By Progression PT | Physical Therapy in Princeton & Somerville, NJ
If you’ve noticed a dull ache, sharp pinch, or grinding sensation in your hip when you walk — whether it shows up after a few minutes or the moment you take your first step — you’re not alone. Hip pain when walking is one of the most common complaints we see at Progression PT, and it affects people of all ages, from active young adults to older adults managing arthritis.
The frustrating part? Hip pain is often misunderstood. People assume it’s just part of getting older, or that they need a cortisone shot or surgery to feel better. In most cases, neither is true. Physical therapy is one of the most effective treatments for hip pain — and the earlier you start, the faster and more completely you recover.
Here’s what you need to know about what’s causing your hip pain and how PT can fix it for good.
Where Is Your Hip Pain, Exactly?
Before diving into causes, it helps to understand that “hip pain” can mean different things depending on where you feel it. Location is one of the most important clues for identifying what’s actually going on.
Pain on the outside of the hip (lateral) Usually points to IT band tightness, hip abductor weakness, or greater trochanteric bursitis — inflammation of the fluid-filled sac on the outer hip.
Pain deep in the front of the hip or groin Often linked to hip flexor tightness, hip impingement (FAI), a labral tear, or hip joint arthritis.
Pain in the buttock Can indicate hip joint problems, piriformis syndrome, SI joint dysfunction, or referred pain from the lumbar spine.
Pain that radiates down the leg May involve the sciatic nerve or other nerve structures originating in the lower back — not purely a hip problem.
Knowing where your pain lives helps your PT zero in on the cause quickly during your evaluation.
Common Causes of Hip Pain When Walking
1. Hip Osteoarthritis
One of the most common culprits, especially in adults over 50. Osteoarthritis occurs when the cartilage cushioning the hip joint gradually wears down, causing bones to rub together and leading to pain, stiffness, and reduced range of motion. Walking — particularly on hard surfaces or for extended distances — often aggravates it.
Many patients with hip OA assume surgery is inevitable. But research consistently shows that physical therapy can significantly reduce pain, improve function, and delay or even eliminate the need for joint replacement.
2. Hip Bursitis (Greater Trochanteric Bursitis)
Bursae are small fluid-filled sacs that reduce friction between bones and soft tissues. When the bursa on the outside of the hip becomes inflamed — often from repetitive movement, prolonged walking, or direct pressure — it causes a sharp or burning pain on the outer hip that can worsen with activity and lying on that side at night.
3. Hip Flexor Tightness or Strain
The hip flexors are the muscles that lift your leg when you walk. If you sit for long periods during the day, these muscles shorten and tighten — and when they’re chronically tight, they create pain at the front of the hip or groin during walking, especially when extending the leg behind you.
This is extremely common in office workers, drivers, and anyone who spends most of the day seated.
4. Hip Impingement (Femoroacetabular Impingement / FAI)
Hip impingement occurs when the ball and socket of the hip joint don’t fit together perfectly, causing abnormal contact and pinching of the soft tissue inside the joint. It creates a deep, sharp pain in the front of the hip or groin — often described as a “pinching” sensation — that worsens with walking, prolonged sitting, or squatting.
FAI is particularly common in younger, active adults and athletes.
5. Labral Tear
The labrum is a ring of cartilage that lines the hip socket and helps stabilize the joint. A tear — often caused by impingement, trauma, or repetitive stress — can cause deep groin pain, a clicking or locking sensation, and pain that worsens with walking or pivoting movements.
Physical therapy is often the first-line treatment for labral tears, and many patients avoid surgery entirely with the right rehabilitation program.
6. IT Band Syndrome
The iliotibial (IT) band is a thick band of connective tissue running from the hip down to the knee. When it becomes tight or overloaded — common in runners, cyclists, and hikers — it creates pain on the outside of the hip and sometimes the knee. Walking downhill or on uneven terrain is often particularly aggravating.
7. Muscle Weakness and Imbalances
This is the most underappreciated cause of hip pain — and one of the most common things we identify at Progression PT. Weak glutes, hip abductors, and core muscles force the body to compensate with altered movement patterns that overload the hip joint and surrounding structures. Over time, this mechanical stress leads to pain, inflammation, and injury.
The good news: muscle weakness responds extremely well to targeted physical therapy.
8. Referred Pain From the Lower Back
Not all hip pain originates in the hip. The lumbar spine and hip share nerve pathways, meaning disc problems, joint dysfunction, or nerve irritation in the lower back can produce pain that feels like it’s coming from the hip — a phenomenon called referred pain. This is why a thorough physical therapy evaluation looks at both the hip and the spine together.
Why Walking Makes Hip Pain Worse
Walking is a repetitive, weight-bearing activity that places significant demands on the hip joint, muscles, and surrounding soft tissue. With each step, your hip absorbs forces equivalent to several times your body weight.
When any of the structures around the hip — muscles, tendons, bursa, cartilage, or the joint itself — are compromised, that repetitive loading becomes a source of pain rather than a healthy activity. Over time, your body begins to compensate by altering your gait: leaning to one side, shortening your stride, or rotating your foot outward to reduce load on the painful area.
These compensations feel protective but create new problems in the knee, lower back, and opposite hip if left unaddressed.
How Physical Therapy Treats Hip Pain
At Progression PT, we don’t just treat the hip in isolation. We look at how the entire lower body — your foot, ankle, knee, hip, and spine — works together and identify where the system is breaking down.
Here’s what a personalized hip pain treatment plan at our Princeton and Somerville clinics may include:
Manual Therapy
Hands-on joint mobilization and soft tissue techniques to restore normal hip mobility, reduce stiffness, and decrease pain. Many patients notice meaningful improvement in range of motion and comfort after their first few sessions.
Targeted Strengthening
Weakness in the glutes, hip abductors, and core is one of the most common drivers of hip pain — and one of the most fixable. We build a progressive strengthening program designed specifically for your body and your movement deficits, without overloading the structures that are already irritated.
Gait Analysis and Retraining
If your walking pattern has been altered by pain or compensation, we identify those changes and help you restore a more efficient, pain-free gait. Small corrections in how you walk can make a dramatic difference in how much load the hip absorbs with every step.
Flexibility and Mobility Work
Tight hip flexors, piriformis, IT band, and surrounding muscles are addressed with targeted stretching and mobility exercises designed to restore full, pain-free range of motion.
Activity Modification and Education
We’ll give you practical guidance on how to modify activities that aggravate your hip while you recover — including walking distance, footwear, surface choices, and daily habits — so you can stay active without making things worse.
Dry Needling (When Appropriate)
For patients with significant muscle tightness or trigger points contributing to hip pain, dry needling can provide rapid relief and improve tissue mobility before strengthening work begins.
Can Hip Pain Go Away Without Surgery?
For most people, yes. Surgery is rarely the first or best option for hip pain. Even conditions that sound serious — like hip impingement, labral tears, or moderate osteoarthritis — are highly treatable with conservative care when caught before they become severe.
The key is not waiting too long. The longer hip pain goes unaddressed, the more the surrounding muscles weaken, the more compensatory patterns develop, and the harder the condition becomes to treat conservatively.
If you’ve been told you might need a hip replacement or surgical repair, it’s always worth getting a physical therapy evaluation first. Many of our patients in Princeton and Somerville, NJ have avoided surgery entirely by committing to a structured PT program.
4 Signs Your Hip Pain Needs a PT Evaluation Now
Don’t wait on your hip pain if any of these apply:
- Pain has been present for more than 2–3 weeks and isn’t improving on its own
- You’re limping or changing your gait to avoid putting weight on the painful side
- Pain is waking you up at night, especially when lying on the affected hip
- You’ve had to reduce or stop activities you love — walking, exercising, hiking, or playing with your kids or grandkids
In New Jersey, you can come directly to Progression PT without a referral. Same-week appointments are typically available at both our Princeton and Somerville locations.
What to Expect at Your First Hip Pain Evaluation at Progression PT
Your first visit will include a thorough assessment of your hip mobility, strength, movement patterns, and gait. We’ll ask about when the pain started, what makes it better or worse, and what activities matter most to you.
From there, we’ll explain exactly what we found, what’s causing your pain, and outline a clear treatment plan with realistic timelines. Most patients leave the first appointment already feeling more in control — because understanding what’s happening is the first step toward fixing it.
Get Back to Walking Without Pain — No Referral Needed
Hip pain doesn’t have to slow you down. At Progression PT, our experienced physical therapists have helped hundreds of patients throughout central New Jersey recover from hip pain and get back to the activities they love — without surgery, without injections, and without putting life on hold.
We have two convenient locations serving central New Jersey:
- 📍 Princeton, NJ — our main branch, serving Mercer County and surrounding areas
- 📍 Somerville, NJ — serving Somerset County and central New Jersey
No referral required. Most major insurance plans accepted. Same-week evaluations available.
📅 Ready to Walk Without Pain Again? Book Your Evaluation Today.
Don’t wait for hip pain to get worse. The sooner we identify what’s causing it, the faster we can fix it.
👉 Schedule your free consultation at progressionpt.com
Frequently Asked Questions
What causes hip pain when walking? The most common causes include hip osteoarthritis, bursitis, hip flexor tightness, hip impingement, IT band syndrome, and muscle weakness or imbalances. In some cases, hip pain is actually referred from the lower back. A PT evaluation can identify the exact cause and create a targeted treatment plan.
Can physical therapy fix hip pain without surgery? In most cases, yes. Physical therapy is the recommended first-line treatment for the majority of hip pain conditions, including osteoarthritis, bursitis, impingement, and labral tears. Surgery is typically only considered after conservative treatment has been tried.
How long does it take to recover from hip pain with PT? Recovery timelines vary depending on the cause and severity. Many patients see significant improvement within 4–8 weeks. More complex conditions like moderate OA or labral tears may take 8–12 weeks of consistent treatment.
Do I need a referral to see a physical therapist in NJ for hip pain? No — New Jersey’s direct access law allows you to see a licensed PT without a physician referral. You can book directly with Progression PT at our Princeton or Somerville location.
Is it okay to keep walking if my hip hurts? It depends on the cause and severity. Gentle walking is generally beneficial, but pushing through significant pain can worsen some conditions. A PT can evaluate your specific situation and advise you on safe activity levels while you recover.
Do you treat hip pain at both your Princeton and Somerville locations? Yes — hip pain is one of the most common conditions we treat at both our Princeton, NJ and Somerville, NJ clinics. Call or book online at either location to get started.
Progression PT is a physical therapy clinic with locations in Princeton, NJ and Somerville, NJ. We help patients throughout central New Jersey recover from hip pain, lower back pain, sports injuries, and more — using evidence-based, hands-on physical therapy.
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