Unfortunately hands on treatment for the hip and groin can often be sparse or non existent or, on the other end of the spectrum, be carried out without addressing the underlying biomechanical issues using targeted exercises. Hands on treatment is often essential to reduce pain, release tight, stiff or overactive structures and improve sensory feedback to the brain. This enables the muscles to be switched on more effectively, resulting in more sustainable improvements. Hands on treatment is always tailored to the individual patient.
Common conditions
Common conditions that give hip or groin pain include those listed below. Some are local and some are referred from structures elsewhere, which is sometimes why they are missed in diagnosis. Almost always there are a combination of the following things going on and often treatment or surgery has only addressed one or some of the structures involved. We assess and treat all of the contributing factors and it is this thorough approach that gets people better. This means we work closely with leading hip surgeons and consultant physicians who give their input where required to ensure optimal management.
Common Causes of Hip Pain |
| FAI – Femoral acetabular impingement or hip impingement |
| Tendinopathy – most commonly of the gluteus medius tendon, hip flexor tendon and the hamstring tendon |
| Trochanteric bursitis |
| Hernia |
| Hip arthritis |
| Cartilage damage |
| Labral tear |
| Lumbar spine injury or pain (e.g. disc, facet problem, arthritis) |
| Adductor, or hip flexor muscle strain or tear |
| Symphysis pubis dysfunction |
Treatment
Treatment will vary depending on the specific diagnosis, but any biomechanical inefficiencies which may have caused or resulted from the original injury will need to be addressed thoroughly; this is often the aspect of treatment that is neglected. These often include imbalances and weaknesses in the muscles of the hip, pelvis and lower back and incorrect alignment of the leg, particularly when walking or running. It will also include hands on treatment including mobilisation of stiff joints and release of tight or overactive musculature. Our top five most useful hands on techniques for the hip are as follows:
| Deep soft tissue massage of the lateral hip muscles, hip flexors and hip adductors (extending down the anterolateral aspect of the thigh) |
| Acupuncture to the posterolateral hip musculature |
| Mobilisation with movement into hip flexion (often with a belt) although care must be taken because this can be an aggravating movement |
| Hold relax techniques to the adductors and abductors |
| Thoracic mobilisation |
Scroll down for further information on common conditions and exercise ideas.
Please note that although the advice and exercises provided are designed to assist your recovery they are not a replacement for seeing a Physiotherapist or Osteopath! It is essential that you ALWAYS make sure you see your Osteopath, Doctor or Physiotherapist to diagnose your injury and guide you through recovery.
FAQ
What causes hip and groin pain?
Common causes include hip joint impingement, labral irritation, gluteal tendinopathy at the outer hip, adductor or hip flexor strains in the groin, and referred pain from the lower back. Load-related onset — a jump in training, a new activity, more sitting — is far more common than a single injury.
Is my pain coming from my hip or my back?
Hip joint problems typically produce pain deep in the groin or front of the thigh, worse on rotating the hip, squatting or getting out of a car. Referred pain from the lower back usually sits in the buttock or outer hip and changes with spinal position. Both need testing, because treating the wrong one is the commonest cause of failed treatment.
What is hip impingement?
Hip impingement, or femoroacetabular impingement, is contact between the femur and the rim of the hip socket at the end of range, usually felt as deep groin pain on flexing or rotating the hip. It is common in people who squat deeply, cycle, or play sports involving rotation, and it responds to strength and load management.
Why does the outside of my hip hurt when I lie on it?
Pain on the outer hip that is worse lying on that side, crossing your legs or climbing stairs usually indicates gluteal tendinopathy — irritation of the tendons attaching to the bony prominence at the side of the hip. It is often mislabelled as bursitis. Compressive stretching makes it worse; progressive loading improves it.
How long does a groin strain take to heal?
A mild adductor strain typically settles in two to three weeks and a moderate one in four to eight. Return-to-sport timing should be decided on strength and movement testing rather than on the calendar, because groin strains have a high recurrence rate when athletes return before adductor strength has been restored.
Can physiotherapy help hip pain without surgery?
For most hip and groin problems, yes. Impingement, gluteal tendinopathy, muscle strains and mild to moderate hip osteoarthritis all respond to a properly progressed strengthening and load-management programme. Surgery has a role for specific structural problems, but it is not the first-line answer for the common presentations.