The hip is a ball-and-socket joint with a large range of movement and numerous muscle, tendon and ligament attachments — all of which can become a source of pain. Hip pain can be acute (from sudden injury or trauma) or chronic (gradual onset over weeks or months), and is most commonly driven by overuse, poor lower limb mechanics, or degeneration of the joint or surrounding tissues.
Because so many structures converge at the hip, accurate diagnosis is essential. A detailed history and targeted clinical tests are needed to identify exactly what is injured, why it has become painful, and how best to treat it.
Hip pain can arise from three distinct regions, each associated with different structures and conditions. Identifying the location is the first step in establishing the diagnosis.
Anterior
Front of the Hip
Often related to hip flexor strain, hip impingement (FAI), labral tears, or referred pain from the lumbar spine.
Lateral
Side of the Hip
Commonly caused by greater trochanteric pain syndrome, gluteal tendinopathy, or IT band-related issues.
Posterior
Back of the Hip
May involve the piriformis, deep hip external rotators, sacroiliac joint, or lumbar spine referral.
Hip pain is frequently multifactorial — a combination of mechanical, structural, and load-related factors acting together. From a podiatric perspective, the foot and lower limb play a critical role that is often overlooked.
Foot & Lower Limb Mechanics
Poor foot posture, overpronation, and altered gait patterns change how forces travel up through the ankle, knee and hip — often loading hip structures asymmetrically with every step.
Leg Length Discrepancy
A true or functional difference in leg length alters pelvic alignment and can place persistent asymmetric load on the hip joint and surrounding muscles.
Muscle Overuse & Weakness
Repetitive loading of underprepared or imbalanced hip, gluteal and lower limb muscles leads to fatigue, inflammation and progressive tendon or joint irritation.
Training Load Spike
A sudden increase in running volume, walking distance or high-impact activity places the hip structures under more load than they can currently manage.
Degeneration
Age-related changes to cartilage, tendons and joint surfaces can reduce the hip's capacity to absorb load — particularly when combined with mechanical inefficiency further down the chain.
Joint & Soft Tissue Compression
Femoroacetabular impingement, bursitis and local compression of tendons or bursae at the hip can cause significant localised pain with movement.
The foot is the foundation of the kinetic chain. Every step begins at the foot, and how the foot contacts and leaves the ground directly influences the timing, alignment and load of structures all the way up to the hip. Altered foot mechanics — overpronation, supination, limited ankle mobility, asymmetric push-off — change the rotation, adduction and extension patterns at the hip across thousands of steps per day.
This is why a podiatric assessment looking from the foot upwards is a valuable part of managing hip pain — particularly in runners, walkers and those with chronic or recurring symptoms that haven't resolved with local hip treatment alone.
Our assessment looks at the full lower limb chain rather than the hip in isolation. We take a detailed history of the pain and how it developed, then carry out a biomechanical examination from the foot upward.
Full medical history and history of the problem
Biomechanical assessment of foot, ankle, knee and hip mechanics
Gait and movement pattern analysis
Muscle strength and flexibility testing
Referral for imaging or specialist opinion where indicated
Treatment focuses on identifying and addressing the mechanical drivers of your hip pain — not just managing the symptom. Your plan is tailored to your diagnosis, activity level, and goals.
01
Avoid sudden increases in walking, running or high-impact activity
02
Wear supportive footwear — unsupportive shoes amplify poor lower limb mechanics
03
Include regular hip, glute and lower limb strength work — not just stretching
04
Monitor training load and recovery — fatigue and sleep have a significant effect on pain levels
If your hip pain has lasted more than a few weeks, is affecting your daily activity or exercise, or keeps recurring after rest, a full biomechanical assessment is recommended. Hip pain that is driven by lower limb mechanics will not resolve without addressing those mechanics.
Early assessment gives the best outcomes. Chronic hip pain that has been present for months or years is more complex to treat — the sooner contributing factors are identified, the faster recovery tends to be.
Why would a podiatrist treat hip pain?
The foot is the base of the kinetic chain — how it functions directly influences the hip. Podiatrists are specialists in lower limb biomechanics, making them well placed to identify how foot mechanics, gait patterns and leg length differences contribute to hip pain, and to address these through orthotics, gait retraining and rehabilitation.
Can flat feet cause hip pain?
Yes. Overpronation and flat foot posture alter the rotation and alignment of the leg during walking and running, which can place abnormal stress on the hip joint and surrounding muscles over time — particularly in high-volume walkers and runners.
Can a leg length difference cause hip pain?
Yes. Even a small functional or structural leg length discrepancy can alter pelvic tilt and hip loading significantly. A heel lift or orthotic correction is often a straightforward and effective part of treatment.
Do I need a scan?
Not in most cases. Clinical assessment provides sufficient information to diagnose and treat the majority of hip pain presentations. Imaging is arranged where structural damage, labral tears, or joint degeneration needs to be confirmed, or where symptoms are not improving as expected.
Will I need to stop running?
Not necessarily. Modified training — adjusting volume, surface and intensity — often allows continued activity while the underlying mechanics are addressed. We provide a clear load management plan from the outset rather than defaulting to rest.
Ready to book your hip assessment?
We'll assess your full lower limb mechanics and build a plan to resolve your pain and prevent it coming back.
