Hip and pelvic pain rarely comes from a single isolated cause. Here are the contributors we see most often in our South Edmonton clinic.

Sacroiliac Joint Dysfunction

The SI joints are designed for small, controlled motion, and problems often stem from motion being either too restricted or too excessive.

• Joint irritation or altered mobility can develop when an SI joint becomes either too stiff (hypomobile) or too mobile (hypermobile) relative to what it needs to do its job well.

• Load transfer issues between the spine and lower limbs can place uneven stress on one or both SI joints, particularly with repetitive or asymmetric movement.

• Typical pain referral patterns for SI joint dysfunction often include one-sided low back or buttock pain, sometimes spreading into the back of the thigh.

• Mechanical versus inflammatory contributors both deserve consideration. Most SI joint pain is mechanical in origin, though inflammatory conditions can occasionally play a role and are part of what a thorough history helps rule in or out. Identifying these conditions is key, as often they require medication in addition to a rehabilitation strategy.

Hip Joint Impingement (FAI)

Femoroacetabular impingement, or FAI, describes a pattern where parts of the hip joint come into contact in a way that limits comfortable movement.

• Femoroacetabular impingement occurs when the ball and socket of the hip joint collide during certain movements, which can create a pinching sensation.

• A movement-related pinching sensation is the hallmark symptom, often felt in the groin or the front of the hip during deep bending or rotation.

• Activity-related symptoms tend to flare with deep squatting, pivoting sports, or prolonged sitting in certain positions.

• Hip mobility restrictions, particularly with hip flexion and internal rotation, are common alongside the pinching sensation.

• Often, these cases had a “hip problem” as a child. Congenital hip conditions can predispose younger adults to experiencing hip pain and are often discovered on X-rays. Yes, our clinic will order X-rays for you if they are deemed necessary!

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Gluteal Tendinopathy

The tendons of your gluteal muscles attach along the outside of your hip and can become a significant source of lateral hip pain.

• Lateral hip pain, felt along the outside of the hip, is the classic presentation of gluteal tendinopathy.

• Load sensitivity in glute tendons develops when these tendons are asked to handle more than their current capacity, often due to a sudden increase in walking, stair climbing, or hill training.

• Pain with lying on the affected side is a common and often frustrating symptom, since it can disrupt sleep.

• Is common around menopause when hormones that keep tendons healthy shift, which can weaken tendons.

Hip Osteoarthritis

Hip osteoarthritis involves gradual “wear and tear” changes in the cartilage and tissue of the hip joint, and it's a common contributor to hip pain, particularly later in life.

• Degenerative changes in the hip joint happen gradually over time and reflect normal tissue adaptation, not necessarily a sign that the joint is "wearing out" beyond use.

• Morning stiffness and reduced range are typical early signs, often easing somewhat as the joint warms up with movement.

• Gradual onset symptoms distinguish hip osteoarthritis from more sudden injuries, with discomfort usually building slowly over months or years rather than appearing overnight.

Low Back Pain

Your lower back and hip are closely connected, and lumbar spine issues can produce symptoms that feel like they're coming from the hip or pelvis.

• Referred pain from the low back can travel into the buttock, hip, or thigh, sometimes without significant low back pain itself.

• Nerve root irritation in the lower spine can produce pain, numbness, or tingling that extends into the leg, mimicking or overlapping with hip symptoms.

• Overlap between back and hip symptoms is common enough that a thorough assessment always considers the lumbar spine when evaluating hip or pelvic pain.

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Muscle Imbalances and Movement Dysfunction

How your muscles work together around the hip and pelvis has a major influence on load distribution and comfort.

• Weak glutes and core stability deficits can shift more load onto other structures, including the SI joint and the hip joint itself.

• Tight hip flexors or adductors can alter pelvic positioning and movement mechanics, contributing to pain over time.

• Movement compensation patterns often develop gradually as the body finds ways to avoid discomfort, potentially creating new strain elsewhere if left unaddressed.

Postural and Overuse Factors

Daily habits and repetitive demands can add up to meaningful strain on the hip and pelvis. Identifying these is key in managing any bone, muscle or joint problem!

• Prolonged sitting changes hip flexor length and pelvic position, which can contribute to stiffness and discomfort over time. Sitting can be considered the “new smoking” in observing the negative health of prolonged sitting.

• Standing desks. Wait a minute???? Didn't we just say too much sitting is bad? Well, too much standing and “posting” on one leg, as people often do out of habit at a standing desk, can also be a root cause of hip, SIJ, or low back problems. Everything in moderation!

• Repetitive strain from running, cycling, or other repetitive activities can outpace tissue capacity if training volume increases too quickly.

• Occupational loading patterns, such as standing for long shifts or repetitive lifting and bending, are common contributors we see in working adults.

Post-Traumatic Hip and Pelvic Pain

Injury to the hip or pelvis can lead to ongoing symptoms, sometimes evolving in ways that differ from expectations. 

• Falls, sports injuries, or motor vehicle collisions are common mechanisms of hip and pelvic injury, ranging from a direct impact to an awkward landing or twisting motion.

• Acute versus chronic progression matters for understanding your situation. Some injuries resolve predictably, while others develop into more persistent patterns that benefit from a structured rehabilitation approach.

• Recovery considerations depend on the specific structures involved and the nature of the original injury, which is why a thorough assessment after any traumatic hip or pelvic injury is valuable.

• Other health considerations: While there are many health considerations related to menopause, decreased bone density, which often accompanies this hormonal change, should be noted. Weaker bones can be more prone to subtle fractures even from little bumps. Sometimes these subtle fractures are missed on X-ray and require a bone scan for proper diagnosis. Don’t worry, our office will order a bone scan if necessary for you!