Hip pain has many causes — and getting the right diagnosis makes all the difference. Learn about common hip conditions and what modern treatment looks like, in plain language.
Hip Impingement (FAI — Femoroacetabular Impingement)
Your hip is a ball-and-socket joint — the ball is the top of the thighbone and the socket is in the pelvis. In a normal hip, the ball and socket fit together smoothly and move freely. In FAI, extra bone has grown on the ball, the socket rim, or both — causing the two surfaces to pinch against each other during movement. Over time, this pinching damages the soft tissue (labrum and cartilage) inside the joint.
The Two Types
Cam impingement: Extra bone on the ball of the hip (like a bump) — most common in young athletic males
Pincer impingement: The socket rim overhangs and covers too much of the ball — more common in middle-aged women
Many patients have a combination of both types
The extra bone is usually present from development — not caused by a specific injury
What You'll Feel
Groin pain — especially with sitting for long periods, squatting, or getting in and out of a car
A sharp pinch at the front of the hip when you pull the knee toward the chest
Stiffness and limited range of motion, especially rotating the hip inward
Pain during or after athletic activity — cycling, soccer, hockey, martial arts, yoga
A dull ache in the groin or outer hip after prolonged activity
Diagnosis: X-rays show the extra bone clearly. An MRI (often with dye injected into the joint) shows whether the labrum or cartilage has been damaged. Dr. McLaughlin performs a thorough physical exam including the FADIR test — flexing, rotating, and pushing the hip inward — which typically reproduces the pain.
Treatment Options
Non-Surgical
Physical therapy: strengthening the hip stabilizers (glutes, core) and improving movement patterns to reduce stress on the joint
Activity modification: avoiding deep hip flexion and high-impact activity during a flare
Anti-inflammatory medications (NSAIDs) for pain
Cortisone injection into the joint for diagnostic and temporary relief
Non-surgical care manages symptoms but does not correct the underlying bony problem — impingement and damage can continue
Surgical — Hip Arthroscopy
Using a camera and small instruments through 2–3 tiny incisions, Dr. McLaughlin shaves down the extra bone (osteoplasty) and reshapes the ball and/or socket rim
Any labral tear found is repaired at the same time using suture anchors
Cartilage damage is addressed if present
Outpatient procedure: you go home the same day
Over 85% of patients report significant improvement in pain and function after hip arthroscopy for FAI
RecoveryCrutches for 2–4 weeks to protect the labral repair. Physical therapy begins within the first week. Most athletes return to sport at 4–6 months. Full recovery and tissue healing take up to a year.
Hip · Labrum
Hip Labral Tear
The labrum is a ring of tough, rubbery cartilage that lines the rim of your hip socket. Think of it like a gasket or suction cup — it deepens the socket, helps the ball fit snugly, absorbs shock, and creates a fluid seal that keeps the joint surfaces lubricated. When the labrum tears, that seal is broken. The hip can feel painful, unstable, and may make a clicking or catching sensation.
What Causes It
FAI (hip impingement) — by far the most common cause; the extra bone pinches and tears the labrum over time
Hip dysplasia — a shallow socket puts abnormal stress on the labrum
Trauma — a fall, sports collision, or sudden twisting injury
Degenerative wear — the labrum can tear gradually, especially in middle-aged adults
What You'll Feel
Groin pain — patients often describe it by wrapping their hand in a "C" shape around the front of the hip
A clicking, locking, or catching sensation inside the hip
Pain with prolonged sitting, walking, or climbing stairs
Stiffness and limited range of motion
A feeling that the hip might "give out" with certain movements
Important: Hip labral tears are frequently misdiagnosed as groin strains, hip flexor injuries, or referred back pain. If you have persistent groin pain that hasn't responded to months of therapy, a labral tear may be the cause. An MRI arthrogram (with contrast dye) is the most accurate imaging test.
Treatment Options
Non-Surgical
Rest and avoiding movements that provoke the clicking or pain
Physical therapy to unload the labrum by improving hip muscle strength and movement quality
Cortisone injection into the joint — can provide months of relief and confirms the hip joint is the source of pain
Appropriate for small, minimally symptomatic tears or in patients who prefer to avoid surgery
Surgical — Hip Arthroscopy
Labral repair: The torn labrum is stitched back onto the socket rim using small anchors — the most common and preferred approach when the tissue is healthy enough
Labral reconstruction: When the labrum is too damaged to repair, a graft (from the patient or a donor) is used to rebuild it — restores the joint seal and function
Any FAI bone abnormality is corrected at the same time to eliminate the root cause
Performed arthroscopically through tiny incisions — outpatient surgery
RecoveryCrutches for 4–6 weeks, with the hip kept in a protected range of motion. PT begins immediately. Return to sport: 4–6 months for repair; 6–8 months for reconstruction.
Persistent groin pain with clicking or catching? Dr. McLaughlin specializes in hip arthroscopy and labral repair.
Your hamstrings are three muscles that run down the back of your thigh. They all attach at the top to the same spot on your sitting bone (the ischial tuberosity). A proximal hamstring tear means the tendon has partially or completely pulled away from that attachment point. This is different from a typical "pulled hamstring" in the belly of the muscle — it's a much more serious injury that often requires surgery to get full strength back.
How It Happens
Sudden explosive movement — sprinting, water skiing, doing the splits
The hip bends forward while the knee straightens — creating a violent stretch at the tendon attachment
Most common in recreational athletes aged 35–60
Often misdiagnosed as a "bad hamstring pull" — if it's not getting better in 4–6 weeks, it may be a proximal avulsion
What You'll Feel
A sudden, severe pain deep in the buttock at the moment of injury
Bruising that tracks down the back of the thigh over 24–48 hours
Significant weakness — difficulty running, climbing stairs, or sitting on a hard surface
A palpable gap or fullness at the top of the thigh
Chronic partial tears: a persistent nagging ache in the buttock that never fully heals
Don't wait: Complete tears (especially when all three tendons pull off the bone) left untreated result in permanent weakness and chronic pain. Surgical repair gives the best results when done within the first 4–6 weeks of injury — after that, the tendon retracts and scars, making repair much more difficult.
Treatment Options
Non-Surgical
Appropriate for partial tears where less than 2 tendons are involved and there is minimal retraction
Relative rest — avoiding positions that stretch or load the hamstring
Use of a donut-shaped cushion for sitting to take pressure off the attachment
Gradual PT starting with gentle range of motion and progressing to strengthening
PRP injection may assist healing of chronic partial tears
Surgical
For complete tears (all three tendons avulsed from the bone) and many 2-tendon tears, surgery is strongly recommended
The tendon is pulled back to the bone and reattached using strong anchors — typically through a single incision in the buttock crease
Acute repairs (within 4–6 weeks) are significantly easier and give better outcomes
Chronic repairs require releasing scar tissue and may need a graft — more complex but still successful
RecoveryNon-weight-bearing on crutches for 4–6 weeks. Running begins around 3–4 months. Full return to sport: 6–9 months. Strength recovery continues for up to a year.
Hip · Inflammation
Greater Trochanteric Bursitis (Hip Bursitis)
Feel the bony bump on the outer side of your hip? That's the greater trochanter. A small fluid-filled sac called a bursa sits between that bone and the tendons that run over it, acting as a cushion. When that bursa becomes irritated and inflamed — from friction, overuse, or a direct fall — it causes pain on the outer hip. This condition is also closely related to the gluteus medius tendon, which can become sore or partially torn alongside it.
Who Gets It & Why
More common in women, especially middle-aged and older adults
Runners — especially those who increase mileage quickly or run on cambered roads
A direct fall on the outer hip
Tight IT band (the thick band of tissue running down the outside of the thigh)
Weak hip abductor muscles (the muscles that lift the leg out to the side)
Leg length difference — puts uneven stress on the hip
What You'll Feel
Aching or burning pain on the outer side of the hip — not the groin
Tenderness when pressing directly on the bony bump
Pain that is worse when lying on that side at night
Pain going up stairs, hills, or rising from a chair
Pain that radiates down the outer thigh (but not below the knee — that suggests a back or nerve problem)
Treatment Options
Non-Surgical (Primary Treatment)
Physical therapy: the most important step — focuses on strengthening the gluteus medius and hip abductors, which reduces friction over the bursa
Cortisone injection into the bursa — provides rapid relief and allows PT to work effectively
PRP injection for gluteus medius tendinopathy when cortisone has limited effect
The vast majority of patients improve significantly within 6–12 weeks with PT and injections
Surgical (Rarely Needed)
Reserved for patients with a significant gluteus medius tendon tear or those who fail 6+ months of conservative treatment
Arthroscopic bursectomy — removal of the inflamed bursa through tiny incisions
Gluteus medius tendon repair — when a substantial tear is identified
IT band release for severe cases
RecoveryMost patients see significant improvement in 6–12 weeks with consistent PT and an injection. Surgical bursectomy: return to full activity in 6–12 weeks. Tendon repair: 3–6 months.
Outer hip pain that keeps you up at night or limits your walking? This is very treatable. Let's find the right plan for you.
In a normal hip, the socket (acetabulum) covers the ball of the thighbone like a deep cup. In hip dysplasia, the socket is too shallow — more like a saucer — and doesn't cover the ball adequately. This forces the labrum and cartilage to act as extra stabilizers, leading to overload, tearing, and eventually early arthritis. Dysplasia is often present from birth but may not become painful until young adulthood, especially with increased activity.
Who Is Affected
More common in women (4–5:1 ratio)
Often runs in families
May be detected at birth (developmental dysplasia of the hip) or discovered in adulthood when pain develops
Firstborn children and those born breech are at higher risk
Active young women with groin pain who have already been told they have "a labral tear" — the dysplasia may be the underlying cause
What You'll Feel
Groin pain that worsens with activity — walking, running, climbing stairs
A sense of instability or that the hip might "give out"
Clicking, catching, or a "clunking" sensation
Pain and fatigue with prolonged standing or walking
Symptoms often start in the teens or 20s and progressively worsen
Critical point: Hip arthroscopy alone is not appropriate for most patients with significant dysplasia. Without correcting the shallow socket, the labrum will re-tear and symptoms will return — or worsen. A thorough evaluation to determine the degree of dysplasia is essential before any treatment decision.
Treatment Options
Non-Surgical
Physical therapy to strengthen the muscles around the hip and compensate for the shallow socket
Activity modification — reducing high-impact sports and activities that cause pain
May slow progression but does not correct the underlying anatomy
Appropriate for mild cases, older patients, or as a bridge to surgery
Surgical — PAO or Hip Arthroscopy
Periacetabular Osteotomy (PAO): The gold-standard surgery for hip dysplasia. The socket is carefully cut free from the pelvis and repositioned to better cover the ball, then secured with screws. A major but highly effective procedure that can prevent or significantly delay the need for hip replacement
Hip Arthroscopy: May be performed alongside PAO to address associated labral tears or FAI — but is not done alone for significant dysplasia
Best results in patients under 40 without advanced arthritis
RecoveryPAO: crutches for 6–8 weeks; full weight-bearing by 3 months. Most patients return to sport and full activity in 6–12 months. Long-term outcomes are excellent — over 80% of patients avoid hip replacement for 20+ years.
Hip · Snapping & Clicking
Snapping Hip Syndrome
Snapping hip is exactly what it sounds like — a snapping, clicking, or popping sensation around the hip with certain movements. It's very common and usually not dangerous, but it can become painful and interfere with daily activities or sport. The snap is caused by a tendon or band of tissue flicking over a bony landmark. There are three main types, each with a different cause and location.
The Three Types
Internal (most common): The iliopsoas tendon (hip flexor) snaps over a bony ridge at the front of the hip. Felt or heard at the front of the hip with certain leg movements
External: The IT band snaps over the greater trochanter (outer bony bump). Felt on the outside of the hip
Intra-articular: A clicking that comes from inside the joint — often a sign of a labral tear or loose body
What You'll Feel
A snapping or popping — audible or felt with certain movements (swinging the leg, getting up from sitting, walking)
May be completely painless and just annoying — or can cause significant pain, especially with repetitive activity
In dancers and gymnasts, can interfere with technique and performance
Intra-articular snapping is usually more painful and more concerning
Treatment Options
Non-Surgical (Most Cases)
If painless, reassurance is often all that's needed — snapping alone is not harmful
PT: stretching the iliopsoas and IT band; strengthening the hip stabilizers
Activity modification to avoid provocative movements during a flare
Cortisone injection into the psoas bursa (for internal type) — can reduce inflammation and improve symptoms
Most cases resolve or become manageable with 6–12 weeks of PT
Surgical (Resistant Cases)
Reserved for cases that cause significant pain despite months of conservative care
Arthroscopic iliopsoas tendon release or lengthening: The tendon is carefully cut or lengthened to prevent the snapping
IT band release: A portion of the band is released to stop the external snap
Any associated labral tear is repaired at the same time
RecoveryNon-surgical: improvement in 6–12 weeks of PT. Surgical tendon release: return to activity in 6–10 weeks; full sport at 3–4 months.
Hip · Degenerative Condition
Hip Osteoarthritis
Hip osteoarthritis is the gradual breakdown of the cartilage that cushions the hip joint. When that cartilage wears away, the bones begin to rub directly against each other — causing pain, stiffness, and a grinding sensation. It's one of the most common causes of chronic hip pain in adults over 50, though it can develop earlier — especially in people with prior hip conditions like dysplasia or FAI. Hip arthritis is very manageable, and when conservative treatments no longer provide relief, hip replacement is one of the most successful operations in all of medicine.
Risk Factors
Age — most common over 50
Prior hip conditions: FAI, dysplasia, labral tears, or fractures that were not treated
Obesity — every extra pound adds 3 pounds of force on the hip with each step
Genetics — hip arthritis runs in families
History of avascular necrosis (loss of blood supply to the femoral head)
What You'll Feel
Deep groin pain or front-of-hip pain — often described as a "toothache" in the hip
Morning stiffness that loosens up after 20–30 minutes of moving
Pain that worsens with activity and eases with rest (early) — then eventually pain at rest and at night
Difficulty putting on shoes and socks, getting in and out of a car, or climbing stairs
A grinding or crunching feeling inside the hip joint
Limping — especially after prolonged activity
Treatment Options
Non-Surgical (First-Line)
Low-impact exercise: swimming, cycling, and walking — maintain joint health without excessive loading
Weight loss — even modest weight reduction significantly decreases hip pain
Physical therapy to improve strength and flexibility around the hip
Anti-inflammatory medications (NSAIDs)
Cortisone injections for pain flares — provide temporary but meaningful relief
Assistive devices: a cane (held in the opposite hand) reduces hip joint force by up to 30%
Surgical — Hip Replacement
When arthritis is severe and non-surgical measures are no longer enough, total hip replacement is the solution
The damaged ball and socket are replaced with metal, ceramic, and plastic implants — smooth surfaces that glide without friction
One of the most successful surgical procedures in all of medicine — over 95% of patients report excellent pain relief and function
Modern implants last 20–25+ years
Hip replacement dramatically improves quality of life — most patients are walking independently within days
RecoveryAfter hip replacement: walking with a walker the day of surgery. Home within 1–2 days. Walking independently in 2–4 weeks. Return to golf, swimming, or cycling in 6–12 weeks. Most patients reach full functional recovery by 3–6 months.
Hip arthritis doesn't have to stop you from living fully. Dr. McLaughlin will help you find the right solution — from injections to hip replacement — for where you are today.
The hip abductor muscles — primarily the gluteus medius and gluteus minimus — attach to the outer side of the hip (the greater trochanter) and are responsible for stabilizing the pelvis with every step you take. When these tendons tear, the result is deep lateral hip pain, weakness, and a characteristic limp or Trendelenburg gait. Hip abductor tears are sometimes called the "rotator cuff of the hip" because of their functional similarity to rotator cuff tears in the shoulder — and like rotator cuff tears, they are underdiagnosed and often mistaken for hip bursitis or back pain.
Causes & Risk Factors
Degenerative tearing over time — most common in women over 50
Acute tear from a fall directly onto the outer hip
Repetitive overuse: running, step aerobics, lateral training
Prior hip surgeries — including total hip replacement — can disrupt abductor tissue
IT band tightness causing mechanical irritation where the tendon attaches
Low estrogen levels after menopause appear to weaken tendon tissue
Signs & Symptoms
Deep, aching pain on the outer side of the hip — often confused with bursitis
Pain that worsens with stairs, crossing legs, or lying on the affected side at night
Weakness when raising the leg out to the side (hip abduction)
Trendelenburg gait — the pelvis drops on the opposite side when standing on one leg
Tenderness directly over the greater trochanter
MRI confirms the tear — distinguishing it from bursitis alone, which requires different treatment
Hip abductor tears are one of the most underdiagnosed causes of lateral hip pain. Many patients are told they have "hip bursitis" and receive repeated steroid injections with no lasting benefit — because the underlying tendon tear has not been addressed. If lateral hip pain is not improving with standard bursitis treatment, an MRI specifically evaluating the abductor tendons is essential.
Treatment Options
Non-Surgical
Physical therapy focused on hip abductor and external rotator strengthening
Activity modification — avoiding high-impact and lateral loading activities
Corticosteroid injection into the trochanteric bursa for associated bursitis pain
PRP injection directly into the tendon — evidence supports improved healing in partial tears
Effective for partial tears and mild to moderate symptoms over 3–6 months
Endoscopic Abductor Repair
Complete or large partial tears that fail conservative care require surgical repair
Minimally invasive endoscopic technique — small incisions, camera-guided repair
The torn tendon is re-attached to the greater trochanter with suture anchors
IT band release may be performed simultaneously if it is contributing to tendon irritation
Trochanteric bursectomy is performed at the same time
Protected weight-bearing and brace for 6 weeks post-operatively
RecoveryProtected weight-bearing: 6 weeks → Formal PT: 6 weeks–4 months → Return to running: 4–6 months → Full strength and return to sport: 6–9 months.
Hip · Groin Injury
Adductor & Groin Injuries (Athletic Pubalgia)
Groin injuries are among the most common problems in sports — accounting for nearly 25% of all hip injuries in athletes. The adductor muscles (the inner thigh muscles that bring the legs together) attach at the pubic bone and are subject to large tensile forces during kicking, cutting, sprinting, and change-of-direction movements. Adductor strains range from mild muscle pulls to complete tendon tears, while the more complex condition of athletic pubalgia (often called a "sports hernia") involves disruption of the soft-tissue attachments of the lower abdominal wall and adductors at the pubic symphysis.
Types of Groin Injuries
Adductor strain (Grade I–III): Muscle or musculotendinous junction injury — ranges from mild pain to complete tear
Adductor tendinitis: Chronic overuse inflammation at the tendon-bone junction without a discrete tear
Adductor tendon avulsion: The tendon pulls away from the pubic bone — more common in explosive sprinting athletes
Athletic pubalgia / core muscle injury: Complex injury of the rectus abdominis and adductor attachments at the pubic symphysis — causes chronic debilitating groin pain
Signs & Symptoms
Sharp or aching inner groin pain — often felt during or after kicking, sprinting, or pivoting
Tenderness along the inner thigh or at the pubic bone attachment
Pain with resisted hip adduction (squeezing the legs together against resistance)
In athletic pubalgia: diffuse lower abdominal and groin pain that worsens with exertion and improves with rest
MRI of the pelvis is the gold standard — differentiates muscle strain, tendon tear, and athletic pubalgia
Adductor injuries account for 10–18% of all injuries in ice hockey, soccer, and football. Research shows that athletes with hip adductor strength less than 80% of their abductor strength are at significantly elevated risk for groin strain. Pre-season adductor strengthening programs reduce groin injury rates by up to 41% in high-risk sports.
Treatment Options
Non-Surgical (Most Cases)
Acute strains: RICE protocol, activity modification, and progressive rehabilitation
PRP injection for chronic tendinitis or partial tears — strong evidence in high-level athletes
Most Grade I–II strains return to sport in 2–6 weeks with proper management
Athletic pubalgia: structured 6-week rehab program resolves symptoms in approximately 60% of patients
Surgical (Selected Cases)
Complete adductor avulsion tears: surgical reattachment of the tendon to the pubic bone with suture anchors
Athletic pubalgia failing rehab: core muscle repair of the torn posterior inguinal wall and adductor reattachment
Minimally invasive techniques preferred when available
Return to sport: 3–4 months after surgical repair
Elite athletes have excellent return-to-sport rates after properly indicated surgery
RecoveryGrade I–II strain: 2–6 weeks → Grade III / complete tear (non-surgical): 3–4 months → Surgical repair: return to sport in 3–4 months. Athletic pubalgia surgical repair: 3–6 months.
Hip · Revision Surgery
Failed Hip Arthroscopy & Revision Hip Surgery
Hip arthroscopy has transformed the treatment of intra-articular hip conditions — but not every procedure achieves the desired outcome. When a patient continues to experience pain after hip arthroscopy, or when symptoms return after a period of improvement, a thorough re-evaluation is essential. The causes of failed hip arthroscopy are varied and nuanced: some are technical (inadequate bone resection, missed pathology, overtightened capsule), and some are patient-related (underlying dysplasia that was not recognized, advanced arthritis that was not a good candidate for scope surgery). Identifying the correct cause is the critical first step before pursuing revision surgery.
Common Reasons for Failure
Inadequate FAI bone resection — residual CAM or pincer impingement continues to damage the labrum
Missed hip dysplasia — arthroscopy alone in a dysplastic hip accelerates cartilage damage and worsens instability
Labral re-tear or failure of labral repair tissue
Iatrogenic instability — excessive capsular resection creates a new instability problem
Advanced chondral damage that was not amenable to arthroscopic management
Missed extra-articular impingement (subspine, ischiofemoral) that was not addressed at the first surgery
Evaluation After Failed Arthroscopy
Detailed review of prior operative report, imaging, and physical examination findings
CT scan with 3D reconstruction to assess residual bony impingement and hip morphology
MRI arthrogram to evaluate labral integrity and cartilage status
Dynamic impingement testing under fluoroscopy or exam under anesthesia if needed
Assessment for hip dysplasia using standing AP pelvis with lateral center edge angle measurement
Spine evaluation — lumbar pathology frequently mimics or coexists with hip conditions
Hip arthroscopy in the setting of unrecognized hip dysplasia is one of the most significant causes of failed hip arthroscopy. Arthroscopy alone cannot correct the underlying socket coverage problem — and without addressing the dysplasia with a periacetabular osteotomy (PAO), any labral repair will fail under the abnormal joint loading. Careful pre-operative assessment of lateral center edge angle and acetabular coverage is essential before any hip arthroscopy.
Revision Surgical Options
Revision Hip Arthroscopy
Indicated when residual FAI bone remains, the labrum has re-torn but cartilage is preserved, or iatrogenic capsular instability needs repair
Capsular reconstruction using graft tissue (iliotibial band or allograft) for patients with instability from over-resection
Revision labral repair or labral reconstruction using tendon graft if insufficient native tissue remains
Requires complete reassessment of the bony and soft-tissue anatomy before proceeding
Open / Corrective Procedures
Periacetabular osteotomy (PAO): if dysplasia was the root cause, PAO is required to properly re-orient the acetabulum before or instead of further arthroscopy
Total hip replacement: for patients with advanced cartilage loss where joint-preserving options are no longer appropriate
Surgical dislocation of the hip: allows complete 360° access for complex revision cases not possible arthroscopically
Ischiofemoral decompression for missed extra-articular impingement
RecoveryHighly variable by procedure — revision arthroscopy: similar to primary scope (3–6 months) → PAO: 9–12 months → Total hip replacement: 3–6 months to full recovery.
Persistent pain after hip arthroscopy needs a fresh, specialist evaluation — not another round of the same treatment. Dr. McLaughlin will find the root cause and build the right revision plan.