Struggling with hip pain can be frustrating and detrimental to your ability to live your best life. At the Unpain Clinic, we regularly work with patients living with hip pain to help them feel and move better. If you live in Edmonton (or the surrounding area) and you are dealing with a painful hip, read on to learn more about hip pain and consider booking a no obligation consultation with us to see if we can help you too.

The hip (nope, not the band)

The hip is a very deep and typically very stable ball and socket joint made between the femur and the bones of the pelvis. The socket of the hip and the head of the femur are covered in a thick cartilage and are surrounded by a joint capsule, several ligaments and a number of muscles. The main muscles responsible for moving the hip are:

• the gluteal muscles
• the piriformis
• the quadriceps
• the hamstrings
• the adductor (inner thigh) muscles 

---

*Sometimes people refer to their hips as everything below their lower back and above their thighs, but in this instance we are going to differentiate the hip joint itself from the pelvis with the intent of providing a clearer picture to our readers.

Hip joint pain

As you can see above, many parts make up the hip joint, meaning that there are many possible causes of hip pain. There are two major categories of hip pain:

• Traumatic injury – a sudden event that can cause instant pain and dysfunction such as a torn muscle, strain or sprain, fracture, impact injury or blunt force trauma. Generally these types of injuries require medical attention within minutes or days of onset.
• Non-traumatic processes– pain which seems to creep in over time and which may seem to the patient not to have an obvious cause or source. This type of pain may be related to:
  •  muscular dysfunction (hip muscle pain)
  • changes to the health of joint elements such as ligaments, cartilage or bone
  • degenerative processes related to metabolic changes or aging

The types of conditions which can affect the hip vary with the patient’s age, activity level, general fitness and morphologic structure (body shape and size).

Non-traumatic pain usually requires more help from healthcare providers to determine the underlying cause and specialized imaging or other tests may be needed to make a diagnosis. Sometimes if a patient has irreparable damage to their hip, they may need referral for hip replacement surgery.

Hip pain causes

There are hundreds of possible causes of non-traumatic hip pain but some of the more common clinical diagnoses include:

• Osteoarthritis –includes wear and tear to cartilage or bony structures

• Rheumatoid arthritis
• Greater trochanteric pain syndrome[h1] 
• Trochanteric bursitis
• Tendonitis
• Snapping hip syndrome
• Sciatica/nerve impingement
• Labral tears
• Stress fractures (usually fractures result from trauma, but stress fractures are an exception as they can develop in the absence of trauma.

---

When do I absolutely need to get help for my hip pain?

• If you have experienced a sudden traumatic injury, especially if it you heard a loud pop or snap at the time of injury
• If you cannot weight-bear on that leg
• If your hip is red, very warm, very swollen or if you have an obvious deformity
• If you have dramatic changes in your range of motion  – e.g. you can’t move your hip or leg
• If you have hip pain with signs of an infection (fever, chills, redness)

Hip pain treatment

Treatment for hip pain greatly depends on the cause of the discomfort and the individual factors related to the onset of hip pain. The most successful plans of management for hip pain generally include:

• education about the cause of the pain
• home based pain relief strategies (heat, ice, foam rolling, rest, using topical creams or pain relief medications)
• avoiding aggravating activities (at least for a period of time)
• rehab exercises and stretches
• clinical therapy –  may involve hands on treatments (massage, adjustment, mobilizations, acupuncture or needling) or the use of modalities like shockwave therapy, laser therapy, ultrasound, TENS or others.

---

The Unpain Clinic’s healthcare professionals assess every patient and offer advice on the right treatment plan to address the cause of your hip pain, reduce your recovery time, improve your quality of life and get you back to the activities you love.

Lower back and hip pain

The lower back and hip share a number of muscle groups which makes them codependent areas; pain or dysfunction in one area can cause pain or dysfunction in the other. Sometimes it can be difficult to know which area is the main generator of the pain –the low back or the hip. In cases of combined lower back and hip pain, it is usually helpful to see a healthcare professional such as a physiotherapist, chiropractor or medical doctor. They will help determine the cause of your pain and get you started on a treatment plan to manage it.

Hip pain when walking

The hip is a weight-bearing joint, so people who are suffering from a hip condition could, unfortunately, have pain when walking. Pain during walking can occur with any condition that affects the hip but it is most common in arthritis sufferers. If you are having pain when walking, make sure you see your medical doctor, chiropractor or physiotherapist for an assessment so you can get back to pain free walking faster.

Hip pain from sitting

If you have a hip condition, such as arthritis or bursitis (among others) you may suffer from hip pain when you sit. Even if you don’t have a condition you are aware of, you could still experience hip pain when sitting. Some of the most common reasons for hip pain when sitting include:

• Sitting with your legs crossed or in an awkward position – this can put greater stress on one or both of your hips
• Sitting with poor posture – slumping, slouching or sitting in a chair without proper back support can all put extra pressure on your hips
• Sitting on an uneven surface –typically surfaces that are very soft (some couches, beds, sitting on a sandy beach) can cause you to tilt when sitting putting too much pressure on your hips

Hip pain during pregnancy

Hip pain during pregnancy affects as many as 32% of pregnant people and can start as early as the first trimester but is more common further along in the pregnancy. The main causes of hip pain during pregnancy are:

• weight gain – usually 25-35 lbs which can put additional stress on the hips
• pregnancy related postural changes – as the body’s center of gravity changes this can cause changes in postural alignment which can strain the hips
• release of a hormone called relaxin –alters tendons and cartilage to make them looser. This is beneficial to help deliver the baby but also makes pregnant people more prone to injury.

During pregnancy women may also be prone to pelvic girdle pain which affects the pelvic joints (pubic joint, sacroiliac joints) and may cause pain in the hip region, but does not affect the hip joints themselves.

Stretches for hip pain and hip pain exercises

Knee to chest stretch

• Lay on your back on a comfortable surface
• Pull one knee close to your chest until you feel a comfortable stretch in your back and posterior hip
• Hold for 30-60 seconds and then repeat on the opposite side

External rotator stretch

• Lay on your back on a comfortable surface
• Pull one leg toward you in a figure 4 position until you feel a comfortable stretch across your buttocks and hip.
• Hold for 30-60 seconds and repeat on the opposite side

Butterfly stretch

• Sit with the soles of your feet together and your knees apart
• Slowly bring your feet closer to your body and gently press your knees to the floor until you feel a good stretch along your inner thighs.
• Hold for 30-60 seconds. You can repeat 1-2 times.

Quad stretch

• Stand with good posture
• Use your hand (or a towel/band/belt looped around your ankle) to pull your ankle behind you and as close to your buttocks as you can. You should feel a comfortable stretch along the front of your thigh.
• Hold for 30-60 seconds and repeat on the opposite side.

*You should use the other hand to hold onto something if you struggle with balance.

Hamstring stretch

• Lay on your back on a comfortable surface
• Keeping your knee straight, lift your leg at the hip as high as it can go
• Pull your leg towards your head with your hands (or a towel or belt looped around your foot and ankle) until you feel a good stretch in your posterior thigh
• Hold 30-60 seconds and repeat on the opposite leg

Clamshells

• Lay on one side with your knees bent to 90 degrees and your hip and ankles stacked
• Keeping your ankles touching, use your gluteal muscles to raise your top knee as high as comfortable
• Hold a few seconds then lower the top leg. Repeat 10-20 times on each leg

*You can do this exercise with a theraband around your knees for more resistance

Donkey kick

• Start on your hands and knees in table-top position
• Bring one leg back and up into a controlled kicking motion (like a donkey would do)
• Bring the leg back to the floor and repeat on the other side.
• Perform 10-20 repetitions per leg

Squat

• Stand with good posture and your feet in a comfortable position (about shoulder width)
• Squat by bending your hips
• Go as low as you can but stop at the point where you can no longer keep your back flat
• Rise by straightening your hips and then repeat for 10-20 reps.

Band walk

• Attach tubing or theraband around to ankles or calves and stand with your feet about shoulder width apart
• Take a slight bend in your knees and hips
• Step one leg out to the side as far as you can against the resistance of the band
• Bring the other leg toward the first leg so your feet are back to shoulder width
• Repeat the step back in the other direction. Continue this way for 10-20 repetitions.

Frequently Asked Questions:

Hip and leg pain –  What causes hip pain that radiates down the leg?

Short answer: a few things can cause pain that travels down the leg.

Generally people like to call pain that radiates down the leg “sciatica” but this isn’t a diagnosis in itself. Sciatica generally follows the course of the sciatic nerve and is the result of a nerve impingement in the low back, hip or buttock region. This type of pain usually gets worse with movement, feels burning or electric and may come with weakness, numbness or tingling in the affected leg.

Sometimes pain can also radiate down the leg from sore muscles, ligaments or tendons. This pain usually feels more diffuse and harder to localize and generally doesn’t produce any tingling or numbness in the affected leg.

Paying close attention to where your pain travels can provide beneficial information to help your healthcare provider diagnose the cause of your symptoms.

What can I do to prevent hip pain?

Some people will develop hip pain no matter what because of their lifestyle or genetics, however, some general strategies to improve hip health include:

• Remaining active and getting adequate amounts of physical activity each week (experts recommend at least 150 minutes of moderate intensity cardiovascular exercise per week). The best activities for the hips include low impact exercises like cycling, swimming or walking.
• Engaging in regular stretches and strengthening exercises for the hips
• Maintaining a healthy body weight
• Eat a balance diet
• Avoid injury around the house – minimize the potential for trips and falls as much as possible

Chiropractor for hip pain?

Yes, absolutely! A chiropractor can be a good place to start if you have hip pain. They can provide an assessment and diagnosis for your pain and help to create a plan of management that meets your needs. They can also refer you to other healthcare professionals for further management if your condition is more serious or requires a different type of management than they provide.

Physiotherapy for hip pain?

Also a YES! Physiotherapists, like chiropractors are skilled at assessing and treating hip pain.

If you are considering chiropractic or physiotherapy in Edmonton for your hip pain, consider the Unpain Clinic. Our practitioners are knowledgeable, highly skilled and are also trained shockwave therapists. Each one brings their training and years of experience into every appointment to help our patients feel better and move better.

Shockwave for hip pain?

Potentially yes. There is good evidence that shockwave therapy can be helpful for some types of hip pain including greater trochanteric pain syndrome, hip muscle tendonitis and bursitis. The Unpain Clinic’s shockwave therapists will be able to help determine if shockwave could be the right treatment for you.