Hip Pain
Hip pain is a symptom. The cause is what we treat.
Assessment-led hip rehabilitation for athletes and active adults. From the first session: a diagnosis, a plan, and treatment — not a referral to come back next week.
Assessment + treatment from session one · $750 MXN · Zona Rio, Tijuana.
Conditions
What we treat.
A mechanical conflict between the ball and socket of the hip during certain movements, common in athletes with deep-flexion or rotational demands. Managed through loading and movement modification.
Damage to the cartilage rim of the hip socket, often alongside impingement. Both surgical and non-surgical management — assessment-led decisions on the right path.
Acute or chronic strain of the iliopsoas or rectus femoris, common in sprinting, kicking, and change-of-direction sports.
Lateral hip pain from gluteus medius/minimus tendon overload — often mislabeled as "bursitis." Requires progressive tendon loading, not rest or injections alone.
Deep buttock pain from proximal hamstring tendon overload, common in runners and sprinters. Responds to progressive, staged tendon loading.
Groin pain from adductor strain or overload, common in field-sport athletes with cutting and kicking demands. Addressed through progressive strength and load management.
Recovery after total hip replacement. Staged return to full function with strength, range of motion, and daily activity milestones.
Chronic or acute hip pain without a confirmed diagnosis. Assessment identifies the source and drives a targeted treatment plan — not generic management.
Who we see
Three kinds of hip patients.
The athlete with an acute strain.
A hip flexor, hamstring origin, or adductor. Something happened in training or competition and now there is a load-tolerance question. Assessment clarifies the injury, defines the treatment path, and establishes a return-to-sport timeline based on tissue readiness.
The runner or field athlete with chronic pain.
Gluteal tendinopathy, hamstring origin pain, or impingement-related stiffness. Pain that builds with mileage or repeated hip flexion under load. The cause is usually a load or capacity mismatch — not structural damage. Assessment identifies the deficit and builds a plan that keeps you training while the tissue recovers.
The post-surgical patient.
Hip arthroscopy for labral repair, or total hip replacement. Surgery repaired the structure — rehabilitation restores the capacity. Staged progressive loading from protection through to full return of strength, movement, and function.
The approach
How hip rehabilitation works here.
Assessment first
Movement screen, load testing, pain provocation, and functional testing in session one. The treatment plan follows what the examination finds — not what the complaint sounds like.
Progressive loading
Rest does not rebuild a hip. Controlled, progressive loading of the tissue — through appropriate range and at appropriate intensity — is what drives recovery. We establish what the tissue can tolerate and build from there.
Return-to-performance criteria
Clearance to return to sport is based on clinical criteria — single-leg strength benchmarks, load tolerance, movement quality — not a calendar. You return when the hip is ready, with evidence, not assumption.
Same clinician throughout
Every session is with Leonardo. The same assessment logic, the same clinical reasoning, the same relationship from session one through to discharge. No handoffs.
Case example
What recovery looks like.
A 34-year-old recreational runner presented with three months of lateral hip pain, worse when lying on the affected side and after longer runs. Previous advice: rest and anti-inflammatories. Symptoms plateaued but never fully resolved.
Assessment revealed a significant single-leg load deficit and pain reproduced under resisted hip abduction — consistent with gluteal tendinopathy driven by a proximal strength deficit, not a structural or inflammatory hip problem. Imaging was not indicated.
Treatment: graded isometric and then progressive gluteal loading, running gait assessment, and a phased return to mileage. By session seven, side-lying pain had resolved. By session twelve, full training volume was restored with no recurrence.
Case presented with patient consent. Identifying details modified.
What delays recovery
Three things that slow hip rehabilitation.
Resting too long.
Pain reduction through rest does not equal recovery. Tissue capacity is not rebuilt through unloading — it requires progressive loading. Extended rest leads to strength loss, stiffness, and a longer return-to-sport timeline.
Treating the symptom, not the driver.
Hip pain is often a downstream result of proximal strength deficit, load mismatch, or movement compensation elsewhere in the kinetic chain. Treating the hip in isolation without addressing the source leads to recurrence — sometimes within weeks of returning to activity.
Returning before the tissue is ready.
Clearance based on pain reduction alone is not safe clearance. Return-to-sport requires single-leg strength benchmarks to be met, load tolerance to be demonstrated, and movement quality to be verified. Skipping this step is how reinjury happens.
Questions
Common hip questions.
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Do I need an MRI before starting?
No. Clinical examination is the primary diagnostic tool for most hip conditions. MRI results are useful context when available, but assessment begins with what we find in the physical examination. Bring any imaging you have — it will be used, but it is not a prerequisite. Read more: Do You Need an MRI Before Physical Therapy? →
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Can I continue training while my hip recovers?
In most cases, yes — with appropriate load modification. Blanket rest is rarely the right answer. After assessment we establish what you can continue, what needs modification, and what to temporarily avoid. The goal is to keep you moving at the highest level the tissue can safely tolerate.
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What is the difference between hip impingement and a labral tear?
Hip impingement (femoroacetabular impingement) is a mechanical conflict between the ball and socket of the hip joint during certain movements. A labral tear is damage to the cartilage rim of the socket, which can occur alongside impingement or independently. Assessment clarifies which is driving your symptoms.
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Will I need surgery?
Many hip conditions, including some labral tears and cases of impingement, respond well to structured rehabilitation without surgery. Assessment clarifies what conservative treatment can achieve and when a surgical opinion should be sought.
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How long before I return to sport?
This depends on injury type, severity, and pre-injury capacity. Return-to-sport is determined by clinical criteria — not a fixed calendar. After the first session you will have an honest estimate with specific milestones to hit before return.
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How is this different from standard physiotherapy?
Standard physiotherapy often focuses on pain reduction through passive treatment and generic exercise. PhysioPro uses a performance rehabilitation model: thorough assessment, progressive loading, and return-to-activity criteria built for what you need to do — not just for daily comfort.
Read more: Why Physical Therapy Didn't Work The First Time →
More questions? See the full FAQ →
Book an assessment
Find out what is actually driving your hip pain.
Assessment + treatment from session one. $750 MXN. Zona Rio, Tijuana.