Hip and pelvic pain

Understanding groin pain

Groin pain typically refers to discomfort or pain in the area of the groin, which is the region between the abdomen and the thigh. It can arise from various causes, ranging from injuries to medical conditions. Groin pain is common among athletes but can affect anyone.

Definitions and sources of groin pain:

  • Adductor-related groin pain

  • Iliopsoas-related groin pain

  • Inguinal-related groin pain

  • Pubic-related groin pain

  • Hip–related groin pain

Femoroacetabular impingement

Femoroacetabular impingement (FAI) is a condition that affects the hip joint, where there is abnormal contact between the femur (thigh bone) and the acetabulum (the socket of the pelvis). This can cause pain and damage to the joint over time, leading to hip dysfunction.

Two types of FAI:

  1. Cam impingement: This occurs when the head of the femur is not perfectly round, which leads to it rubbing against the acetabulum, especially when the hip is in certain positions, like deep flexion.

  2. Pincer impingement: This is when the acetabulum extends too far over the femoral head, causing a “pinching” effect when the hip moves.

Common symptoms:

  • Hip pain (especially in activities that involve bending or twisting the hip)

  • Stiffness, and reduced range of motion.

  • Pain in the groin, front of the hip, or outside of the thigh.

Hip labrum tear

A hip labrum tear refers to damage to the labrum, which is a ring of cartilage that lines the edge of the acetabulum (the hip socket). The labrum helps to stabilise the hip joint by deepening the socket, making the joint more secure, and acting as a cushion to absorb shock.

Labrum tear symptoms:

  • Pain in the hip or groin: This is typically felt during activities like prolonged standing, walking, or twisting movements.

  • Clicking, locking, or popping: Some people report a sensation of the hip joint catching or clicking, especially when moving the leg in certain directions.

  • Reduced range of motion: There may be a feeling of stiffness or restriction in the hip joint.

  • Weakness: A tear can also lead to muscle weakness around the hip.

Pelvic torsion

For the most part, asymmetry in the pelvis is not symptomatic, but for some people an imbalance in the pelvis can affect posture, gait, and the alignment of the spine, hips, and lower limbs. Pelvic torsion can result in a variety of symptoms, ranging from mild discomfort to more significant pain or dysfunction.

Typical symptoms:

  • Lower back pain

  • Hip pain

  • Postural issues

  • Leg length discrepancy

Hip osteoarthritis

Osteoarthritis in the hip is the most common form and is generally age-related. The wear and tear on the cartilage lead to its gradual breakdown, and eventually, the bones may begin to rub directly against one another.

Typical hip OA symptoms:

  • Pain: Typically felt in the groin area, but can also radiate to the outside of the hip, buttocks, or thighs.

  • Stiffness: Difficulty moving the hip joint, especially in the morning or after sitting for extended periods.

  • Reduced Range of Motion: Difficulty with activities that require bending or twisting the hip.

  • Swelling and Tenderness: The hip may feel swollen or tender to touch in the affected area.

  • Crepitus: A cracking or grinding sensation when moving the hip, caused by roughened joint surfaces.

The pregnant pelvis

Many changes occur in the pelvic region during pregnancy to accommodate the growing baby and prepare for labour. The body undergoes several structural and hormonal adaptations to support the increased weight, the developing uterus, and the upcoming delivery.

Key changes:

  • Relaxation of Ligaments:

  • Pelvic Tilt:

  • Increased Blood Flow:

  • Enlargement of the Uterus:

  • Increased Weight

Common symptoms during pregnancy:

  • Pelvic Girdle Pain (PGP)

  • Sciatica

  • Round Ligament Pain

  • Back Pain