When to See a Physical Therapist for Hip Pain

If you have hip pain, you may think it’s not “bad” enough to seek help, especially if it comes and goes. But as Meghan Lamothe, PT, DPT, a physical therapist at the Orthopedic Physical Therapy Center of HSS, explains, any pain is enough of a reason to get your hip checked. “The common misconception is that you go to physical therapy to get rid of pain,” she says. “That’s only phase one. Phase two should be preventing the problem from happening again and slowing the progression of problems, if any, so you can stay active and happy.” A physical therapist, she notes, can help fill your hip-health toolkit with strategies to do just that.

Here, Lamothe offers insights on why the hip is prone to pain, how to know if you’re a good candidate for physical therapy and what you’ll experience if you decide to go.

Why your hip might hurt

From a bone-and-muscle standpoint, the hip presents some unique issues. “Ball-and-socket joints are generally quite mobile, but when compared to the shoulder—the other well-known joint of this type—the hip is a bit more stable, so it’s easier for the muscles in that area to get tight,” says Lamothe. “If that happens, your hip might start to hurt, or your body may look to other areas to bear the weight, which often leads to back problems.”

Another issue is how the hip connects to the upper body. “It’s like a highway that’s splitting into two roads—from one spine to two hips,” she says. “The hips have to bear the load symmetrically, and if they don’t, that can bother them.”

How PT can help hip pain

“One example of a good candidate for PT for a hip issue is someone who has a symptom that is mechanical in nature, which means it is aggravated by movement or actions—even things as simple as sitting for long periods,” she says. “A physical therapist is really a type of movement specialist, so if you have a problem related to movement, it’s definitely a good time to see a PT.”

These are some common types of hip pain that may bring you to physical therapy:

• Pain that comes on suddenly and/or pain when standing (bearing weight on the hip), which may be a bone injury.
• Pain when lying down on one side that goes away when you flip onto your back or opposite side, which may be bursitis (inflammation of the fluid-filled sac between a tendon and a bone, in this case your hip bone).
• Pain in the groin (as opposed to the side of the hip/body), which generally indicates an issue with the joint that could be from arthritis or physical damage.
• Pain you suspect may be from overuse or using less-than-ideal form when performing a sport or exercise—or a similar type of issue caused by repetitive work, for example.

Find details on more possible causes of hip pain here.

Things you can try before PT

No one wants to run to the doctor at the first twinge of pain. Of course, there are times you should, says Lamothe: For example, if the pain is severe, occurs after a blow to the hip or symptoms are affecting your everyday routine, seek medical attention right away.

If that’s not the case, she suggests starting with the RICE method: rest, ice, compression and elevation. (There are compression braces for the hip and thigh that basically look like a pair of shorts.)

“When we say ‘rest,’ that just means you should avoid the activities that are bothering you, not avoid activity altogether,” says Lamothe. If after two to four weeks, the symptoms are still interfering with simple daily activities (sitting, standing, sleeping, climbing stairs, etc.), it’s definitely a good time to see a physical therapist. “Even if you go for just one visit, at least you will get an evaluation and a better understanding of what’s going on,” she says.

What to expect at your first appointment

Initially, you’re just going to talk—a lot, says Lamothe. “We’ll ask what you’re feeling, when you feel it, where you feel it, what it feels like, what makes it better or worse, what tests you’ve had, what activities you like to do, what do you do in a typical day—lots of details to help us take in the whole picture,” she says. Your physical therapist will also review your medical history including surgeries, medications, previous injuries and family history.

Next, they’ll ask you to move (walk, squat, climb stairs, etc.), which can help them decide what other tests and measurements to do, if any. Sometimes all of this is enough to pinpoint the problem. Other times, an MRI, X-ray or other test may be suggested, or you might be referred to a different specialist. If your problem is appropriate for them to treat, your PT can set you up with things to do (or stop doing) that may not only ease your current pain but also prevent it from coming back and/or delay the progression of an underlying condition like arthritis. For example:

• If you have hip pain when sleeping, getting a new mattress and/or sleeping with a pillow between your knees (if you’re a side sleeper) may help.
• If you have weak glutes or poor hip flexibility—both very common problems—your PT can suggest exercises that can improve your butt and your hips.
• Supportive, well-fitting shoes can also be a game-changer. They even make a difference for Lamothe: “If I wear loafers all day, my back hurts, but if I wear my more supportive shoes, it doesn’t.”

Reasons to see a PT sooner rather than later

If you delay treatment until your pain is bothering you every day or is more intense, you run the risk of it becoming a chronic (ongoing) problem—one that may not entirely go away, says Lamothe. “A lot of the time, people wish they had come to PT sooner,” she adds. “You can’t know exactly when it’s the ‘right’ time to seek help. But there’s not a ‘wrong’ time to see a PT.” After all, what do you have to lose, except for that nagging pain?

If you don’t live close to an HSS facility, Lamothe suggests checking out the HSS Rehabilitation Network, which includes only physical therapy practices that have been visited and vetted by members of the HSS team.