The hip is a major joint in the body impacted by many forces all day long. One of the largest articulations in humans, this complex joint is a chief factor in all functional mobility. For example, walking, bending over, stepping, standing, and running are all integral motions potentially affected when a person has hip pain. The hip has an amazing capacity to absorb weight, sometimes bearing up to 5 times a person’s body weight when walking. That said, when significant hip pain occurs, every step can feel like a mile, which in New York City (or any city), can get very uncomfortable, very quickly.
In this article, we will talk about the structure of the hip, some causes of hip pain, actions you can take to prevent or treat a sore hip, and show you some easy stretches and physical therapy exercises for hip pain you can do.
Anatomy of the Hip
The hip is a ball and socket joint designed with a deep structural socket that lends increased stability to this area of the body. This stability is extremely important because the hip withstands repetitive daily stresses even in normal activity.
Strongly supported by large muscles on all sides, the hip functions to provide adequate mobility in most of the things we do. From curling up with a good book to a high-intensity game of basketball, keeping the hip flexible, strong, and pain-free promotes a high quality of life through the years.
In addition to the big muscles like the gluts and hip flexors, there are many strong ligaments and tendons that help support the hip joint. Many important nerves and blood vessels course through the hip region as well.
When dysfunction occurs in any of these structures, muscle, ligament, tendon, or otherwise, hip pain can range from mild to debilitating. Let’s talk about some of the things that can go wrong in the hip area, and how to best address some of the symptoms.
Hip Pain Causes
Bursitis
The hip area contains several bursae, or fluid-filled sacs, that decrease the friction forces that occur during activity. For the most part, any hip bursa can become inflamed and cause hip pain. The most common area affected is the lateral hip, over the bony prominence in the upper thigh called the greater trochanter.
When the hip bursa becomes inflamed, often from rapid activity increases or biomechanical forces, you may feel a sensation ranging from achy discomfort to a sharp pain in the lateral portion of the hip. In fact, many people describe this sensation as a burning-type pain. Often pushing on the “hot spot” at the side of the outer hip can reproduce symptoms in cases of hip bursitis.
Tendonitis
Hip tendonitis is a common ailment causing hip pain, especially in active people who participate in sports like running, bicycling, or high-intensity exercise. The hip has many strong muscles and tendons surrounding it, but often it is the iliopsoas muscle, also known as the hip flexor, that is prone to developing tendonitis.
Often in these cases, the pain onset is gradual, and you may experience irritation, tenderness, or mild swelling in the front of the hip. If left untreated, the hip may become stiff and more inflamed, leading to subsequent mobility issues.
Labral Tears
Another cause of hip pain, especially in athletes, is known as a labral tear. The labrum is a ring of cartilage surrounding the hip joint socket that provides cushioning and stability. When this cartilage is torn, often through a trauma or contact injury, you can feel locking, clicking, or catching in the hip, or even just stiffness and decreased motion. Some people describe the pain as an ache that increases with prolonged standing or sitting.
In fact, not all labral tears occur due to trauma. Some occur over time with repetitive motions, such as in a golf swing or long-distance running, and have a more gradual onset of pain. In other cases, a person’s genetic bony positioning may increase the possibility that the hip labrum will wear and tear over time.
Hip Impingement
This is a syndrome that develops when the ball and socket aspects of the joint, specifically the femoral head and the acetabulum, do not fit together properly and cause poor mechanics of movement. Usually, this is due to a bony abnormality that causes malalignment. In some cases, physical stresses over time that place the hip in extremes of motion can contribute to developing a hip impingement.
Symptoms often include hip stiffness, groin pain after hip flexion, and the inability to fully flex the hip up towards the chest. Hip impingement most commonly affects active adolescents and young adults and if left untreated can lead to osteoarthritis.
Piriformis Syndrome
Located in the back of the hip near the center of the buttocks, the piriformis is a flat band-like muscle that stabilizes the hip joint and lifts and rotates the leg up and out. Sometimes, pain, numbness, or tingling in the back of the hip can radiate even down the leg causing movement difficulties. Indeed, this syndrome is more frequently seen in relation to a history of repetitive, vigorous activity, like long-distance running. Pushing firmly at the center of the buttocks, in the back of the hip can reproduce a person’s hip pain.
8 Stretches & Physical Therapy Exercises for Hip Pain
When your hip hurts, there are a few movements you can try to help alleviate the pain. In many cases stretches and exercises can help a painful hip, but please note, if anything seems to be making your pain worse, stop what you are doing and seek care from a medical professional.
Hip Pain Stretches
When your hip hurts, it is common to get into a cycle of guarding your movements, which in turn can cause increased tightness and dysfunction. Sometimes, by doing some gentle stretches, your hip mobility can improve, and subsequently, pain may diminish.
When performing stretching exercises for your hip, the key is slow, controlled, sustained stretch. Always avoid bouncing or ballistic movements and listen to your body’s cues, stopping if you feel any sharp, grabbing pain. Here are some stretches that may help relieve hip pain:
Hip Flexor Stretch
- Stand tall, in a lunge style position with your right foot forward and the left behind.
- Position your feet like they are on train tracks, with a little width between them, not standing on a tightrope. This will help your balance.
- Bend into your front knee, making sure your knee does not go past your toes.
- Tuck your buttocks under to increase the stretch in the front of the hip.
- Hold 30 seconds, repeat a few times, and switch legs.
Butterfly Stretch
- Sit on the floor, maybe on a small pillow or blanket, to help maintain good alignment.
- Gently bring your feet toward you groin, one at a time, while your knee bends.
- Keep your back straight and allow your knees to fall towards the ground.
- If your flexibility allows, you can apply gentle pressure on the inner thigh with your elbows to deepen the stretch.
- Hold 20-30 seconds, release, and repeat.
- Remember, no bouncing, and do not force anything. You should feel a gentle pull and tension in the groin.
Figure Four Stretch
- Lie on your back with feet flat on the floor.
- Cross the right ankle over the left knee, while keeping your right foot flexed.
- Bring your left knee into your chest by reaching your right hand through your leg space and clasping hands behind your left thigh.
- Use your arms to gently pull your lower body in towards the chest, feeling a stretch in the right hip or glut area.
- Hold for 5 deep breaths. Switch legs and repeat on the other side.
Knee to Chest Stretch
- Lie flat on the floor with legs outstretched.
- Slide one foot back towards your buttocks, in a heel slide, and gently pull that knee into your chest.
- Hold for 20-30 seconds. You may feel a stretch in both hips, in different places.
- Switch legs and repeat on the other side.
- Remember any sharp pain in the hip indicates you should stop the exercise.
Hip Pain Exercises
In general, by keeping the hip muscles strong, balanced, and healthy, you may be able to decrease your hip pain. Here are some physical therapy exercises you can try:
Hip Exercise #1: Hip Pendulums (warm-up)
- Warm-up your hip by swinging your leg left to right in front of you, then front to back.
- Move within a gentle range of motion, loosening up the structures in the hip joint.
- Swing each leg 10 times, in each direction, then switch sides.
- Lie on your back with your knees bent and feet flat on the floor.
- Push down through your heels and up with your pelvis, squeezing the buttocks to lift your hips up.
- Repeat this 15 times. Remembering not to hold your breath.
Hip Exercise #3: Hip Circles
- Position your body on all fours with hands under shoulders and knees under hips.
- Tighten your core muscles and lift one leg out to the side.
- Make a large circle with your knee, moving up to the front, down, back, and then to your starting position.
- Repeat this again, making 10 circles, then switch to the other side.
- Pay attention to your spine keeping it neutral throughout the circle and not allowing it to over arch or flex. Let your hip do the moving.
Hip Exercise #4: Hip Flexion
- Stand upright, with hands-on hips, or with one arm holding on to a wall or furniture for support.
- Slowly raise the right knee up to the level of the hip, or a bit higher, while keeping the left leg straight.
- Hold for 1-2 seconds, and place back down on the floor.
- Repeat on the other side, the alternates, doing 10 reps on each side.
Keep the Hip Moving.
Certainly, we ask a lot of our hips, especially when we lead an active lifestyle. For instance, jumping, running, and repetitive motions can all add up to a sore joint. By performing these stretches and exercises you may be able to decrease hip pain when it occurs or even prevents it in the first place.
In addition, by working towards strong, flexible hip joints, you can prolong hip mobility that tends to naturally decline as we age. If, however, you find that these exercises and stretches are not helping your pain, or certainly, if your pain is getting worse, it is important that you seek care from a trusted medical professional who can perform a thorough evaluation and make appropriate recommendations such as regenerative medicine for your hip.
In the meantime, stay strong and flexible. We are here to help if you need us. Just give us a call at our Brooklyn, NY clinic or start by filling out the form below.