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Hip Pain & Symmetry

Uneven Pavement

Has hip pain limited your active lifestyle? 

Is it painful to sleep on one hip but not the other?

Or maybe you have had a friend or family member notice you are limping or you prefer leaning to one side more than the other. Or have you been told your hip is bone on bone and may need to be replaced? This article will outline how bone on bone, impingement syndromes (external and internal), gluteus medius tear and S-I joint dysfunction cause hip pain and help you learn how manual physical therapy can help ease your chronic hip pain.

At Manual Physical Therapy & Concierge Services, we operate on the idea that your body functions most efficiently when both sides are symmetrical and therefore used equally. When one side is worn more than the other, the question we ask is, “why is one hip painful and not the other?”

The answer to this question often brings us to the root cause of your problem and why your chronic pain won’t go away.

Instead of blaming a diagnosis such as osteoarthritis, we analyze your movement patterns and the consequences that occur as a result of these disordered movement patterns. We call these movement pattern compensations.

The compensations developed into the current pain you are experiencing now because you use both of your legs for all weight bearing activities. If they do not wear down equally, you end up using one side more than the other and compensations occur. Likewise, if the wheels of your car were misaligned, you would end up having 1 or 2 tires that wear out more than the others. Or, they wear down unevenly and a portion of the tire would end up more worn than the rest. The same thing can happen with your joints if they are misaligned or not symmetrical.

Bone On Bone

In the case of bone on bone hip joints, it is common to find osteoarthritis developed in one hip joint as a result of this asymmetry. In other words, if our bodies are not symmetrical, this means we are using the left and right side differently. In some cases only one hip is arthritic and the other one is not. The loss of symmetry sends a signal of pain to the brain and the body automatically begins to compensate and starts moving differently to avoid this pain.

For example, you may start to limp or stand differently as you favor the less painful side and start to avoid activities that cause pain. This is when your body first compensates to avoid pain.

Over time, certain muscles begin to tighten and others become overstretched to adapt to the new way of moving that reduces pain. This ultimately leads to one side of your hip being higher and one side of your hip being rotated forward or back (anterior or posterior rotation). This can also result in bone on bone over time as you begin to overuse one hip vs the other.

Unfortunately, we cannot get rid of the arthritic changes, but we can address the muscular asymmetries between the right and left leg to achieve a more neutral pelvis. In addition, we can decompress the hip joint area to allow the nerves and tendons to move freely as they should. This will shut off your body's alarm system which is the pain. Imagine what you will be able to accomplish!

Doctors always say groin pain equals hip joint pain (bone on bone).

This is not necessarily true. If the painful hip is the higher hip/ anteriorly rotated hip, this could be a biomechanical and impingement problem.

Hip pain may not always be coming from an osteoarthritic hip. There are other possibilities. Some possible causes of hip pain, that is not from bone on bone, are impingement syndromes (external and internal), gluteus medius tear and S-I joint dysfunction. Since these conditions are muscular, we are able to address these issues with manual physical therapy. This natural solution produces lasting results without surgery.

For example, we are able to diagnose these problems for some of our patients who come in with gluteus medius tear (which is very common). The diagnosis is not as important as it is to ask the question, “so what are we going to do about it?” Many times doctors give patients a diagnosis but are unfortunately unable to provide lasting solutions.

At MPT, we are able to analyze your abnormal movement patterns that the chronic pain has caused over the years and are able to fix them via holistic manual therapy techniques. This approach doesn't only focus on your hip but in your entire body as a whole. This holistic method is proven to be successful in achieving long term results, allowing you to stay active and continue to do the things you love.


Joann Pung

Joann Pung

Founder of Manual Physical Therapy & Concierge Services and leading PT in Bradenton and Sarasota, Florida. Joann has been helping transform people’s lives since she was introduced to Manual Therapy techniques 28 years ago. Since opening up her own clinic in July 2016, her reputation has grown quickly, with patients now driving from areas as far as Punta Gorda and Orlando to see her and some even enjoying telehealth from as far as Denver, Seattle, London and UAE. To help more people, Joann works extensively with her team and spends a vast amount of her time continually training them. This ensures that our treatment approach is consistent and that every patient gets the functional outcome that is most important to them, regardless of who treats them. When not at work, Joann spends her time with Joel, her best friend, husband, and fellow PT who now runs the front desk. She has raised 2 amazing daughters and enjoys spending time with her family, learning new ideas (such a nerd), watching funny videos on YouTube, or planning for the next family trip.
Joann Pung

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