Pelvis & Hip Pain

Introduction

Hip and pelvic pain can be surprisingly disruptive — affecting how you sit, walk, exercise, sleep, and even how comfortable you feel standing for longer periods. The hip joint and pelvis play a central role in transferring load between your upper and lower body, so when something feels “off” in this area, everyday movement can quickly become frustrating.

Research suggests that around 10–15% of adults experience hip pain at some point, with prevalence increasing with age and activity demands. For many people, symptoms develop gradually rather than from one specific injury, which can make the pain confusing or concerning. The good news is that hip and pelvic pain responds very well to physiotherapy, with the right assessment and a clear, structured plan to restore comfortable movement.

Anatomy & Biomechanics

The pelvis and hips form a strong, stable base for movement, designed to handle large forces while still allowing freedom to walk, run, bend, and rotate. The hip itself is a deep ball-and-socket joint, built for both mobility and load-bearing, while the pelvis acts as a central link between the spine above and the legs below.

Key structures involved include:

• The hip joint – femur (thigh bone) and acetabulum (socket).
• The pelvic bones – ilium, ischium, and pubis.
• The sacroiliac joints – connecting the pelvis to the spine.

These joints are supported by powerful muscles — including the gluteals, hip flexors, adductors, and deep stabilising muscles — that help control movement and absorb load. Pain often develops when these tissues are exposed to more stress than they’re currently prepared for. Importantly, pain does not automatically mean damage; it usually reflects a temporary mismatch between load, movement, and recovery.

What Causes Pelvic & Hip Pain (Acute vs Chronic)

Acute pain tends to come on suddenly and is often linked to a clear event, such as a fall, a sudden twist, sprinting, or lifting something heavy. This pain may feel sharp or catching initially and often settles well with appropriate early management.

Chronic or gradual-onset pain is far more common. In many cases, there isn’t one single cause. Instead, pain builds up slowly as smaller stresses accumulate over time, especially when recovery or movement variety is limited.

Common contributing factors:

• Prolonged sitting at a desk or in the car.
• Sudden increases in walking, running, or gym training.
• Reduced hip strength following an old injury.
• Pregnancy-related or post-partum load changes.
• Compensating for pain elsewhere, such as the lower back or knee.

Common Symptoms

Symptoms vary fluctuation is normal and usually reflect how the area is responding to load and recovery. Common experiences include:

• A dull ache or stiffness in the hip, groin, buttock, or pelvic region.
• Discomfort after sitting for long periods.
• Pain when walking, climbing stairs, or getting in and out of a car.
• Reduced hip movement or a feeling of tightness.
• Occasional sharp or catching pain with certain movements.

Common Diagnoses

Several clinical labels help guide treatment, though imaging findings don't always match symptoms:

• Hip osteoarthritis: Age-related changes that don't always correlate with pain severity.
• Femoroacetabular impingement (FAI): A variation in joint shape that can become symptomatic with certain loads.
• Labral irritation or tears: Sensitivity of the cartilage rim around the hip joint.
• Greater trochanteric pain syndrome: Pain on the outside of the hip related to tendon overload.
• Hip flexor or adductor strains: Muscle-related pain often linked to activity changes.
• Sacroiliac joint pain: Pain arising from the joints between the pelvis and spine.
• Pelvic floor-related pain: Muscles contributing to pelvic stability becoming overactive or underactive.

How Physiotherapy Can Help

Treatment starts with a comprehensive assessment to understand how you move and what matters most to you. We provide a clear explanation of what is contributing to your pain and what can be done to improve it.

Your treatment plan may include:

• Hands-on therapy to reduce pain and improve joint and tissue movement.
• Individualised rehabilitation exercises to restore strength, control, and confidence.
• Education and guidance around posture, activity modification, and load progression.

Most people notice improvement within a few weeks. The goal isn’t just pain relief — it’s restoring function and reducing the risk of future flare-ups for patients in Pretoria, Mayville, and The Moot.