Hip pain is a common musculoskeletal problem that can interfere with walking, standing, climbing stairs, getting up from a chair, sitting for long periods, sleeping on one side, exercising or participating in sports.
Some hip problems develop gradually because of repeated loading, changes in physical activity, tendon overload, age-related joint changes or reduced muscle capacity. Others begin after running, twisting, sudden acceleration, falling or another traumatic injury. Depending on the underlying condition, hip pain may occur together with stiffness, weakness, clicking, reduced movement or pain extending toward the groin, thigh or buttock.
The hip is a major weight-bearing joint that connects the pelvis to the lower limb. Normal hip function depends not only on the joint itself but also on articular cartilage, the labrum, joint capsule, ligaments, muscles, tendons, bursae and surrounding neural structures. Because problems in several different structures can produce similar symptoms, not every person with hip pain has the same condition or requires the same rehabilitation approach.
At Asia Digital Physiotherapy Orthopedic Rehabilitation Center (ADPORC), hip rehabilitation is planned according to the patient's clinical assessment, pain pattern, range of motion, muscle strength, walking pattern and functional limitations. Management may include activity and load modification, mobility exercises, progressive strengthening, gait and movement retraining, manual therapy and other physiotherapy interventions according to clinical need.
Understanding Hip Pain: A Structural Perspective
Hip pain refers to discomfort arising from the hip joint or the structures surrounding the hip and pelvis. Pain may be felt at the front of the hip or groin, outer side of the hip, deep within the joint or around the buttock.
The hip region contains several clinically important structures:
- Femoral head
- Acetabulum
- Articular cartilage
- Acetabular labrum
- Joint capsule and ligaments
- Gluteal muscles and tendons
- Iliopsoas and other hip flexors
- Adductor muscles and tendons
- Hamstring origin
- Greater trochanter and surrounding soft tissues
- Bursae around the hip
- Deep gluteal muscles
- Nearby peripheral nerves
Depending on the structure involved, hip problems may produce aching or sharp pain, stiffness, weakness, reduced range of motion, tenderness, clicking, catching, difficulty walking or pain during weight-bearing.
Pain location can provide useful clues about the possible source of symptoms, but it cannot confirm a diagnosis by itself.
Common Locations of Hip Pain and What They May Mean
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Front of the Hip or Groin Pain:
Pain deep in the front of the hip or groin may be associated with the hip joint itself.Possible causes include:
- Hip osteoarthritis
- Femoroacetabular impingement
- Labral pathology
- Iliopsoas-related pain
- Adductor or groin-related problems
Pain may become more noticeable during walking, squatting, getting into or out of a car, prolonged sitting or activities involving deeper hip flexion.
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Outer or Side of the Hip Pain:
Pain around the lateral hip, particularly over or near the greater trochanter, is commonly associated with Greater Trochanteric Pain Syndrome (GTPS).Gluteal tendons are often involved, and symptoms may become worse when:
- Walking for longer periods
- Climbing stairs
- Standing on one leg
- Lying on the painful side
- Running or increasing activity load
Lateral hip pain should not automatically be labelled simply as "bursitis," because tendon-related structures may also contribute.
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Buttock or Back of the Hip Pain:
Pain around the buttock or posterior hip can arise from several structures.Possible causes include:
- Deep gluteal muscle problems
- Piriformis-related symptoms
- Proximal hamstring problems
- Sacroiliac-region pain
- Referred pain from the lumbar spine
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Hip Pain With Stiffness:
Deep hip or groin pain accompanied by progressively reduced movement may occur with Hip Osteoarthritis or other joint-related conditions.Patients may notice increasing difficulty putting on socks or shoes, crossing the legs, getting in and out of a car, walking longer distances or rotating the hip.
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Hip Pain During Running or Sports:
Pain during running, kicking, sprinting or rapid direction changes may be associated with:- Adductor strain
- Hip flexor strain
- Gluteal tendon problems
- Proximal hamstring injury
- Femoroacetabular impingement
- Labral injury
- Other sports-related hip or groin conditions
The mechanism of injury and exact location of pain are important for differentiating these problems.
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Hip Pain With Clicking or Catching:
Clicking around the hip is not always abnormal. However, painful clicking, catching or deep groin pain associated with movement may require assessment for intra-articular or tendon-related causes.Labral pathology, femoroacetabular impingement and snapping hip presentations are some possible considerations.
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Hip Pain Extending Down the Leg:
Pain felt around the hip or buttock that extends down the thigh or leg, particularly when accompanied by tingling or numbness, may not originate solely from the hip joint.The lumbar spine, sciatic nerve or other neural structures may need to be assessed.
Common Causes of Hip Pain
Hip-region pain can originate from the joint, muscles, tendons, bursae, labrum or surrounding neural structures. The following are some of the important causes.
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Hip Osteoarthritis:
Hip Osteoarthritis is a joint condition involving structural and functional changes within the hip.Symptoms commonly develop gradually and may include deep groin or hip pain, stiffness, reduced hip rotation and difficulty walking, climbing stairs, getting out of a chair or performing other weight-bearing activities.
Reduced hip movement and muscle weakness can gradually affect gait and daily function.
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Greater Trochanteric Pain Syndrome:
Greater Trochanteric Pain Syndrome (GTPS) is an important cause of pain around the outer side of the hip.It commonly involves the gluteal tendon region and may occur with irritation of nearby bursae.
Typical symptoms include lateral hip tenderness and pain during prolonged walking, stair climbing, standing on one leg or lying on the affected side.
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Gluteal Tendinopathy:
The gluteus medius and gluteus minimus tendons contribute significantly to pelvic and hip control during walking and single-leg activities.Tendon overload can produce pain around the outer hip, particularly with activities that repeatedly load the lateral hip.
Rehabilitation may require progressive strengthening and appropriate load management rather than prolonged rest alone.
Gluteal tendinopathy and GTPS overlap clinically, so they should not necessarily be treated as completely separate diagnoses in every patient.
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Femoroacetabular Impingement:
Femoroacetabular Impingement (FAI) refers to a pattern in which hip morphology and movement can contribute to contact between the femur and acetabular region during certain positions.Patients may experience front-of-hip or groin pain, particularly during deep hip flexion, squatting, prolonged sitting or sports involving repeated hip rotation.
FAI-related imaging findings do not automatically explain pain, so clinical symptoms and functional assessment are important.
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Hip Labral Injury:
The acetabular labrum is a ring of fibrocartilage around the hip socket that contributes to joint function and stability.Labral pathology may occur after trauma, repetitive sports activity or alongside other hip conditions.
Symptoms may include deep groin pain, painful clicking, catching or discomfort during twisting and hip flexion.
Not every labral abnormality seen on imaging causes symptoms, so clinical correlation is important.
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Hip Flexor and Iliopsoas-Related Pain:
The iliopsoas is one of the major hip flexor muscle-tendon complexes.Pain may be felt around the front of the hip or groin and may increase during repeated hip flexion, running, stair climbing or activities that require lifting the thigh.
Muscle strain and tendon-related conditions require different rehabilitation depending on the mechanism and stage of injury.
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Adductor-Related Groin Pain:
The hip adductor muscles are located along the inner thigh and contribute to hip control during walking, running and sporting movements.Overload or injury can cause pain around the inner thigh and groin, particularly during sprinting, kicking, changing direction or squeezing the legs together.
Related guide: Groin Pain: Causes, Symptoms & Physiotherapy Treatment
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Piriformis Syndrome / Deep Gluteal Pain:
Piriformis-related pain may produce deep buttock discomfort and, in some patients, symptoms extending toward the posterior thigh.Prolonged sitting, certain hip movements and walking may aggravate symptoms.
Because similar symptoms can arise from lumbar radiculopathy and other deep-gluteal conditions, careful differential assessment is important.
ADPORC already has a dedicated Piriformis Syndrome article covering buttock pain, radiating symptoms and sitting-related aggravation.
Related guide: Piriformis Syndrome: Causes, Symptoms & Physiotherapy Treatment
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Proximal Hamstring Tendinopathy or Injury:
The proximal hamstring tendons attach near the sitting bone at the lower buttock.Repetitive running, sprinting, bending or prolonged sitting may aggravate tendon-related pain. Sudden sporting injuries can also cause hamstring strain or tearing.
Patients often report pain around the lower buttock rather than directly over the side of the hip.
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Hip Bursitis:
Several bursae around the hip reduce friction between nearby tissues.Bursal irritation can contribute to local pain and tenderness, particularly around the lateral hip.
However, lateral hip pain is frequently more complex than isolated bursitis, so assessment should consider the gluteal tendons and surrounding structures as well.
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Hip Muscle Strain:
Hip flexor, adductor, gluteal and other muscles may be injured during sprinting, kicking, sudden direction changes, slipping or unexpected loading.Symptoms may include localized pain, tenderness, weakness and pain during resisted movement or stretching.
The severity of muscle injury determines the appropriate progression back to activity.
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Referred Pain From the Lumbar Spine:
Not every pain felt around the hip comes from the hip joint.Lumbar spine problems may produce pain around the buttock, lateral hip, thigh or leg.
Symptoms such as back pain, tingling, numbness, radiating leg pain or pain influenced strongly by spinal movement increase the need to assess the lumbar region.
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Hip Fracture or Significant Traumatic Injury:
Hip and proximal femoral fractures may occur after significant trauma and are particularly important in older adults after a fall.Severe pain, inability to bear weight, visible leg deformity or sudden marked loss of hip function after trauma requires urgent medical assessment rather than routine physiotherapy management.
Risk Factors for Developing Hip Pain
Several factors may increase loading around the hip or contribute to particular hip disorders:
- Sudden increase in walking, running or sports training
- Repetitive running, sprinting or kicking
- Repeated deep squatting or hip flexion
- Previous hip, pelvic or lower-limb injury
- Reduced hip or gluteal muscle capacity
- Poor load management during exercise
- Prolonged sitting in some hip and buttock conditions
- Age-related joint changes
- Repeated occupational loading
- Reduced balance or lower-limb control
- Previous surgery or prolonged immobilization
Having one or more risk factors does not confirm the cause of hip pain. Symptoms should be interpreted together with the patient's history, examination and functional demands.
Symptoms of Hip Pain
Symptoms vary according to the structure involved. Common complaints include:
- Pain in the groin or front of the hip
- Pain on the outer side of the hip
- Buttock or posterior hip pain
- Pain while walking or climbing stairs
- Difficulty getting up from a chair
- Pain when lying on one side
- Hip stiffness or reduced range of motion
- Weakness during walking or single-leg activities
- Clicking, catching or painful rotation
- Difficulty running, squatting or participating in sport
- Pain extending into the thigh or leg
- Tingling or numbness when neural structures are involved
Hip Pain Symptoms That Should Not Be Ignored
Some hip symptoms require medical assessment rather than routine self-management alone.
Seek appropriate professional care if you experience:
- Severe hip or groin pain after a fall or significant trauma
- Inability to stand or bear weight after injury
- Visible deformity or abnormal leg position
- Rapidly increasing swelling or extensive bruising
- A hot, red or significantly swollen joint with fever
- Progressive weakness or numbness in the leg
- Severe persistent pain without a clear mechanical pattern
- Significant unexplained loss of function
- Persistent pain after trauma despite initial rest
- Sudden severe pain in a person at increased risk of fracture
These symptoms do not always indicate a serious disorder, but fracture, infection, neurological dysfunction or other pathology may need to be excluded.
Severe pain after a fall, inability to bear weight, or a hot swollen hip with fever warrants urgent medical assessment.
How Hip Pain Is Diagnosed
Accurate assessment is important because joint, tendon, muscle, lumbar and nerve-related problems can produce overlapping symptoms around the hip.
Clinical assessment may include:
- History of how and when symptoms began
- Exact location and behaviour of pain
- Mechanism of injury when trauma occurred
- Walking and gait assessment
- Hip range of motion
- Hip and lower-limb muscle strength
- Single-leg control and balance
- Tendon loading assessment when indicated
- Functional movements such as squat, step or sit-to-stand
- Hip joint provocation tests when clinically relevant
- Neurological screening when symptoms radiate
- Lumbar spine assessment when referred pain is suspected
Different presentations require different clinical tests. A patient with lateral hip tendon pain, for example, should not automatically be assessed or treated in exactly the same way as someone with deep groin pain or radiating neurological symptoms.
Imaging is not necessary for every person with hip pain.
When clinically indicated, investigations may include:
- X-ray
- MRI
- Musculoskeletal ultrasound
- Other medical investigations according to the suspected pathology
The need for imaging should be determined by the clinical presentation rather than used routinely for all hip pain.
Physiotherapy Treatment for Hip Pain
There is no single physiotherapy treatment or exercise program suitable for every type of hip pain.
Rehabilitation depends on the involved structure, duration and irritability of symptoms, range of motion, muscle capacity, walking pattern and individual functional goals.
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Education and Load Modification:
Activities that repeatedly aggravate the hip should first be identified.Depending on the condition, temporary modification of long-distance walking, running, jumping, deep squatting, repeated stair use, prolonged sitting or high-load sports may help control symptoms.
The goal is generally to reduce excessive load while maintaining appropriate activity rather than unnecessarily stopping all movement.
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Pain Management:
An irritated hip joint, tendon or muscle may initially require strategies to reduce aggravating load and allow movement within an appropriate level of symptoms.Management should be tailored to the diagnosis rather than relying only on passive pain-relieving treatments.
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Mobility and Range-of-Motion Training:
Hip stiffness may affect walking, sitting, dressing and other functional tasks.When appropriate, rehabilitation may address:
- Hip flexion
- Hip extension
- Hip abduction
- Hip internal rotation
- Hip external rotation
- Functional mobility
Mobility exercises should be selected according to the specific condition because repeatedly forcing a painful hip into end-range positions may aggravate some disorders.
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Progressive Strengthening:
Strengthening is an important component of rehabilitation for many hip conditions.Depending on the diagnosis, treatment may focus on:
- Gluteus medius and minimus
- Gluteus maximus
- Hip flexors
- Hip adductors
- Hip rotators
- Quadriceps and hamstrings
- Core and pelvic control
- Functional lower-limb strength
Loading should be progressed according to symptoms, tissue capacity and functional goals.
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Gluteal and Pelvic Control Training:
The gluteal muscles contribute to pelvic control during walking, stair climbing, running and single-leg activity.When clinically relevant, rehabilitation may include exercises targeting hip abductor strength, pelvic control and movement efficiency.
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Movement and Gait Retraining:
Pain or weakness can alter the way a person walks, climbs stairs or loads one leg.Rehabilitation may address:
- Walking pattern
- Sit-to-stand
- Stair climbing
- Squatting
- Single-leg control
- Running mechanics when relevant
- Sport-specific movement
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Tendon Rehabilitation:
For gluteal, iliopsoas, adductor or proximal hamstring tendon disorders, progressive tendon loading may form an important part of rehabilitation.The exercise program should be specific to the involved tendon and progressed gradually according to response.
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Manual Therapy:
Joint mobilization and other manual therapy techniques may be used for selected patients with pain or movement restriction.Manual therapy should generally support rather than replace active rehabilitation and progressive exercise.
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Lumbar or Nerve-Related Rehabilitation:
When hip-region pain is referred from the lumbar spine or associated with neurological symptoms, rehabilitation may also need to address spinal movement, neural sensitivity, strength and functional control. -
Sports and Return-to-Activity Rehabilitation:
For athletes recovering from hip or groin injuries, later-stage rehabilitation may include:- Progressive running
- Sprinting
- Change-of-direction drills
- Jumping and landing
- Kicking or sport-specific movements
- Strength and functional testing
Return to sport should be based on functional recovery rather than time alone.
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Post-Surgical Rehabilitation:
After hip surgery, rehabilitation may include:- Pain and swelling management
- Restoring appropriate range of motion
- Muscle activation
- Progressive strengthening
- Balance training
- Gait retraining
- Return to daily activities, work or sport
Progression should follow the specific surgical procedure and the treating team's precautions or protocol.
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Electrotherapy and Other Adjuncts:
Electrotherapy or other physical modalities may be used in selected patients when clinically indicated.These interventions should support, rather than replace, education, load management, therapeutic exercise and functional rehabilitation.
Why Early Assessment Matters
Persistent hip pain can gradually change the way a person walks, climbs stairs, stands on one leg or loads the lower limb.
Patients may reduce their activity, lose muscle capacity or compensate through the lumbar spine, pelvis, knee or opposite leg.
Appropriate assessment helps determine whether symptoms are primarily joint-related, tendon-related, muscular, neural or referred from another region.
Physiotherapy can then be directed toward the patient's actual impairments and functional goals rather than treating every type of hip pain in the same way.
When Should You See a Physiotherapist for Hip Pain?
Consider physiotherapy assessment if:
- Hip pain is interfering with walking or daily activities
- Stair climbing or getting up from a chair has become difficult
- Hip stiffness or movement restriction is developing
- Lying on one side has become persistently painful
- Hip or lower-limb weakness is affecting function
- Pain repeatedly returns when activity increases
- Groin, buttock or lateral hip pain persists despite reasonable activity modification
- You are recovering from hip or lower-limb injury
- You are recovering after immobilization or hip surgery
If symptoms suggest fracture, infection, significant traumatic injury or progressive neurological involvement, appropriate medical assessment may be required before or alongside physiotherapy.
Why Asia Digital Physiotherapy Orthopedic Rehabilitation Center (ADPORC) Is a Trusted Physiotherapy Center in Dhaka
ADPORC focuses on evidence-based physiotherapy for musculoskeletal, neurological and sports-related conditions.
- Expert Care by Dr. Saddam Hossain, PT
Structured rehabilitation under experienced clinical supervision. - Condition-Specific Physiotherapy Programs
Treatment plans designed according to assessment, pain stage and functional goals. - Advanced Electrotherapy and Rehabilitation Equipment
Modalities used only when clinically indicated. - One-on-One Supervised Sessions
Direct supervision supports safe and individualized rehabilitation. - Accessible Location in Jatrabari, Dhaka
Serving patients from Jatrabari, Dholaipar, Shonir Akhra, Doyagonj, Puran Dhaka, Keraniganj, Narayanganj and surrounding areas.
If you are looking for reliable physiotherapy for hip pain in Dhaka, ADPORC provides structured rehabilitation based on clinical assessment, mobility, strength, walking pattern and individual functional goals.
Book Your Appointment Today
Do not let persistent hip pain continue to interfere with walking, sitting, climbing stairs, work, exercise or everyday activities. Appropriate assessment can help identify the likely source of symptoms and determine a suitable rehabilitation plan.
Visit ADPORC for professional physiotherapy assessment and rehabilitation for hip pain and related lower-limb conditions.
- Location: 270/1 Dholaipar, South Jatrabari, Dhaka-1204
- Call: 01950-935236
- Website: adporc.com
Asia Digital Physiotherapy & Orthopedic Rehabilitation Center