Fixing Those ‘Tricky’ Hip Pain Patients

Posted By: Andy Barker

Hip pain can be tricky at times to get a hold of.

Often quick changes can be made in patient symptoms but often these effects only last for a short time.

Patients are then not able to progress and as a therapist you may sometimes find yourself trying various treatment techniques and rehab exercises to try get on top of their symptoms.

This was a common problem among therapists when I presented recently at Therapy EXPO.

I presented a practical demo titled ‘Assessing & Treating The Rib-Cage For Quick Changes In Symptoms For Patients With Hip Pain.’

I presented this topic because it is a common problem many therapists, New Grad’s and experienced therapists, struggle with.

It has been great to hear from many therapists that have integrated some of the techniques I covered at Therapy EXPO into practice and had great results.

What I want to do in this blog is to highlight why so many hip pain results are often short lived and what you need to consider instead to get quick, but long-lasting treatment results.

The Most Common Hip Problems

Anterior hip pain is frequent within all areas of therapy.

It might be that runner, a patient that gets pain driving or whilst sat at work, or that athlete who gets pain when squatting.

We may diagnose these patients with hip impingement.

I don’t like that term as a diagnosis, as I don’t think it really helps us to be specific with our hands-on treatment techniques and rehab, but I won’t get into that know.

That can be the topic of another blog another day!

That patient that does present with anterior hip pain or ‘impingement’ may symptoms originating from a few different structures.

Commonly, patients like these may have either a CAM (femoral head) or pincher lesion (acetabulum), or sometimes a mixture of the two.

What they have really does not matter too much, and this is why…

Is It A Hip Problem Or Something Else?

A restriction and pain into hip flexion are symptoms we see in patients with anterior hip pain.

To cause flexion at the hip we can either move the hip (hip moving on a fixed pelvis) – think lifting your knee towards your chest, or move the pelvis (pelvis moving on a fixed hip) – think reaching down to touch your toes.

Both movements can produce the same motion at the hip – hip flexion.

So why is it that when most therapists treat hip pain, they only treat the hip.

What about the pelvis?

The acetabulum, which is half of the hip joint, is part of the pelvis and therefore can have a big impact on hip motion and function.

This is the reason why most hip problems persist.

Therapists do a good job with the hip but often forget about the pelvis and the acetabulum.

But in doing so, you are only considering half of the hip joint, so is it any wonder that symptoms may not progress in the way that you would like?

So, what should you do instead…?

Quick Fixes That Allow Long-Lasting Results

Considering both the hip and the pelvis will give you not only quick changes in patients hip symptoms but also help you keep these changes and allow you to progress your patient along their treatment plan.

This example will help you see how…

We know that patients in an anteriorly tilted pelvic position (think big lumbar extension position) are more prone to anterior hip symptoms because they have less room for movement before contact is made between the femoral head and the acetabulum in movements involving hip flexion – sitting, driving, squatting, running etc…

So, if we can change the starting position of the pelvis and even the pelvis position during movement there is no question this will be beneficial, as we will create more ‘space’ for the hip to move before bony contact is made between the femoral head and the acetabulum.

If we can do this alongside local hip treatments and rehab exercises, then we will stand a much better chance of not only changing a patient’s hip symptoms quickly, but also making sure these symptoms do not come back just as quick.

Key Take-Aways

Hip Pain Often Comes Back Quickly & Many Effects Of Treatment & Rehab Tend To Be Short-Lived

Does The Patient Have A Hip Problem Or Something Else? – Considering The Influence Of The Pelvis Is Key For Patients With Hip Pain

Treating Both The Hip & Pelvis Will Help You Get Quick Changes To Patient Symptoms & Stop Those Symptoms Returning Quickly

Andy Barker
The New Grad Physio Mentor

PS. I will be covering the hip and specific treatment and rehab techniques, like those I presented at Therapy EXPO that you can use on patients with ‘tricky’ hip pain, on my upcoming New Grad Physio Lower Limb Course.

Very soon I will be releasing dates and venues for this course so to make sure you do not miss them, visit to sign up to my exclusive wait list and be the first to hear about these events and get access to early-bird discounted tickets.