“Hip Pain in Adults: Common Causes, Evidence-Based Treatment, and When to See a Physiotherapist”

Hip pain is a frequent complaint among active adults and older populations alike. Whether you’re an athlete who feels a sharp pain during training, a weekend walker who struggles on inclines, or someone over 50 noticing increased discomfort around the hip, it’s important to understand what’s going on — and how physiotherapy can help.

At Body Fit Physiotherapy in North Adelaide, we treat hip pain every day, using evidence-based strategies to get people moving stronger and more confidently.

This article explores:

• The most common causes of hip pain

• How clinicians diagnose hip problems

• What current evidence says about effective treatments

• Safe exercises and when to seek help

Why Hip Pain Needs Attention

Hip pain can be caused by a variety of structures — from joint cartilage and tendons to muscles and bursae. Ignoring ongoing hip pain can lead to:

✔ Reduced mobility

✔ Compensatory movement patterns

✔ Secondary injuries

✔ Reduced quality of life

Research consistently shows that early assessment and targeted intervention improve outcomes and reduce long-term disability.

Common Causes of Hip Pain

1. Greater Trochanteric Pain Syndrome (GTPS)

Overview:

GTPS is one of the most frequently diagnosed causes of lateral (outer) hip pain in adults, especially women aged 40–60. It’s often linked to gluteal tendinopathy (tendon degeneration) and irritation of the trochanteric bursa.

Symptoms:

• Pain on the outside of the hip

• Discomfort when lying on the affected side

• Pain during prolonged standing or walking

Evidence & Management:

Studies support a combination of progressive loading exercises and education, rather than corticosteroid injections alone. Exercise programs improve pain and function more effectively long-term.

2. Hip Osteoarthritis (OA)

Overview:

Hip OA is a degenerative joint condition that becomes more common with age. It’s characterised by cartilage thinning and inflammation in the hip joint.

Symptoms:

• Deep ache in hip or groin

• Stiffness after periods of inactivity

• Pain with weight-bearing activities

Evidence & Treatment:

Evidence strongly supports multi-modal physiotherapy including strength training, hip mobility exercises, aerobic conditioning, and education. Such programs are shown to reduce pain and improve walking capacity even among people with radiographic OA.

3. Gluteal Tendinopathy

Closely related to GTPS, gluteal tendinopathy involves degenerative changes in the gluteus medius/minimus tendons.

Research shows that load-based programs, rather than passive therapies alone, are most beneficial.

4. Hip Labral Tear

The hip labrum is a ring of cartilage around the socket that provides stability. Tears can arise from repetitive movements (e.g., in dancers, runners) or trauma.

Symptoms:

• Groin pain

• Clicking or catching sensation

• Pain with hip flexion

MRI or diagnostic ultrasound may be used in diagnosis, but not all imaging findings correlate with symptoms. Physiotherapy focusing on muscle control, hip stability, and movement retraining often helps, even in mild labral pathology.

How Physiotherapists Diagnose Hip Pain

A physiotherapy assessment is key to identifying which structure is contributing most to your pain. Typical examination includes:

✔ Movement screening (walking, squatting, stairs)

✔ Strength testing (hips, glutes, core)

✔ Joint mobility assessment

✔ Functional capacity analysis

✔ Load history and activity patterns

Imaging tests (MRI, ultrasound, X-ray) are sometimes used but are often not needed unless symptoms are severe or not improving with rehabilitation.

Evidence-Based Treatment Strategies

1. Progressive Strength Training

Loading the muscles and tendons around the hip improves strength, reduces pain, and enhances function. Progressive exercise is one of the strongest evidence-backed treatments for tendinopathy and OA.

2. Movement and Load Management

Pain often increases when tissue is loaded more than it can tolerate. Physiotherapists help you modify activity patterns to allow adaptation rather than aggravation.

3. Manual Therapy (Joint and Soft Tissue Techniques)

While not always curative on its own, manual therapy can improve hip mobility and reduce pain when combined with exercise.

4. Education and Self-Management

Teaching you how to manage symptoms, pacing your activity, and identifying aggravating factors significantly improves long-term outcomes.

Simple Exercises That Help Hip Pain

These exercises are general recommendations; a physiotherapist will tailor them to your individual needs:

Hip Strengthening

1. Hip Bridges

– Lie on your back, knees bent

– Lift hips toward the ceiling

– 10–15 reps × 2–3 sets

2. Side-Lying Hip Abduction

– Lie on side, lift top leg upward

– 10–15 reps × 2–3 sets

(Progress to resistance band versions)

Mobility & Motor Control

3. Hip Internal & External Rotation (Supine)

– Gently rotate hip inward/outward

– 10 reps each direction × 2

4. Clamshells

– Side-lying, knees bent

– Lift top knee while keeping feet together

– 10–15 reps × 2–3 sets

Functional Strength

5. Step-Ups

– Step onto a stable platform

– 10 reps each leg × 2 routines

Improves power and daily function

When to See a Physiotherapist

Make an appointment if you experience:

✔ Persistent pain lasting more than 2 weeks

✔ Difficulty walking, climbing stairs, or squatting

✔ Pain at night or stiffness in the morning

✔ Pain that limits daily activities

✔ Pain unaffected by brief rest or self-management

How Body Fit Physiotherapy Can Help You

At Body Fit Physiotherapy, North Adelaide, we combine:

• Thorough assessment

• Individualised exercise prescription

• Hands-on techniques

• Education and movement strategy

• Long-term progression plans

Our goal is not just to relieve pain — but to restore function, optimise movement, and reduce the risk of recurrence.

Key Takeaways

✔ Hip pain is common in active adults and older populations.

✔ Multiple structures can cause pain, including tendons, joints, and cartilage.

✔ Physiotherapy is one of the most effective treatment options for many causes of hip pain.

✔ Addressing strength, mobility, and load is key.

✔ Early intervention leads to better outcomes.

References

1. Grimaldi A, et al. Gluteal tendinopathy: integrating pathomechanics and clinical features in its management. J Orthop Sports Phys Ther.

2. Mellor R, et al. Exercise for greater trochanteric pain syndrome. BMJ.

3. Fransen M, et al. Exercise for osteoarthritis of the hip. Cochrane Review.

4. Fearon A, et al. Greater trochanteric pain syndrome. Curr Rev Musculoskelet Med.

5. Binder A, et al. Progressive resistance training in hip OA. Clin Rehabil.

6. Saito T, et al. Hip muscle strength and OA outcomes. Osteoarthritis Cartilage.

7. Kujala UM, et al. Hip OA and exercise. J Rheumatol.

8. Tarnowski AM, et al. Muscle activity patterns in hip tendinopathy. Phys Ther Sport.

9. Krych AJ, et al. Hip labral tear management. Arthroscopy.

10. Worsfold M, et al. Manual therapy for hip pain. J Manipulative Physiol Ther.