Hip pain is one of the most commonly misunderstood and mismanaged areas in musculoskeletal healthcare. Because the hip is a deep joint surrounded by layers of muscle and connective tissue, and because it plays a central role in nearly every lower body movement, hip pain can present in a wide variety of ways and is frequently driven by factors that are not immediately obvious without a thorough evaluation.
At Cross the Line Physical Therapy and Performance, hip evaluations look beyond the joint itself to assess the entire lower extremity and lumbar spine, since problems at the hip are often connected to movement patterns and strength deficits both above and below it. Below is an overview of the most common hip conditions we treat in Winter Park and the greater Orlando area.
Hip Pain Treatment in Winter Park, FL | Sports Physical Therapy
Hip Pain and Mobility Restrictions
General hip pain and mobility restrictions are among the most common complaints we see from both athletes and active adults. Hip stiffness that limits how far you can bend, rotate, or extend the hip can affect everything from your running stride and squat depth to simple daily activities like getting in and out of a car or climbing stairs.
Hip mobility restrictions are frequently caused by a combination of muscular tightness, joint capsule stiffness, and movement patterns that have developed over time in response to discomfort or previous injury. In many cases, what feels like a hip flexibility problem is actually a strength and control problem, where the hip lacks the muscular support needed to move freely and confidently through its full range of motion.
A thorough evaluation is the most reliable way to determine what is actually driving your hip pain or mobility limitation and what the most effective treatment approach will be.
Hip Labral Tears and Femoroacetabular Impingement (FAI)
The labrum is a ring of tissue that lines the hip socket and plays an important role in joint stability, shock absorption, and the distribution of forces across the hip. A hip labral tear involves damage to this tissue, most commonly at the front of the hip, and typically presents as a deep aching pain in the groin or front of the hip, sometimes accompanied by clicking, catching, or a feeling of the hip locking in certain positions.
Femoroacetabular impingement, or FAI, is one of the most common underlying causes of hip labral tears. It occurs when there is abnormal contact between the ball and socket of the hip joint due to bony irregularities, either on the ball of the joint, the socket, or both. This abnormal contact can pinch the labrum over time, eventually leading to tearing.
Not all hip labral tears require surgery. Many patients with labral tears and FAI respond well to a Physical Therapy program focused on improving hip strength, mobility, and movement mechanics to reduce the forces that cause impingement and irritation. When surgery is the right path, our Post-Surgical Physical Therapy FAQ covers our approach to post-operative rehabilitation in detail, including how we approach hip labral repair recovery.
Hip Flexor and Adductor Strains
The hip flexors and adductors are among the most heavily loaded muscle groups in sports involving running, kicking, cutting, and explosive lower body movements. Strains to either of these muscle groups are particularly common in soccer players, runners, and court sport athletes, and can range from mild discomfort and tightness to significant tears with immediate pain and weakness.
Hip flexor strains typically present as pain at the front of the hip or groin that worsens with lifting the knee or sprinting. Adductor strains, commonly called groin strains, present as pain along the inner thigh that is aggravated by side to side movements, kicking, or bringing the legs together against resistance.
Returning to sport too quickly after either of these injuries is one of the most common reasons they become chronic or recurring. A structured rehabilitation program that progressively loads the muscle back to full capacity and addresses the demands of your specific sport is essential for a complete and lasting recovery.
Gluteal Tendinopathy
Gluteal tendinopathy involves irritation of the tendons attaching the gluteal muscles to the outside of the hip. It typically presents as pain on the outside of the hip that may radiate down the outside of the thigh, and is often aggravated by activities like climbing stairs, walking on inclines, crossing the legs, or lying on the affected side at night.
This condition is particularly common in active adults and runners, and is frequently misdiagnosed as hip bursitis. While bursitis can coexist with gluteal tendinopathy, the primary driver is almost always tendon irritation rather than bursal inflammation, and treating it as bursitis alone rarely produces lasting results.
Gluteal tendinopathy responds well to a carefully progressed loading program targeting the gluteal muscles. The hip and glute strength work discussed in our Running Injury FAQ is directly relevant to understanding why this region is so commonly affected in active individuals.
Athletic Pubalgia (Sports Hernia and Core Muscle Injury)
Athletic pubalgia, often called a sports hernia or core muscle injury, involves pain in the lower abdomen and groin caused by weakness or disruption of the soft tissue structures in the pubic region. Despite the common name, it is not a true hernia in the traditional sense. It most commonly develops in athletes who perform repetitive high-speed cutting, twisting, and kicking movements, and is particularly prevalent in soccer, hockey, and football players.
Athletic pubalgia typically presents as a deep, aching pain in the groin or lower abdomen that worsens with explosive movements, kicking, sit-ups, or adductor squeezing. It can be a difficult condition to diagnose accurately since it overlaps with other groin and hip conditions, and imaging findings do not always correlate with symptoms.
Physical Therapy for athletic pubalgia focuses on strengthening the core, hip flexors, and adductors in a progressive and sport-specific manner. While some cases require surgical intervention when conservative treatment has been exhausted, many athletes respond well to a structured Physical Therapy program without needing surgery.
Hip Osteoarthritis
Hip osteoarthritis involves gradual wear of the cartilage within the hip joint over time, leading to stiffness, reduced range of motion, and pain that may worsen with activity or after prolonged periods of rest. It is one of the most common sources of hip pain in active adults and is not an inevitable consequence of aging, though it does become more prevalent as we get older.
While the structural changes of osteoarthritis cannot be reversed, the pain and functional limitations associated with it are heavily influenced by the strength and movement quality of the surrounding muscles. A targeted Physical Therapy program focused on building hip and gluteal strength, improving mobility, and optimizing movement mechanics can meaningfully reduce pain and improve function, often allowing people to remain significantly more active than they might expect given their diagnosis.
Hip osteoarthritis does not automatically mean hip replacement is in your future. For many people, Physical Therapy provides enough improvement in pain and function that surgery is delayed for years or avoided altogether.
Post-Operative Hip Rehabilitation
Several hip surgeries benefit significantly from a structured rehabilitation program, including hip labral repair, FAI surgery, and total hip replacement. Recovery timelines and protocols vary considerably depending on the specific procedure.
For hip labral repair and FAI surgery, rehabilitation involves a carefully staged progression from early protected mobility through progressive strengthening and eventually sport-specific training, with return to sport guided by objective strength and movement criteria rather than time alone.
For total hip replacement, the goal is restoring strength, mobility, and confidence in the joint so that daily activities and an active lifestyle can be resumed as fully as possible. At Cross the Line Physical Therapy and Performance, every post-surgical plan is built around your specific goals from day one, whether that means returning to recreational sport, staying active in the gym, or simply moving through daily life without pain or limitation.
Our Post-Surgical Physical Therapy FAQ covers our overall approach to post-operative rehabilitation in more detail, including our use of Blood Flow Restriction Training to support early strength development when traditional loading is not yet appropriate.
Not Sure Which Category Fits Your Hip Pain?
If your hip pain does not fit neatly into one of these categories, or you are simply not sure what is going on, that is exactly what an evaluation is for. Call, text, or fill out our contact form to schedule an evaluation at Cross the Line Physical Therapy and Performance in Winter Park, FL.