Hip Pain

Hip pain is rarely straightforward — and rarely just the hip.

The hip is one of the most load-bearing joints in the body, and one of the most commonly mismanaged. Pain in or around the hip can come from the joint itself, the surrounding musculature, the bursa, the labrum, the lumbar spine, the sacroiliac joint or the pelvis — and distinguishing between these requires a careful assessment, not just an MRI finding.

Hip pain is also highly age-variable in how it presents. In younger active people it often involves labral tears, impingement (FAI) or tendinopathy. In older adults, osteoarthritic change, bursitis and referred lumbar pain are more common. The treatment approach differs significantly across these presentations.

The pelvis and lumbar spine connection

The hip, pelvis and lumbar spine form a functional unit. Restriction in one area creates compensatory load in the others. Restricted hip extension is one of the most reliable drivers of lumbar overload — the spine compensates for what the hip can't do. Similarly, sacroiliac joint dysfunction frequently presents as hip or groin pain, and is regularly missed when assessment focuses only on the hip itself.

How Dr Chase approaches it

Assessment covers the hip joint, the surrounding musculature (including the deep rotators, glutes and hip flexors), the pelvis, the sacroiliac joints and the lumbar spine. Where groin pain or anterior hip symptoms are present, visceral assessment may also be relevant — the psoas has direct connections to both hip mechanics and the abdominal organs.

Treatment draws from hip and lumbar joint mobilisation, myofascial release, and targeted rehabilitation guidance to restore hip mobility, strength and load tolerance. For labral and FAI presentations, conservative management can produce significant improvement and is always worth a thorough trial before surgical options are considered.

Hip pain that's been present for a while has usually developed a layer of compensation and habit around it. A thorough assessment is the starting point for understanding what's actually driving it.