If I say “touch your hip” most everyone would pat the outermost edge of their body where the thighs meet the pelvis. Yes, that is your hips! But it’s not your hip.
Follow me down this little rabbit hole. Hypothetically, you have started to notice a sharp sensation at your outer hip that is worse with activities like standing on one leg, walking, and running. This is understandably alarming and maybe you are starting to get concerned about joint damage, reduced activity level, and maybe even a surgical repair or replacement! You go to PT and now I have the happy challenge of telling you that “your hip is not your hip, it’s your butt.”
Caveat: some people have low back pain that refers to their outer hip and buttock but let’s gloss over that for now. That’s a topic for a whole different blog.
Most outer hip pain is related to the muscles and tendons that attach to the greater trochanter of the femur (this is the fancy word for the outermost part of the top of the femur). These muscles help abduct your leg (move it out to the side of your body), rotate the thigh, and stabilize the pelvis when you are balancing on one leg or dynamically moving from one leg to the other as in walking or running. If the muscle is strained or the tendon is irritated, when you use these muscles the tension and pulling on the irritated tissues causes pain.
Now you get it: Your hip is not your hip, it’s your butt! Or at least it’s part of a multi-directional, multitasking hip muscle complex.
Special side note for people nearing menopause! Hormonal changes right before menopause can lead to tendon changes and tendinitis. This is very commonly seen in the lateral hip but also in the Achilles tendon.
So where is the hip then?! Let’s review some anatomy again. The hip joint is a ball and socket joint with the head of the femur going into the acetabulum of the pelvis.
When people come to me with hip joint pain they usually describe deep groin pain that might radiate into the inner thigh. Acute injuries might be sharp while arthritic injuries are usually more achy and stiff. Hip joint injuries will also hurt with activity because the muscle activity compresses the ball into the socket but the sensation will be in the groin. This is why most people point to their groin when they have hip pain.
Fun Fact! Some people with hip arthritis will feel no pain in the hip or groin at all. For a small percentage of people, the only complaint they have is inner knee pain! This is why it’s so important for physical therapists to look at the joint above and the joint below where someone is having symptoms.
I hope you’ve learned a little more than you knew before about the hip and how your symptoms might be related to the muscles or to the joint itself!