Pain in the gluteus and groin, treatment: Focus Physical✓

Physical therapy Belgrade | Pain in the gluteus and groin

Pain in the gluteus and groin

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Pain in the gluteus and groin

Pain that occurs simultaneously in the gluteal region and the groin presents a complex diagnostic challenge as it points to an issue at the core of the human body's biomechanics. The pelvis functions as a closed bony ring that connects the spine to the lower limbs, and pain in the groin and buttocks is often a sign that this system is experiencing uneven stress. This area is rich in ligaments, tendons, and deep muscles that stabilize the hip joint and enable movement in all planes.

The anatomy of this region includes the hip joint (acetabulum and femoral head), the adductor muscles of the groin, and the strong gluteal muscles. Pain arises when there is irritation of the internal structures of the joint, inflammation of tendons that attach to the pelvic bones, or pressure on nerves passing through the pelvic cavity. In active individuals, this pain is often caused by sports injuries, while in older adults, it is associated with degenerative processes. Understanding the connection between internal hip rotation and tension in the gluteal region is crucial for determining the cause of discomfort. Timely physiotherapeutic diagnosis prevents the onset of permanent movement restrictions and damage to joint cartilage.

Symptoms

The symptomatology of pain in the gluteal region and groin varies from a dull discomfort deep in the joint to sharp, stabbing pain when attempting to spread the legs or rotate the torso. Patients often describe a sensation of "catching" in the hip area that makes it difficult to get into a car or put on shoes. The clinical picture is specific because the pain can radiate from the buttocks to the groin, depending on the type of movement performed.

The most common symptoms associated with gluteal and groin pain include:

  • Sharp pain in the groin that occurs during sudden lunges, running, or changes in direction.
  • Deep, dull pain in the buttocks that worsens after prolonged sitting or crossing the legs.
  • A sensation of clicking or popping deep in the hip, followed by immediate pain in the groin.
  • Limited range of motion, especially when attempting to draw the knee toward the chest or spread the legs apart.
  • Pain radiating down the inner thigh, sometimes accompanied by weakness in the leg.

These signs are clear indicators that the joint structures or muscle attachments in the pelvic region are under stress, which requires professional evaluation. Timely recognition of these symptoms allows the physiotherapist to apply manual mobilization techniques and prevent the development of chronic pain.

 

Causes

  • Sciatica
  • Gluteal and groin muscle strain
  • Herniated disc pressing on nerves
  • Sports injury

The causes of combined pain in the gluteal region and groin are most commonly associated with mechanical overload of the hip joint, soft tissue injuries, or referred pain from the lower back. Factors such as weakness of the "core" muscles, leg length asymmetry, or specific sports activities directly contribute to the onset of symptoms. While the pain is felt in the groin and buttocks, the root cause is often found in the poor mechanics of the entire lower body.

The main causes of gluteal and groin pain include:

  • Femoroacetabular impingement (FAI) – abnormal bone shape causes collision within the hip joint, leading to pain and limited motion.
  • Coxarthrosis (hip osteoarthritis) – degenerative cartilage wear in the hip joint, causing groin pain and referred pain to the buttocks.
  • Sports hernia (athletic pubalgia) – soft tissue injury in the groin region, often causing reflex tension in the gluteal muscles.
  • Hip labral lesion – damage to the cartilage ring (labrum) surrounding the hip joint, causing pain during movement and sometimes clicking.
  • Referred pain from the lumbar spine (L1-L3) – irritation of nerve roots in the lower back can present primarily as groin pain.

Accurately determining whether the pain originates from the joint itself or from the surrounding soft tissues enables the creation of an individualized treatment plan. Each of these causes requires a specific rehabilitation approach to achieve lasting relief.

Treatment

Treatment of pain in the gluteal and groin region at the Physical Therapy Focus center is aimed at reducing inflammation, improving hip mobility, and strengthening pelvic stabilizers through the use of modern therapeutic methods. The therapeutic protocol combines advanced physical modalities for tissue regeneration with manual techniques for joint mobilization and repositioning. Successful rehabilitation involves pain elimination, improved function, and restoration of full pelvic and hip stability.

The modern rehabilitation approach includes the following phases:

  • Detailed functional assessment: Analysis of hip biomechanics, specific orthopedic tests for the groin region, and evaluation of gluteal muscle strength.
  • Physical therapy: Application of Tecar therapy, high-intensity laser, and magnetotherapy to reduce pain, inflammation, and edema.
  • Manual therapy and hip mobilization: Techniques aimed at improving joint capsule mobility and releasing restricted hip structures.
  • Kinesiotherapy: Focus on strengthening deep hip rotators and adductor muscles, along with exercises for pelvic stabilization and movement control.
  • Education and prevention: Guidance on gait correction, proper movement patterns, and the use of kinesio taping for groin support.

Continuous adherence to the prescribed exercise program is essential for maintaining results and preventing recurrence of symptoms. This comprehensive approach restores hip and pelvic stability and allows a safe return to daily and sports activities without discomfort.

FAQ

What is the most common cause of combined groin and buttock pain?

The most common cause is degenerative changes in the hip (coxarthrosis). The pain of hip osteoarthritis is typically felt deep in the groin, but often radiates into the gluteus and down the thigh to the knee. Another common cause is inflammation of the bursa (bursitis) or tendon of the hip rotator cuff muscle.

Can the pain be related to a herniated disc in the back?

Yes. Although sciatica (pain in the buttocks) is more commonly mentioned, a herniated disc in the higher lumbar levels (L2-L4) can cause referred pain directly to the groin. If you feel weakness when you lift your knee to your chest, the problem is likely in the lumbar spine.

In athletes or very active people, groin and gluteal pain is often caused by an imbalance in the pelvic muscles. If the gluteal muscles are weak, the adductor muscles in the groin take on too much strain, leading to chronic inflammation of the pubic symphysis.

How important is physical therapy to address this problem?

Without hip stabilizer strengthening exercises, the pain usually returns. Physical therapy focuses on strengthening the gluteus medius and stretching the hip flexor (psoas) muscles. The goal is to center the femoral head in the hip joint to reduce friction and pressure on the groin.

What physical procedures give the best results?

  • TECAR therapy: The best method for deep warming of the hip joint and relaxing the large muscle groups of the buttocks and groin.
  • HILT laser: High power that reduces inflammation within the joint and calms irritated nerves.
  • Shockwave: Extremely effective therapy for chronic inflammation of the tendons in the groin and gluteus tendons that have become painful to the touch.

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