Hip Pain? Here’s What is Causing It…

Hip Pain

Hip Pain

This week, I’m focusing on a common problem that we treat here at Preferred Physical Therapy: Hip Pain!

When a patient describes their hip pain as either: pain radiating down the front of the leg, pain in front of the hip joint, or pain along the underwear line, this is considered a primary hip problem.

Hip Pain

In the case where the pain tends to radiate down the front of the leg, it’s common to do a thorough exam in order to rule out the possibility of the pain being generated from the back.

Pain felt at the front of the hip joint tends to be very painful with walking, flexing the hip, or getting up from a seated position. It’s important to have it evaluated by your local Physical Therapist sooner rather than later, so you can get back to doing the things that you enjoy every day.

But why do hips hurt on the front of the hip joint or as some patients often describe it, along the underwear line? Today I’m talking to you about the common musculoskeletal causes of pain at the front of the hip.

Common Causes of Pain in the Front of the Hip or “Anterior Hip Impingement”

1. The Hyperactive Psoas

Now you may be thinking “what the heck does that mean?”. Well, the psoas muscles (pronounced as so-as-) are the deepest muscles in your core. They attach your 12th thoracic vertebrae to your 5 lumbar vertebrae and femurs. Without this muscle group, you wouldn’t even be able to get out of bed in the morning! They help to lift the leg (essential when climbing stairs) and also allow you to bend forward to bring your chest to the knees. When the muscles aren’t working, they should be able to relax. So when it’s in a hyperactive state, they pull the top of the femur forward, making it difficult for the femur to relax and not compress the socket.

This is exactly the cause of the front hip pain! When you begin to walk or do any other movements, the femur begins to migrate forward, impinging on the tissues, creating hip pain. This is where Physical Therapists derived the name “Anterior Hip Impingement”. So, more often than not, when a patient is describing their pain as coming from the front of the hip joint, it is due to hyperactive psoas muscles. This can be treated with physical therapy.​​​​​​​

2. Weak Glutes

The gluteal muscles are located on our backsides. The three main gluteal muscles include the gluteus maximus, gluteus medius and the gluteus minimus. Together, they move the thigh behind the body, more the leg to the side, and turn the leg inward. Patients that are experiencing pain at the front of the hip tend to have very strong front of thigh muscles, but very weak glutes. This weakness can eventually lead to altered walking and movement and poor flexibility into hip extension. This is very treatable with a therapy program prescribed by a physical therapist.

3. Poor Posture

Posture plays an important role in preventing spine pain and headaches. Believe it or not, bad posture can lead to front hip pain as well. Many of us, unfortunately, have a tendency to slump forward when we stand, walk or sit. This tends to put unnecessary strain on the muscles and other tissues that support our hips.

Is your hip pain giving you trouble? Check out this technique video where Colton will demonstrate techniques to release tightness in your hip flexors. These stretches will improve your squat, help ease your transition from sitting to standing and hopefully alleviate some of that pain you are experiencing. Take a look below.

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Nick Hunter, PT, DPT

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