Causes of Hip Pain


Causes of Hip Pain

Causes of Outer Hip Pain Physiotherapy Downtown Toronto

Causes of Hip Pain

The hip is an important component of the human body. It is a ball-and-socket joint which joins the legs to the lower part of torso, it also acts as a shock absorber of the force applied by the weight of the body, particularly when locomoting.  As this type of joint allows a high level of mobility, there are a number of muscles, tendons, ligaments, and other supportive tissue connected to the hip to support smooth movement around the joint and to prevent any movements that might result in pain, such as a dislocation.

What are the causes and symptoms of pain of the outer hip?


The source of hip pain can sometimes be difficult to determine due to the complexity of the hip joint and the role it plays in many movements of the body. Some of the most common causes of hip pain, specifically the lateral hip, include:

  • Tight or stiff muscles: muscles in and around the hip when excessively tight or stiff can place a higher strain on the tendons and bursae of the hip, causing limited mobility and further friction and pain of the hip.
  • Labral Tear: a tear of the hip joint cartilage, the labrum.
  • Causes: Labral tears occur due to a sudden impact to the area, an impingement on the cartilage or over time with repetitive stress.
    • Symptoms:
      • Pain and tenderness in the groin or hip area
      • Decreased mobility
      • Sometimes a clicking noise can be heard from the hip joint
      • The joint is commonly very tight and stiff
  • Hip bursitis: inflammation of one or more of the three bursae of the hip. The most common is the trochanteric bursa, located on the lateral part of the hip between the gluteal muscle attachments and greater trochanter.
    • Causes: Hip bursitis can be caused by a traumatic impact to the area, or overuse of the bursa through repetitive work/sport associated injuries or due to biomechanical abnormalities, such as overpronation.
    • Symptoms:
      • Pain and tenderness on the outside of the hip which may radiate down the leg
      • Increased pain is felt specifically when climbing stairs or running
  • Hip tendonitis: inflammation of one or more of the tendons of the hip.
    • Causes: Overuse is the common cause. Biomechanical abnormalities such as overpronation can have a substantial effect, or work/sport related activities that are abnormally high in volume or repetition
    • Symptoms:
      • Pain and tenderness on the outside of the hip, specifically at the insertion point of the tendon to the hip
      • Pain is at its worst when any activity is initiated from rest – such as in the morning – or when exercising. During activity, some may find that the pain will subside, however the pain felt post-exercise is commonly more severe than prior to exercise pain levels
  • Hip pointer: Bruising and sometimes internal bleeding and avulsion fractures.
    • Causes: Hip pointer’s are caused by sudden impact to the hip joint, specifically the top of the femur (thigh bone), the greater trochanter and top of the hip, the iliac crest.
    • Symptoms:
      • Pain and tenderness at the point of impact
      • Swelling, sometimes associated with internal bleeding
      • Bruising of the tissue and bone
      • Limited mobility
      • Muscle weakness

Treatment for outer hip pain:

Initial treatment for acute outer hip pain should involve PRICE principles:

  • Protection: In many cases this part of the hip is not padded with body fat very well and so further caution is generally needed to avoid causing more pain.
  • Rest: Avoid any movements that will further exacerbate the pain.
  • Ice: Apply ice for 10 minutes each hour for the initial 24-48 hours as required. Heat may be more beneficial for chronic pain.
  • Compression: Sometimes used to reduce pain and inflammation of the area, however should be used with caution as it may cause more pain.
  • Elevation: Elevation of the injury if possible can reduce pain and swelling.

A doctor may send you for an X-Ray or an MRI to rule out any avulsion fractures, particularly in cases where the pain has resulted due to sudden impact on the bony protrusions of the hip. Avulsion fractures are defined as a small part of the bone breaking away with a tendon.

Physiotherapy Treatments at Ace Physio

Additional therapy modalities are sometimes used by a Physiotherapist to reduce the pain and inflammation of the injury and to increase the body’s healing processes.

  • Joint mobilization to improve joint range of movement and function
  • Ultrasound therapy to reduce pain and inflammation.
  • Sports massage reduce scar tissue build-up and relieve tight muscles.
  • Custom orthotics to correct any muscle imbalances causing excessive overpronation or oversupination.
  • Shockwave Therapy is used to break down adhesions and scar tissue, increase blood flow and promote healing.  Effective in the treatment of Hip Bursitis.
  • Acupuncture of the hip joint and surrounding musculature, relieve pain and promotes circulation.
  • Laser therapy can be helpful to reduce inflammation and decrease pain

Once pain has subsided for the most part, light stretching and strengthening rehabilitation exercises will be prescribed to slowly increase mobility and to relieve any stiffness or tightness of the internal muscles, tendons, ligaments and other connective tissues.  Often tight or/and a combination or weak muscles contribute to the prevalence of an injury occurring as they create muscle imbalances, causing other parts of the body to compensate. These exercises will progressively become harder, and will focus more on the specific rehabilitation required for the injury, such as the introduction of eccentric strength training for hip tendonitis.

While you may be able to return to training while during the rehabilitation phase, you will often need to adjust your training methods. For example, hip bursitis permits running, but only on flat surfaces. The addition of custom orthotics are also beneficial in some cases, allowing you to train while your body moves away from a compensated state.

The benefit of rehabilitation with a registered physiotherapist is not only will they assist you in rehabilitation and further strengthening of the injured part of the body, but they will also assess how this injury was caused and try resolve these issues, so as to avoid re-injury. This helps them to identify the injury itself and the specific rehabilitation required to get you back to your pre-injury self.

If injuries are left untreated, pain and injury to the area will worsen, causing more chronic pain and long term associated issues, such as osteoarthritis of the hip.

To book an appointment at Ace Physio Toronto Physiotherapy Clinic, please call (416) 900-6653 today!

About the Author

Brad SaltzBrad is a Registered Physiotherapist at Ace Physio, a highly respected Physiotherapy clinic in downtown Toronto. Ace Physio provides high quality one on one Physiotherapy that combined state-of-art technology such as; Shockwave Therapy, Laser Therapy, and Spinal Decompression with traditional Physiotherapy.View all posts by Brad Saltz