Hip Pain

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Hip pain/impingement involves a change in the shape of the surface of the hip joint that predisposes it to damage, resulting in stiffness and pain. To treat hip pain/impingement, physical therapists prescribe stretches and strengthening exercises to better balance the muscles around the hip to protect it, and use manual therapies to help restore range of motion and increase comfort.

Signs and Symptoms

Hip pain/impingement may cause you to experience:

• Stiffness or deep aching pain in the front or side of the hip or front of the upper thigh while resting.
• Sharp, stabbing pain when standing up from a chair, squatting, rising from a squat, running, “cutting,” jumping, twisting, pivoting, or making lateral motions.
• Hip pain described in a specific location by making a “C” with the thumb and hand and placing it on the fold at the front and side of the hip, known as the “C-sign.”
• Pain that most often starts gradually, but can also remain after another injury resolves.
• Pain that increases with prolonged sitting or forward leaning.
• Feeling less flexible at the hips, including a decreased ability to turn your thigh inward on the painful side.

How Is It Diagnosed?

Your physical therapist will evaluate the range of motion (movement) of the hip and surrounding joints, and test the strength of the muscles in that area. Your therapist will feel the hip joint and surrounding muscles to evaluate their condition. The examination will include observing how you move, standing from a sitting position, walking, running, or squatting, as appropriate. Your physical therapist may perform special tests to help determine whether the hip is the source of your symptoms.

How Can a Physical Therapist Help?

When a person develops hip pain, but does not have severe symptoms or joint damage, the recommended treatment is physical therapy. The following interventions can help decrease pain, improve movement, and avoid the progression of hip impingement and the need for surgery:

• Improving the strength of your hips and trunk. Strengthening of the hips and trunk can reduce abnormal forces on the already injured joint and help with strategies to compensate.
• Improving hip muscle flexibility and joint mobility. Stretching tight muscles can reduce abnormal forces that cause pain with motion. Joint mobilization may help ease pain from the hip joint; however, these treatments do not always help range of motion, especially if the shape of the bone at the hip joint has changed.
• Improving tolerance of daily activities. Your physical therapist can consider your job and recreational activities and offer advice regarding maintaining postures that are healthier for your hip and activity modification. Often this involves limiting the amount of bending at the hip to avoid further hip damage.