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Bluebird Sport & Spine
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Hip Pain

Hip pain covers several distinct problems that feel similar from the outside, from tendon irritation on the outer hip to joint restriction at the front and referred pain from the low back. Sorting out which one you have is most of the work, because the treatments differ.

What people mean by hip pain

“Hip pain” is one of the least specific complaints there is, because at least four different problems live under the label and they need different plans.

Outer hip. Pain over the bony point on the side, tender to touch, worst lying on that side at night. Usually gluteal tendinopathy, which is irritation where the gluteal tendons attach. It is still often called bursitis, but the bursa is generally secondary.

Groin and front. A deep pinch in the crease of the hip, worse with deep squatting, getting out of a car, or bringing the knee toward the chest. Often related to hip impingement, where the ball and socket make earlier contact than they should.

Buttock. Deep ache behind the hip, sometimes travelling down the back of the thigh. This is where hip and spine overlap, and where the low back is frequently the actual source.

Front, muscular. Hip flexor strain, usually with an obvious event behind it, such as a sprint, a kick or a heavy lift.

The useful rule of thumb: pain in the groin points at the joint, pain on the side points at tendons, and pain travelling past the knee points at the back.

Why it shows up in active Okanagan people

Hiking is the local driver. Kal Park, the BX trails, Enderby Cliffs and Rose Swanson all involve sustained climbing and descending, and descending in particular loads the gluteal tendons hard while the muscle is fatiguing. People often describe a hike that felt fine at the time and a hip that complained for a week afterwards.

Cycling adds a different version: long hours in a flexed hip position with a narrow range of movement, which tends to quieten the glutes and tighten the front of the hip.

Then there are the desk and driving patterns, which do the same thing more slowly. Sitting is simply a lot of time in hip flexion with the glutes doing very little.

In older adults, outer hip pain becomes more common again, particularly in post-menopausal women, where tendon tissue is more susceptible. That is a well-recognised pattern rather than an inevitability, and it responds to loading like any other tendon.

How we assess and treat it

Assessment is the part that earns its keep here, because the four presentations above need genuinely different approaches. We test hip range and which movements reproduce the pain, strength through the glutes in several positions, whether the low back and sacroiliac joint reproduce your symptoms, and how you move through a step, a squat and a single leg stance.

Treatment then follows what we find:

Alongside that we usually change two or three daily habits, because they often matter more than anything done in the clinic: how you sleep, whether you stand on one leg all day, and how quickly your hiking or running volume is climbing.

Red flags that need a doctor

Seek medical assessment rather than booking with us if you have:

  • Hip pain after a significant fall, particularly if you cannot bear weight
  • An inability to put weight through the leg at all
  • Fever, redness or heat around the joint, which can indicate infection
  • Night pain that is unrelenting and not related to position, alongside unexplained weight loss
  • A history of cancer with new hip or thigh pain
  • Groin pain in a child or adolescent, which has its own specific causes and needs assessment
  • Sudden severe pain with the leg appearing shortened or rotated, which suggests a fracture

Anyone on long-term corticosteroids with new deep hip pain should also be assessed medically.

When to book

Book when hip pain has lasted more than a couple of weeks, when it is disturbing your sleep, when it is changing how you walk, or when it keeps returning every time you increase your activity. The night-pain presentation in particular tends to respond well, and people put up with it for far longer than they need to.

Common symptoms

  • Pain on the outer hip, often worse lying on that side at night
  • Deep groin pain, sometimes described as a pinch at the front of the hip
  • Stiffness after sitting, easing once you get moving
  • Pain climbing stairs, getting out of a car or standing from low chairs
  • A catching or clicking sensation with certain movements
  • Pain referred down the outside of the thigh, usually stopping above the knee

Common causes

  • Rapid increases in walking, hiking or running volume
  • Reduced gluteal strength, so the tendons take load the muscle should carry
  • Prolonged sitting, which shortens the front of the hip and quiets the glutes
  • Hip joint shape, which makes impingement more likely in some people
  • Single-sided habits such as always standing on the same leg or carrying a child on one hip
  • Low back or sacroiliac problems referring pain into the hip region

Services we use for this

Frequently asked questions

Is my hip pain coming from my hip or my back?
It is a genuinely common mix-up and worth testing rather than guessing. As a rough guide, true hip joint pain is usually felt in the groin and often reproduced by rotating the hip, while pain on the outer hip is more often tendon-related, and pain that travels past the knee is more likely coming from the low back. The examination sorts it out, which matters because treating the wrong one wastes weeks.
Why does it hurt most at night?
Lying on the painful side compresses the tendons where they wrap over the bony point of the hip, and lying on the other side with the top leg dropped forward stretches them across it. Both positions load exactly the tissue that is irritated. A pillow between the knees is usually the single most effective thing you can change this week.
Should I stretch it?
Often not, and this is where a lot of people go wrong. Gluteal tendinopathy, the most common cause of outer hip pain, is usually aggravated by the compressive stretches people reach for, such as pulling the knee across the body. Loading the tendon tends to help where stretching it does not. We will tell you which category you are in rather than giving you a generic stretch sheet.
Do I need an X-ray or MRI?
Usually not at the start. Most hip pain is diagnosed from history and examination, and imaging findings like mild arthritis or a slightly unusual joint shape are common in people with no pain at all. Imaging becomes useful when symptoms are not responding as expected, when there is significant trauma, or when the examination points to something structural.
How many visits will I need?
It depends on what's going on, but most patients with uncomplicated musculoskeletal issues notice meaningful improvement within two to four visits and resolve within four to eight visits. Longer-standing problems (chronic back pain, frozen shoulder, severe whiplash) often need more, sometimes a few months of structured care. We'll give you an honest sense of what to expect at the end of your first visit, and we re-assess regularly. If we're not seeing the progress we'd expect, we change the plan or refer you to the right provider. We'd rather have that conversation than book you for visits that aren't moving the needle.
Can I exercise after my appointment?
Usually yes, and often we encourage it. Movement after treatment helps the body integrate the changes from hands-on work. A walk, light cycling, or your normal training session is generally fine. A few situations where we'd suggest dialing it back for the first 24 hours: - After a particularly intense soft-tissue session - During the acute phase of a new injury (we'll tell you specifically) - If you're already running hot: sleep-deprived, stressed, sore from a hard workout If your training is at all unusual (heavy lifting day, long run, intense sport), tell us at the start of the appointment so we can match the intensity of the treatment to what your week looks like.
Is it normal to feel sore after a treatment?
Yes. It's common to feel mildly sore for a day or two after a chiropractic adjustment, soft-tissue treatment, or deep massage. The sensation is similar to having done a focused workout: a dull achiness in the treated area that resolves within 24–48 hours. Things that can help in the first day after treatment: - Drinking water normally (no need to over-hydrate, but don't get behind) - Gentle movement, a walk, easy stretching - Avoiding really intense activity right after if you're already sore Things that aren't normal: sharp pain that lasts more than a couple of days, significant bruising in unexpected places, or worsening of your original symptoms beyond the first day. If any of those happen, give us a call so we can adjust the next session.
Do you treat older adults?
Yes, and we adjust technique to match. Older adults often have considerations (osteoporosis, joint replacements, blood thinners, multiple medications) that change the appropriate approach. We screen carefully at the first visit and modify treatment accordingly. For patients with significant osteoporosis, joint replacements, or other situations where high-velocity adjustments aren't appropriate, we use lower-force methods, mobilizations, instrument-assisted adjusting, and soft-tissue work, that are equally effective for many of the issues older adults come in for. The goal across every age group is the same: address what's bothering you with the technique that's right for your body, and build the strength and mobility that supports the activities you want to keep doing.

General information only, not medical advice and not a substitute for assessment by a qualified health professional. If you have specific concerns about a symptom, book a consultation or contact your healthcare provider.

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