Why is the pain on the outside of my hip not going away?

Pain on the outside of the hip (“lateral hip pain”) affects roughly 1 in every 500 people annually. In a country of 4.9million people that means almost 10,000 people every year have pain on the outside of their hip.

There are many structures on the outside of the hip. Often pain on the outside of your hip is aggravated by sitting for long periods of time, going up and down the stairs, lying on your sore side and doing high impact physical activities. Pain on the outside of your hip is most common in people between the ages of 40 and 60. It is also more common with women than men. 

Does pain on the outside of my hip mean it’s damaged?

The answer to this is the answer everyone hates the most… It depends.

At our clinic the first thing we want to determine is if your pain is as a result of an injury or a trauma. If you do not remember a moment of impact or a pulling sensation when running/playing sports and your pain slowly came on over time it is likely that your hip pain does not equal damage. 

Of course we cannot say this without an assessment whether or not you have damaged your hip. If you think you have an injury or a pathology then you should contact a physio you trust. But, if you don’t have an injury then keeping moving shouldn’t cause any damage to the structures at/around the hip. If anything, stopping everything may be less beneficial. The body needs movement to help heal.

Why is the pain on the outside of my hip not going away?

Often pain on the outside of the hip is mistreated and there are many mistakes that both physiotherapists and patients make when trying to alleviate pain on the outside of the hip. 

Mistake 1:  Too much stretching. . . 

A lot of time stretching can be a nice way to reduce some pain and give you some relief. But, often with pain on the outside of your hip stretches like the piriformis stretch, IT band stretches and any variation of the Pigeon pose used in yoga will actually increase the irritability of the pain on the outside of the hip. Of course in some cases, stretching can help but instead, the focus here should be on strengthening the weaker muscles around the hips, often the glutes. And, modifying the activities that cause the pain.

Mistake 2: Reliant on passive treatments. . . 

Often to treat pain physiotherapists use hands on treatments like massage or passive treatments like ultrasound, laser or dry needling. Hands on treatment can be a useful tool to reduce the symptoms of an injury such as hip pain. But, if your therapist is only using hands on/passive treatment then they are just reducing your pain without addressing the causes. Massage needs to be combined with a unique home exercise program and planning/modifying your activities in order to reduce pain, increase strength and get you back doing what you love. 

There is a lot of research which shows results of patients with hip pain are often better or the same without reliance on hands on treatments. One study had two groups, one group received 18 massages and an exercise program, the other group had 1 visit to the physio where they were given and shown the exercise program. On follow up, both groups had the same results in the end. 

Mistake 3: No education or activity modification. . . 

If you have pain on the outside of your hip and you aggravate it by, let’s say, going for a big run too soon into your rehab process. This is not your fault. It is important that you question your physio so you know why you’re doing certain exercises. What you can and can’t do for the time being and know how your hip will react to certain activities. This doesn’t mean stopping everything and never getting back doing what you loved, this may just mean modifying your activity for a short period of time while the pain settles and you are then able to build back into your activities

Mistake 4: No plan. . . 

Your physiotherapist should always have a plan for the next session based on how you respond to the initial program. If you ask your physio for an idea of this plan they should give it to you. Of course, no plan is set in stone but an idea of the direction the treatment is heading is essential. Be sure to question your physio and ask what their expectations are for the next few weeks. It shouldn’t be acceptable in any health care to just “wing it” or “wait and see”

Mistake 5: No Progressions. . .

Often we see with hip pain that treatment is stagnant, you’re doing the same exercises over and over and when you come to the physio you get a passive treatment or a massage, and then, you’re sent away again without a progression. This mistake is a combination of mistakes 2 and 4. No plan and reliance on passive treatments like massage will mean your exercise programme will not be sufficient to build the capacity to return to doing the things you love to do. 

If you have any questions about hip pain you can always contact us via social media, email, on the phone, or book in for a face-to-face consultation online. If you can’t make it into the clinic you can always book an online consultation instead.

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Tommy Brennan

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Our goal here is to get you out of pain and back to your physical best so that you can enjoy the things that are important to you.  

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