🤔 What Is It?

Your hip flexors are a group of muscles at the front of your hip that help lift your leg and stabilise your pelvis — including the iliopsoas, rectus femoris, and TFL.

When they become tight, overused, or poorly coordinated, it can lead to:

• Pain or tightness at the front of the hip or groin

• Discomfort when sitting, sprinting, lunging, or squatting

• A feeling of “snapping” or pinching during hip movement

• Referred tightness or aching into the lower back or thigh

This condition is common in:

• Desk workers who sit for long periods

• Athletes who sprint or kick

• Lifters who overload hip flexion without mobility or glute strength

💡 Common Physiotherapy-Related Causes:

• Prolonged sitting leading to adaptive shortening of hip flexors

• Poor glute activation and hip extension control

• Overuse of hip flexors during training or sport

• Weak or poorly coordinated core and pelvic stabilisers

• Lumbar lordosis (arched back) increasing hip flexor load

🛠️ What You Can Do:

• ✅ Avoid excessive sitting without movement breaks

• ✅ Perform hip flexor mobility and glute activation drills daily

• ✅ Strengthen your posterior chain and deep core system

• ✅ Address technique in squats, lunges, and hip-dominant training

• ✅ Book physio to assess movement, mobility, and muscle control

👩‍⚕️ How Physio Can Help:

• Assess your hip flexor length, control, and contribution to pain

• Use release techniques, dry needling, or cupping to reduce tension

• Restore hip movement with joint and soft tissue mobility work

• Build a personalised plan to improve glute function and core stability

• Retrain squat, lunge, run, and lift patterns to offload the hip

🙋‍♀️ Answers to Common Questions

1. What does hip flexor tightness feel like?

• Tightness or pulling at the front of the hip or groin

• Pain during squats, lunges, or hip stretches

• A sensation of “snapping” or “pinching” when moving the leg up

• Sometimes refers into the lower back or thigh

2. Why are my hip flexors always tight?
Because they’re doing too much or being held in a shortened position. This can happen from too much sitting, poor glute engagement, or compensating for weak core/pelvis muscles.

3. Should I just stretch them?
Stretching might help short-term, but without addressing the cause — like weak glutes or poor posture — the tightness often comes back. Strength and control are just as important.

4. Can this affect my back?
Yes — tight hip flexors can pull on the lumbar spine, increasing load and contributing to lower back pain or instability.

5. What exercises help loosen hip flexors?

• Half-kneeling hip flexor stretch with core control

• Glute bridges, clamshells, and side-lying leg lifts

• Posterior pelvic tilt drills

• Dynamic lunge sequences and banded mobility work
  All progressions are tailored to your activity level and sport/training goals.

6. Can I still train legs at the gym?
Yes — but we’ll adjust form, tempo, and range to offload the hip flexors and rebuild balanced movement.

🤔 What Is It?

Femoroacetabular Impingement (FAI), or hip impingement, occurs when there’s excess contact between the hip ball (femoral head) and the socket (acetabulum) — especially during movements like squatting, lunging, or bending.

This leads to:

• Pinching or sharp pain in the front of the hip or groin

• Pain during deep squats, hip flexion, or rotation

• A sense of hip “blocking” or catching

• Possible referral into the thigh, glute, or groin

FAI is often structural (e.g. cam or pincer shape), but symptoms are usually driven by how you move, train, and load your hip — which is why physio works so well.

💡 Common Physiotherapy-Related Causes:

• Squatting or lunging beyond your active hip range

• Poor core or glute control, leading to joint compression

• Hip stiffness, weakness, or poor mobility balance

• Previous injury or overload that hasn’t been fully rehabbed

• Imbalanced training — too much hip flexion without posterior chain support

🛠️ What You Can Do:

• ✅ Avoid repeatedly pushing into the painful range (e.g. deep squats)

• ✅ Improve hip mobility and glute control

• ✅ Work on core stability and trunk position during lifts

• ✅ Use movement modifications while symptoms settle

• ✅ Get physio guidance on technique, loading, and long-term management

👩‍⚕️ How Physio Can Help:

• Confirm whether your symptoms are truly impingement or something else

• Mobilise stiff hip structures and reduce muscular guarding

• Improve joint alignment, mobility, and movement control

• Adjust gym or sport technique to avoid aggravation

• Build a strength plan that keeps you training without pain or fear

🙋‍♀️ Answers to Common Questions

1. What does hip impingement feel like?

• Pinching, catching, or sharp pain at the front of the hip

• Worse with deep squats, sitting, driving, or lunges

• Sometimes refers to the groin, thigh, or side of the hip

• May feel like a “block” or restriction when lifting the leg

2. Is this caused by bone shape?
FAI can involve bone shapes (e.g. cam or pincer morphology), but pain usually results from how the hip is used. Plenty of people have FAI-shaped hips and no pain — movement matters more than structure.

3. Will I need surgery?
Not usually. Surgery is reserved for cases that don’t respond to rehab after several months. Most people improve significantly with targeted physiotherapy and movement retraining.

4. Can I keep squatting or training?
Yes — but with modifications. We’ll adjust depth, stance, tempo, and load to find a pain-free pattern and rebuild your hip’s capacity over time.

5. What exercises help FAI?

• Hip mobility (90/90s, active external/internal rotation drills)

• Glute strength (bridges, sidesteps, RDLs, step-ups)

• Core control and pelvic positioning in movement

• Lateral hip stability and rotational control
  We’ll guide you through a full return to lifting, running, or sport.

6. Can I improve hip range of motion?
Yes — mobility, control, and strength can all improve. We’ll help you restore functional range without forcing painful positions.

🤔 What Is It?

Your gluteus medius is one of the key muscles that stabilises the pelvis during walking, running, and standing on one leg. When its tendon becomes overloaded, irritated, or compressed, it can lead to tendinopathy — a breakdown of tendon tissue that causes:

• Pain on the outside of the hip, especially over the bony point (greater trochanter)

• Pain during or after walking, climbing stairs, running, or lying on the affected side

• Tenderness to touch and aching after activity

• Often mistaken for hip bursitis

It’s especially common in:

• Women over 40

• Runners and walkers

• Those who sit a lot or stand with hip dropped out to one side

💡 Common Physiotherapy-Related Causes:

• Weak or poorly controlled hip stabilisers (glute med and glute min)

• Poor pelvic control during single-leg activity

• Overuse (e.g. sudden increase in running or walking)

• Compression of the tendon when lying on the side or sitting with crossed legs

• Postural habits like hip hitching or leaning onto one leg

🛠️ What You Can Do:

• ✅ Avoid lying on the painful side (or use a pillow for support)

• ✅ Don’t stretch aggressively — it often worsens tendon compression

• ✅ Reduce uphill walking, stairs, and excessive step count temporarily

• ✅ Strengthen your glute medius and pelvic control with physio guidance

• ✅ Start a progressive loading program as soon as pain allows

👩‍⚕️ How Physio Can Help:

• Confirm whether the issue is tendinopathy, bursitis, or referred pain

• Reduce pain using manual therapy, load management, and taping if needed

• Teach you how to move and sleep without compressing the tendon

• Progress you through a staged glute and hip rehab plan

• Address root causes like gait, core weakness, or training load

🙋‍♀️ Answers to Common Questions

1. What does glute med tendinopathy feel like?

• Aching or sharp pain on the outer side of your hip

• Worse when walking, climbing stairs, or lying on that side

• Tender to press and sometimes swollen or inflamed

• May feel stiff after sitting or first thing in the morning

2. Is this the same as hip bursitis?
Not quite — bursitis can occur alongside tendinopathy, but the underlying issue is often tendon overload or compression. Treating the tendon, not just the bursa, gives better long-term results.

3. Should I stretch my hip if it’s tight?
No — aggressive stretching can compress and irritate the tendon further. Focus on strength, control, and posture correction instead.

4. Can this get better on its own?
Sometimes — but recovery is much faster and more complete with the right rehab program. Untreated tendinopathy can become chronic and limit activity.

5. What exercises help glute med tendinopathy?

• Isometric side-lying abductions (with support)

• Wall push abductions and banded sidesteps

• Glute bridges, clamshells, and single-leg progressions

• Gait retraining and glute strengthening in functional movement

6. Can I keep walking or training?
Often yes — we’ll help you adjust intensity, stride, and load to stay active without flaring symptoms. The goal is to move smarter, not less.

🤔 What Is It?

Hip bursitis refers to inflammation of the bursa — a small fluid-filled sac that cushions your joints. The most commonly affected one is the trochanteric bursa, which sits over the bony point on the outside of your hip.

When irritated, it can cause:

• Sharp or aching pain on the outer side of the hip

• Pain that’s worse when lying on the side, walking, or going up stairs

• A feeling of swelling, heat, or tenderness over the hip bone

• Sometimes pain that spreads into the outer thigh

This condition is common in:

• Women over 40

• People with glute weakness or poor pelvic control

• Runners, walkers, or those who sleep on one side

💡 Common Physiotherapy-Related Causes:

• Repetitive friction or compression over the bursa (e.g. lying on that side)

• Poor glute strength leading to pelvic drop or hip hiking

• Increased walking or stair climbing without adaptation

• Imbalanced muscle use around the hip

• Poor sleep or sitting posture (e.g. crossed legs)

🛠️ What You Can Do:

• ✅ Avoid lying directly on the sore hip (use a pillow between knees)

• ✅ Reduce activities that aggravate it (stairs, hills, side-lying)

• ✅ Don’t stretch aggressively — it can worsen the inflammation

• ✅ Start gentle hip stability and glute strengthening exercises

• ✅ Seek physio to reduce symptoms and rebuild movement control

👩‍⚕️ How Physio Can Help:

• Differentiate bursitis from tendinopathy or referred pain

• Reduce inflammation with manual therapy, taping, or deloading strategies

• Prescribe hip and glute rehab to correct the underlying cause

• Teach postural changes to reduce bursa compression

• Help prevent recurrence with strength, stability, and gait retraining

🙋‍♀️ Answers to Common Questions

1. What does hip bursitis feel like?

• Pain or pressure over the bony point of your outer hip

• Worse when lying on that side, walking long distances, or climbing stairs

• May feel warm, tender, or swollen

• Can refer pain down the outer thigh, but doesn’t go below the knee

2. Is bursitis the same as tendinopathy?
They often coexist. Bursitis is inflammation, while tendinopathy is tendon overload. Both are treated similarly with load management and glute control.

3. Should I get a cortisone injection?
Injections may relieve pain short-term, but they don’t fix the underlying cause. Physio focuses on strengthening and movement retraining to prevent recurrence.

4. Can I still walk or train?
Yes — with some adjustments. We’ll help you modify activity so you can stay active without flaring the bursa.

5. How long does bursitis take to heal?
Mild cases can settle in 2–4 weeks, but full recovery (including strength and control) may take 6–8+ weeks, especially if the issue has been ongoing.

6. What exercises help bursitis?

• Side-lying glute isometrics with support

• Bridges, wall abductions, and resistance band sidesteps

• Core and pelvic control drills

• Postural modifications and gait retraining

🤔 What Is It?

Your adductors are the muscles on the inner thigh that help stabilise the pelvis, control lateral movement, and assist with sprinting, kicking, and squatting.

When these muscles are overstretched or overloaded, you may develop:

• An adductor strain — an acute injury to the muscle fibres

• Or a groin tendinopathy — a longer-term irritation or degeneration of the tendon near the pubic bone

This leads to:

• Pain in the groin or inner thigh, especially during sprinting, lunging, or side-stepping

• Discomfort with hip adduction (squeezing the legs together)

• Tenderness to press along the inner thigh or pubic area

• Difficulty accelerating, cutting, or decelerating

💡 Common Physiotherapy-Related Causes:

• Sudden change in direction or acceleration in sport

• Weak or unprepared adductors exposed to high load

• Imbalance between adductors and glutes/core

• Rapid increase in training volume or intensity

• Poor hip mobility or pelvic control

🛠️ What You Can Do:

• ✅ Avoid sprinting, lunging, or side-stepping until pain improves

• ✅ Use ice, compression, and deloading strategies early on (for strains)

• ✅ Start isometric holds to rebuild tendon strength

• ✅ Gradually return to sport-specific drills under guidance

• ✅ See a physio to distinguish between strain vs tendinopathy

👩‍⚕️ How Physio Can Help:

• Confirm whether your issue is a muscle strain, tendon overload, or pubic joint irritation

• Guide you through staged rehabilitation — from pain relief to full-speed return

• Restore hip control, balance, and adductor strength

• Address biomechanics, foot position, and cutting technique

• Monitor symptom response to load and help prevent recurrence

🙋‍♀️ Answers to Common Questions

1. What does an adductor injury feel like?

• Pain in the groin or upper inner thigh, often sharp if strained

• Pulling or tightness when sprinting, lunging, or side-stepping

• Soreness with squeezing the legs together

• In tendinopathy, pain is often dull and progressive, worse after activity

2. What’s the difference between a strain and tendinopathy?

• A strain is an acute tear from overload or overstretching

• Tendinopathy develops over time from repetitive stress or poor recovery
  Treatment is similar but rehab progression will vary

3. Should I stretch my groin if it’s sore?
No — aggressive stretching can worsen the tendon. Focus on controlled strengthening instead.

4. How long does it take to recover?

• Mild strains: 2–3 weeks

• Moderate strains or tendinopathy: 4–8+ weeks
  Consistent rehab ensures full return to sport with reduced reinjury risk

5. What exercises help with adductor rehab?

• Isometric adduction holds (e.g. ball squeeze)

• Side-lying leg lifts and Copenhagen planks

• Adductor slides and banded strengthening

• Sport-specific drills like change-of-direction and lateral hops (later stages)

6. Can I keep training?
Yes — but activity should be modified to avoid pain and protect healing tissue. We’ll adjust your plan and gradually build back to performance level.

🤔 What Is It?

Hip osteoarthritis is a condition where the cartilage in the hip joint gradually wears down, leading to:

• Joint space narrowing

• Mild inflammation and bone spurring

• Changes in how the hip moves and loads

It’s most common in people aged 50+, but can also occur earlier in those with a history of injury or heavy joint loading.

Symptoms often include:

• Stiffness and deep ache in the hip or groin

• Pain that’s worse with walking, standing, or stairs

• Stiffness after rest or sleep, easing with gentle movement

• Difficulty putting on shoes, socks, or getting in/out of a car

• Sometimes pain referring to the thigh, buttock, or knee

💡 Common Physiotherapy-Related Causes (or contributors):

• Past injury to the hip or pelvis

• Long-term asymmetrical loading or poor biomechanics

• Weakness in glutes, hip stabilisers, and core muscles

• Sedentary lifestyle, leading to joint stiffness and reduced nutrition

• Poor movement control or lack of full hip range in training or daily life

🛠️ What You Can Do:

• ✅ Keep moving — regular, low-impact exercise is key

• ✅ Strengthen your glutes, quads, and hip stabilisers

• ✅ Improve your hip mobility and posture during movement

• ✅ Avoid long periods of inactivity or sitting without movement breaks

• ✅ Work with a physio to build a safe and effective training program

👩‍⚕️ How Physio Can Help:

• Confirm the diagnosis and assess joint mobility, strength, and control

• Reduce symptoms using manual therapy, dry needling, and movement drills

• Build a strength-based rehab program tailored to your pain and function

• Help delay or avoid surgery through targeted intervention

• Support recovery before or after hip replacement, if needed

• Teach you how to keep doing what you love — with less pain and more confidence

🙋‍♀️ Answers to Common Questions

1. What does hip osteoarthritis feel like?

• Deep aching pain in the groin, thigh, or buttock

• Stiffness in the morning or after sitting

• Reduced range of motion, like trouble putting on socks or shoes

• Pain with walking, stairs, or prolonged standing

2. Is OA a normal part of ageing?
Yes — joint wear is natural over time, but not everyone has pain. The key difference is how strong and mobile your joint is, not just how it looks on a scan.

3. Should I stop exercising?
Absolutely not — exercise is the best treatment for hip OA. It improves joint nutrition, strength, control, and overall function.

4. Will I need a hip replacement?
Not necessarily. Many people avoid or delay surgery for years — or altogether — with the right physio care and strength training.

5. What exercises help hip OA?

• Glute bridges, sit-to-stands, and resistance band work

• Stationary cycling, walking, and water-based movement

• Hip mobility drills and gentle stretching

• Balance and coordination exercises
  We tailor these based on your goals, lifestyle, and flare-up pattern.

6. What if I already have a hip replacement booked?
We can help you prepare your body before surgery (prehab) for better outcomes — and guide your post-op rehab to get back to walking, stairs, and the gym faster.

7. Can physio really help with arthritis?
Yes — research shows that strength and movement-based physio reduces pain, improves function, and helps people with hip OA stay active and independent.

🤔 What Is It?

The pelvic floor is a group of muscles that supports your pelvic organs, stabilises the pelvis and spine, and plays a major role in core control, continence, and breathing.

When these muscles are too tight, weak, overactive, or poorly coordinated, it can lead to:

• Lower back, pelvic, or hip pain

• Difficulty controlling intra-abdominal pressure (especially under load)

• Leaking with lifting, coughing, or running

• Feelings of heaviness, dragging, or instability

• Poor performance or recurrent injuries in sport and training

This condition is common in:

• Postpartum clients (even years after birth)

• Weightlifters and CrossFit athletes

• People with chronic back, SIJ, or hip issues

• Clients who can’t seem to “switch on their core properly”

💡 Common Physiotherapy-Related Causes:

• Pregnancy or birth-related trauma to pelvic floor or core

• Poor breathing and bracing mechanics

• Overuse of superficial muscles like rectus abdominis or hip flexors

• Compensatory patterns due to back, hip, or pelvic pain

• Lack of awareness or training in deep stabilisers (e.g. diaphragm, TVA, pelvic floor)

🛠️ What You Can Do:

• ✅ Start with a pelvic floor physio assessment (yes, even if you haven’t had kids)

• ✅ Learn to coordinate breathing, pelvic floor, and core bracing

• ✅ Avoid excessive bearing down during lifting or straining

• ✅ Integrate pelvic floor work into gym, pilates, or daily movement

• ✅ Build load tolerance slowly and with good form

👩‍⚕️ How Physio Can Help:

• Assess your pelvic floor function (external or internal if appropriate)

• Rebuild core control through breath, pelvic floor, and deep stabiliser activation

• Provide manual therapy or release for overactive or tight pelvic floor muscles

• Retrain your posture, breath mechanics, and movement patterns

• Integrate rehab into your training goals — whether gym, sport, or daily life

🙋‍♀️ Answers to Common Questions

1. What are signs of pelvic floor dysfunction?

• Leaking with cough, sneeze, jump, or lift

• Pelvic, hip, or low back pain that won’t resolve

• A feeling of heaviness, weakness, or pressure in the pelvis

• Trouble engaging your core or bracing properly

• Ongoing pain or dysfunction postpartum, even years later

2. Do I need an internal assessment?
Not always — many core and pelvic floor issues can be addressed externally through movement, breath, and control work. For more complex symptoms, internal assessment may help (always with consent).

3. Can men have pelvic floor dysfunction too?
Yes — men also benefit from pelvic floor training, especially after prostate surgery, chronic back pain, or pelvic instability.

4. Should I just do Kegels?
Kegels alone aren’t the answer — coordination and timing are just as important as strength. Some people actually need to learn how to relax the pelvic floor, not just tighten it.

5. Can I keep training while rehabbing this?
Yes — we’ll help you modify how you move and load to reduce symptoms and improve performance. Rehab is most effective when it’s built into what you already do.

6. What exercises help with core and pelvic control?

• 90/90 breathing and diaphragmatic activation

• Pelvic floor lifts with breath coordination

• Dead bugs, bird-dogs, and side planks

• Controlled compound lifts with proper bracing and alignment

🤔 What Is It?

Sometimes hip pain doesn’t come from the hip joint itself — it’s referred from the lower back or spine, especially from the L2–L4 nerve roots or lumbar facet joints.

This can cause:

• A deep ache in the groin, buttock, or outer hip

• Pain that moves or shifts with posture

• Symptoms that don’t change with hip stretches or mobility drills

• Pain during walking, sitting, or after prolonged standing

It’s often misdiagnosed as a hip labral tear, impingement, or arthritis, when in reality, the true source is lumbar spine-related.

💡 Common Physiotherapy-Related Causes:

• Lumbar facet joint irritation or disc referral

• Spinal stiffness or poor movement control

• Weak glutes and poor hip-spine load transfer

• Sedentary posture or desk work habits

• Previous low back injury that’s altered movement patterns

🛠️ What You Can Do:

• ✅ Avoid excessive hip stretching if it’s not helping

• ✅ Work on core strength, lumbar mobility, and spinal posture

• ✅ Trial gentle McKenzie extension or spinal mobility drills

• ✅ Book a physio assessment to clarify the true source of pain

• ✅ Treat the spine and hip together for best results

👩‍⚕️ How Physio Can Help:

• Differentiate between true hip vs spinal referral using clinical tests

• Mobilise stiff segments in the lumbar spine or SIJ

• Address strength and control deficits in the core, hips, and pelvis

• Teach you how to move and load without reproducing pain

• Prevent future flare-ups by treating the full movement chain

🙋‍♀️ Answers to Common Questions

1. How do I know if my hip pain is from my back?

• Pain moves around (groin, outer hip, glute)

• Hip stretches don’t help, or make it worse

• Pain with sitting, bending, or twisting the spine

• No clear hip injury or trauma, and scans may be normal

2. Can this still be treated like hip pain?
Yes — but we also need to treat the spine and nervous system. Once the true cause is found, physio is very effective.

3. Should I still strengthen my hips?
Absolutely — but hip strength alone won’t solve spinal referral. We integrate core, glutes, posture, and spinal mobility into your plan.

4. Can physio tell the difference between hip and back pain?
Yes — a skilled physio can use movement testing, palpation, and load response to pinpoint the source and build the right plan.

5. Will I need a scan?
Not necessarily — many referred pain issues can be diagnosed clinically. Scans are only needed if symptoms are severe, progressive, or not improving.