Conditions

Hip Pain

Our hip joints are ball-and-socket joints like our shoulders, but are much more stable because of how they articulate with the pelvis. As a result, it is more common for our hips to become tight and restricted in motion over time, and easier for certain muscles to be underused and on the weaker side.

Certain types of hip pain increase as we age, while others are common regardless of our age but vary with our activities, postures, genetics, hobbies, etc. Hip pain can occur from repetitive overuse, trauma, or postural strain to the muscles, ligaments, joints, and nerves of the hip and pelvis. Since our hip function is largely influenced by our pelvic, low back, and core muscle function, these areas also influence the daily stress and strain our hips may face.

Hip pain is frequently treated by Chiropractors. A thorough assessment can help reveal the cause of hip pain, and treatment including joint and muscle hands on therapies, as well as exercise therapies can help to reduce hip pain and improve hip function.

Foam rolling hip muscles Chiropractic self-treatment exercise

Causes of Hip Pain

Hip strains are injuries to any one or more muscles surrounding the hip joint. Most commonly this is the gluteal muscles and hip flexors, but can also include other muscles like our external or internal rotators and hip adductors. Chiropractors are able to assess hip injuries in depth and diagnose which muscles are most effected.
Assessment involves classifying the grade or intensity of the strain, and designing a treatment plan that matches this as well as the phase of healing.
Treatment typically includes soft tissue therapies to help speed up the acute phase and give symptom relief, then building on this with mobility and graded strengthening exercises.
A sprain to the ligaments or joint capsules of the hip. This usually takes sudden force or trauma, and is not likely with repetition or sustained postures alone. The goal of sprain rehabilitation is to provide symptomatic relief while staging progressive exercise to help support the ligament(s) and reduce risk of re-injury as things heal.
Our bursae are fluid-filled sacs that lubricate tendons near where they attach to the bone. Bursitis is when there is inflammation in one or more bursae. This can present as pin-point pain in the side of the hip, often making it difficult to tolerate direct pressure like lying on your side at night.
There is some overlap with the sensitivity in bursitis, gluteal tendinitis, and general tightness of hip muscles attaching to the side of the hip. All three issues benefit from soft tissue therapy to reduce the pulling force from tendons on the side of the hip from muscles that are too tight, overworked, or compensating for other weak areas.
This is a common issue that effects around 15% of women and 8% of men. Chiropractors are able to assess this issue and help treat it by working on soft tissues in the surrounding area.
Gluteal tendinitis involves inflammation of the gluteal tendons (the tendons that attach to the side or bottom of the hip). This is often sharp and pinpoint pain on the side of the hip that comes on during repetitive use of the muscles in the area.
Gluteal tendinosis is a chronic form of gluteal tendinitis, where inflammation is no longer present but a degenerative remodeling of the tendon structure has started to occur. This presents as a more long-standing fluctuating pain that goes through periodic flare ups. It may feel better with rest over time, but tends to get re-aggravated when introducing activity. Often tendinosis feels better during activity, but worse after.
Both gluteal tendinitis and tendinosis can get relief from soft tissue therapies that Chiropractors perform, and tendinosis in particular requires a graded tendon loading program in order to let the tendon heal and remodel the unhealthy tendon architecture.

Hip osteoarthritis research has significantly increased in the last two decades. This condition was previously thought to be a “wear and tear” condition where anyone with mild arthritis is destined for a joint replacement.
Newer studies show that mild and moderate severity osteoarthritis does not necessarily lead to a replacement. You can significantly mitigate your chances and sometimes even prevent the need for a hip replacement with the right approach. Our joints have more capacity to remodel and remain healthy than we previously thought. For this reason researchers are shifting to more of a “use it or lose it” view of arthritis.
Treatment of hip arthritis depends on the severity, and mild-moderate arthritis is often responsive to a combination of hands on and exercise therapies.
Following an assessment, a Chiropractor can perform soft tissue and joint therapies for relief, and introduce a graded exercise program involving mobility and strengthening exercises to better support to hip joint(s). Weight management and proper nutrition is also very important in managing osteoarthritis.
Hip impingement occurs when the ligaments (the hip labrum) around the hip joint get “pinched” or restricted with movement. This condition is also known as FAI - femoroacetabular impingement, and effects 10-15% of adults.
Sometimes this condition is associated with a “snapping” tendon as the hip moves, but this can also be a problem on its own.
Hip impingement is treated by using exercise therapies to strengthen weak muscles around the hip and pelvic girdle, as well as improving posture and muscle control in the area. The idea is to reduce the mechanical strain on the site of impingement by altering local and surrounding joint mechanics, thereby reducing symptoms and improving hip function over time.
Hip Snapping syndrome occurs when the tendons around the hip joint make an audible “snap” or “pop” during hip movement. This can sometimes be painless and audible, but can progress to being painful. As a result, hip motion is limited and function can be reduced.
Chiropractors are able to assess which hip muscles/tendons are “snapping” over other hip structures, and use soft tissue techniques to reduce tension in the involved soft tissues. This reduces pain, reduces frequency of snapping, and improves hip function over time. Additional exercise therapies may be used to improve hip mechanics and reduce the chances of reoccurrence, especially when it is a chronic issue.