Hip pain can be caused by a number of factors and can occur in the joint, labrum, tendons, muscles, bursa and ligaments around the hip. It can also be referred from the back.

Most hip pain we see isn’t arthritis but is muscle weakness, joint rubbing issues like bursitis tendinopathy and muscle tears. These issues can usually be resolved with treatment.

Don’t live with hip pain and find you are skipping activities and therefore losing your fitness. If you have ongoing pain you need to be assessed to have a more definitive diagnosis, and understand the cause and how to manage it. Our physiotherapists will assess, treat and give you a strengthening, stretching program, a comprehensive treatment plan and an estimate of how long it will take to resolve.

Our experienced physiotherapists have been helping clients with hip pain for many years.

See our physiotherapists for a detailed assessment and treatment plan

If you do have advanced arthritis, we work with a number or orthopedic surgeons and can refer to them if you have joint related pain.

Hip muscle exercise

Our Clinical Pilates studios provide the ideal equipment for hip strengthening exercising focusing on deep muscles like the hip rotators, gluteals, adductors, hip flexors and more superficial muscles that stabilize and move the hip. We use our Pilates expertise to design home exercise programs to further strengthen your muscles and get you back to full function.

More detail about hip pain

Hip pain can be caused by anything from sports injuries to arthritis.

• Lateral hip pain and gluteal pain
• Hip bursitis
• FAI (femoroacetabular impingement)
• Labral tears
• Hip arthritis
• Hip replacement surgery

This is a condition where the tendon of the gluteal muscles becomes painful and dysfunctional.

It is call tendinopathy and not tendonitis as the tendon is not in an active inflammation state – the suffix “ itis” is used for inflammation. When a tendon is damaged but no healing state is being stimulated it is termed an “opathy”

The insertion of the tendon is onto the upper portion of the greater trochanter. Pain can also occur around the rim of the pelvis where the gluteal muscles attach to the ilium of the pelvis. The condition is characterized by pain and tenderness and is aggravated by walking and running, stairs and lying on that side.

Causes of this condition can be overuse, biomechanical factors like running on roads with a camber always in one direction, and age is a big factor.

Age can also be a factor as tendons become weakened.

Menopause and onwards is a common period in life when this condition occurs as the reduction in oestrogen causes less production of collogen which is the key component of tendons.

Accompanying the tendon pain is muscle weakness due to pain. This puts more stress on the tendon and it becomes a vicious cycle.

Treatment with our physiotherapists

Physiotherapy is usually the most effective treatment where we start with the primary issue of tendon pain. We need to stimulate a healing response in the tendon.

We use Shockwave, which is strong soundwave pulses to generate a very mild inflammatory process to get some action in the tendon and stimulate healing and more collagen being laid down in the tendon. Shockwave is usually required for 6 sessions, a week apart.

The next issue is progressively strengthening the gluteal muscles and other pelvic muscles found to be weak.

We have many years of experience in muscle strengthening programs for complex hip problems and can prescribe exercise programs for home or in our Clinical Pilates studios.

Lateral hip pain is most commonly caused by rubbing over the lateral bursa positioned over the greater trochanter. The bursa is a sac containing grease like fluid that allows muscles and tendons to slide over joints and bones. If it is inflamed from excess pressure and rubbing it can swell and become painful.

Lateral hip bursitis pain is generally worse when lying on that side in bed, sit to stand, walking up and down stairs.

This condition can occur in athletes where hip joint range is working hard like jumping, dancing, running.

It is also a common condition in people who are ageing, inactive and who sit through most of the day.

Bursitis is often treated with a cortisone injection which reduces the inflammation and swelling. This doesn’t always settle the problem. Because of the close proximity of the gluteal tendon on the lateral thigh, bursitis and gluteal tendinopathy can both occur; or it could be bursitis only or gluteal tendinopathy only. An ultrasound scan is often required to ascertain an exact diagnosis.

A physiotherapy assessment to determine if there is muscle weakness or tightness is also a great adjunct to comprehensive management of this condition. We love to provide comprehensive management of your pain so exercises will be included.

This condition is caused by a poor fit of your hip bones; the femur head and the acetabulum (the socket). It is usually a genetic condition of how your bones have been shaped. They don’t come together correctly and therefore rub abnormally which can cause wear and tear on the labrum which is a cartilage type structure like a gasket in the joint, it can also damage the cartilage lining the hip joint head. FAI can go on to cause osteoarthritis in the hip joint.

You usually become aware of this condition because your hips don’t move through certain ranges during sport and you are getting pain in the hip.

There are 2 types of impingements:-

1. A Cam impingement is where the femoral head is not perfectly round and can bump against the acetabulum.
2. The Pincer impingement is where the acetabulum ( the hip socket) covers too much of the femoral head, pinching the labrum. (a cartilage ring in the hip)

Symptoms of FAI can include pain in the groin or hip, limited range of motion, and a clicking, popping, or catching sensation in the hip.

What this leads to - If left untreated, FAI can lead to cartilage damage, labral tears, and eventually osteoarthritis

Treatment

Our physiotherapists can assess your hips to determine what muscle weakness you have in hip muscles that support your joints. We can prescribe specific exercise. We can give advice about what physical activities to avoid and what are suitable. Its important to stay active and fit. An Xray is often recommended to diagnose the bony problem in the hip.

We may also suggest that you see an orthopedic surgeon with a speciality in hips. They do offer surgery in some cases to trim bones and improve mobility of the hip.

Treatment options include activity modification, physical therapy, and in some cases, surgery to reshape the bones and improve hip.

If you are experiencing persistent hip pain, clicking, or catching sensations in the hip joint and it feels unstable on some movements it could be the hip labrum. The hip labrum is a ring of cartilage that helps stabilize the hip joint, deepen the socket, and act as a cushion.

A tear can occur due to a fall, trip, push into end range in a sporting injury or it can occur due to wear and tear and overuse. It can also occur due to the structure of the hip (see FAI section).

If you are getting these symptoms you need to seek an assessment and diagnosis so you can manage your condition.

Your best course of action at the outset is to rest, take pain medication if necessary and see us for advice and treatment and be prepared to modify your sport and activity levels to avoid further damage.

Our experienced physiotherapists can assess your pain and symptoms and set about providing treatment and strengthening. If the tear appears to be serious we may advise you to see a doctor for imaging and you may need a referral to an orthopedic surgeon

If non-surgical treatments are not effective, arthroscopic surgery may be an option to repair or remove the torn labrum.

The most common causes of hip arthritis include:-

• Osteoarthritis - wear and tear from aging and overuse.
• Rheumatoid Arthritis- An autoimmune disease that causes inflammation in the joints.
• Other Causes: Injuries such as a car accident resulting in hip fractures or joint dislocation, a sporting injury resulting in hip dislocation.
• Developmental problems like dislocated hips at birth that were not identified, Perthe’s disease, FAI.

Osteoarthritis is the most common cause

In osteoarthritis the cartilage in the hip joint wears away, bones press on bones causing pain, stiffness, inflammation and reduced mobility. It develops gradually, often due to wear and tear, and can significantly impact daily activities.

Pain felt could include groin pain, buttock and thigh pain and it can even be felt in the knee.

The hip may feel stiff, especially after period of rest like getting out of bed or out of a chair. Range my be limiting squatting or reaching your feet to put your socks and shoes on.

You can’t reverse the damage that has been done but progress can be slowed and some range gained with targeted hip muscle strengthening to stabilize the joint, gait modification, a switch to low impact exercise like cycling or swimming and weight loss if you are overweight.

Treatment

Our physiotherapists can assess your hips and identify weakness and prescribe a treatment and strengthening program so you can manage your hip pain. We are all trained in Clinical Pilates.

Clinical Pilates is a go to for hip muscle strengthening as many of the Pilates exercises can target the deep hip stabilizing muscles.

If you are in a lot of pain we can also start you on Hydrotherapy.

Other lifestyle changes

• Modify Activities: Adapt daily activities to minimize pain and strain on the hip.
• Pace Yourself: Avoid prolonged periods of sitting or standing, and take breaks when needed.
• Choose Appropriate Footwear: Wear supportive shoes with cushioned soles. No high heels
• Lose weight
• Join our GLA:D program . This is an education and strengthening program that runs for 6 weeks to kick start your hip rehab. See our website page about GLAD >>

Pre -Hab and Rehabilitation for hip replacements

Pre-Hab

If you need to have surgery for a hip replacement our team can help you build strength, flexibility, mobility, and balance before surgery to improve your post-surgical outcomes.

We can design a Clinical Pilates program targeting strengthening hip muscles and core to improve mobility and expedite your recovery after surgery or we can give you a home program.

A great conditioning program before surgery will kick start your recovery and give you the strength and balance to get up and about with confidence after surgery.

We can also assist with training on using crutches, how to set your home up with shower chairs and elevated toilet seating, height of “lounge chairs” etc, and Chair transfers.

Post -operative treatment

After surgery we can see you for home visits and assist with pain management then move you towards post operative rehabilitation to strengthen and mobilize.

Hydrotherapy after your wound has been deemed healed enough can be a great way to mobilize and exercise with less weight through your joints.

Clinical Pilates offers light graded exercises in the early post op period through to increased loading and more complex movements in preparation for return to your activity goals.

Our physiotherapists and exercise physiologists can progress your exercise rehabilitation and tailor your progressions for you.

A prosthetic hip will reduce the pain but you must put the work into strengthening throughout the pelvis trunk and legs to get your optimal result.

Our team of physiotherapists and exercise therapist love to see our clients through the full course of their rehab and to see them off to a happy, strong , pain free life.