Common Hip Conditions I Treat

I regularly support clients across Bristol with:

• Post-operative total hip replacement (THR)

• Hip arthroscopy rehabilitation

• Femoroacetabular impingement (FAI)

• Labral-related hip pain

• Gluteal tendinopathy

• Hip flexor, inguinal and groin strains

• Femoral neck stress fractures

• Running and sport-related hip pain

Each condition requires careful staging and load management — particularly when returning to impact activity.

Why Hip Pain Develops

Hip pain often arises due to a mismatch between load and tissue capacity.

Common contributing factors include:

• Reduced gluteal strength

• Sudden increases in running or training volume

• Repetitive hip movement under load

• Inadequate rehabilitation post-surgery

• Altered pelvic control

• Poor load progression following stress injury

For FAI and labral-related pain, symptoms may be influenced by joint morphology combined with repeated high-load flexion and rotation. However, research increasingly supports strengthening and load modification as effective first-line management before surgical intervention.

Gluteal tendinopathy, particularly common in runners and middle-aged adults, responds best to progressive loading rather than prolonged rest.

Is It Really Hip Pain?

Hip pain is one of the most diagnostically challenging presentations in physiotherapy, because pain felt around the hip, groin, and buttock can originate from numerous structures — many of which are not the hip joint itself. Misdiagnosis is common, and this is one area where a thorough clinical assessment makes a significant difference to outcomes.

Conditions that commonly refer pain to the hip region include:

• Lumbar spine — L2, L3 and L4 referral patterns produce anterior hip and groin pain that closely resembles hip joint or iliopsoas pathology

• Femoral nerve irritation — anterior thigh and groin pain, often with some weakness in hip flexion or knee extension, occasionally misidentified as hip flexor pathology

• Meralgia paresthetica — lateral femoral cutaneous nerve compression producing burning, numbness or tingling at the outer thigh, sometimes presenting as lateral hip pain

• Sacroiliac joint (SIJ) — buttock and posterior hip pain with occasional radiation into the thigh, closely mimicking proximal hamstring or posterior hip pathology

• Proximal hamstring tendinopathy — deep buttock pain that worsens with sitting and is often misidentified as SIJ or lumbar pathology

• Adductor and groin pathology — medial groin pain that can overlap clinically with anterior hip joint symptoms, particularly in footballers and runners

Differentiating hip joint pathology from lumbar referral, nerve irritation and soft tissue sources requires a systematic assessment approach. At ADAPT. PERFORM. this always includes lumbar and neural screening alongside local hip testing.

How I Assess Hip Pain in Bristol

At ADAPT. PERFORM., hip assessment includes:

• Range of motion and joint mechanics

• Gluteal strength testing

• Single-leg control and pelvic stability

• Running or squat analysis (if relevant)

• Load tolerance profiling

Where relevant, I use objective strength data to guide progression and highlight asymmetry — particularly important in post-operative hip replacement and hip arthroscopy cases where recovery timelines are driven by tissue healing as much as symptoms.