Hip pain causes, treatment and stretching exercises for relief

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There are many possible causes for hip pain, but trochanteric bursitis is often not one of them. That’s why a cortisone injection only offers temporary relief, if any.

In fact, in my ten-year career as a physical therapist, I’ve never seen trochanteric bursitis in our practice.

Hip pain at night, when lying on your side or when sitting is almost always a muscular problem. There is also a strong relation with back pain, limited back, and hip mobility.

In this post, I’ll explain exactly what is causing your hip pain and how to treat it with several stretching and strengthening exercises for full relief.

In fact, this is what you will learn today:

  1. The anatomy of the hip
  2. Hip pain causes and symptoms
  3. Hip pain treatment with four exercises
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The anatomy of the hip

Your leg and your pelvis together form your hip joint. Your hip joint is located in your groin area and not at the outer side of your leg, as many people think.

Because your hip is a ball and socket joint, it can move in almost every direction. That the reason why there are so many muscles surrounding your hip. The movement of your hip can be limited by stiff muscles as well as a stiff lower back. Therefore the treatment includes back exercises as well.

The bones forming the joint are covered with cartilage to improve mobility and reduce friction. When the cartilage wears down after many years, your hip can become stiffer, and this might result in pain. However, this doesn’t have to be.

hip anatomy
gluteal anatomy

At the back of your hip area, you have your gluteal muscles forming you’re, but. These are four different muscles:

  • Piriformis muscle
  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus

These are often the ones that cause hip pain.

At the front, you have the rectus femoris muscles. It’s the most significant muscle of your quadriceps, and it runs over the hip area. You can also find the iliopsoas muscle here, which is an essential hip flexor.

On the outer side of your leg, you can find the trochanteric bursa. It’s the best-known bursa in the hip area, blamed for a lot of pain problems. Irritation of this bursa is often a result of another problem than the actual reason for pain.

Hip pain causes and symptoms

In this section, I’ll show you the four most common causes of hip pain. When you know why you have hip pain, you can find a way to treat it yourself and reduce your hip pain.

Lack of hip muscle strength

The most common hip pain cause is a lack of hip muscle strength. The hip muscle that causes the most significant problems is the gluteal muscles. They attach to the greater trochanter on the outer side of your hip area.

Lack of hip muscle strength causes outer hip pain as well as hip pain when you lay at your side. That’s why you feel your hip pain primarily at night. But it can also cause hip pain when sitting because then you put pressure on the painful muscles.

It’s often confused with trochanteric bursitis by doctors and specialists. So when your doctor thinks you have trochanteric bursitis, it’s likely a lack of hip muscle strength instead that causes your pain.

 

Hip osteoarthritis

A second hip pain cause is osteoarthritis. Osteoarthritis occurs when the amount of cartilage covering your hip joint decreases. It’s often an age-related problem, but can also be caused by overweight, poor general health or prolonged heavy labor.

Symptoms are a pain in your groin area, especially when getting out of bed or after sitting for an extended period. Also pain during lifting your leg and during squatting can indicate hip osteoarthritis. The best way to determine the level of osteoarthritis is an x-ray.

However, the amount of degeneration on the x-ray doesn’t correlate with the amount of pain. That’s because you can do a lot to compensate for the degeneration. You can even postpone hip replacement surgery for several years. To do that, you have to make sure to maintain the strength and mobility of your hip area.

 

Front hip pain due to Iliopsoas tightness

The third hip pain cause is the tightness of the iliopsoas muscle. The muscle runs over your hip at the front of your leg. Its function is to lift your leg. Therefore it’s most active during walking. That’s why it can cause front hip pain when walking or running.

To treat this, you’ll have to stretch and train the muscle to improve its function.

 

Back pain

The final hip pain cause is back pain. Back problems often cause a radiating pain towards your hip area.

Also, a stiff back reduces the mobility and function of your hip, which can cause pain. Hip pain from your back can cause pain at night, lying on your side or outer hip pain. But also, pain in your buttock is a common symptom.

To treat this type of hip pain, you should focus on improving the function and strength of your back. That will heal your hip pain as well.

Hip pain treatment with four exercises

There are several things you can do to treat your hip pain successfully.

You’ll have to improve the mobility and strength of both your hip and back. When they are stronger and more flexible, you’ll notice that the pain decreases. It works for every joint in your body.

Furthermore, you can apply heat to the painful area to reduce the pain or use this anti-inflammatory cream. It helps to relief pain as well.

When you have hip pain when sitting, a seat cushion can reduce the pressure on the painful area and help with pain reduction.

So now, let’s start with the exercises that will help to reduce your hip pain. When you do all the exercises listed below, you know you have the best chance to relieve your hip pain.

piriformis cushion

Hip pain exercise 1: Stretching your hip muscles

As I mentioned before, tight hip muscles are the number one reason for hip pain. So when you stretch your hip muscles and relieve the tension, the pain will disappear.

This first exercise helps especially for hip pain on the outer side or hip pain when lying down on your side when sleeping. It’s also a good exercise against piriformis syndrome.

Perform the exercise like this:

  • Grap your right knee with your right hand
  • Grap your right ankle with your left hand
  • Pull your knee and ankle both towards your left shoulder
  • Hold this position for 20 seconds
  • Repeat it three times

You can find the exercise also in the video below:

The exercise is shown for hip pain on your right side. For your left side, do it the other way around. Perform the exercise 3 times a day. You should feel stretch in your buttock area.

Hip pain exercise 2: Stretching your iliopsoas muscle

The second stretching exercise you can do for your hip is to reduce hip pain at the front side. Front hip pain is often felt during walking or running.

The exercise stretches your iliopsoas muscle, which is the most prominent hip flexor.

You can perform the exercise like this:

  • Place your healthy leg in front of you with the knee bend
  • Place your painful leg/hip behind you with the knee slightly bent as well
  • Move your hips forward until you feel stretch at the painful spot at the front of your hip
  • Hold this position for 20 seconds and repeat it three times

You can see how to perform the exercise in the picture below.

illiopsoas stretch

Perform the exercise when you experience front hip pain as often as possible.

When the pain is primarily at the side or the back of your hip, you only have to do the first exercise and can skip this exercise.

Hip pain exercise 3: Improve the mobility of your hip

The purpose of the third exercise is to increase the mobility of your hip. These hip exercises are especially helpful when you experience hip pain at the outer side or when laying down on your side. Also, for osteoarthritis, improved hip mobility reduces pain.

Optimal hip mobility is essential for proper hip function. There are two exercises to help you improve the mobility of your hip.

The first exercise goes like this:

  • Grab with your right hand your right knee.
  • Grab with your left hand your right ankle
  • Keep your lower leg in a horizontal position
  • Push away your knee and pull your ankle towards you at the same time
  • Hold this position for 20 seconds
  • Repeat three times

The second exercise goes like this:

  • Grab the knee of the painful side with both hands
  • Pull your knee towards your chest
  • Keep your other leg flat on the ground
  • Hold this position for 20 seconds
  • Repeat three times

You can see how to perform the exercise in both videos below:

With the first exercise, you feel the pain or stretch mainly at the side or front of your hip. The second exercise puts more pressure on your SI-joint, which you’ll feel at the back of your hip around your lower back.

Hip pain exercise 4: Improve the strength of your hip muscles

The fourth exercise is the final exercise for your hip. Its purpose is to improve the strength of your hip muscles. These exercises work for every kind of hip pain and should both be down when experiencing hip pain.

Proper strength is essential for excellent hip functionality. There are also two exercises to increase hip strength.

The first exercise focuses on the gluteal muscles as well as the outer hip muscles.

Perform the exercise like this:

  • Lay down on your pain-free side
  • Extend your leg and pull your toes towards you
  • Lift your leg sideways and keep your leg extended
  • Repeat this ten times and do it three times

The second exercise increases the strength of your iliopsoas and quadriceps muscles.

Perform the exercise like this:

  • Lay down on your back with both legs extended
  • Lift your leg to about 45 degrees
  • Repeat this ten times
  • Do this three times

You can do both exercises on both sides.

You can see how to perform the exercises in the videos below.

When the exercises become more comfortable, you can increase the number of repetitions to 15-20. You can also add ankle weights to increase the resistance even further.

Hip pain exercise 5: Improve the mobility of your lower back

Together with treating your hip, we also have to improve the function of your lower back to reduce hip pain.

By improving the mobility of your lower back, your hip mobility also enhances. That’s because these structures affect each other.

There are two exercises as well to improve the mobility of your lower back.

The first one improves the rotation of your lower back and the second exercise the stretching of your back.

Perform the first exercise like this:

  • Lay down on the ground with your knees bent
  • Rotate your knees to one side and hold this position for 10 seconds
  • Now rotate your knees to the other side and hold for 10 seconds
  • Repeat this five times for both sides
  • Perform the exercise several times a day

You can see how to perform the exercise in the video below:

For the second exercise, you’ll have to buy this back stretcher. You have to lay down on the back stretcher for 10-20 minutes and 1-2 times a day. You can use the back stretcher also to increase the mobility of your upper back against neck pain and tension headache.

back stretcher

Together with improving the mobility of your lower back, we’ll have to improve the strength of your lower back as well. That’s where the final exercise is for.

Hip pain exercise 6: Improve the strength of your lower back

The last exercise improves the strength of your lower back and also your gluteal muscles. It’s a vital exercise against back pain but also very helpful against a herniated disc.

You can perform the exercise like this:

  • Lay down on your back with your knees bent
  • Cross your arms over your chest
  • Lift your hip
  • Repeat this ten times
  • Do this three times

You can see how to perform the exercise in the video below:

As you can see, you can increase the difficulty of the exercise matching your level of fitness. In the end, you can also extend the leg and hold that position for 10-15 seconds as the final stage of the exercise.

At first, the exercise might feel very difficult, but it will get easier over time.

Conclusion

You’ve read the ultimate hip pan treatment plan that will help you for sure. If you have any questions left after reading the article, feel free to send me an e-mail to [email protected], and I will try to help you.