Hip pain can come from any of your thighs, buttock or lower back muscles also your hip, sacroiliac and lower back joints. To establish where precisely the hip pain is can be very helpful in identifying what structure is causing the pain.
Hip pain is one of the most common aches and injury that we treat. We treat hip injuries in young dancers to 80-year-old patients with arthritis.
Pain may arise from structures that are within the hip joint or from structures surrounding your hip. The precise location of your hip pain can provide valuable clues about the underlying cause. The area of pain can identify structures with problems. The hip is a complex region to determine where the pain is coming from due to the proximity to the lower back. It can make it difficult to distinguish if the pain is indeed coming from your hip or lower back.
Any pain or problem in the hip joint will have a ripple effect on the knee, ankle and foot. So get it sorted before you cause even more problems. Hip pain causes include the muscles, tendons or joints of the hip. So let’s look at the different types of structures in your hip.
The primary muscle group in the back of the hip are the Gluteal muscles. There are a large number of muscles around the hip, each one doing its part to keep our hip joint stable. The gluteal group consists primarily of three muscles (Gluteus Maximus, Gluteus Medius, Gluteus Minimus muscle). Underlying the three layers is an inner layer of muscles that mainly turn the hip outwards.
Firstly, in the front of the hip, we find the Quadriceps muscles. Secondly, at the back, the Hamstring muscles start just below the fold of our buttocks. Thirdly, on the inside is a group of four muscles forming the adductor group. And lastly, on the outside, the tensor fasciae latae and a thick band of connective tissue called the ITB (Iliotibial band).
The muscles around the hip are injured if stretched too far. Muscle strains are also known as ‘muscle tears/pulls’ or ‘torn/pulled muscles’ because of the way these injuries occur. The muscle tissue will tear if forcibly stretched resulting in an injury.
Inside the Hip joint
The inside of the hip joint has a ring of fibrocartilage called the labrum. The labrum makes the socket deeper and helps to stabilise the joint. Labrum tears can happen from increased pressure or strain to the structure. Labrum injuries also known as Labral tears are sometimes surgically repaired. However, in most cases, it is first picked up by a Physiotherapist and is treatable.
Large bursas (fluid-filled sacs) surround areas of the hip to allow the muscles and tendons to glide more easily over bony bumps. Hip Bursitis is a condition when this protective fluid-filled sac, becomes inflamed and irritated. Direct pressure over the bony point where the bursa is on the side of the hip will cause pain. These patients usually complain of being unable to sleep on their side because it is too painful.
A hip joint can refer pain downwards, or upwards towards the lower back. The hip is a ball-and-socket joint. The femur forms the ball, and the hip acetabulum forms the socket. The joint surfaces is lined with articular cartilage that allows the bones to move frictionlessly within the joint.
Also, the socket area has a fibrous labrum to increase compatibility. Just like any other joint cartilage, these areas can wear away or tear and become the source of pain.
Hip joint pain mainly presents close to the groin area as the hip sits about 2.5cm in and down from the crest of your hip bone. In contrast, a labrum injury presents with C-sign. This sign describes pain as on your hip by putting your hand over your hip with your thumb pointing backwards (Your thumb and index finger creates a “C” around your hip).
On the other hand groin pain when moving your hip is a warning sign of a problem inside the joint itself. Joint pain is challenging to pinpoint; therefore a skilled physiotherapist is necessary.
Hip joint issues arise from damage or injury to the hip ball-and-socket connection. Osteoarthritis (OA) is normal wear and tear of the joint and is a problem only if severe. Diseases can also attack and destroy the hip joint surfaces. The disease are commonly arthritis-type conditions like Rheumatoid Arthritis (RA), Juvenile arthritis and gout.
Tendons are cables that anchor the bone to muscle to the bone. Every muscle has a tendon on either side of the muscle, the one at the top called the proximal tendon and one at the bottom, called the distal tendon. Either or both tendons can become irritated resulting in an inflamed tendon. The gluteal tendon is one of the most commonly damaged tendons in the hip.
The hamstring tendon that attaches onto our sitting bone can become irritated and give you a hamstring tendinitis. The Rectus femoris muscle attaches onto the front of the hip and can cause you to feel pain there.
Structures outside the hip joint can refer pain to the joint. Meaning that while the hip hurts, the problem may potentially originate elsewhere. Inflammation or compression of the sciatic nerve, as it arises from the spinal cord in the back, can cause hip pain. Compression or inflammation in the L1 to L5 nerve roots can refer to the hip.
Other types of nerve inflammation may manifest as hip pain, including pain in the lateral femoral cutaneous nerve of the thigh. Pain from an inguinal or femoral hernia may also cause pain that is felt deep inside the hip and groin.
The hip joint is kept stable by a group of robust ligaments that must be able to allow movements into specific directions but prevent the femur head from popping out of its socket. Thick bands of tissue surround your hip joint, forming a capsule. Inside the capsule, constant negative pressure allows light suctioning to pull the joints together. The ligaments and capsule weave into each other and keeps the hip joints stable.
Ever seen a Ballet dancer do the splits? They take years to lengthen and condition their hips to allow such an increased range of movement. If you would jump into a split you may rip some of your hip ligaments and start experiencing clicking deep inside your hip. This ‘click’ is an abnormal translation of the ball & socket joint due to the hip ligaments not being able to stabilise your hip joint. Be very careful.
Nerve supply to the hip comes from two big branches. The firsts is the femoral nerve in the front of the hip. The second is the sciatic nerve at the back. Irritation, compression or impingement of these nerves can cause a dull ache with sharp sting running down your leg.
Sciatica is the common condition that can cause thigh pain at the back of the leg and down to your toes. Pain radiating from your lower back down your leg is a problem.
Hip pain is a common complaint that we treat daily. We have helped many patients successfully relieve their pain. Unfortunately, we frequently see patients suffering for months before they decide to get help. Usually, hip pain develops gradually, but it can occur as a result of sports injuries, work injuries or merely walking.
If you are suffering from hip pain, get it checked out. Do not delay in consulting your physiotherapist if you experience hip pain. Instead, do something about it and get it diagnosed as it is easier to treat early.
An accurate diagnosis is vital to manage your pain and treat it appropriately. Treating without a diagnosis is not ethical, as what works for one problem rarely works for another. There are so many home remedies that can cause complications; we strongly advise you to see an expert that work with these types of problems every day. Delayed treatment or misdiagnosis results in longer healing times, sometimes months extra.
Hip Pain in the …
Causes of Hip pain
It’s a problematic assessment, and only a few medical practitioners can pinpoint the primary source of your pain. The result is that they instead only attempt to relieve the symptoms of your hip pain, but rarely get to the root cause. Poor management makes your hip more vulnerable to injury and wears down the joint. Hip pain must not be taken lightly; there is a reason why hip replacement surgery is such a well-known surgery.
Your hip contains some of the most important muscles in your body, not to mention you use them every day. We rely on your hip muscles to stand up, walk and run. The structures in the hip are vulnerable to overuse injury, i.e. repetitive movements like walking, climbing stairs and running.
Hip pain may be caused by:
- Overuse – Tendon inflammation, labrum injuries and arthritis
- Trauma – Contusions, fractures and labrum injuries as well as muscle or ligament strains.
- Repetitive – A high repetition of muscle contractions like increasing your running distance too fast. Tendons become inflamed causing tendinitis or bursitis (hip bursitis).
- Overload – The muscle is suddenly and forcefully contracted, as in overloaded leg press, squats or lunges.
- Overstretch – Muscles are vulnerable in a stretched position. When the hip structures forcibly extended beyond its normal boundaries, it will tear.
- Weakness – Muscle fatigue can play a role or general muscle weakness.
- Poor technique – During improper training loading can stress specific structures more.
- Poor Management – Neglecting an injury that has not entirely healed.
- Excessive stretching – of the muscle against a force, for example during weight lifting like a dead-lift, when the load is applied on both sides of the tendon, while it needs to contract and lengthen at the same time.
- Instability – The femur buckles under load, and its not able to stay centred in the hip socket.
- Autoimmune – Rheumatoid arthritis
- Referral from other joints – Hip or the Lower back
- Referral from nerves – Irritation, compression of the femoral or sciatic nerves.
What needs to be tested to determine the source of the hip pain
- The movements from your ankle, knee and hip (how they interact with each other)
- Lumbar and Sacral vertebrae
- Pelvis (forwards and backwards tilt)
- Muscles surrounding the hip joint
- Core muscle control and pelvic floor muscles
- All the thigh muscles that attach onto the Femur (Quadriceps, Hamstrings, Adductors)
- The Sciatic and Femoral nerves
- The articular surface of the Ball and socket joint of your hips
Hip Pain Treatment
- Acupuncture & Dry Needling
- Heat packs (Thermal therapy)
- Kinesiology Tape
- Rigid Strapping or taping
- Neurodynamics (Nerve tissue mobilisations)
- Dynamic Strapping
- Strengthening exercises
- Guided loading protocol
- Stretches (Static, dynamic and ballistic)
- Moon boot
- Compression Bandage or Sleeve
- Supportive strapping and taping
- Biomechanical Analysis
- Gait Analysis
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 walking, sit to stand, single leg balance, stairs or even sleeping in severe cases.
Hip pain goes hand in hand 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 problems. They may even advise you to use a walking aid 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 issues and subtle hip weakness may only show on a slow-motion video.
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.
Other Causes of Hip pain
- Joint – Hip joint pain, Labrum tear, Osteoarthritis of the Hip joint
- Muscles – Gluteus muscle strain, Quadriceps muscle tear, Groin muscle tear, Hamstring muscle tear
- Tendons – Quadriceps tendinitis, Gluteal tendinitis, Hamstring tendinitis
- Bursa – Hip Bursitis
- Ligaments – Inguinal ligament sprain
- Nerve- Pinched Sciatic nerve over the hip
- Bone – Femur Fractures, Avultion fractures or Stress fracture of Femur Head
- Iliotibial band
Have you asked yourself these questions?
“How to put an end to Hip Pain & Stiffness – without taking painkillers, without risking surgery & without having to wait to see the GP!”
If you’ve got hip pain, stiffness or an ache – it’s very tempting to think that it’s nothing, that it will go away on its own. Or, you pass it off as having just “slept awkwardly”, or that it’s just a “spasm” or a bit of stiffness that “everyone” your age suffers from…
There’s no obvious reason why it happened – but it doesn’t seem to be shifting! If that’s happening to you, you’re not alone – and we hear this type of thing all the time. Hip Pain and Sciatica is THE most common problem that we see in our physio practice in Pretoria.
And when it comes to living with hip pain, everybody we see wants to know
“Why is this happening to Me?” or,
“Why am I still suffering from Hip Pain after putting up with it for six months (Maybe even more)?”
Most people think that when they get Hip Pain, it’s just going to go away on it’s own.
That they’ll wake up one morning and like “magic”, it’ll be as if the hip pain never happened…
But then 6 months later you’re still living with hip pain – often even worse than it was when it came on.
Does That Sound Like You?
Another scenario we see all the time in our Physio Practice is when people go to the Doctors, and the Doctor tells them to rest and “try these painkillers” and “see how it goes”.
But this is rarely ever the best advice and often 6 weeks later, they end up going back to the Doctor again because it hasn’t got any better. Worse, they’re often given yet another prescription of even stronger pills, and advised MORE rest. This is madness and explains why so many people are suffering with chronic hip pain.
Has this happened to You?
Why else does hip pain last longer than it should? Well, it’s easy to get confused because you’ve been told different things, by different people. There’s lots of people out there who are happy to dispense advice – but not all of it is credible.
Maybe you think your hip pain was caused by doing something – like lifting or sleeping awkwardly – but it was caused by years and years of poor posture that caused the muscles in your hips to become weak and walking in that awkward position was just the EFFECT of that.
If you don’t know what you’re doing – hip pain can be very confusing. Many people just end up accepting it as ‘part of life’, thinking as if it’s normal and ‘just the way it is’.
If you’re currently living with Hip Pain, here’s 7 more reasons Why it could be lasting longer than it should:
If any of these have happened to you – we would love to help you by inviting you to book an appointment with one of our physios at our Pretoria Physiotherapy practice to find out what can be done to help you. The fact that you’ve tried any or all of these things already is actually a GOOD THING because when you know what doesn’t work – you are closer to finding the thing that does!
Click the link below to book a call with us if you would like to get some solid advice given to you over the phone. The phone call is complimentary and there is no obligation to book any appointments with us after the call is over. Our goal is to help you make the right decision about what to do next.
You thought it would go away on it’s own – but it didn’t
You went to the Doctor who told you to rest and take painkillers – but the pills did nothing to help your hip, and as soon as they wore off the Hip pain struck again
A family member, or friend, told you that everybody gets Hip pain as they get older, so you just accepted it
You already tried other Healthcare Professionals, or a Physio in the past, but nothing they said or did seemed to help
YouTube exercises either didn’t do a thing, or made your Hip pain ten times worse
You thought it would be a good idea to rest because your Hip pain was so bad, but all that did was make it feel even more stiff & tight
Maybe you tried to get a few “massages” hoping that would fix the pain, but all they did was feel nice and relaxing, and didn’t do anything to fix it long term…
“How can choosing to see a Physiotherapist at Cilliers & Swart Physio help you get rid of your Hip pain – in the next few days?”
Here’s just a few of the things our Physiotherapist Team can do for you:
We can quickly take away the pain and stiffness – often inside a couple of sessions
We can help you find out what’s really going on, and get to the root cause of your Back pain once and for all – often inside 20 minutes
Pain can steal your energy and limit a peaceful nights sleep – we can help you to enjoy sleeping at night and living with more energy each day
Cilliers & Swart will ensure that your problem is “corrected” and “healed” properly – and we will provide you with the perfect set of exercises that will speed up your recovery
We can help you put an end to taking all of those painkillers that are no good for your health long-term
Our physiotherapists can help you avoid dangerous spinal surgery – and painful injections
We can help you keep out of the Doctor’s waiting room or from making repeat visits only to be given more pills!
Our experts can help you get back to enjoying quality time with family and friends that your hip pain has stolen from you
We can help you to finally get a good night’s sleep without tossing and turning trying to find that one position that feels right
We can help you to sit more comfortably and walk longer than 15 minutes without your hips feeling weak and painful or like it is going to “give-way”…
Basically, we can help you get back to living life free from the curse of chronic hip pain
If you want to know what it costs – and what availability we have at our physiotherapist practice in Pretoria, then please just click the button below:
“What can I do to get rid of my hip pain Quickly?”…
Well, here’s 4 things you can do:
First off, you need to make a decision about getting help.
So many people procrastinate for so long, thinking that Hip pain will ‘just go away with time’. Unfortunately, six months down the line they’re still putting up with it, and nothing’s changed… Or it gets worse
Do the RIGHT exercises.
One of the best things to help you ease your hip pain is the right series of progressed exercises. The right exercises will help reduce pain and allow you to move freely again. Above all, it will make sure that the problems don’t come back anytime soon. Wrong exercises will aggravate your hips even more.
Avoid sitting for long periods and rest.
Ever tried to get up from the sofa after resting for a while, but you struggle because your hips feel so painful and tight? That’s because one of the worst things you can do – is rest, and sit for long periods. Too much rest and sitting in awkward positions makes your hips stiff and tight. It would really help if you were given specific strengthening exercises for better posture. Together with the hands-on treatment, we get you active and healthy.
Get real, “hands-on” Physio.
Physio is proven to help people with hip pain. In fact, at Cilliers & Swart Physiotherapist it’s one of the most common injuries we see. If your hip pain is affecting your job and your ability to keep active. Or if it threatens your independence or gets in the way of spending quality time with family and friends. Physiotherapy can help get you back to living the life you deserve as quickly as possible.
If you would like to know how the Physiotherapy team at Cilliers & Swart Physiotherapist can help you live with less Hip pain. We invite you to start with a completely free, no-obligation, risk-free “Call me back” phone call.
Note: This Free Call is something that we offer to people who are nervous or unsure. You might not know if Physiotherapy is right for you. If that sounds like you, then please fill out our online form. We will contact you to find out what is wrong and how we can help. There is no financial risk on your part.