Hip and SI joint pain
Hip pain. Usually a deeper pattern.
The hip is a load-transfer joint between the spine and the lower limb. When something above or below stops working, the hip pays the price. Impingement, labral patterns, glute pain, post-replacement recovery: all benefit from treating the system, not just the joint.
The condition
The hip is built for both stability and motion. Most hip pain is a problem with one or the other.
Hip pain has several common patterns. Femoroacetabular impingement (FAI) is bony or soft-tissue impingement at end-range hip flexion, usually with deep groin pain. Labral irritation produces sharp catches in specific positions. Greater trochanteric pain (often called bursitis) is more often a gluteal tendon problem from poor pelvic control. SI joint patterns refer pain into the hip region from a different source entirely.
Post-surgical hip recovery, whether from replacement, arthroscopy, or labral repair, depends on how mobility and strength are rebuilt in the months after the procedure. The surgical work is one part of the outcome. The PT determines the rest.
How we treat it
Mobility where it is stuck. Strength where it has stopped firing.
Manual therapy addresses the joint restrictions, capsule tightness, and soft tissue that are limiting hip motion. For most patients with hip impingement or labral patterns, restoring posterior capsule mobility and addressing iliopsoas tone is the first priority. This is hands-on work, not stretches you do alone.
Then the strength and motor control: gluteal activation, pelvic stability, hip rotation control, and the trunk-hip coordination that distributes load properly through the joint. The exercises are specific to your pattern. Athletic or activity return is part of the plan if relevant.
Why it works here
Hip evaluated in context. Spine, hip, and foot together.
Hip pain that is treated in isolation often persists because the spine above or the foot below is feeding the dysfunction. Here, the evaluation looks at the whole kinetic chain. If the hip pain is downstream of a spine pattern, we address the spine. If it is a primary hip problem, we treat it directly.
One clinician, one hour, hands-on for the bulk of the session. The case is managed by the same therapist throughout. Post-surgical patients work to a clear functional milestone progression, not generic exercise sheets.
Questions
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I was told I have hip impingement (FAI). Do I need surgery?
Not necessarily. Many FAI cases respond well to conservative care that addresses hip mobility, gluteal strength, and load management. Surgery is a consideration for cases that have not responded to focused PT or that have specific structural patterns. The evaluation can help determine which category you are in.
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I had a hip replacement and feel stuck. Can PT still help?
Yes, often. Even years after a hip replacement, mobility and strength can be improved. The surrounding muscles, the opposite hip, and the spine all adapt to the prosthetic and can develop compensatory patterns that benefit from focused work.
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I have been told it is bursitis. Why has it not improved?
What is often diagnosed as trochanteric bursitis is actually gluteal tendinopathy from poor pelvic control, not a bursa problem. Anti-inflammatories and rest do not change the underlying mechanics. PT addresses the gluteal strength and pelvic stability that maintain the irritation.