Physical Therapy for Hip Pain

A physical therapist working a a young woman's hip or leg.
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If you have hip pain, you may benefit from physical therapy to help control your symptoms and improve your overall functional mobility.

The hip is a ball and socket joint consisting of the thigh (femur) and the pelvis. There are many ligaments that support the bones, which provide considerable stability to the joint. Numerous muscles also attach around the hip to help move the joint.

Hip pain can be caused by many factors.

Often, you may start feeling hip pain for no apparent reason. Sometimes recreation or sports puts repetitive strain on the hip causing pain. Because the hip is a major weight bearing joint, arthritis of the hip is a common problem. The hip is responsible for such functional activities as walking, running, rising from sitting, and climbing stairs. Pain in the hip can limit these activities.

Where Hip Pain is Felt

The hip is close to the low back, and it can be difficult to determine if your hip pain is truly coming from the hip or coming from your low back. The location of your symptoms can often help solving this problem.

  • Pain in the groin or front of the hip. If you feel pain in the front of the hip, this is most likely due to arthritis in the hip joint. Muscular strain around the hip can also cause pain here.
  • Pain in the side of the hip. Pain in the side of the hip typically indicates a problem with the muscles or structures around the hip. A common problem here is hip bursitis. A bursa is a fluid filled sac that allows muscles and bones to glide smoothly past one another. Bursitis is irritation of that sac. There is a large bursa on the side of the hip, and this can become irritated with repetitive strain or muscle imbalance.
  • Pain in the buttocks or back of the hip. If you feel pain in the buttock, there is a good chance this pain is coming from your low back and not your hip. A simple test for this is to stand with your feet apart and bend your body forward. Let your low back bend. Come back to the starting position and repeat this bending 5 or 6 times. If your pain changes significantly while bending, then your hip pain is likely coming from your low back and not the hip.

    Remember, if hip pain persists for more than 2 or 3 weeks or occurs as the result of major trauma, a visit to a physician, physical therapist, or health care provider is recommended.

    What to Expect From Physical Therapy for Hip Pain

    Your first visit to physical therapy for hip pain will begin with an initial evaluation. This visit is important to ensure correct diagnosis and proper management. During this visit, the physical therapist will interview you to gather information about the history of your problem, the aggravating and relieving factors, and about any past medical history that may contribute the overall problem. From the information gathered during the history, a focused examination will be conducted. The examination may consist of several sections including, but not limited to:

    • Gait evaluation. A gait evaluation is an assessment how of you are walking. Physical therapists are trained to notice small changes in the hip during different phases of walking. This can help lead to proper management.  Your physical therapist may also perform a video gait analysis to identify nuances in your gait that may be leading to your pain.
    • Palpation. This involves using the hands to touch various structures around the hip to feel for abnormalities or to assess if a structure is painful to touch.
    • Range of motion measurements. Range of motion refers to how far your hip is bending, straightening, or rotating. The physical therapist may use special instruments to measure how the hip joint is moving to help direct treatment.
    • Strength measurements. There are many muscular attachments around the hip and a measurement of strength can help determine if muscular weakness or imbalance is causing your hip pain.
    • Functional mobility tests. Your PT may watch you walk, climb stair, or run to determine how your hip pain affects your overall mobility.
    • Special tests. Special tests are specific maneuvers performed around the hip to help determine which structure may be at fault and may be causing the problem. This may include testing of the low back to determine if your hip pain is really coming from your spine.

    After the initial evaluation, you and your physical therapist will be able to initiate a plan of treatment for your hip. The therapist may use physical agents like heat or ice help with inflammation. Exercises to improve hip strength or mobility may be started. You also may have to perform exercises at home each day. It is important for you to be an active participant with physical therapy, and ask questions if you have any.

    Exercises to improve the mobility or strength of your hip are important to keep your hip healthy. Simple exercises performed once daily are a good way to keep the hips working properly. As your hip pain improves, advanced hip strengthening may be another option to maximize hip function.

    The hip is a major weight bearing joint in the body and is responsible for many functional activities such as walking and running, sitting and standing, and climbing stairs. By keeping your hips strong and mobile, hip pain can quickly be eliminated and a rapid return to normal activity can occur.

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