The Many Causes of Hip Pain

By Julie Donnelly, LMT

The hip is a complicated joint. You have incredible range of motion due to the synchronicity of many muscles, all inserting at different points around your hip and pelvis. Some of the muscles pull your thigh bone in a series of different directions, while other muscles impact your pelvis so it’s in the right position for your leg bone to move. Think of this analogy, if you pull your hair, your scalp hurts. In like manner, if the muscle is pulling on the bone, the joint hurts. To stop joint pain you need to release the tension of the muscle pulling on the bone.

The two primary muscles that cause hip pain are the iliopsoas (pronounced “ill-e-o-so-as”) and the quadriceps. These muscles cause so many problems that I’m writing a book just to explain everything they do, but for our purpose here we’ll just note that they rotate your pelvis forward and down, causing all of the muscles that insert into the pelvis to torque and spasm.

Basically, when the iliopsoas muscle contracts it pulls down on the front side of your lumbar vertebrae and you bend over, or it pulls up on your thigh bone and you lift your leg to take a step or sit down. However, when the muscle is in spasm and it’s pulling your thigh and trunk toward each other, and when you try to stand up you are forcefully separating them, pulling on your lumbar vertebrae and also on the inside of your hip.

Your quadriceps originate on the tip of your anterior pelvis and then insert into your shinbone, just below your knee joint. When the quads are tight they pull hard on the front of your pelvis and you feel it in the front of your hip, and also at your knee.

Another muscle, the tensor fascia lata, is on the outside of your hip. This muscle merges into the iliotibial band (ITB) that inserts into your lateral knee. When the tensor fascia lata is in spasm it not only causes terrible hip pain, but it will also cause the outside of your knee to be painful and to feel like it’s going to pop out of the joint.

To complicate the problem, while the iliopsoas and quadriceps are pulling your hip down in the front, your tight hamstrings are pulling your pelvis down in the back. This will cause pain at the top of the back of your leg, and also at your groin. Plus, as the muscles are pulling on both sides of your pelvis, you will have pain that radiates all around your hip.

The bottom line is, in order to treat hip pain you need to locate the source of the pain. The best way to do this is to look at exactly where you are feeling the pain and then look to see what muscle inserts at that point. This will be the muscle that is causing your pain. If you’re having a problem, come to my forum at and post a message, I’ll be happy to help you figure it out.

Once you know which muscle to treat, the rest is easy:

  1. Locate the most painful point in the length of the muscle. This normally is the spasm that is putting the pressure onto the area where the tendon attaches to the bone. When looking at hip pain, the spasm could be above the hip, below the joint, or even directly on the joint. This is where you may need a little assistance finding the right muscle.
  2. Maintain deep pressure on the point for 60 seconds. Holding pressure directly on the knot in the muscle will flush out toxins and stretch the muscle fibers. When the trigger point is released and the toxins are removed, there is a void in the muscle fiber. The body will fill the void in the muscle with nourishing blood.
  3. Stretch. Stretches are most effective after the muscle spasms have released their strain on the tendon and bone.

While it is useful to have a therapist treat your muscles, it is more beneficial to do regular, even daily, treatments on the muscles that are repetitively strained. Maintaining healthy muscle tone will reward you with greater strength and flexibility, and will eliminate pain!