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) occurs when an abnormal bone shape causes impingement in the hip joint.
  • Osteoarthritis (Coxarthrosis) is the degenerative wear of cartilage in the hip joint, which causes pain in the groin and referred pain in the buttocks.
  • Sports Hernia (Athletic Pubalgia) is a soft tissue injury in the groin region that often causes reflex tension in the gluteus muscles.
  • Labral Tear, damage to the cartilage ring inside the hip joint that acts as a shock absorber.
  • Referred pain from the lumbar spine (L1-L3 levels), where nerve irritation in the back causes symptoms primarily in the groin.

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

At Focus Physical Therapy Center, the treatment for gluteal and groin pain focuses on reducing inflammation, improving joint mobility, and strengthening stabilizers through the use of advanced methods. The therapeutic protocol combines the application of deep tissue healing technologies with manual repositioning and mobilization techniques. Successful rehabilitation involves eliminating pain and restoring full function to the pelvic girdle.

The modern rehabilitation approach includes the following phases:

  • Detailed functional assessment of hip biomechanics, specific clinical tests for the groin, and checking the strength of the gluteus muscles.
  • Application of physical therapy procedures such as TECAR therapy, high-power laser, and magnetotherapy for the rapid elimination of pain and swelling.
  • Manual therapy and hip mobilization to release the joint capsule and increase the range of motion.
  • Kinesiotherapy focuses on specific exercises for strengthening the deep hip rotators and groin adductors.
  • Education on protective postures, gait correction, and the use of kinesiology taping for groin support.

Ongoing adherence to the prescribed exercise program is crucial for maintaining the achieved results and preventing the recurrence of pain. This comprehensive treatment restores stability to the hip and pelvis, enabling a return to all physical 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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