Most hip injuries don’t announce themselves. They show up as a little twinge after a run. A click when you stand up from your desk. A dull ache that you’d swear started in your back but somehow ended up parked in your groin. Patients usually wait far too long before getting it checked, and by then a problem that could’ve been handled with six weeks of rehab has turned into something messier.
Dr. Mufaddal Gombera, a board-certified orthopedic surgeon who completed his sports medicine and arthroscopy fellowship at Northwestern, sees this same story play out almost every week at his Houston practice. The injuries themselves aren’t all that mysterious. They follow patterns. Knowing what those patterns look like is half the battle, especially if you’re active and want to stay that way.
Below is a working list of the eight hip injuries that show up most often in clinic, written for real people who are trying to figure out what’s going on with their body.
Why Hip Injuries Hit Active People So Hard
The hip is built tough. It’s the largest ball-and-socket joint in the body and carries the weight of pretty much everything you do, from getting out of bed to running a 5K. But “tough” isn’t the same as “indestructible.”
Sports that involve cutting, pivoting, kicking, or pounding the pavement (think soccer, hockey, dance, distance running, CrossFit) put loads on the hip that it wasn’t designed to absorb on repeat. Office life isn’t much kinder. Sitting eight hours a day shortens hip flexors and weakens glutes, which leaves the joint working with bad mechanics the moment you do try to be active. Either path can lead you to the same waiting room.
Older adults face a different set of risks, mostly around bone density and balance, but the eight conditions listed below cut across age groups. They’re more about activity level than birthdays.
1. Hip Labral Tear
The labrum is a ring of cartilage that hugs the socket of your hip joint. Think of it like a rubber gasket. It seals the joint, keeps the ball centered, and gives the cartilage inside a stable environment to glide. When it tears, the whole system gets noisier.
What it feels like
- A sharp, deep pain in the groin or front of the hip
- Clicking, catching, or that unpleasant “locked up” sensation mid-stride
- Pain that’s worse after sitting for a long stretch, especially in low chairs or car seats
- A nagging stiffness that doesn’t loosen up the way it used to
Why it happens
Repeated twisting and pivoting are the usual suspects. Soccer players, hockey players, dancers, and golfers see a lot of these. So do patients with underlying hip impingement, which we’ll get to in a minute. Direct trauma can do it too, though that’s less common.
Diagnosis usually starts with a physical exam, then an MRI (often with contrast) to see the cartilage clearly. Plain X-rays help check for bony issues that may have caused the tear in the first place.
2. Snapping Hip Syndrome (Iliopsoas Impingement)
If you’ve ever felt a thunk in the front of your hip when you lift your leg, you’ve met snapping hip. The iliopsoas tendon, which runs along the front of your pelvis, can snap over a bony bump during certain movements. Sometimes it’s painless. Sometimes it’s the most annoying thing in your life.
What it feels like
- A pop or snap in the front of the hip with leg lifts, getting out of a car, or kicking
- Discomfort that builds the more you train
- Eventually, soreness even at rest if the tendon’s been irritated long enough
Why it happens
Tight hip flexors. Skipped stretching. A lot of repetitive flexion (cycling, ballet, hurdles, kickboxing). Dancers tend to get hit hardest here, which is why snapping hip is sometimes called “dancer’s hip.” If you ignore it, the constant friction can wear down the labrum underneath, turning a nuisance into an actual joint problem.
3. Hip Bursitis
Bursae are little fluid-filled cushions that sit between bone and soft tissue. They keep things from grinding when you move. When one gets inflamed, even rolling onto your side in bed can wake you up.
The two locations that flare up most are the outside of the hip (trochanteric bursitis) and the front near the groin (iliopsoas bursitis). Trochanteric is more common.
What it feels like
- Sharp pain on the outer hip, sometimes shooting down the side of the thigh
- Tenderness when you press on the bony point on the side of your hip
- Pain that gets worse climbing stairs or standing up after sitting
- Sleep that gets ruined because lying on that side just isn’t possible anymore
Why it happens
Repetitive motion, especially running or long walks on uneven surfaces. Weak glutes are a huge contributor. Hip surgeries, trauma, or even just a sudden jump in activity can set it off. Ultrasound or MRI helps confirm the diagnosis when standard treatment isn’t moving the needle.
4. Femoroacetabular Impingement (FAI)
This one’s worth knowing about because it’s behind a lot of “mystery” hip pain in young athletes. FAI happens when the bones of the hip joint don’t quite fit the way they should. There are two main shapes: cam (extra bone on the ball) and pincer (extra coverage on the socket). Many patients have a combination of both.
Every time the hip flexes deeply, the abnormal bone makes contact with cartilage and labrum where it shouldn’t. Over years, that contact takes a toll.
What it feels like
- Deep groin pain after sitting, squatting, or driving
- Loss of internal rotation (the affected hip just won’t turn inward like the other one)
- Symptoms that creep in gradually, often dismissed as tightness for months or years before someone takes it seriously
Why it happens
FAI is usually structural. People are born with the bone shape, and it shows up symptomatic during the teens and twenties when activity ramps up. X-rays show the bony anatomy. MRI catches the secondary damage, which is often a labral tear.
“FAI is the diagnosis I wish more patients knew to ask about,” says Dr. Gombera. “It’s the underlying reason behind a huge chunk of the labral tears and persistent groin pain I see in athletes under forty. Treating the tear without addressing the impingement is how you end up back in surgery a few years later.”
5. Hip Dislocation and Subluxation
This is the emergency on the list. Dislocation means the head of the femur has been forced fully out of the socket. Subluxation is the same thing, partial. Either way, you’ll know immediately. Nobody walks this off.
What it feels like
- Severe pain, instantly
- Inability to put any weight on the leg
- The hip and leg may look rotated, shortened, or just plain wrong
- Swelling and bruising follow quickly
Why it happens
High-energy trauma. Car accidents are the classic cause. In sports, it usually takes a hard collision, like a tackle in football or a bad fall from height. Patients with prior hip surgery or instability are at higher risk for a subluxation event during normal activity. Imaging needs to happen fast to check for nerve injury, blood vessel damage, and fractures that often come along for the ride.
6. Hip Stress Fracture
Stress fractures are tiny cracks in bone that develop from repeated load instead of one big hit. The femoral neck, the narrow part of the bone just below the ball of the hip, is a common site. These are sneaky. Pain often shows up only during activity at first, fades with rest, and then comes back a little worse the next time.
What it feels like
- Groin pain that builds during running or jumping
- Pain that eases when you stop, only to return when you start back up
- A limp that gets harder to hide as the weeks go on
- In bad cases, pain at rest and at night
Why it happens
Runners are at the top of the list. Military recruits and new CrossFit athletes show up with these too. Risk factors include sudden mileage increases, poor recovery, low vitamin D, low energy availability (especially in female athletes), and a history of menstrual irregularities. X-rays may look clean early on. MRI is the better test if a stress fracture is suspected.
Don’t push through one of these. A femoral neck stress fracture that progresses to a full break is a different conversation entirely, and one no athlete wants to have.
7. Hip Muscle Strain
Strains range from a minor pulled fiber to a complete muscle tear. The hip flexors get strained most often, but the adductors (groin muscles), hamstrings at their hip attachment, and rectus femoris all see their share.
What it feels like
- Sudden pain during a sprint, kick, or sudden change of direction
- Tenderness, swelling, and sometimes visible bruising a day or two later
- Weakness or hesitation with movements that load the injured muscle
- A “pop” sensation in more severe tears
Why it happens
Cold muscles, insufficient warm-up, fatigue late in a workout, and weak surrounding muscles all set the stage. The fix isn’t usually surgical. Grades I and II strains respond well to rest, protected activity, and a real physical therapy plan. Grade III tears (full ruptures) need closer evaluation and occasionally surgical repair.
8. Osteitis Pubis
Osteitis pubis is inflammation of the pubic symphysis, the cartilage joint at the front of the pelvis where the two pelvic bones meet. It gets confused with groin strain all the time, which is why it lingers. Patients spend months treating the wrong thing.
What it feels like
- Pain right at the center-front of the pelvis
- Discomfort that sometimes shifts to one side
- Pain with kicking, long strides, or sit-ups
- Hip and core weakness from guarding
Why it happens
Repeated stress across the pelvic joint, usually from sports with cutting and kicking. Soccer players and distance runners head the list. Pregnancy and prior pelvic surgery also raise the risk. MRI is helpful when symptoms aren’t sorting themselves out under standard care.
When Hip Pain Needs an Orthopedic Specialist
A lot of hip pain settles down with sensible rest and the kind of stretching most people skip. Some of it doesn’t, and the difference matters. Get evaluated if your hip pain:
- Has stuck around for more than two weeks despite reasonable rest
- Is keeping you awake at night
- Comes with clicking, locking, giving way, or sudden weakness
- Is bad enough to cause a limp
- Followed a fall, collision, or any clear traumatic event
- Came on with fever, redness, or warmth (this needs urgent attention)
Hip problems that get caught early usually have more treatment options on the table. Once cartilage is gone, putting it back is a much harder conversation.
How Hip Injuries Get Diagnosed
A good hip workup isn’t just a quick scan and a prescription. Dr. Gombera’s evaluations start with a detailed history of how the pain started, what makes it better or worse, and what activities the patient is trying to get back to. The hands-on exam tests range of motion, strength, gait, and specific provocative maneuvers like the FADIR and FABER tests, which help identify impingement or labral involvement.
Imaging is layered. X-rays come first to look at bone alignment and check for arthritis or FAI. MRI (and sometimes MRI with intra-articular contrast, called an MR arthrogram) shows soft tissue clearly, including the labrum and cartilage. Diagnostic ultrasound has a role too, particularly for guiding injections or evaluating dynamic problems like snapping hip.
Treatment Options: From Rehab to Arthroscopy
Most hip injuries get better without surgery. That’s worth saying out loud, because patients walk in assuming the opposite.
Non-surgical care
This is the starting point for almost every condition above. It includes activity modification, targeted physical therapy, anti-inflammatory medication when appropriate, and image-guided injections (cortisone for inflammation, PRP for select tendon and joint problems). For most strains, bursitis, and early-stage impingement, this is enough.
Hip arthroscopy
For labral tears, FAI, and certain cases of snapping hip that haven’t responded to conservative care, arthroscopic hip surgery offers a minimally invasive way to repair the damage. Two or three small incisions, a camera, and specialized instruments are used to reshape impinging bone, repair the labrum, and clean up any related damage. Recovery is faster than open surgery, though the rehab is real and patients need to commit to it.
Open surgery
Reserved for situations like complete tendon ruptures, severe dislocations with associated fractures, and advanced arthritis requiring joint replacement. Far less common in active patients seen for sports-related hip pain, but part of the toolkit when needed.
Frequently Asked Questions About Hip Injuries
What’s the most common hip injury in athletes?
Muscle strains (especially hip flexor and adductor strains) are the most common. Labral tears are next, and they tend to be more underdiagnosed because patients and even some clinicians mistake them for ordinary groin pulls.
Can a hip injury heal on its own?
Mild strains and some cases of bursitis can settle down with rest, ice, and a smart return to activity. Labral tears, FAI, stress fractures, and dislocations do not heal on their own and need medical attention.
How long does it take to recover from a hip injury?
It depends on what you’ve got. Mild strains heal in two to four weeks. Bursitis flare-ups typically settle in six to eight weeks with proper treatment. Recovery from hip arthroscopy for a labral tear or FAI is usually four to six months for return to sport, sometimes longer for high-level athletes.
Should I get an MRI for hip pain?
Not always. X-rays come first. MRI is the right next step if a labral tear, stress fracture, or significant soft-tissue injury is suspected, or if pain isn’t improving with conservative care.
What kind of doctor should I see for hip pain?
A board-certified orthopedic surgeon with fellowship training in sports medicine. For athletes, dancers, and active patients dealing with hip pain that hasn’t resolved on its own, that combination matters. General sports doctors and physical therapists are great partners in care, but the diagnostic complexity of the hip often benefits from a surgeon’s eye, even if surgery isn’t ultimately needed.
Can I keep working out with hip pain?
Maybe, maybe not. The honest answer is that pushing through hip pain without knowing what’s causing it is a coin flip. Some conditions get dramatically worse with continued activity. Get evaluated first, then build a smart plan around the diagnosis.
Don’t Wait It Out
Hip pain has a habit of getting talked out of. People tell themselves it’s tight muscles, or old age catching up, or the price of doing what they love. Sometimes that’s true. Often it isn’t, and the longer the real problem gets ignored, the smaller the menu of treatment options becomes.
If your hip has been bothering you for more than a couple of weeks, or if any of the symptoms in this article sound familiar, getting it looked at is a reasonable next step. Dr. Mufaddal Gombera and his team at Mufaddal Gombera, MD work with athletes, weekend warriors, and everyday Houstonians trying to stay active. The practice handles everything from straightforward sports injuries to complex hip conditions requiring arthroscopic repair, with an emphasis on conservative care first whenever it’s the right call.
