What Causes Hip Pain?
Hip pain is frequent 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 analyse and assess any dysfunction correctly.
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 fall risk. Your physiotherapist may prescribe Falls prevention exercises 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. Many other causes of groin pain 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 biomechanics and function. Your assessment should include a functional evaluation of your knee, foot and ankle joints, plus your thigh and calf muscles. They all contribute to your hip function.
For specific advice regarding your hip pain, please seek a hip physiotherapist or healthcare practitioner who has a particular interest in hip pain and related injuries.
Common Causes of Hip & Groin Pain
Hip Joint Pain
- Hip Arthritis - Hip 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
Adductor-Related Groin Pain
Pubic-Related Groin Pain
Inguinal-Related Groin Pain
- Inguinal hernia
- Sportsman's hernia
Iliopsoas-Related Groin Pain
- Hip Flexor Strain
Other Muscle-Related Pain
- Piriformis Syndrome
- Muscle Pain -Muscle Strain
- Poor Hip Core
- DOMS -Delayed Onset Muscle Soreness
- Core Stability Deficiency
Hip Pain Treatment
A thorough analysis of WHY you are 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.
The first choice of short-term therapy has been symptomatic hip treatment. This approach 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.
You should consult a healthcare practitioner who has a particular interest in hip pain and injury management to thoroughly assess your hip, groin, pelvis, lower limb and spine. Due to the kinetic chain, they all impact, especially at the high athletic performance end. A quality practitioner will educate you on your condition and combine it with exercise and 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 regular sport or daily activities in the shortest time possible.
For specific rehabilitation advice regarding your hip pain, seek the professional advice of high quality and up-to-date physiotherapists 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.
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 hip joint control exercises as they deem appropriate for your specific functional and sporting needs. Please consult with them for advice.
Acute Injury Signs
Acute Injury Management.
Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.
For detailed information on specific injuries, check out the injury by body part section.
Don't Ignore these Injury Warning Signs
Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.
If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.
Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.
Reduced Range of Motion
If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.
Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.
Immediate Injury Treatment: Step-by-Step Guidelines
- Stop the activity immediately.
- Wrap the injured part in a compression bandage.
- Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
- Elevate the injured part to reduce swelling.
- Consult your health practitioner for a proper diagnosis of any serious injury.
- Rehabilitate your injury under professional guidance.
- Seek a second opinion if you are not improving.