Hip Pain Relief in Calgary: How Physiotherapy Can Help You Move Better (2026 Update)

"Hip pain" is one of the most slippery terms in musculoskeletal care. People point to four different places when they say it. The pain on the outside of your hip that flares when you lie on that side has almost nothing in common with the deep groin pain that hurts when you put on your socks. They are different problems with different treatments.

I am Colin Bouma, an FCAMPT-certified physiotherapist (the highest manual therapy designation in Canada) practising on MacLeod Trail SW. This post is the 2026 update to one of our most-read pieces, rebuilt around the strongest current evidence — including a 2018 BMJ trial that should have changed how cortisone is used for hip pain, but mostly has not. Here is what is actually going on and what to do about it.

The Five Most Common Hip Problems We See

1. Gluteal tendinopathy (lateral hip pain / "trochanteric bursitis")

Pain on the outside of the hip — over the bony prominence (greater trochanter) — that hurts when you lie on that side, walk uphill, or cross your legs. Old language called this "trochanteric bursitis," but contemporary research is clear that the primary culprit is usually a gluteal tendinopathy — a load-tolerance problem of the gluteus medius and minimus tendons. Greater trochanteric pain syndrome (GTPS) affects roughly 18–50% of middle-aged adults with lateral hip pain, with women affected far more often than men.

2. Hip osteoarthritis

Deep groin pain or anterior hip pain, stiffness in the morning or after sitting, and difficulty with rotation (putting on socks, getting out of a car). Hip OA tends to ramp up gradually over years and is one of the most common reasons for joint replacement in adults over 60. We have a dedicated post on arthritis care — the short version: exercise, weight management, and education are first-line, regardless of imaging severity.

3. Femoroacetabular impingement (FAI) syndrome

Pinching groin pain with deep hip flexion or rotation, often in younger, active adults. It involves the shape of the femoral head and/or acetabulum producing abnormal contact during certain movements. Important caveat: FAI imaging findings are extremely common in people without hip pain — Frank and colleagues showed roughly 37% of asymptomatic adults have cam morphology and 67% have pincer morphology on imaging (Frank et al., 2015). A "positive MRI" is not the same as a diagnosis.

4. Hip labral tears

Often labelled the cause of a young athlete's hip pain — and again, the imaging story is loose. Labral tears appear in roughly 69–85% of asymptomatic adults. Treating the tear seen on a scan rather than the person sitting in front of you is one of the most common errors in hip care. Many labral tears are incidental.

5. Hip flexor or adductor strains

Acute pain with sport, sprinting, or sudden direction change — common in soccer, hockey, and running. Most respond well to progressive loading rather than rest alone.

What the Evidence Actually Says

Cortisone for lateral hip pain: the LEAP trial

Lateral hip pain is one of the most-injected conditions in primary care. The 2018 LEAP trial published in the BMJ randomized 204 adults with gluteal tendinopathy to education plus exercise, a single corticosteroid injection, or a wait-and-see approach (Mellor et al., 2018). At 8 weeks, the education-plus-exercise group had better outcomes than the injection group across pain, function, quality of life, and self-efficacy. At 52 weeks, the exercise group still had less frequent pain.

A 14-session structured rehab program, with patient education to avoid compressive hip postures (sitting cross-legged, sleeping on the painful side, certain stretches), beat the injection by every reasonable measure. Yet the most common first-line treatment offered in clinic is still the injection. That is a system problem, not an evidence problem.

Exercise for hip osteoarthritis

A 2023 systematic review and cumulative meta-analysis of 18 RCTs found exercise therapy produces small but consistent improvements in pain and function in hip OA, with benefits maintained at 6–9 months (Teirlinck et al., 2023). Effects are modest, but the alternative — doing less — leads to worse strength, more deconditioning, and faster progression to surgery.

FAI: surgery vs. physiotherapy

The 2018 UK FASHIoN trial published in the Lancet randomized 348 patients with FAI syndrome to either hip arthroscopy or "personalised hip therapy" — a supervised, progressive physiotherapy program. At 12 months, the arthroscopy group had modestly better outcomes on hip-specific scoring, but a meaningful proportion of the conservative group also improved substantially (Griffin et al., 2018). The honest read: surgery has a small statistical edge for FAI syndrome in well-selected patients, but it is not a slam dunk, and a 3–6 month course of focused rehab first is reasonable for most.

What an Honest Treatment Plan Looks Like

1.     Diagnose, then treat. Lateral hip pain, deep groin pain, posterior hip pain, and referred pain from the lumbar spine all look different on assessment. The right plan depends on which one you actually have.

2.     For gluteal tendinopathy: load + unload. Progressive isometric and slow heavy loading of the hip abductors. Equally important: stopping the compressive positions (crossing legs, hanging on one hip when standing, sleeping on the painful side without a pillow between knees) that aggravate the tendon.

3.     For hip OA: strength, walking, and a real exercise program. Hip and quad strength matter enormously. We use programs like GLA:D where appropriate.

4.     For FAI: rehab first, then re-evaluate. Mobility, motor control, and gluteal strength reduce symptoms in many FAI cases. If three to six months of focused care does not produce meaningful change, an orthopedic consult is reasonable.

5.     Manual therapy as an adjunct. Mobilization and soft-tissue work reduce sensitivity so loading can progress — not the main course.

6.     Realistic timelines. Most patients with lateral hip pain feel meaningful change inside 6–12 weeks. Hip OA is a longer-term project measured in months. FAI rehab is typically 3–6 months. Anyone promising a fix in three sessions is selling, not treating.

Habits That Help (Most Hip Conditions)

•      Walk daily — pacing matters. Build up, do not push through escalating pain.

•      Side-sleep with a pillow between your knees; back-sleep with a pillow under your knees if your back tolerates it.

•      Stop standing on one leg. The "hip hang" you do at the kitchen counter compresses the lateral hip structures and feeds gluteal tendinopathy.

•      Two strength sessions a week: hip abduction, hip extension, single-leg work scaled to ability.

•      Manage your overall load. A 25,000-step weekend hike after five sedentary weekdays is a common flare-trigger.

When Hip Pain Needs Urgent Attention

•      Sudden severe pain following a fall, especially in older adults — possible fracture.

•      Inability to bear weight on the leg.

•      Fever, redness, and joint pain — possible joint infection.

•      Night pain that is steadily worsening despite reduced activity, particularly with a history of cancer.

•      Numbness, tingling, or progressive weakness in the leg — possible nerve involvement.

How We Treat Hip Pain at Our Calgary Clinic

7.     Detailed assessment. Joint-specific testing for the hip, screening for lumbar referral, neurological screen, and functional movement analysis. The cause is rarely where it hurts.

8.     Classification-driven plans. Tendinopathy, joint, impingement, or referred — each gets a different program.

9.     Progressive loading. Strength training scaled to where you are, designed to build the capacity your hip actually needs for your life.

10.  Honest navigation of the wider system. If you are heading toward injections, imaging, or a surgical consult, we coordinate with your physician and orthopedic team and pre-habilitate so you go in stronger and recover faster.

11.  Outcome tracking. Validated tools (HOOS, HAGOS for athletic populations, sit-to-stand counts, gait analysis) so progress is measured, not guessed.

Why Choose Our Clinic on MacLeod Trail?

We are at 8989 MacLeod Trail SW, serving Haysboro, Kingsland, Fairview, Acadia, and surrounding South Calgary neighbourhoods. We treat a lot of hips — retirees with OA, women with lateral hip pain from menopause-era hormonal changes and load shifts, weekend runners with deep groin pain, and post-surgical patients. As an FCAMPT-certified clinician, I bring advanced manual therapy and clinical-reasoning training to every assessment.

Book a Hip Pain Assessment

If your hip has been bothering you for more than a few weeks, is getting worse, or is starting to dictate how you sit, sleep, walk, or train, get it assessed properly. Most patients feel meaningful change in the first three to four sessions when the plan is matched to the actual problem.

This article is for general educational purposes only. It is not medical advice, does not replace individualized assessment by a qualified healthcare professional, and does not create a physiotherapist–patient relationship. Always consult a regulated healthcare provider before starting a new exercise program or making changes to your care.

Bibliography

Frank, J. M., Harris, J. D., Erickson, B. J., Slikker, W., III, Bush-Joseph, C. A., Salata, M. J., & Nho, S. J. (2015). Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: A systematic review. Arthroscopy, 31(6), 1199–1204. https://doi.org/10.1016/j.arthro.2014.11.042

Griffin, D. R., Dickenson, E. J., Wall, P. D. H., Achana, F., Donovan, J. L., Griffin, J., Hobson, R., Hutchinson, C. E., Jepson, M., Parsons, N. R., Petrou, S., Realpe, A., Smith, J., Foster, N. E., & FASHIoN Study Group. (2018). Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): A multicentre randomised controlled trial. The Lancet, 391(10136), 2225–2235. https://doi.org/10.1016/S0140-6736(18)31202-9

Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., Wajswelner, H., & Vicenzino, B. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: Prospective, single blinded, randomised clinical trial. BMJ, 361, k1662. https://doi.org/10.1136/bmj.k1662

Teirlinck, C. H., Verhagen, A. P., van Ravesteyn, L. M., Reijneveld-van de Vendel, E. A. E., Runhaar, J., van Middelkoop, M., Ferreira, M. L., & Bierma-Zeinstra, S. M. A. (2023). Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis. Osteoarthritis and Cartilage Open, 5(1), 100338. https://doi.org/10.1016/j.ocarto.2023.100338