Hip pain can be complicated, and not just a simple case of rest, take painkillers, and hope for the best. There can be multiple issues occurring at once, which can make you feel like you’re going crazy as the pain feels like it moves around and you can’t always pinpoint the major area of concern.

In general, the first thing that a clinician may do is rule out the lumbar spine as a cause of your hip pain. This can often be done through subjective assessment of how your injury started, alongside some clinical tests. Once the lumbar spine has been ruled out as a cause of your pain, there are 5 ‘non-red flag’ types of hip and groin pain:

1. Adductor-related pain

2. Pubic-related pain

3. Hip flexor-related pain

4. Inguinal-related pain

5. Hip joint-related pain

Common Causes of Hip Pain

• Young people have bones that aren’t fully matured. Growth issues or traumatic injuries during sport can cause apophysitis issues in the hip (tendon pulling on soft bone’ or can get avulsion fractures (muscles pulls part of the bone off of the pelvis).

• Sports and activities with lots of repeated movements can cause tendinopathies, where too much load has gone through a tendon too quickly, which has caused a flare up of pain, and weakness in using that muscle.

• Hip issues starting during childhood may cause issues later in life. If you have hip dysplasia or a similar issue as a child, you are at a higher risk of developing conditions like osteoarthritis or femoroactetabular impingement (FAI).

• Inability to sit for long periods may lead us to think that potentially an inflammatory issue is going on, or osteoarthritis where the hip joint doesn’t like being compressed.

• The presence of clicking and pain on twisting movements in a younger patient may suggest a labral issue, whereas this may mean early stages of osteoarthritis in the older person.

Red Flags to Look Out For!

If you are getting any of these symptoms, it is important to discuss your symptoms with a health professional as early as possible:

• Night pain in the hip

• Hip pain with a history of drugs, heavy alcohol, or steroids can put a person at risk of avascular necrosis (AVN)

• Any recent changes to bladder and bowel symptoms

• Unexplained weight loss may indicate cancer. Especially important for anyone with a history of prostate, bowel, bladder, gynaecological, or breast cancers

Do I need a scan of my hip?

In some cases where a red flag is present, or imaging may change the course of treatment, you might be referred for scans. Imaging gives us a good picture about what is happening, but is often only useful with a hands on examination, and a thorough medical history taken by a health professional. 

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.