fit FAIS, a hip labral tear, hip flexor pain, adductor overload, back referral or early joint change.

What Is Hip Impingement?

Hip impingement happens when the ball and socket of the hip come into early contact during movement. This contact most often occurs when the hip moves into deep flexion and rotation.

The hip may have a cam shape, a pincer shape or both. These shape features can increase contact between the femoral head-neck junction and the socket rim. This may irritate the labrum, joint surface and nearby tissues.

Still, structure is only one part of the picture. Pain, movement, strength, training load and daily positions all matter.

Common Signs of Hip Impingement

  • deep groin or front-of-hip pain
  • pinching with squatting, lunging or sitting low
  • reduced hip range, especially flexion or rotation
  • clicking, catching or a blocked feeling
  • pain with running, kicking, pivoting or gym training

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What Causes Hip Impingement?

Hip impingement usually relates to a mix of hip shape, repeated loading and movement demand. Symptoms may start when training rises, hip control drops, squat depth increases, or sport loads the hip into deep flexion and rotation.

Primary causes often relate to hip development and long-term loading patterns. This is one reason active people and athletes may notice symptoms. Secondary causes may follow previous hip problems or structural change, such as Perthes disease or a previous fracture around the hip.

Hip impingement can also overlap with hip flexor pain, hip adductor tendinopathy, hip labral irritation and lower back referral. Pain location alone is not enough.

What Are the Types of Hip Impingement?

Hip impingement types showing pincer, cam and combined femoroacetabular impingement patterns.
Pincer, cam and combined hip impingement types.

There are three common patterns:

  • Cam impingement: extra bone at the femoral head-neck junction can reduce smooth motion.
  • Pincer impingement: extra coverage from the socket rim can increase contact at the front of the hip.
  • Combined impingement: cam and pincer features both contribute to early contact.

Many people have mixed features. The key question is whether the shape, symptoms and clinical tests all match.

How Is Hip Impingement Diagnosed?

Hip impingement is diagnosed using symptoms, physical tests and imaging where needed. Scans alone are not enough. Some people show hip shape changes without pain.

Your physiotherapist will ask which movements provoke symptoms. They may check whether the hip clicks, catches or feels blocked. They will also ask whether sitting, stairs, squats, running or sport make pain worse.

Assessment usually includes hip range testing, strength testing, movement control checks and provocation tests. These tests aim to reproduce your familiar symptoms. X-rays may help assess hip shape when FAIS is suspected. MRI may help when a labral tear, cartilage injury or another joint problem is being considered. For a broader clinical overview, see the clinical practice guideline for non-arthritic hip pain.

Assessment Usually Checks

  • hip flexion and rotation range
  • pain during squat, lunge, step or sitting positions
  • hip, pelvis and trunk strength
  • clicking, catching, locking or giving way
  • overlap with groin, back or outer hip pain

Hip Impingement Treatment

Most people start with non-surgical treatment. Physiotherapy aims to reduce pain, improve useful hip mobility, rebuild strength and improve hip, pelvis and trunk control. This helps the joint handle load with less repeated pinching.

Early activity changes often help. This may mean reducing deep squats, changing sitting breaks, adjusting running volume, modifying kicking load or changing gym depth for a short time.

A rehabilitation plan may include manual therapy, strength work, movement retraining and a gradual return to sport or gym tasks. Your physiotherapist may also help you adjust training volume, exercise technique and loading speed. For broader context, see our physiotherapy and common physiotherapy treatment techniques pages.

Can You Keep Exercising?

You may keep exercising if symptoms stay mild, your walking stays normal, and pain settles quickly after activity. However, sharp pinching, limping, night pain or worsening next-day stiffness means you should scale back and seek advice.

Hip Impingement Load Guide

Usually okay Walking, easy cycling, light strength work and shallow range exercise if symptoms stay mild.
Modify Deep squats, heavy lunges, sprinting, kicking, pivoting and long sitting if they trigger pinching.
Book assessment Repeated flare-ups, limping, catching, locking, night pain or loss of range.

When Is Surgery Considered for Hip Impingement?

Surgery may be considered when symptoms remain limiting after a well-guided period of rehabilitation and load change. This is more likely when pain affects work, sport, daily function or sleep, and when clinical findings and imaging support hip impingement as the main driver.

Hip arthroscopy is the most common surgical approach. It may address the bony impingement pattern and, where needed, associated labral or cartilage problems. Surgery is not the first step for most people, so conservative care is usually tried first.

When Should You Worry About Hip Impingement?

Organise an assessment if groin or hip pain keeps returning, the hip catches or locks, pain stops you from training, or you are losing range of motion. Ongoing symptoms can mimic or overlap with hip arthritis, greater trochanteric pain syndrome, gluteal tendinopathy or hip clicking.

Seek medical care quickly if hip pain follows major trauma, you cannot bear weight, you feel unwell with fever, pain is severe at night, or symptoms are rapidly worsening.

What to Do Next

If your hip feels pinchy, stiff or painful with loaded movement, a physiotherapy assessment can help clarify whether hip impingement is likely. It can also check whether another hip or groin condition is contributing.

A clear diagnosis matters because treatment should match the structure involved, your activity goals and the movements that trigger symptoms. Many people improve with education, load change, hip strength work, movement retraining and a graded return to activity.

Related Hip Pain Information

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Hip Products

These hip products are commonly used by our physiotherapists to improve strength, posture, movement, plus assist home exercise programs.

View all hip products

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Get physiotherapy tips, exercise videos, recovery advice and blog updates.

Hip Impingement FAQs

What does hip impingement feel like?

Hip impingement often feels like a deep pinch at the front of the hip or groin. It may worsen during squats, lunges, sitting low, running, kicking or twisting. Some people also notice stiffness, clicking, catching or a blocked feeling.

Is hip impingement the same as FAIS?

Hip impingement is the common term. FAIS, or Femoroacetabular Impingement Syndrome, is the clinical term when symptoms, physical signs and imaging findings fit together. Hip shape alone does not confirm FAIS because some people have shape changes without pain.

Can hip impingement improve without surgery?

Yes. Many people start with physiotherapy, load change, strength work and movement retraining. The goal is to reduce repeated painful pinching, improve hip and pelvis control, and rebuild activity tolerance. Surgery is usually considered only when symptoms remain limiting despite a clear rehabilitation plan.

Should I stretch hip impingement?

Gentle mobility may help some people, but forceful stretching into a painful pinch can irritate symptoms. Many people do better with a mix of activity changes, hip strength, trunk control and careful range work. Your assessment should guide which movements suit your hip.

When should I get imaging for hip impingement?

Imaging may help when symptoms persist, the diagnosis is unclear, or a labral or cartilage problem is suspected. X-rays can assess hip shape. MRI may help assess soft tissues. A physiotherapist or doctor can advise whether imaging is needed.

Can I run with hip impingement?

You may run if symptoms stay mild, your walking or running gait stays normal, and pain settles after training. Reduce speed, hills, stride length or volume if symptoms build. Stop and book an assessment if you limp, lose range, or symptoms keep flaring the next day.

References

  1. Enseki KR, Bloom NJ, Harris-Hayes M, Cibulka MT, Disantis A, Di Stasi S, et al. Hip Pain and Movement Dysfunction Associated With Nonarthritic Hip Joint Pain: A Revision. J Orthop Sports Phys Ther. 2023;53(7):CPG1-CPG70. doi:10.2519/JOSPT.2023.0302
  2. Gómez-Verdejo F, Alvarado-Solorio E, Suarez-Ahedo C. Review of femoroacetabular impingement syndrome. J Hip Preserv Surg. 2024;11(4):315-322. doi:10.1093/jhps/hnae034
  3. Kemp JL, Scholes MJ, Smith AJ, et al. Physiotherapist-led treatment for femoroacetabular impingement syndrome (the PhysioFIRST study): an assessor-blinded, limited disclosure randomised controlled trial. Br J Sports Med. Published online 2026. doi:10.1136/bjsports-2025-110986
  4. Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50(19):1169-1176. doi:10.1136/bjsports-2016-096743
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