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HealthInfo Canterbury

Overview of hip & groin pain

Illustration showing the hip bones.Hip and groin pain are common in people of all ages.

Your hip joint is a ball and socket joint between your pelvis and your thigh bone (femur). It has very strong ligaments holding it together, including one deep inside the joint. That’s why dislocations are rare and need a very strong force to happen, such as a motorbike accident.

You have four main muscle groups that move your hips. They are:

Illustration showing the hip muscles.Tendons attach your muscles to your bones.

As well as bones, muscles, ligaments and tendons, your hip joint has:

Causes of hip & groin pain

Any of the structures in your hip can cause you pain if they're injured or overloaded. The most common conditions are:

Adhesive capsulitis

Adhesive capsulitis commonly affects the shoulder in a condition called frozen shoulder, but it can also affect the hip.

It can be very painful initially then settle down to a stiffness when you move your hip. You may need pain medication from your GP during the initial painful stage.

It's worse at night and when you put weight on the leg. It mostly affects middle-aged women.

Adhesive capsulitis is treated with exercises that aim to restore your full movement after the painful stage has finished.

Femoroacetabular impingement (FAI) and labral tears

See Hip labral tears.

Fractures

There are several types of hip fractures:

The main aim when treating fractures is to help the natural healing process of the fracture and surrounding soft tissues.

If you've had a stress fracture, your health professional will look at your training methods to see if you need to change them. You may also need to see a podiatrist to check your foot and leg alignment.

Greater trochanteric pain syndrome (GTPS)

GTPS is a condition that causes pain on the outside of your hip. It might be sore to touch the area, to lie on your side, to go up stairs and to walk or run. It's more common in women than men.

The condition can be caused by a sudden increase in activity, a sedentary lifestyle or a fall onto your hip.

It can be diagnosed with an ultrasound scan or an MRI.

To treat GTPS, you'll be given exercises to do. You may also need to see a podiatrist to check your foot and leg alignment.

Mechanical or non-specific hip pain

This is a common cause of hip pain. It's caused by movement and isn't due to damage to any of the structures in your hip. You'll feel the pain in your hip region including your buttocks and groin.

Usually, moving your hip in one direction causes then increases the pain (for example, going up steps or sitting in a low seat) and moving it in the other direction decreases the pain. So, if bending your hip forwards makes it sore, stretching it backwards will relieve the pain.

To treat this condition, you'll be given exercises to do. Your health professional may also apply joint mobilisation to specific areas of your body.

Osteoarthritis

See Osteoarthritis.

With osteoarthritis of the hip, you normally feel it on the inside of your hip, either towards the front or back. You don't normally feel it on the outside of your hip.

Pregnancy-related issues

Being pregnant increases the risk of a condition called tear ligamentum fovea. It's more common in women who are highly active.

This condition causes pain in your groin and deep in your hip. It makes putting weight on your legs gradually get harder and makes it harder to do exercise. You may need to use crutches.

To treat the condition you'll be given exercises to increase the strength of the muscles that support your hip joint.

Talk to your midwife about the best method to avoid putting pressure on your hip during delivery.

Tendinopathy

Tendinopathy is the term for a painful tendon. It can happen in any of your tendons and you'll feel pain in the area of the tendon. For example, tendinopathy in the tendons that attach your adductor muscles to your pelvis causes pain in your groin (a groin strain).

Tendinopathy can happen if you suddenly increase your training level. It can also happen after an injury. A fall, for example.

With tendinopathy, you get pain when you use the affected tendon. For example, kicking a ball with a groin strain, running with a hamstring strain, climbing stairs with a hip flexor strain.

To treat tendinopathy, you'll be given exercises that gradually strengthen the affected tendon. You should avoid stretching the affected tendon until it has recovered.

Total hip replacement dislocation

This causes sudden pain and the joint might be visibly out of place. You won't be able to put your weight on your legs.

It can be caused by crossing your legs, rolling in bed, sitting in a deep chair or bending forward. It's more common if you've previously had a dislocation.

If this happens, immediately contact the hospital where you had your total hip replacement surgery.

Low back pain

Low back pain can also cause pain in your hip, buttock and leg. This is called referred pain, which means the cause is in one part of your body but you feel it somewhere else. Hip pain that's from your low back is usually worse with sitting and better with standing and walking.

See About low back pain for information about low back pain and how to treat it.

Treating hip & groin pain

The first thing you should do is have a health professional such as your GP, physiotherapist, chiropractor or osteopath assess you and determine the most likely cause of your hip or groin pain.

The health professional is likely to get you to do exercises that will restore your movement, relieve your pain and get you back to doing all your normal activities safely. They may also do some joint mobilisation to help get the joint moving.

Written by HealthInfo clinical advisers. Page created May 2021.

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