Hip Pain in Midlife Women: Causes & Treatment
Hip pain is a common complaint among women in midlife, in Barrie and surrounding communities, particularly between the ages of 40 and 70. It can affect mobility, exercise participation, sleep quality, work performance, and overall quality of life. While many women assume that hip pain is simply a sign of aging or arthritis, there are many potential causes, such as muscle and tendon problems, joint conditions, referred pain from the lower back or pelvis and even pelvic floor dysfunction.
Research suggests that women are more likely than men to experience certain hip conditions, including gluteal tendinopathy (a common cause of pain on the outside of the hip), osteoarthritis, and pelvic floor-related dysfunction. The good news is that many causes of hip pain respond well to physiotherapy and targeted exercise.
At Integrative Physiotherapy & Wellness in Barrie, physiotherapy can help women manage hip pain through individualized treatment plans focused on improving mobility, building strength, addressing movement patterns, and helping you return to the activities that matter most.
Causes and Risk Factors
Hip pain can originate from several structures around the hip and pelvis.
Common Causes of Hip Pain in Midlife Women
Gluteal Tendinopathy (Greater Trochanteric Pain Syndrome)
A common cause of pain on the outside of the hip. It involves irritation or degeneration of the tendons that attach the gluteal muscles to the hip.
Hip Osteoarthritis
Degeneration of the cartilage within the hip joint can lead to pain, stiffness, and reduced mobility.
Hip Bursitis
Irritation of the fluid-filled bursae around the hip may contribute to pain and tenderness.
Lumbar Spine Referral
Conditions affecting the lower back can refer pain into the hip, buttock, groin, or thigh.
Labral Tears and Femoroacetabular Impingement (FAI)
Changes within the hip joint can cause groin pain, clicking, catching, or restricted movement.
Muscle Strains and Tendon Injuries
Overuse, sudden increases in activity, or muscle weakness can contribute to injury around the hip.
Pelvic Floor Dysfunction
The pelvic floor muscles work closely with the hip and core muscles. Dysfunction in this region may contribute to hip, groin, buttock, or pelvic pain.
Risk Factors
Several factors can increase the likelihood of developing hip pain:
● Female sex
● Age over 40
● Menopause and hormonal changes
● Reduced muscle strength
● Sedentary lifestyle
● Excess body weight
● Previous injuries to the hip, pelvis, or lower back
● Repetitive activities or overuse
● Sudden increases in exercise intensity
● Occupations involving prolonged sitting or standing
Symptoms
The location and nature of hip pain often provide important clues about its cause.
Early Symptoms
● Mild discomfort during walking or exercise
● Pain when lying on one side
● Morning stiffness
● Tenderness around the hip
● Occasional groin, buttock, or outer hip pain
Advanced Symptoms
● Persistent pain during daily activities
● Difficulty climbing stairs
● Reduced walking tolerance
● Night pain that disrupts sleep
● Clicking, catching, or locking sensations
● Weakness or instability
● Difficulty getting in and out of a car
Pain Location May Help Identify the Cause
Groin pain is often associated with hip joint conditions such as osteoarthritis, labral tears, or impingement.
Pain on the outside of the hip is commonly linked to gluteal tendinopathy or Greater Trochanteric Pain Syndrome.
Buttock pain may be related to the lumbar spine, deep hip muscles, or pelvic floor dysfunction.
Front-of-hip pain may indicate hip flexor irritation or joint-related pathology.
Diagnosis
Accurate diagnosis is important because different causes of hip pain require different treatment approaches.
Diagnosis typically involves:
● A detailed health history
● Review of symptoms and activity limitations
● Assessment of hip mobility
● Muscle strength testing
● Evaluation of walking and movement patterns
● Examination of the lower back and pelvis
● Functional tests such as squatting, stair climbing, and single-leg balance
● If the pelvic floor is involved, a comprehensive pelvic floor physiotherapy assessment can be beneficial
Physiotherapy Approach
Physiotherapy aims to identify the source of pain, reduce symptoms, restore function, and help prevent recurrence.
Education and Activity Modification
Understanding which activities aggravate symptoms can help reduce irritation while maintaining an active lifestyle.
For example, research on gluteal tendinopathy suggests that prolonged standing with weight shifted onto one hip, crossing the legs while sitting, or sleeping directly on a painful hip may increase stress on irritated tissues.
Strengthening Exercises
Targeted strengthening is often a cornerstone of treatment and may focus on:
● Gluteal muscles
● Core muscles
● Hip stabilizers
● Pelvic floor muscles when indicated
● Lower limb muscles
Improving strength can reduce joint stress and improve movement efficiency.
Mobility and Flexibility Training
Exercises may be prescribed to improve hip mobility, reduce stiffness, and restore normal movement patterns.
Manual Therapy
Hands-on techniques may be used to improve mobility, reduce discomfort, and complement an active rehabilitation program.
Movement Retraining
Improving walking, stair climbing, balance, and exercise mechanics can reduce strain on painful structures and improve long-term outcomes.
Return to Activity Planning
Physiotherapists can help patients safely return to walking, running, sports, gardening, fitness classes, and other activities they enjoy.
Therapeutic Modalities
Depending on the diagnosis and individual presentation, physiotherapists may incorporate therapeutic modalities to help manage pain and support tissue healing.
Shockwave Therapy
Shockwave therapy uses acoustic waves to stimulate healing and may be beneficial for certain tendon-related conditions, including gluteal tendinopathy. Research suggests it can help reduce pain and improve function in some individuals with chronic tendon disorders.
Acupuncture and Dry Needling
Acupuncture and dry needling may be used to reduce pain, improve muscle function, and address trigger points or muscle tension around the hip and pelvis. These techniques are often combined with exercise and movement-based rehabilitation.
Therapeutic Ultrasound
Ultrasound therapy may be used to provide pain relief and promote circulation in affected tissues. While evidence for ultrasound varies depending on the condition being treated, it may be used as part of a comprehensive treatment plan.
Patient Education and Self-Management
There are several strategies that may help manage hip pain at home:
Stay Active
Complete rest is rarely recommended. Maintaining appropriate activity levels helps support joint and muscle health.
Build Strength
Regular strengthening exercises can improve stability, reduce pain, and support long-term hip health.
Optimize Sleep Position
If lying on your side causes discomfort, placing a pillow between your knees may reduce pressure on the hips.
Avoid Prolonged Static Positions
Take breaks from prolonged sitting or standing and change positions regularly throughout the day.
Maintain a Healthy Weight
Managing body weight can reduce stress on the hips and improve overall mobility.
Address Whole-Body Health
Sleep quality, stress management, physical activity, and overall fitness all play important roles in recovery and long-term health.
Conclusion
Hip pain in midlife women can have many causes, including tendon disorders, arthritis, bursitis, muscle weakness, lower back dysfunction, and pelvic floor-related conditions. Because symptoms can overlap, an accurate assessment is important for determining the source of pain and guiding effective treatment.
Physiotherapy can play a key role in reducing pain, improving strength and mobility, restoring function, and helping women return to the activities they enjoy. Early intervention often leads to better outcomes and may help prevent symptoms from becoming chronic.
If you are experiencing hip pain that is affecting your daily activities, exercise routine, or sleep, at Integrative Physiotherapy and Wellness in Barrie, Ontario, our physiotherapists can provide a comprehensive assessment and individualized treatment plan to help identify the cause of your symptoms and support your recovery.
Contact our clinic today to schedule an assessment and take the first step toward moving comfortably again.
Hip Physiotherapy in Barrie
At Integrative Physiotherapy & Wellness, our physiotherapists provide individualized treatment for people experiencing hip pain conditions.
Your physiotherapy program may include:
Comprehensive physiotherapy assessment
Pain education and nervous system retraining
Movement-based rehabilitation
Gradual return-to-activity programs
Our goal is to help reduce pain, restore movement, and support long-term recovery.
Book a Physiotherapy Assessment in Barrie
If you are experiencing ongoing pain, an assessment can help determine the cause and guide your recovery.
Contact Integrative Physiotherapy & Wellness in Barrie to book a physiotherapy assessment today.
References
Grimaldi A, Mellor R, Hodges P, et al. Gluteal Tendinopathy Masterclass: Refuting the Myths and Engaging with the Evidence. British Journal of Sports Medicine.
Mellor R, Bennell K, Grimaldi A, et al. Education Plus Exercise Versus Corticosteroid Injection Use Versus Wait and See for Gluteal Tendinopathy. BMJ. 2018.
Fearon AM, Cook JL, Scarvell JM, et al. Greater Trochanteric Pain Syndrome Negatively Affects Work, Physical Activity and Quality of Life. Journal of Arthroplasty.
Cibulka MT, White DM, Woehrle J, et al. Hip Pain and Mobility Deficits: Clinical Practice Guidelines. Journal of Orthopaedic & Sports Physical Therapy.
Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. The Lancet.
