Lateral Hip Pain: Physical Therapist Tips for How to Prevent and Relieve It

You’ve been adhering to the same routine for years when, suddenly, you find yourself sidelined by a nagging pain on the outside of your hip. Maybe it impacts your workout routine, job, daily activities, or your ability to go up and down the stairs in your home. Regardless of how it impacts your day, it’s annoying and you want to know what you can do about it.

Lateral hip pain is a very common condition, says Steven Goostree, PT, DPT, OCS, a physical therapist at Hinge Health. It can come on gradually or very suddenly, and although it usually doesn’t indicate a serious issue, it can certainly be uncomfortable. Thankfully, there are some relatively easy things you can do at home to relieve pain and get you back to doing what makes you you.

What Is Lateral Hip Pain?

Here’s a quick primer on your hip: It’s a ball-and-socket-joint. Your femur — the long thigh bone with a rounded top — fits into the cup-like socket of your pelvis. This gives your hips a wide range of motion, allowing you to swing your leg backward and forward and side to side. The hips also provide support for your legs to hold your body upright. Next time you climb a flight of stairs, walk to work, or kick a soccer ball to your kids, you can thank your hips for helping you out.  

As you can see, your hips have a big job, but they’re designed to handle those various responsibilities. The hip is one of the largest joints in the body, and surrounding muscles, ligaments, and cartilage make the hips very strong and resilient. Still, there are still many factors that can contribute to hip pain or injury. 

“If you have weak or tight muscles, overdo a workout, or begin to develop a condition like arthritis, you may really feel it in your hips,” explains Dr. Goostree. Because the hip is so big, it’s also common to experience pain in specific areas of the hip, such as the outer aspect of the hip. In some cases, this can help you determine how best to manage your pain and begin healing.  

Causes of Outer (Lateral) Hip Pain

Remember, your hips are incredibly strong and resilient. Normally, the muscles, cartilage, tendons, ligaments, and everything else works together so you can go about your daily activities without pain or having to give one minute of thought to your hips. Sometimes though, things get out of whack and contribute to outer hip pain. Although inconvenient, each of these factors can usually be addressed with conservative measures, such as gentle movement and exercise therapy (more information below). 

Here are some of the most common contributing factors to outer hip pain:

• Gluteal tendinopathy. Your glutes, which are muscles that run from your pelvis to the top of your femur, help your hips move. “Sometimes the muscles and tendons that surround the hip get compressed or irritated and contribute to outer hip pain,” explains Dr. Goostree. “It’s one of the most common causes of hip pain.”

• Hip osteoarthritis. It’s very normal for joints to change over time, just as it’s normal to develop gray hair on your head as you age. Osteoarthritis causes changes to a joint’s cartilage, the smooth, slippery surface that cushions your bones and allows them to move easily. Sometimes these changes are completely unnoticeable, and other times they contribute to symptoms such as pain. 

• Overuse. If you notice hip pain when walking, it may be because you’ve ramped up your activity quicker than your body was prepared for. This can irritate your iliotibial (IT) band, the long band of connective tissue that runs from your knee to your hip, and cause some pain, notes Dr. Goostree. 

• Referred pain. Believe it or not, your outer hip pain may not be coming from your hip. “Oftentimes, it’s actually related to your lower back,” says Dr. Goostree. The hips and spine are connected by muscles, ligaments, and nerves, which create common pathways to pain. No matter where the pain starts, it’s much less important to focus on what’s causing your pain and instead think about how to get relief. Regular gentle movement is often the best thing you can do for persistent back and hip pain.

In the past, outer hip pain was often thought to be related to bursitis — inflammation of the fluid-filled sacs (bursa) that cushion the joints. But research now shows that it’s usually tendons, not bursa, that are the culprit of outer hip pain, explains Dr. Goostree.

Prevention Tips

Lateral hip pain usually isn’t serious and is often related to your daily activities. While it can usually be managed with gentle movement and activity modifications, there are certain measures you can take to prevent it from occurring or recurring, especially if you’re prone to hip pain.

Adjust your standing position. Staying in the same position for long periods of time, including standing, can trigger outer hip pain. If possible, change positions frequently to give your hips a break. If you’re not able to move around or change positions (say, while at work), try to stand on a soft, cushioned surface with an equal amount of weight on each leg. Or, rest one foot on a foot stool and switch legs periodically to alleviate some pressure on your hips.

Watch your carrying mechanics. Whether you’re carrying a heavy backpack or a tired toddler, try to distribute your weight evenly, advises Dr. Goostress. “I see a lot of new parents who carry their baby on the same hip all the time, which can really irritate their glute muscles and tendons over time.” There’s no “right” or “wrong” way to carry something. You just want to find a technique that’s comfortable for you and incorporate some variety.

Uncross your legs every once in a while. If you stay in the same position for a long time, this could contribute to hip pain, including if you stay in a cross-legged position for too long. To be clear, sitting cross-legged isn’t bad for you, or worse than any other sitting position. But staying in any position for too long — including cross-legged —  may bring on some stiffness and muscle tension. Generally speaking, it helps to keep your knees lower than your hips when sitting. If your feet don’t reach the floor, use a foot stool. If sitting cross-legged is most comfortable for you, create some variety by alternating which leg crosses over the other and where you cross your legs (at the knees, ankles, and placing an ankle on top of the opposite knee).

Stay active. If you don’t move your hips, their muscles can weaken and tighten up, which makes you more prone to outer hip pain, says Dr. Goostree. Any type of movement is beneficial, but walking, stretching, and doing strengthening exercises such as squats and lunges can be especially beneficial (more information below). A quick warm-up routine before a workout can also help reduce hip pain. “This helps increase blood flow to the area, so you’re less likely to stretch or strain hip muscles while you exercise,” says Dr. Goostree.

Work on your balance. “My patients are always very surprised to learn that their outer hip muscles are important for balance,” explains Dr. Goostree. Practicing simple balance exercises, like standing on one leg for 30 seconds or walking heel-to-toe across the room, helps strengthen hip muscles while also reducing fall risk.

How to Relieve Outer Hip Pain

There’s plenty you can do to treat your hip pain. “Most folks respond well to conservative management such as physical therapy, and they very rarely need medical interventions such as injections or surgery,” says Dr. Goostree. Here’s what to do for lateral hip pain treatment:

• Get physical therapy. A physical therapist will teach you stretching and strengthening exercises to help strengthen surrounding muscles, which can be very effective for outer hip pain. Almost 80% of people who receive physical therapy and education for gluteal tendinopathy see improvements in pain within eight weeks, which is better than steroid injections and a “wait and see” approach, according to a study published in the British Medical Journal. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit

• Use heat. Heat increases blood flow, promotes muscle relaxation, and helps relieve ongoing aches and pains. Applying heat, such as with a hot water bottle or soaking in a hot bath, can help relieve pain and improve range of motion, says Dr. Goostree.

• Switch your sleeping position. If you’re a side sleeper, it may help to temporarily avoid sleeping on the painful side and rest your top leg on a pillow alongside your body, advises Dr. Goostree. This will help take pressure off of your sore hip.  

• Modify activity. You may wonder, “Can I still go running with lateral hip pain?” Yes, you sure can, reassures Dr. Goostree. Continuing to exercise should help your pain, but you may need to adjust your running intensity or frequency to avoid pain and allow your body to heal. That may mean that you opt for a flat jogging route rather than your usual hills, or do a jog/walk to relieve pressure on hip muscles and tendons. Alternatively, walking, biking, swimming, and strength training may be great options to explore.  

• Use over-the-counter (OTC) medication. Over-the-counter (OTC) medication such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be considered to help reduce pain and swelling. It’s important to make sure that you are safely able to take these medications, based on your medical history.

When to See a Doctor

Most of the time, outer hip pain does not indicate a serious issue and can be treated at home, says Dr. Goostree. See your doctor if:

• You are not seeing progress on your own (pain is getting worse or not getting better) after a few weeks

• Your symptoms interfere with your everyday activities, such as sleep, or make it very hard to do things like walk upstairs or sit on the toilet 

• You have hip numbness or tingling

• Hip pain worsens after a trauma, such as a car crash

• Hip pain is accompanied by signs of infection like fever, chills or redness

The best way to both treat and prevent outer hip pain is to focus on specific exercises at home that strengthen hip muscles, says Dr. Goostree. The following strengthening exercises recommended by Hinge Health physical therapists can help beef up the muscles around your hips and reduce pain. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Movement is Medicine 

“Your hip is a huge ball-and-socket joint that craves movement,” says Dr. Goostree. “If you don’t give it the activity and movement it wants, its muscles and tendons may begin to stiffen up and ache.” Even slight tweaks in your activity level, like taking the stairs more than the elevator or parking further away from the door to get more steps in, can make a huge difference in preventing and treating outer hip pain. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Alaia, M. J. (2020, July). Hip Strains. OrthoInfo — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/hip-strains/

2. Foran, J. R. H. (2021, February). Osteoarthritis of the Hip. OrthoInfo — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/osteoarthritis-of-the-hip/#:~:text=In%20osteoarthritis%2C%20the%20cartilage%20in,in%20bone%20rubbing%20on%20bone.

3. Mulcahy, J. A. (2020, June 2). 6 Exercises to Promote Balance That You Can Do at Home. American Physical Therapy Association. https://www.choosept.com/health-tips/6-exercises-promote-balance-home

4. Noake, J., Masci, L., & Pedret, C. (2020, November 17). Lateral ‘Hip’ Pain? Don’t Always Blame the Glutes….Blog: British Journal of Sports Medicine

5. Gluteal Tendinopathy. (2020, May 3). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22960-gluteal-tendinopathy#:~:text=What%20is%20gluteal%20tendinopathy%3F,pain%2C%20especially%20in%20older%20women.

6. Your Guide to Lateral Hip Pain. (n.d.). National Health Service. Retrieved from https://www.solent.nhs.uk/media/1548/your-guide-to-lateral-hip-pain.pdf

7. Hip Pain. (2021, June 13). Penn Medicine.  https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/hip-pain

8. Paoloni, J. (2021, October 1). Approach to the Adult with Unspecified Hip Pain. UpToDate. https://www.uptodate.com/contents/approach-to-the-adult-with-unspecified-hip-pain

9. Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., Wajswelner, H., & Vicenzino, B. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ, 361, k1662. doi:10.1136/bmj.k16622