Hip Pain in Active Adults: Front, Side and Back of the Hip Explained

Hip pain physiotherapy in Edmonton starts with one practical question: where exactly do you feel it? Pain at the front of the hip or groin, on the outer side of the hip, or deep in the buttock near the sit bone tends to follow different patterns, and each one responds to a different plan. At Aura Physiotherapy in downtown Edmonton, a physiotherapist looks at where your pain sits, what makes it worse and how your hips and trunk handle load, then builds a plan that keeps you as active as possible while you recover.

This article is written for active adults: runners, cyclists, gym-goers, hockey and soccer players, and people who sit at a desk all day and train in the evening. It covers the common hip pain patterns by location, why the low back can be the real source, why rest alone often falls short, the signs that need a doctor, and how an assessment at Aura works.

General information only, not a diagnosis. Our physiotherapists, chiropractor and massage therapists assess every patient first.

Where is your hip pain? Front, side or back

People say "hip pain" to describe very different spots. Notice where you would point if someone asked you to show them. That location is not a diagnosis, but it gives your physiotherapist a useful starting point.

• Front of the hip or groin: often linked to the hip flexors, the adductors (inner thigh muscles) or the hip joint itself. It may show up when you lift your knee, kick, change direction or sit for a long time.
• Side or outer hip: often linked to the gluteal tendons that attach to the bony point on the side of your hip. It may hurt when you lie on that side, climb stairs or stand on one leg.
• Back of the hip or buttock: can come from the hamstring tendon where it attaches at the sit bone, from the deep buttock muscles, or from the low back.

Pain can also spread. Groin pain may creep into the front of the thigh, and buttock pain can travel down the back of the leg. Keep a simple note of where it hurts, what sets it off and what eases it. That record makes your assessment more useful.

Front of the hip and groin pain: strains and pinching pain

Groin and front-of-hip pain is common in sports with kicking, sprinting and quick changes of direction, like soccer and hockey. Runners who add speed work or hills quickly can feel it too.

Hip flexor and adductor strains

A hip flexor strain usually hurts at the front of the hip when you lift your knee against resistance, sprint or kick. An adductor strain sits on the inner thigh near the groin and tends to flare with skating strides and side-to-side movement. Both can start with a sudden pull during play, though some build up over weeks. Groin pain physiotherapy for these patterns usually focuses on restoring strength and control through the inner thigh, hip and trunk before speed and power return.

Pinching or deep pain at the front of the hip

Some people describe a deep, pinching ache at the front of the hip when they squat low, sit in a low chair or pull the knee toward the chest. This is sometimes called impingement-type pain. Many factors can contribute, including hip shape, how the joint is loaded and how much deep bending your sport asks for. An article cannot tell you what is going on in your hip. A physiotherapist can assess your hip movement and strength, and refer you to a doctor if imaging or a medical opinion would help.

Outer hip pain: the gluteal tendons and the side of the hip

Outer hip pain usually sits over the bony point on the side of the hip, and it can spread down the outer thigh. Clinicians often look at the gluteal tendons here, which help hold your pelvis level every time you stand on one leg.

Common aggravating activities include:

• Lying on the painful side at night, or on the other side with the upper knee dropped across
• Climbing stairs or walking uphill
• Standing on one leg, for example while putting on pants
• Standing with your weight shifted onto one hip, or sitting with your legs crossed
• A sudden jump in running distance, hill work or step-based classes

Tendons generally respond to load. Too much, too soon can irritate them, and too little leaves them less able to cope. That is why stretching the outer hip hard or stopping all activity often does not help much on its own. A physiotherapist will usually look at how you stand, step and balance on one leg, then build gradual strengthening the tendon can tolerate. Small changes help too, such as a pillow between your knees at night.

Back of the hip, the sit bone and pain from the low back

Pain deep in the buttock or right at the sit bone has a few common sources, and sorting them out is a key part of the assessment.

Hamstring tendon pain at the sit bone

Hamstring tendon pain usually sits right at the bony point you sit on. It often feels worse when sitting on a hard chair, running uphill, sprinting, doing lunges or bending forward with straight legs. Cyclists and runners can notice it after a long ride or run, and desk workers may feel it build through the day. As with outer hip pain, the tendon tends to respond to well-planned loading rather than complete rest or aggressive stretching.

When the low back is the source

The low back can refer pain into the buttock, the back of the hip and sometimes down the leg. If your hip pain changes with bending or sitting, comes with back stiffness, or travels below the knee with tingling or numbness, your physiotherapist will check your spine as well as your hip. Our guide to low back pain physiotherapy in Edmonton explains what that part of the assessment looks at.

Load, capacity and strength: why rest alone is often not enough

Most activity-related hip pain can be understood as load versus capacity. Load is everything you ask your hips to do, from running and skating to long hours of sitting. Capacity is how much your tissues can handle right now. Pain often shows up when load climbs faster than capacity, such as a new training block or the start of hockey season. Rest lowers the load, so pain often settles for a while, but it does not build capacity. Go back to the same training and the pain can return.

Modify training rather than stopping everything

The goal is usually to find a level of activity your hip tolerates and keep going from there: shorter or flatter runs, cycling or swimming in place of some runs, less squat depth, fewer sprints and hard cuts, and short walks to break up long sitting. Runners can find more in our article on returning to running after injury.

Strength work for the hips and trunk

Strength is usually the backbone of the plan. Depending on your assessment, that may include the gluteal and abductor muscles that keep your pelvis level, the adductors that hockey and soccer demand, the hip flexors and hamstrings, and trunk control. Exercises start at a level your hip tolerates, then get heavier or more sport-specific. Manual therapy may be used alongside exercise to help with pain and movement. For team sport, see our guide to sports injury rehab and return to sport.

When to see a doctor or seek urgent care

Most hip pain in active adults comes from muscles, tendons and joints responding to load. Some signs, though, need medical attention first. See a doctor or go to emergency care if you have:

• A fall or impact followed by being unable to put weight through the leg
• A hot, red or swollen hip or other joint
• Hip pain with a fever or feeling generally unwell
• Night pain that is not related to movement or position and does not ease with rest
• Buttock or leg pain with numbness in the groin or inner thighs, or changes in bladder or bowel control (go to emergency care)

A child or teen with a limp or hip pain should be seen by a doctor, especially if the limp has no clear cause or comes with knee or thigh pain. Hip problems in younger people can show up as pain in the knee, so a medical assessment matters.

If you are unsure, a physiotherapist can screen for these signs during your assessment and refer you on when a medical opinion is the right next step.

How an assessment at Aura works

Your initial assessment at Aura is 40 minutes, so there is time to talk through your history, your training and what you want to get back to. Physiotherapy is direct access in Alberta, so you do not need a referral to book, though some insurance plans ask for one before they reimburse.

During the assessment, your physiotherapist will usually:

• Ask where the pain is, how it started and what changes it
• Check hip range of motion and strength
• Watch how you squat, step, balance on one leg and, where relevant, run or hop
• Screen the low back and check for signs that need a doctor

From there, you get a written treatment plan in plain language: the likely contributors, what to change in training for now, your starting exercises and how progress will be measured. You see the same therapist every visit, which keeps the plan consistent. Aura direct bills 16+ insurers, and what you pay depends on your plan. Details are on our insurance FAQ, and you can verify any physiotherapist's registration with the CPTA.

Frequently asked questions about hip pain physiotherapy

Why does my hip hurt when I run?

Hip pain when running often appears after a change in load, such as more distance, more hills or faster workouts. The location gives clues, because front of hip, outer hip and sit bone pain tend to follow different patterns. An assessment looks at your strength, single-leg control and training history to work out what is contributing.

Should I stop exercising if my hip hurts?

Not always. For many activity-related hip problems, adjusting training works better than stopping everything, because rest lowers load but does not build capacity. See a doctor first if you have red flag signs like a fall with inability to bear weight, fever or a hot swollen joint.

Why is outer hip pain worse at night?

Lying on the painful side compresses the tissues over the bony point of the hip, and lying on the other side can stretch them if your upper knee drops across. A pillow between the knees often helps. A physiotherapist can also look at strength and daily habits that keep the area irritated.

Can my hip pain be coming from my back?

Yes. The low back can refer pain into the buttock and the back of the hip, and sometimes down the leg. That is why a hip assessment usually includes a check of your spine, especially if back movement or sitting changes your symptoms.

Do I need a referral to see a physiotherapist for hip pain in Edmonton?

No. Physiotherapy is direct access in Alberta, so you can book an initial assessment at Aura without a referral. Some insurance plans require a referral before they reimburse, so check your plan first.

Important: This article is general information only. It is not medical advice and it cannot be used to diagnose or treat any condition. Every patient is assessed first by one of our registered physiotherapists, our chiropractor or our registered massage therapists before any treatment, and your care plan is based on that assessment. If you have symptoms, please book an assessment.

Related service: Sports rehabilitation and manual therapy

Related reading: Low back pain physiotherapy in Edmonton and Returning to running after injury