Physiotherapy Guidance on Management of Hip Pain

What is Physiotherapy and how can it help your hip pain?

Physiotherapists are experts in helping people maintain the ability to move and function throughout their lives. We use our extensive knowledge of how the body moves and what prevents the body from moving well and use this knowledge to help people of all ages to improve their wellness, mobility and independence.  Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.

Physiotherapy is a science-based profession and in its approach, considers the ‘whole person’, which includes the patient’s general lifestyle.  We encourage patient’s involvement in their own care, through empowerment and participation in their treatment.

Why do I have hip pain?

The hip is a large ball and socket joint, intended to withstand repeated motion and a fair amount of wear and tear.  Its mobility and interrelationship with the pelvis allows fluid transmission of weight to be transferred from the trunk to the lower limbs.  The diagram below shows the smooth layer of cartilage that coats the hip ball and pelvic socket, designed to prevent friction and act as a cushion during weight bearing activities.  Strong ligaments and musculature encase the joint, providing stability.  Despite its durability, the hip joint is not indestructible and is susceptible to injury. Hip pain is therefore a common problem.

What are the common causes of hip pain?

  • Arthritis – Osteoarthritis is the more common complaint, especially amongst older Adults.  It occurs when the protective cartilage lining the joint surfaces wears or the joint becomes inflamed.  Episodes of pain will be become worse as the condition progresses.  Pain and stiffness, especially in the morning and reduced range of movement are the main symptoms of Arthritis.  Regular gentle exercise will keep the muscles around the joint strong and may prevent further wear on the joint.  Mobility aids such as a walking stick and sensible, comfortable footwear can also help to reduce symptoms.
  • Muscle or tendon strain– Repeated activities can cause strain and lead to overuse injuries of the muscles and attached tendons supporting the pelvis and hip joints.  Muscles and tendons can become inflamed and scarred and will inhibit function of the hip joint.  Athletes are particularly prone to this condition and should seek advice from a physiotherapist for a programme of stretches and strengthening exercises.
  • Lumbar spine referral– Nerves exiting the lumbar spine can become irritated by impinging tissues around the spinal column.  This irritation can lead to symptoms of numbness, pain, pins and needles being felt on or around the hip joint and pelvis.  These symptoms normally occur in association with lower back pain but not all cases.  If you are experiencing these symptoms you should seek advice from your GP or see a physiotherapist.
  • Bursitis– Bursae are small fluid-filled sacs that protect muscles and tendons from friction.  Repetitive overuse activities or weakness in the muscles around the hip can cause inflammation of these bursae, leading to pain and swelling.  The most common of these bursae to be affected, the Trochanteric bursae, is located on the side of the hip joint.
  • Tendonitis– The thick bands that connect muscle to bone, can become irritated and inflamed with repetitive activities.  Rest from repetitive activities and applying ice can help to settle symptoms.  If symptoms persist, seek advice from your GP or Physiotherapist.

What exercises can help my hip pain?

Keeping the large muscle groups around the hip, like the gluteal at the back of the hip strong, is very important for maintaining a healthy hip joint.  The exercises detailed below, are just some of the regular exercises you can do to maintain strength and flexibility around the hip joint.


The Pelvis comprises three joints.  Two sacroiliac joints at the back are load bearing joints, transmitting weight from the trunk to the lower limbs.  The Pubic symphysis at the front of the pelvis can become problematic in pregnancy and post-partum.
The hip joints are formed by the femoral head (ball) and Acetabulum (pelvic socket).  The joint surfaces are coated in a protective, friction preventing cartilage layer.  A cartilage called the Labrum, is attached to the socket within the joint and provides both stability and shock absorption.

CLAM SHELLS

While lying on your side with your knees bent, draw up the top knee while keeping contact of your feet together.  Do not let your pelvis roll back during the lifting movement.

10 Repetitions, 3 times daily

PRONE HIP EXTENSION

While lying face down with your knee straight, slowly raise up leg off the ground. Ensure you do not arch your back.

10 Repetitions, 3 times daily

BALL SQUEEZE – SEATED

While sitting, place a ball or towel between your knees. Squeeze the ball with your knees and hold.

Repeat 10 times, 3 times daily

STANDING MARCHING – SINGLE LEG

While standing, draw up your knee, set it down and then repeat on the same side. Use your arms for support if needed for balance and safety.

10 Repetitions, 3 times daily

KNEE FALL OUT STRETCH

While lying on your back with one knee bent, slowly lower your knee to the side as you stretch the inner thigh/hip area.

Hold for 30 seconds, repeat 3 times daily

PIRIFORMIS STRETCH

While lying on your back with both knees bent, cross your affected leg on the other knee. Next, hold your unaffected thigh and pull it up towards your chest until a stretch is felt in the buttock. If you have sciatic symptoms consult your physiotherapist before attempting this stretch.

Hold for 30 seconds, repeat 3 times daily.

HALF KNEE HIP FLEXOR STRETCH

While kneeling, lean forward and bend your front knee until a stretch is felt along the front of the other hip. If you have knee problems use a pillow under your knee or avoid if to uncomfortable.

Hold for 30 seconds, repeat 3 times daily