What it is
“Hip pain” covers a lot of ground, and where you feel it tells us a lot. Pain in the groin or front of the hip often points to the joint itself or the structures around it. Pain on the outside of the hip is frequently the tendons and bursa over the bony point (often called gluteal tendinopathy or bursitis). Pain in the back of the hip or deep in the buttock can come from the glutes, the deep rotators, or be referred from the low back.
The good news: most hip pain in active adults is mechanical, meaning it’s about how the joint and the muscles around it are loaded and moving. Mechanical problems respond very well to the right strengthening and movement work.
What causes it
- Strength and control deficits in the glutes and deep hip stabilizers, so the joint takes load it isn’t ready for
- Mobility limitations that make the hip pinch or compensate at the end of its range
- Tendon overload on the outside of the hip from a change in training, walking, or even sleeping position
- A recent change in activity: new mileage, a new program, more sitting, a long trip, a new job on your feet
- Referred pain from the low back masquerading as hip pain, which is why we assess both
What it feels like
- Groin pain or a pinch in the front of the hip when squatting, sitting deep, or getting out of a car
- An ache on the outside of the hip that’s worse lying on that side at night
- Stiffness first thing in the morning or after sitting that eases with movement
- Clicking, catching, or a feeling that the hip “doesn’t track right”
- Deep buttock pain, sometimes traveling down the leg
How we treat it
A typical course combines:
- A movement assessment that locates the problem (joint, tendon, muscle, or referred from the back) and identifies what provokes and relieves it.
- Hands-on manual therapy to restore mobility and reduce guarding, so the hip can access ranges it’s been avoiding.
- Dry needling when there’s a clear muscular or trigger-point component in the glutes, deep rotators, or surrounding tissue.
- Progressive strengthening of the glutes and hip stabilizers, loaded deliberately so the joint and tendons build real tolerance for the things you need to do.
- A return-to-activity plan that bridges from getting out of pain to running, lifting, or training without it coming back, often into ongoing personal training.
When to seek help
Hip pain that’s lasted more than a week or two, that’s limiting your training or your walking, or that’s interrupting your sleep is worth getting evaluated. Hip tendon and joint issues respond much better when they’re addressed early rather than worked around for months.
Seek immediate medical care for any of the red-flag symptoms above, especially an inability to bear weight after a fall or hip pain with fever.