Assessment focused on identifying the source of pain, not just the location
Experienced physiotherapists with 10–20+ years in clinical practice
Management of hip joint pains, bursitis & tendonopathies
Understanding of compensatory mechanisms leading to disorders of the hip
Progressive rehabilitation to restore movement and reduce recurrence
Hip pain is a common problem that affects everyday activities like walking, sitting or climbing stairs. A narrative review of chronic hip pain reports that around one tenth of the general population experiences hip pain, and a survey of adults over the age of 60 found that 14.3 % reported significant hip pain on most days over the previous six weeks. The frequency of hip pain increases with age and is linked to conditions such as osteoarthritis, tendinopathy and impingement.
Globally, a 2023 meta‑analysis of 31 studies involving 326 463 participants estimated the prevalence of radiographically defined hip osteoarthritis at 8.55 %. They found that hip OA was the second most common form of OA after knee OA.
Physiotherapy is an effective form of treatment for both acute and degenerative hip conditions.
The hip is a ball‑and‑socket joint that connects your thigh bone to the pelvis. Pain can come from the joint itself (articular cartilage, labrum, bone or joint capsule) or from structures around it such as muscles, tendons, ligaments and bursae.
Because the lumbar spine, groin and knee share nerve pathways, hip pain is sometimes felt as back or groin pain. Common symptoms include sharp or dull pain in the groin or buttock, pain when lying on the affected side at night and difficulty with weight‑bearing activities such as walking, climbing stairs or standing up from a chair.
Gluteal tendinopathy occurs when the gluteus medius or gluteus minimus tendons on the outside of the hip become overloaded and irritated. It commonly affects both inactive adults and runners and is more common in women. Symptoms often include tenderness over the outside of the hip, pain when lying on the affected side, and discomfort with walking, climbing stairs or standing on one leg. It typically occurs in women from their 40s onwards, and around 1 in 4 women over 50 are affected by it.
The pain is usually felt over the bony point on the outside of the hip and may refer down the outer thigh. A classic sign is pain when lying on the affected side at night, which is often what prompts people to seek help. Walking, going up stairs, standing on one leg to get dressed and sitting with the legs crossed can also provoke symptoms.
One reason these positions aggravate the tendon is compression. When the hip moves into adduction, such as when you stand with your weight shifted to one side or sit with your legs crossed, the tendon can be compressed against the bone underneath it. This can be uncomfortable for an already sensitive tendon, especially when it is also being asked to tolerate walking, stairs or exercise.
Evidence from the LEAP trial compared three treatment approaches for gluteal tendinopathy: targeted exercise and education, corticosteroid injection, and a wait-and-see approach. At 8 weeks, 77% of people in the exercise and education group rated themselves as moderately better or more, compared with 58% in the injection group and 29% in the wait-and-see group. This supports exercise and education as a strong first-line treatment option, which is exactly where physiotherapy can be very helpful.
Physiotherapy plays an important role in assessing and treating hip pain. Because hip pain can come from the joint, tendons, muscles, lower back or surrounding structures, treatment should be based on the underlying cause rather than the painful area alone. After a thorough assessment, your physiotherapist may use a combination of hands-on treatment, exercise rehabilitation, education and load management to help reduce pain, improve movement and support a safe return to walking, exercise, work or sport.
Physiotherapy for hip pain starts with identifying why the hip is painful. This may include assessing hip movement, muscle strength, walking pattern, balance, lower back involvement and activities that aggravate symptoms. Treatment is then tailored to the condition, whether the pain is related to hip osteoarthritis, gluteal tendinopathy, hip flexor irritation, femoroacetabular impingement, labral irritation or referred pain from the lower back.
Clinical rehabilitation and strengthening is often one of the most important parts of hip pain treatment. Exercises may focus on strengthening the gluteal muscles, hip flexors, deep hip stabilisers, core and surrounding leg muscles. A structured program can help improve walking, stair climbing, balance, running tolerance and confidence with daily activity. Your physiotherapist may also give you specific exercises to continue at home so progress continues between appointments.
Load management is particularly important for hip pain, especially in conditions such as gluteal tendinopathy, lateral hip pain, hip osteoarthritis and hip flexor irritation. Your physiotherapist can help identify activities that are placing too much stress on the hip, such as prolonged walking, stairs, running, side lying, sitting positions or sudden increases in exercise. Education, pacing and graded return to activity can help settle pain while still keeping you moving safely.
Dry needling may be used as part of hip pain treatment where muscle tightness, guarding or trigger points are contributing to symptoms. It may be useful around the gluteal muscles, hip flexors, tensor fascia latae or surrounding muscles, depending on the presentation. Dry needling is usually combined with exercise and education rather than used as a stand-alone treatment.
Our Wynnum massage therapists can be helpful alongside physiotherapy when tightness or tension in the hip, gluteal, lower back or thigh muscles is contributing to discomfort. Remedial massage may help reduce muscle guarding, improve comfort and support mobility, particularly when used together with a strengthening and movement plan.
Exercise physiology may be helpful for more complex or long-standing hip pain, especially when broader strength, conditioning, weight management, arthritis, balance, falls risk or general health factors are involved. It can provide supervised, progressive exercise beyond the early rehabilitation phase and may be useful for people who need ongoing support to build strength, confidence and physical capacity.
You should seek professional assessment if hip pain:
Early assessment helps identify red flags (e.g., fracture, infection or malignancy) and allows timely management. Physiotherapists can perform specific tests to differentiate hip joint pathology from referred pain from the lower back and guide appropriate imaging or medical referral when necessary. Pain in the hip may also be referred from pelvic conditions, something a women's health physiotherapist can often help with.