Ask a PT: What’s the Root of My Hip Pain?

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Question 1:

When I drive my left hip joint hurts after about an hour. I move around and can’t seem to find release. It doesn’t seem to matter what, if any, training I’ve done that morning.

Help a hip out.

–Chad

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Answer: Dr. Marc Robinson

Hi Chad,

Thank you for your question. To get an accurate physical therapy diagnosis, we’d need to do a detailed assessment of your signs and symptoms, the activities or positions that aggravate and alleviate the pain, and how your range of motion and symptoms respond to tests. I’ll discuss a few possible diagnoses, my intent is to help you sort through the information and help you make better decisions, but I am not providing a diagnosis because I do not have enough information to make one.

The first thing that comes to mind when reading your comment is to rule out the lower back as a referral source. It is common for issues in the lower back—even without back pain—to manifest itself in the hip. I have this opinion because your hip pain increases while sitting which is pattern we see in the clinic when the lower back refers to this hip.

A way to investigate this further is to use a lower back support like a rolled up towel to see if that helps to reduce the hip pain. The low back support will change the position of the lower back and you can assess your response to the change. The lower back and hip are closely related, and the position of one can influence the other.

RELATED: Ask a PT: Is There an Actual Cure for Plantar Fasciitis?

The hip joint can also be a source of your pain. In sitting, the hip is positioned in flexion. Sitting for one hour places the hip in prolonged flexion which, at times, can aggravate the joint. In this case, moving the hip in a stretching position such as doing a hip flexor stretch may be another way to investigate whether prolonged sitting is playing a role in the hip pain.

Ask yourself, “Why is my hip hurting?” Try to find the underlying movements or positions that aggravate or alleviate the pain rather than try to guess what structures are hurting. Generally, exercises to strengthen the hip (if there is weakness) and improve mobility (if there are restrictions) are beneficial to maintain an active lifestyle. In addition, progressing your training properly will be key to getting restoring the quality of life you want. It sounds like you are taking action to resolve the hip pain which is the first step to achieving pain-free function.

Stay active,

Dr. Marc

***

Dr. Marc Robinson is a Physical Therapist in San Diego, CA who provides online physical therapy and virtual consultations for those who need on-demand help with injuries. His company, Evercore offers online injury prevention courses and fitness products to promote a pain-free, active life. They specialize in low back pain and helping their clients achieve health goals beyond what the traditional medical system can offer.

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