Hip Pain

What Is Hip Pain?

Hip pain refers to discomfort felt in or around the hip joint and surrounding tissues. It may be felt in the front of the hip, groin, side of the hip, glutes, outer thigh, or pelvis. Some people describe hip pain as sharp, pinching, aching, stiff, tight, unstable, or deep within the joint.

The hip is a major weight-bearing joint. It plays a central role in walking, standing, sitting, climbing stairs, squatting, running, lifting, and athletic movement. Because the hip connects the pelvis to the lower limb, it has a major influence on how force travels through the body.

Hip alignment is one of the most important factors to assess before layering on strengthening, mobility drills, or performance training. If the pelvis and hip are not positioned or moving well, the body may load the joint unevenly. Strengthening on top of poor alignment can sometimes reinforce compensation rather than correct it.

Consider a new house being built. Before the walls and framework go up, the foundation needs to be level. If the foundation is uneven, everything built above it has to adjust around that imbalance. The hip and pelvis work in a similar way. They act as a foundation for how force travels through the body. If hip alignment or pelvic mechanics are not moving well, the knee, ankle, lower back, and even upper body may begin to compensate. Addressing this foundation first can help create a better base for strengthening, mobility work, and long-term movement efficiency.

Hip pain can come from several sources, including joint irritation, muscular strain, tendon irritation, bursitis-like symptoms, mobility restrictions, postural strain, previous injuries, or movement patterns that place excess stress on the hip region. Diagnosis of medical or structural causes should be made by a licensed medical professional when needed.

Individuals May Experience

• Pain in the hip, groin, glutes, or outer thigh

• Stiffness when walking or standing

• Discomfort when sitting for long periods

• Pain when climbing stairs

• Reduced hip mobility

• Pinching in the front of the hip

• Tightness through the hip flexors, glutes, or adductors

• Pain during exercise, running, squatting, or lunging

• Difficulty sleeping on one side

• Lower back discomfort associated with hip stiffness

• Knee or ankle discomfort related to altered hip mechanics

• A feeling that one hip is tighter, weaker, or higher than the other

• Reduced confidence with sport, workouts, or daily activity

• Recurring hip tightness that returns after stretching

What Contributes to Hip Pain?

Several factors may contribute to hip pain or recurring hip discomfort, including:

• Poor hip or pelvic alignment

• Muscle imbalances around the hip and pelvis

• Limited hip mobility

• Reduced glute strength or hip stability

• Repetitive physical activity

• Previous hip, knee, ankle, or lower back injuries

• Prolonged sitting posture

• Tight hip flexors, glutes, adductors, or piriformis region

• Poor squat, lunge, walking, or running mechanics

• Sacroiliac joint or pelvic restrictions

• Reduced core control

• Overuse from sport, gym training, running, or work demands

• Compensation from foot, ankle, knee, or lower back dysfunction

The hip is part of a larger kinetic chain. When the hip does not move or align well, force may travel differently up and down the body. This can affect the lower back, sacroiliac joints, knees, ankles, and feet.

For example, limited hip rotation may cause the lower back to twist more during movement. Poor hip stability may allow the knee to collapse inward during squats, stairs, running, or landing. Reduced glute strength may increase strain through the hip flexors, lower back, or hamstrings. This is why hip pain is often best assessed as a whole-body movement issue rather than just a local joint problem.

How Manual Therapy May Help

Manual therapy and rehabilitation may help identify the mechanical factors contributing to hip pain. Care may focus on improving hip alignment, pelvic mechanics, mobility, soft tissue tension, strength, and movement control.

The first goal is often to improve the foundation: how the pelvis and hip are positioned, moving, and sharing load. Once the foundation is moving more efficiently, strengthening and exercise can be layered in more effectively.

Osteopathic Manual Therapy

Osteopathic Manual Therapy may focus on assessing hip alignment, pelvic mechanics, sacroiliac joint mobility, lumbar spine movement, and surrounding fascial tension. Since the hip acts as a bridge between the upper and lower body, restrictions in the pelvis, lower back, ribs, knees, or ankles may influence how the hip loads.

Treatment may include:

• Assessing hip joint mobility

• Addressing pelvic alignment and sacroiliac mechanics

• Reducing fascial tension around the hip and pelvis

• Improving coordination between the hip, pelvis, and spine

• Addressing lower back or pelvic restrictions that affect hip motion

• Improving load transfer through the lower limb

• Reducing compensation patterns in the knee, ankle, or lower back

• Supporting smoother movement through walking, squatting, and standing

The goal is to restore more efficient hip movement, improve alignment, and reduce mechanical stress through the hip joint and surrounding tissues.

Physiotherapy

Physiotherapy may help improve the strength, stability, and movement control needed to support the hip joint. This is especially important when hip pain is related to weakness, poor movement mechanics, repetitive strain, sport, running, or gym training.

Physiotherapy may involve:

• Hip strengthening exercises

• Glute and core strengthening

• Pelvic stability training

• Mobility exercises for the hip joint

• Movement retraining for squats, stairs, walking, running, or lifting

• Balance and single-leg control exercises

• Gradual activity progression

• Return-to-running or return-to-sport programming when appropriate

• Education on load management and activity modification

Rehabilitation helps improve strength and stability around the hip. However, strengthening is most effective when paired with proper alignment and movement mechanics. If the hip and pelvis are not loading well, exercises may need to be modified first so the body learns to build strength on a better foundation.

Massage Therapy

Massage therapy may help support hip pain care by reducing surrounding muscle tension and improving comfort. When the hip is not moving well, muscles around the joint may tighten protectively or overwork to compensate.

Massage therapy may assist by:

• Reducing muscle tension around the hip

• Improving circulation in surrounding tissues

• Addressing tightness in the glutes, hip flexors, adductors, and outer thigh

• Reducing compensatory lower back or pelvic tension

• Supporting recovery after activity

• Improving comfort with movement

• Helping reduce muscular guarding around the hip joint

Massage therapy can help relieve muscular tightness that contributes to hip discomfort, especially when combined with alignment assessment, mobility work, and strengthening.

Book an Assessment

If hip discomfort is limiting your walking, sitting, stairs, workouts, running, or daily activities, our team can assess contributing mechanical factors and guide a personalized treatment plan.

A comprehensive assessment can help identify whether your symptoms are related to hip alignment, pelvic mechanics, mobility restrictions, strength deficits, muscle tension, posture, gait mechanics, or compensation patterns throughout the body.