Everything You Need to Know About Hip Physical Therapy

About the Author: Dr. Scott Gray

Dr. Scott Gray is the Owner of Back in Motion Physical Therapy & Performance. Each and Every Week He Helps His Clients & Patients Live Their Life to the Fullest, Get Active, and Get Pain-Free.

Are your hips hurting or stiff? Are home treatments and doctor visits not working for you? It’s time to consider hip physical therapy.

Ditch the painkillers for a treatment that heals the hips permanently. Hip physical therapy is the safest and most successful way to fix most hip conditions, injuries, and cases of hip pain.

We’ll tell you everything you need to know about hip physical therapy, including:

  • Why other treatments fail
  • Why hip physical therapy works
  • Who a hip physical therapist is
  • What you can expect from hip physical therapy
  • How a hip physical therapist makes an accurate diagnosis
  • The most common hip injuries (& their symptoms) treated by hip physical therapists
  • What treatment techniques are used by hip physical therapists
  • A quick & easy way to get testoviron started with hip physical therapy

Why Other Treatments Fail

Hip physical therapy is unlike any other treatment available for hip pain and injuries. To understand why hip physical therapy works, you must understand why other types of treatments fail.

We’ll break these “failed treatments” into three categories:

Category 1: Medications, Injections, and Painkillers:

Your doctor may have prescribed you medications such as muscle relaxants, anti-inflammatories, painkillers, or offered an injection. These “treatments” may provide temporary pain relief, but they do not provide a permanent solution to your pain.

The reason why these treatments fail is that they do not fix the underlying issue that is causing your hip pain.

Instead, they merely mask the pain. This can actually make your hip problem worse, because if you do not feel pain, you may feel okay performing certain activities that cause further damage to your hips.

Category 2: Hip Braces, Special Oils and Creams, Supplements, and Devices

There are tons of products out there that are marketed to “treat hip pain.” However, the majority of these products and supplements are not backed by real scientific research.

Practice caution before purchasing any device or supplement that claims to treat hip problems.

The best way to tell if these products are legitimate is to ask a hip pain specialist, such as a hip physical therapist.

Otherwise, a company may fool potential customers into believing that the product is backed by research (for example, if the company publishes its own biased research study). Nobody wants to throw money down the drain on products that don’t work.

Category 3: Surgery

Hip replacement surgery

Hip replacement surgery is sometimes successful in treating severe cases of hip pain that impair your movement and interferes with your sleep and daily activities.

The surgery replaces parts of the femur (thighbone) and pelvis, which make up the hip joint.

Usually, patients with severe hip arthritis opt for hip replacement surgery if the hips don’t heal from other treatments.

The main issues with hip replacement surgery are that it:

  • It’s the most invasive form of treatment
  • Requires a lot of recovery time post-surgery
  • Usually does not permanently fix your hip problem

The last issue is important to remember if you are considering hip replacement surgery. Who wants to go through an invasive procedure that requires extensive recovery time if the pain won’t disappear for good?

Surgery alone is usually not enough to relieve your hip pain for the long haul. You will need to perform specific strengthening and mobility exercises to improve your hip strength and range of motion. These exercises will ensure that your new hip joint stays healthy and doesn’t get dislocated.

The best way to ensure that a successful surgery stays successful is to visit a hip physical therapist for post-surgery rehabilitation. Your hip physical therapist will identify your weak spots and design a strengthening and conditioning program to strengthen and remobilize your hip joint.

Why Hip Physical Therapy Works

What do all of the above “failed” treatments have in common? They do not fix the underlying problem with your hips.

Hip physical therapy is successful because it does.

Most hip injuries and pain are caused by underlying issues such as:

  • Weak muscles
  • Muscular imbalances (for example, strong quads but weak glutes, which are muscles that support your hips)
  • Tightness
  • Poor mobility (meaning your joints can’t move fully)
  • Overuse (meaning you perform too much repetitive movement before your body/hips can adjust)
  • Gait issues (problems with the way you move on foot)

A hip physical therapist will identify which underlying causes contributed to your hip problems and fix those causes with a combination of effective treatments.

Because when the underlying cause is fixed, you can expect permanent relief from hip pain and problems.

Who is a Hip Physical Therapist?

A hip physical therapist is a licensed Doctor of Physical Therapy who specializes in the diagnosis and treatment of hip pain, injuries, and conditions.

Hip physical therapists provide thorough treatment plans that are tailored to each patient’s specific hip condition and goals.

What You Can Expect from Hip Physical Therapy

When you find a physical therapist who specializes in hip physical therapy, you can expect to get the best treatment for your hip condition.

Your hip physical therapist will make an accurate diagnosis of your injury, routinely test your improvement rate, and create a healing plan that is safe and effective.

How Does a Hip Physical Therapist Make an Accurate Diagnosis?

There are many hip conditions that have similar symptoms but require totally different treatments.

So, how will your hip physical therapist distinguish which hip condition you have if it has similar symptoms as another condition?

Your hip physical therapist will know exactly which questions to ask and which tests to perform to give you an accurate diagnosis. These questions and tests will also reveal the underlying cause of your hip problem.

Here are some of the questions and tests that you can expect during your first physical therapy appointment:

Step 1: Initial Questions

You will answer some initial questions about your hip pain. It will help to bring notes about your symptoms, which treatments you’ve tried, and what makes your pain better or worse.

Some questions you may get asked include:

  • Where do you feel the pain (for example, is it one small spot or a large area?)
  • What are your symptoms and what is the intensity of the symptoms?
  • How long have you had the pain?
  • Which treatments did you try and did any of them help?
  • Do certain movements worsen the pain?
  • Do certain activities make the pain feel better?
  • What other things make your pain feel better or worse?

Step 2: Initial Testing

Your hip physical therapist will combine your answers to the questions with specific testing to make an accurate diagnosis. Your physical therapist will guide you through initial testing such as:

Functional Testing

Your physical therapist may ask you to perform a few of your daily activities while he or she monitors how well you function during these tasks.

Often, there are a few modifications you can make to your daily activities to alleviate hip pain. For example, if you do a lot of lifting, your physical therapist may suggest ways to improve your lifting technique.

Muscular Strength Testing

Weakness in the hips is one of the leading causes of hip pain and injuries.

Your physical therapist will test your muscular strength not only in the hips, but other areas such as the legs, to check for weakness and muscular imbalances that may be contributing to your hip problem.

One way to quickly test hip strength is to stand on one leg and then bend down. If your body moves inward as you bend, you likely have weak hips.

Another way your physical therapist may test your strength is to ask you to push or pull on his or her hands with your legs or feet.

You may lay on your back and push down on your physical therapist’s hands, for example, or lay on your side and lift your leg as your physical therapist presses down on it. This will give your physical therapist an idea of how strong you are in the hips and in the muscles around the hips.

Range of Motion Testing

Range of motion testing reveals how far you can move your muscles or joints. If you have poor flexibility (ability to stretch your muscles) or mobility (ability to move your joints), it can lead to hip pain and injuries.

Your physical therapist may pull your leg back using a stretchy exercise band and may guide you through other stretches to see how flexible you are in and around the hips.

Additionally, your physical therapist may ask you to go into different positions while he or she lightly presses a goniometer to your skin (which is a ruler-like device that measures the angles of your joints).

The Most Common Hip Conditions (& Their Symptoms) Treated by a Hip Physical Therapist

Your physical therapist will recommend a specific treatment plan based on the type of injury that you have.

Listed below are the most common types of injuries treated by hip physical therapists. If you identify with the symptoms, it’s time to head to the hip physical therapy clinic:

1) Abductor/Groin Strain

A hip abductor strain (also known as a groin strain) is the most common type of groin injury.

The strain occurs when the hip abductor muscles are stretched or torn. Hip abductor muscles are located in an X-formation from each side of your pelvis to the inner portion of each thigh. These muscles are responsible for rotating the legs and providing stability for your hip.

Hip abductor strains are usually caused by activities that suddenly stretch the hip abductor muscles, such as jumping, kicking, twisting, running, or quickly changing directions.

Football Players

A hip abductor strain requires immediate treatment to heal as soon as possible. This means you will need to grab the ice pack ASAP and elevate the hip while resting. Doctors may suggest surgery to repair torn fibers in severe hip abductor strains.

Hip physical therapy may include a combination of treatments to heal your hip abductor strain, including electrotherapy, manual therapy, ice/heat, strengthening exercises to rebuild muscle, and stretching exercises to alleviate tightness and pain.

Symptoms of an Abductor/Groin Strain:

  • Sudden pain in the hip after a movement that stretches the groin area (such as kicking, running, twisting, or jumping)
  • Snapping sounds or sensations in the groin/hip area
  • Achy pain in the groin/hip
  • Stiffness in the groin/hip
  • Swelling/bruising in the groin/hip

2) Hip Bursitis

Hip bursitis is a condition in which the bursa (small jelly-like sacs that act as cushions between bones and soft tissues) in the hip are inflamed.

Some of the most common causes of hip bursitis include:

  • Overuse injuries (such as repetitive running, climbing, jumping, cycling, or frequent lengthy periods of standing)
  • Accidents (such as falls or bumping your hip against something)
  • Spine Disease (such as scoliosis)
  • Bone Spurs (which are bony overgrowths that can develop on the tendons of your hips and cause inflammation)
  • Hip Surgery (the surgery, as well as prosthetic hip parts, can irritate the bursa)
  • Rheumatoid Arthritis (an autoimmune disease that can cause painful swelling in various areas of the body such as the hips)
  • Significant Differences in Leg Length (when your legs are different lengths, it can hinder your gait and aggravate the bursa)

There are two types of hip bursitis:

  1. Ischial Bursitis: The bursa between the ischial tuberosity (the bottom of the v-shaped bone that forms the pelvis) is inflamed.
  2. Trochanteric Bursitis: The bursa at the greater trochanter (the outside point of the hip) is inflamed.

Hip physical therapy for bursitis may include icing to reduce inflammation, stretches to release tension, strengthening exercises to repair the muscles that support the bursa, and manual therapy to decrease pain and increase circulation.

Symptoms of Hip Bursitis

  • Pain at the outside of the hip that worsens with certain movements such as walking, standing, or running (trochanteric bursitis)
  • Pain in the buttocks area that may radiate down the back of the leg (ischial bursitis)
  • Pain that worsens when pressing on the affected area
  • Achy/stiff feeling in the affected area
  • Swelling/redness in the affected area

3) Hip Dislocation

If you felt a sudden and severe pop of pain during an accident or fall, you may have hip dislocation. Hip dislocation occurs when the femur (head of the thigh bone) is pushed out of its socket (which is the pelvis).

It takes great force to dislocate the hip. Car accidents, the high impact falls, sports injuries, and falls from significant heights are the most common causes of hip dislocation.

Someone who sustains a hip dislocation usually sustains other injuries at the same time, such as fractures in the pelvis, legs, abdominal bones, knees, and/or skull.

A hip dislocation requires immediate medical treatment and follow-up treatment by a hip physical therapist to heal completely.

There are two types of hip dislocations:

Anterior Dislocation: The thigh bone is pushed forward out of its socket. The hip bends slightly while the leg rotates out and away from the body.

Posterior Dislocation: About 90% of hip dislocations are posterior dislocations. The thighbone is pushed backward out of its socket. This will leave the lower part of the leg in a fixed position, with the knee and foot rotated inward facing the other leg.

Hip dislocation is usually first treated with a reduction procedure, which is when an orthopedist pushes the hip back in place while the patient is under anesthesia.

Severe cases of hip dislocation are treated with surgery followed by hip physical therapy.

Hip physical therapy is used to rehabilitate the hip after a reduction procedure or hip replacement surgery.

The hip physical therapy program may include manual therapy to realign joints and the spine, gait training to improve the way you move and walk, stability training to help you stay stable while moving stretches to ease pain and stiffness, and strengthening exercises to repair the muscles that support the hip.

Symptoms of Hip Dislocation

  • Sudden, sharp pain in the hip that may include tingling and numbness
  • Immediate swelling
  • The hip is visibly out of place
  • Lack of sensation in the foot/ankle area
  • Inability to stand/bear weight on the hip
  • Instability and muscle weakness around the hip

4) Hip Impingement

Hip Impingement

This is a condition where the femoral head (ball of the hip) is misaligned with the acetabulum (cup of the hip). The misalignment results from a misshapen femoral head or a misshapen acetabulum and prevents the ball of the hip from gliding smoothly within the socket.

Most people who have this condition are born with a misshapen femoral head or acetabulum. Others, particularly young athletes who frequently squat and twist at the hip, develop hip impingement as their bodies mature.

Hip impingement usually worsens with repetitive movements of the hip required by certain sports such as soccer, golf, or tennis.

If left untreated, hip impingement can cause cartilage/labral damage.

A hip physical therapy program for hip impingement may include mobility exercises to reduce stiffness, manual therapy to ease pain and improve your range of motion, and exercises that increase your hip flexion.

Symptoms of Hip Impingement

  • Stiffness in the thigh, hip, or groin
  • Pain in your groin area, particularly after your hip has been flexed (such as by running, jumping, or sitting for a long period of time)
  • Pain in the hip, groin, or lower back that occurs with both rest and activity
  • The inability to stretch your leg out in front of you beyond 90 degrees when lying down. Bringing your leg in front of you and therefore decreasing the gap between your hips is called hip flexion.

5) Hip Labral Tear

Hip Labral Tear

A hip labral tear occurs when the labrum (a ring of cartilage that surrounds the hip joint and supports the ball of the hip) is torn or injured.

Labral tears are usually a result of:

Trauma: a labral tear may occur when the hip joint was dislocated or injured in an accident

Overuse: Repetitive movement of and impact to the hip joint can provoke a labral tear. Labral tears from overuse are common in athletes who increase the duration or intensity of training too soon.

Athletes who perform high-impact sports or sports that cause repetitive impact to the hip joint are most at risk of labral tears.

Sports that involve long-distance running, twisting, sudden changes in direction, and cutting motions are considered higher-risk sports for labral tears.

Structural Abnormalities: Some people are born with hip problems that can accelerate wear and tear of the joint, leading to a labral tear.

Athletes with structural abnormalities who participate in sports that stress the hip joint must practice extra caution by regularly strengthening, stretching, and mobilizing the hips.

Your hip physical therapist may treat your labral tear with a combination of strengthening, mobility exercises, stretching, stability, and functional training, as well as manual therapy.

Symptoms of a Hip Labral Tear

  • A deep ache in the front of the groin
  • Painful clicking sounds when you move the hip
  • Pain that worsens with prolonged sitting or walking
  • Sharp pain in the hip or groin
  • Weakness in the muscles around the hip
  • Stiffness in the hip

6) Osteoarthritis

Osteoarthritis (also called “degenerative joint disease” or “age-related arthritis”) is the most common type of arthritis in adults aged 60 and older.

The hips, groin, thighs, buttocks, and knees are usually the most painful areas for people who have osteoarthritis.

Osteoarthritis in the hips causes the cartilage in the hip joint to gradually wear away, leading to symptoms such as pain, swelling, and stiffness.

You are more likely to develop osteoarthritis that affects the hip joint if:

  • You are over the age of 60
  • You are overweight
  • Have sustained a previous injury to the hip joint
  • You do not exercise regularly

Just because osteoarthritis isn’t curable doesn’t mean it’s not treatable. Hip physical therapy is tremendously helpful in helping many people with osteoarthritis move and function again with reduced pain and stiffness.

Symptoms of Osteoarthritis

  • A dull to sharp ache in the joints
  • Stiffness that can impair movement
  • Pain or stiffness that worsens with prolonged inactivity such as resting or sitting
  • Pain, swelling, or tenderness in the joints (such as the hip joint)
  • A crunching sound with certain movements (which results from bones rubbing against each other due to worn-down cartilage)
  • Inability to move the hip joint (or other joints), which can hinder daily activities

7) Snapping Hip Syndrome

Snapping Hip Syndrome

Snapping hip syndrome (also called “dancer’s hip”) refers to the sensation or sound of snapping when performing activities that move the hips or require bending at the hips, such as:

  • Running
  • Walking
  • Getting out of a chair
  • Swinging the leg around

This condition is usually more annoying than painful; however, athletes may experience pain and weakness in the hip area that impacts their sports performance.

The most common underlying cause of snapping hip syndrome is tightness in the muscles and tendons that make up the hip joint. Therefore, hip physical therapy for snapping hip syndrome usually includes manual therapy and exercises that decrease tightness.

8) Stress Fracture in the Hip

A stress fracture is an injury in which a small crack forms in the femur (the upper portion of the thigh bone).

Athletes that participate in high-impact sports such as long-distance running are at the highest risk of developing a stress fracture in the hip. This is because the hips act as the main shock absorbers for repetitive high-impact forces.

Hip physical therapists typically treat stress fractures by:

  • Suggesting modifications to activities (for example, a runner may temporarily switch from the high-impact activity of running to a low-impact activity such as swimming to safely maintain fitness levels)
  • Designing an exercise program that strengthens the hips and reduces tightness
  • Helping the patient improve sports technique, gait issues, and posture to reduce the load on the hips

Symptoms of a Stress Fracture in the Hip:

  • Pain in the groin or front part of the hip that worsens with certain physical activities such as running
  • Pain that feels better with low impact activities or rest
  • Pain/tenderness when pressing on a specific area of the hip/groin
  • Swelling in the groin or hip area

Common Hip Physical Therapy Treatments

Your hip physical therapist will combine multiple treatments to maximize your healing. These common hip physical therapy treatments are proven to heal the hips and diminish your pain for good:

Treatment 1: Electrotherapy

Your hip physical therapist may add electrotherapy into your treatment program. Electrotherapy is a safe and non-invasive way to reduce pain without the side effects that are typical of medications, injections, and painkillers.

You will sit or lie down in a comfortable position while your physical therapist presses electrodes (which look like little stickers and conduct electricity) onto your skin near the painful area.

These little electrodes provide big benefits as they stimulate your nerves and muscles. Some of these benefits include:

  • Safely reducing pain (by stimulating specific sensory nerve fibers)
  • Increasing circulation so that healing nutrients can enter the injured area
  • Calming muscle spasms
  • Preventing or reversing muscular atrophy by stimulating the muscles
  • Improving motor coordination

Treatment 2: Functional Exercise

Functional exercise helps those suffering from hip injuries complete everyday tasks more easily.

These types of exercises are designed to improve your technique while you perform daily tasks (such as lifting, twisting, bending, and walking). These exercises also strengthen your hip and core muscles.

Treatment 3: Gait Training

Whether your hip injury impairs the way you move on foot, or the way you move on foot contributed to your hip injury, gait training will help you move on foot more smoothly.

Your physical therapist will guide you in activities such as walking, running, stepping over objects, lifting your legs, and standing up. He or she will suggest changes to the way you move during these activities in order to reduce pain and prevent further injury.

Your physical therapist may also recommend specific footwear or attire, such as orthotics (which are supportive inserts you place in your shoes), sneakers, and supportive braces.

If you have muscular imbalances which are impacting your gait, your physical therapist will have you perform strengthening exercises to correct the imbalances.

Treatment 4: Ice/Heat

When your injury is causing inflammation, your physical therapist will suggest icing and heat. You may use a heating pad before you begin your physical therapy exercises and end your session with an ice pack to reduce inflammation in the injured area.

Treatment 5: Manual Therapy

Physical therapists who are trained in the most advanced hip treatments may perform manual therapy, which is a treatment technique that can significantly speed up your recovery process.

Manual therapy is a technique in which a physical therapist will use his or her hands or a specialized tool to massage your injured area, realign the spine, loosen tight muscle tissues, and mobilize the joints.

These techniques are designed to safely alleviate pain, stiffness, and improve your range of motion so that you can move more easily.

Treatment 6: Mobility Exercises

These exercises are designed to ease stiffness by taking your joints, tendons, and muscles through their full ranges of motion.

Your physical therapist will monitor your mobility exercises to ensure you’re doing them correctly. You will likely need to perform them at home between visits for maximum effectiveness.

Over time, you should feel less stiffness and pain, as well as a greater ability to move fully and smoothly as a result of the mobility exercises.

Treatment 7: Patient Education

Are you wondering when you can return to sport again if you should ditch your old shoes for more supportive ones, how to sleep on your side comfortably, or if that special cream that claims to “fight inflammation” actually works? Your physical therapist can answer all of that and more.

Your physical therapist’s primary goal is to restore your ability to perform normal tasks and enjoy your favorite activities (such as sports) again, pain-free. That’s why your physical therapist will educate you on anything you need to know so that you may get back to your life pain-free and without risk of the injury returning.

Treatment 8: Stability Training

If you can’t manage to stand on one leg longer than twenty seconds or find yourself falling over when trying to perform a single-leg squat, you probably have a problem with stability.

No matter how strong and powerful you are, you will face a higher injury risk and a sub-par performance (if you are an athlete) if you do not have good stability.

Stability training involves performing exercises on an uneven surface to train your stabilizing muscles to work properly. Practicing these exercises regularly will facilitate communication between your muscles and brain, helping you balance and stay stable in your normal activities and exercises.

Treatment 9: Stretching and Strengthening Exercises

Strengthening and stretching exercises are the base of most hip physical therapy programs. These exercises will ease tension and pain, as well as build strength in the hips to prevent re-injury.

Your physical therapist will select stretching and strengthening exercises that are appropriate for your hip condition, lifestyle, and goals.

Here’s a Quick & Easy Way to Get Started

There are a few things you’ll want to look for in a hip physical therapy clinic in order to receive the best care, such as:

  1. A privately owned physical therapy clinic
  2. One on one care (many physical therapists treat more than one patient at a time)
  3. Treatment is given by a certified Doctor of Physical Therapy
  4. A physical therapy clinic that specializes in hip pain and injuries

Back in Motion Physical Therapy & Performance, located in Fort Myers, FL, rigorously fulfills all the aforementioned criteria and more. Our team of highly skilled physical therapists specializes in the precise diagnosis and effective treatment of hip pain and injuries. Furthermore, we are proud to have dedicated specialists in hip pain treatment among our staff.

We employ a state-of-the-art therapeutic approach known as The Gray MethodTM. This innovative method adopts a comprehensive whole-body strategy to effectively alleviate your hip condition by addressing its fundamental causes. It’s important to note that this cutting-edge treatment is exclusively available at our facility.

If you are currently enduring persistent pain, wish to explore alternatives to surgical interventions, or have previously undergone surgery, we strongly encourage you to contact us without delay at 239-610-5083 or click here hip pain treatment near me.

“Physical Therapy, Fitness, & Performance Tips From Dr. Scott & the Back in Motion Team”