The hip is a ball and socket joint that attaches the thigh to the pelvis. While many causes of hip pain can arise from the joint itself, pain can be referred from other structures outside the hip joint, such as the spine, related muscles, or other factors.
The trochanteric bursa is a sac on the outside part of the hip that serves to protect muscles and tendons as they cross the greater trochanter (a bony prominence on the femur). When this bursa gets inflamed, it can cause pain usually on the outside of the hip.
Osteoarthritis is a common causes of hip pain, especially in adults over 50 years of age, and affects 1 in 9 Canadians to a significant degree. Arthritis is associated with inflammation of the hip joint and the breakdown of the cartilage that cushions your hip bones.
Hip pain gradually worsens over time, there is a progressive loss of range of motion in the hip, and some people complain of a grating sensation emanating from the hip.
Sacroiliac joint disorders (SI joint)
The SI joint is part of the bony structures that give stability and load transfer ability to the pelvis. It can be a common pain source both before, during and after pregnancy, and can be injured by traumatic strains.
Tendinitis is inflammation or irritation of the tendons and is usually caused by repetitive stress from overuse. In the hip gluteal tendinopathy can cause lateral or posterior hip pain.
Hamstring and groin strains (pulled groin) are commonly seen in many sports, including hockey, soccer, and baseball. Both of these tendons attach to the pelvis and are injured by fast, dynamic movements, or caused by repetitive strain of tight or weak muscles.
Symptoms can include pain in the groin area, or the inside or back of your thigh and buttock. It can be an achey or sharp pain that is aggravated by pushing off of the affected leg with running or skating. Depending on the severity of the injury, these muscles can be strained or torn, and can limit a player’s ability to return to their sport for weeks or months if not treated properly.
The pelvis and hip joint can commonly suffer from problems related to imbalances of strength, flexibility or muscle weakness syndromes, with many causes.
For example, piriformis syndrome can cause deep posterior hip pain, and/or compression of the sciatic nerve, resulting in leg pain and sciatica. Injuries, arthritis, prior back problems and lower extremity alignment can all have a role.
A fall is the most common reason that people fracture a hip and is usually due to a combination of the effects of aging and osteoporosis. A hip fracture, refers to a fracture of the upper part of the femur or thigh bone.
Along with cushioning your hip joint, your labrum acts like a rubber seal to help hold the ball of the femur securely within your hip socket. Athletes and people who perform repetitive twisting movements are at higher risk of developing this problem. Pain is typically felt in the groin area and can be accompanied by the sensation of the joint ‘catching’ or ‘locking’.
Many women who are pregnant or have just given birth can have hip or pelvic pain.
This can be caused by a variety of factors including laxity of ligaments due to the hormone relaxin being released, the pressure of the baby on the back and pelvis, and the strain on the pelvis and surrounding muscles from childbirth. This can lead to pelvic pain, difficulty with physical activity, and incontinence. Click here to see how one of our pelvic floor therapists can help you.
Referred Hip Pain
Hip pain may not originate in the hip itself but may be felt there due to problems in surrounding structures.
A hernia or tear of the abdominal wall may cause pain in the front of the hip.
They are named according to their location where the inguinal (groin) hernias are most common and femoral hernias that arise from a canal near the hip joint are another type that might also cause hip pain.
Peripheral nerves can become inflamed and cause hip pain. Meralgia paraesthetica occurs when the lateral femoral cutaneous nerve of the thigh becomes irritated. Pain or numbness is typically felt on the outside of the hip and thigh.
Inflammation of nerve roots from the low back may also present as hip pain and pain down the leg. The sciatic and femoral nerves may become inflamed due to spinal stenosis or osteoarthritis of the lumbar spine, ruptured or bulging discs, and spasms of the muscles of the low back.
Physiotherapy Treatment For Hip & Pelvic Pain
Physiotherapy treatment and management of the above conditions has been proven to be helpful to improve pain, help in recovery and deal with chronic symptoms.
Pelvic physiotherapy treatment tools such as education, self-care management, exercise therapy, and manual therapy are commonly used by a registered physiotherapist to treat hip and pelvic pain. Other treatments such as acupuncture, soft tissue release and massage therapy may also help.
A registered physiotherapist can conduct a skilled assessment and examination of the spine and initiate appropriate physiotherapy treatment.
Frequently Asked Questions About Hip & Pelvic Pain
What are some excercise therapy techniques for hip and pelvic treatment?
The causes of hip and pelvic pain are diverse; as such generic exercise is rarely of help. Consult your physiotherapist for a customized care plan based on a thorough assessment.
What gynecological problems cause hip pain?
Differential diagnosis of hip pain includes considering sources of pain that can refer to the hip region. These could be conditions such as endometriosis, uterine fibroids, or other abdominal pain sources, such gastroenteritis.
What are the first signs of hip problems?
Early signs of hip arthritis can be stiffness of the hip on rising, and subtle loss of range of movement. Other early signs of soft tissue pain can be tender or trigger points in the muscles around the hip.
How do I know if my hip pain is serious?
Hip pain alone is rarely an indicator of a serious issue. If associated with an injury or trauma,, you should seek medical care if you can't easy move the leg or hip due to pain, or you cannot take weight on it, or any sudden swelling or change of appearance in the leg is notable.
Does walking help hip pain?
Walking can often reduce the stiffness associated with mild hip issues; in some cases it can aggravate the problem. Listen to your symptoms and exercise in your pain tolerance, and consult a physiotherapist for a personalised care plan.
How should I sit with hip pain?
Hip pain for some can be increased with sitting if you spend prolonged periods with the hips bent past a 90 degree angle. Adjust your posture to prevent this. Also, prolonged sitting can cause shortnening of the hip flexor muscles, so anyone who sits frequently should stretch the front of the hip in a lunge stretch. This may also reduce back pain associated with sitting.
How do you stretch your hip when it hurts?
This is not a simple answer as the condition causing the pain dictates the therapy plan. In general terms, if a muscle feels stiff and tight, gentle range of motion exercise to stretch into stiffness may help; if the hip joint is sore, stretching away from the pain may help, as alos may cyclic motion such as riding a stationaru bike.
East Toronto Orthopaedic & Sports Injury Clinic - Greektown
Adam was super. Always positive and very encouraging thru my rehab.
10 August 2023
Excellent service . I highly recommend this clinic. Teresa the receptionist is very helpful and nice . Adam is a knowledgeable physiotherapist. And Fatima is a very good acupuncturist .
25 July 2023
Excellent experience with Adam - thorough and very personable.
26 June 2023
Marshall was very helpful and professional and worked with me on a very painful knee injury. i began a few months ago barely able to bend it or walk up and down stairs and have improved greatly with his program. i am now able to run up and downstairs with no problems and am almost back to 100%. the receptionists are also accommodating and professional and were easily able to process insurance claims, answer questions, and reschedule appts when i was sick or something came up. i was very impressed by my experience here and would recommend it wholeheartedly to anyone looking for a new physio!
13 June 2023
Great experience. I had foot pain that wouldn’t go away so I came here and found so much assistance in regaining my mobility.
8 June 2023
Went to the Pape and Danforth clinic for a massage with Robert. Customer service from initial onset was with Therese. Was very patient with me when it came to form filling and billing. Robert was also extremely good at working on my pain points and being thorough with his explanations. Overall great massage, experience and education!
26 March 2023
Everyone at this clinic is very kind and professional- Would recommend!
7 January 2023
Trevor is great! He has guided me on my road to recovery. Staff is also friendly and knowledgeable. Nachi is also great!
5 December 2022
I would highly recommend the services of Trevor - he provided excellent care. I received a thorough assessment and a clear treatment plan. Trevor is knowledgeable, friendly and is a good communicator. The office is well-equipped and Mina at the front desk was always very welcoming.
15 November 2022
I have seen Trevor for several different problems over the years and he has always done an amazing job helping me with my recovery. He is knowledgeable in many areas and always happy to answer questions and explain what he is doing. He is thorough with assessment and treatment so you always feel like you are in good hands. He is also very honest and won't push you to keep coming if he doesn't feel you need it. Mina at the front desk is really welcoming and the clinic is very clean and comfortable. Overall a great physio experience and would highly recommend to anyone!