Hip Pain and Rehabilitation

Authored by Michelle Eliason, MS, OTR/L, CKTS, C.D.S.

Top 6 Reasons You have Hip Pain:


Arthritis is a general umbrella term for joint inflammation. Although there are many types of arthritis, osteoarthritis is the most common. The affects of arthritis in your joint, can cause you minimal to severe hip pain. Osteoarthritis happens when the effects of arthritis (inflammation and injury) break down the cartilage surrounding your joints. Cartilage covers the end of your bones to prevent friction and act as a shock absorber for mobility. Unfortunately, your body can not produce new cartilage. Once you experience ‘bone on bone’ arthritis, your physician will typically request a joint replacement surgery. If you are apprehensive about surgery, you can try alternative pain management approaches like kinesiology taping

For more information regarding Arthritis, check out the information found through the American Acadamy for Orthopedic Surgeons

Muscle Imabalances

There are over 650 named skeletal muscles in the human body and all of them serve a unique function. What’s even more significant, is that each muscle was designed to balance each other as they work in synergy to contract and control their counterparts. This process requires a balance between muscle tone, strength, and length. Muscles must be able to ‘work’ in order to keep you independent in mobility and meaningful activities (ADLs and IADLs), but they must also be able to ‘rest’ if they are not being called upon for a task. Your muscles must have the right amount of strength, tone, and length (flexibility) to carry your body and keep it in an upright position while sitting or standing. Because of the intricate relationship, your muscles have to one another, if you have even the slightest muscle imbalance, this could cause you pain.


You have two sciatic nerves beginning in your lower back and continuing down either leg. When your sciatic nerve is compressed, irritated, or injured by a muscle imbalance or trauma, it sends radiating pain (pain that travels) from your lower back, buttock, hip, thigh, and leg. Sciatica can cause mild to severe hip pain if left untreated. Outpatient rehabilitation can help correct muscle imbalance, release trigger points through neuromuscular massage, and provide rehabilitation for upper body and lower body ailments causing hip pain through sciatica. 

Muscle Knots or Tightness

Muscle knots are bumps under the skin formed when muscle fibers or fascia tighten or tense causing pressure on surrounding structures in your body. Muscle knots can also be known as myofascial trigger points and can be treated through neuromuscular massage. Interestingly, hip pain can be caused by muscle knots in other areas of your body but present as if they are originating in your hip. This is called referred pain. Your body is filled with billions of sensory neurons that all communicate with one another. At times, these signals become confused and tell your body your hip hurts when the muscle knot is in your lower back. 

Compensatory Movements

When there is an imbalance of muscle power (not enough ‘control’ during a movement, your body calls on the action of close-by muscles to help control your movements which creates compensatory movements or compensation strategies. This means your body is recruiting muscles to perform an action they were never meant to perform, and eventually, your body will tell you by creating painful signals. If you allow your body to move and function using compensation strategies for too long, your body becomes misaligned and you will see the signs and symptoms of muscle imbalance.


Among many other places, gout can be present in big joints like your hip causing substantial hip pain. Gout typically presents as redness and inflammation around the impacted area due to your body’s response to increased uric acid in the bloodstream. When there is an unbalance amount of uric acid, your body perceives it as an infection and produces increased edema and white blood cells to attack it. Gout can be managed, but if it is untreated, you can experience chronic pain and reoccurring episodes producing pain as high as 10/10. This hip pain can affect mobility, sleep, self-care tasks, and desire to engage in social participation.

For more information regarding Gout, check out the information found through the American Academy of Orthopedic Surgeons.

Most Popular Procedures

  • Total hip replacement
  • Total shoulder replacement
  • Total knee replacement


Meaningful activities [occupations] affected after joint replacement surgery. 

Total hip replacement

  • Getting up and down from a chair or bed
  • Walking around your home or the community
  • Carrying a child or groceries while maintaining precautions or getting stronger
  • Standing for extended periods of time at the sink or stove 
  • Putting on your pants, socks, and shoes while maintaining precautions

Total shoulder replacement

  • Putting on your shirt or jacket
  • Driving 
  • Fulfilling caregiving roles 
  • Showering 
  • Shoveling (in winter) 
  • Writing (with non-dominant hand) 

Total knee replacement

  • Getting up and down from a chair or bed
  • Walking around your home or the community
  • Getting into and out of your bed
  • Carrying a child or groceries while maintaining precautions or getting stronger
  • Standing for extended periods of time at the sink or stove 
  • Putting on edema sleeves or compression garments


What are some questions you can ask your doctor before committing to a joint replacement surgery?

  • Is this joint replacement surgery 100% necessary, what are some alternative options? 
  • What is the recovery time and what is the realistic level of pain I will be in while I recover?
  • How will my range of motion be affected after this procedure? Will it be back to the normal I expect? Or will I always have some range of motion changes? 
  • Can I expect to be 100% after recovery? 
  • How long is rehabilitation for this replacement? Should I have someone lined up before my procedure? 
  • Should my occupational therapist conduct a pre-joint replacement assessment of my house and condition in order to establish a prior level of function and give me advice? 

What are some problems occupational therapy can address?

Check out other problems we help resolve!

Helpful Page Definititions

Instrumental Activities of Daily Living (IADLs)

Instrumental Activities of Daily Living (IADLs) are essential for independence in life roles and required for aging in place. There are 8 activities core activities for independence including cooking, cleaning, communication, taking and managing medication, handling your personal finances, transportation and community mobility, shopping

Cooking - The ability to follow a recipe and having the stamina to prepare a meal for yourself and/or your family

Cleaning -   The ability to perform light housekeeping including making your bed, doing your laundry, washing the dishes, taking out the trash, vacuuming, sweeping, cleaning your bathroom, etc. 

Communication - The ability to use the telephone, the computer, have conversations with people (familiar and strangers), communicate your needs clearly.

Taking medication - The ability to sort and organize your medication or determine a compensatory method to do so as well as taking the appropriate dosage at the appropriate time. 

Personal Finances - The ability to establish an organization method to understand financial responsibilities and pay your bills on time. 

Transportation - Whether you are driving, calling for a driving service like a taxi or Uber, or taking public education. You must have a defined action plan for community mobility and transportation.

Shopping - The ability to plan transportation, plan a grocery/clothing list of needs for yourself and your home, have the stamina to collect your items at the store, and be able to get them into your house. 

Activities of Daily Living

Occupational therapists are trained in occupations and activity analysis. An occupation is an activity that you believe is important to your life. There are many levels of occupations, but activities of daily living (ADLs) are the most personal activities and are usually the ones people find most important if they were to lose the ability to complete them.  

ADLs include:

  • Bathing and showering
  • Getting dressed
  • Going to the bathroom
  • Walking and getting up and down from a chair or car
  • Eating and swallowing
  • Feeding 
  • Sexual activity 
  • Personal hygiene and grooming
  • Being able to use personal care devices like adaptive equipment and durable medical equipment 
Muscle Imbalance

Your body is complex and should be working synergistically with all of its parts. When some muscles have become weaker while others remain strong, an imbalance occurs which causes decrease balance, standing tolerance, and joint stability. 

Neuromuscular Massage

Neuromuscular massage helps many diagnoses. Most specifically used for chronic pain and the release of trigger points (knots), NMM can help resolve debilitating pain resulting from soft tissue implications. Another way we use NMM is to enhance reaction time in individuals after a traumatic neurological event. Studies suggest that NMM can break up adhesions allowing for stronger and faster communication between nerves.