The hip that wakes you up when you roll over
The most common story is outer hip pain: tender to lie on, sore after walking, worse standing on one leg, worse crossing your legs or sitting low. It's frequently labelled bursitis and frequently involves the gluteal tendons.
The second common story is groin or front-of-hip pain with deep squatting, prolonged sitting and rotation — a different problem, and a different plan.
Common sources of hip pain in active adults
- Gluteal tendinopathy / lateral hip pain: tenderness over the outer hip, pain lying on that side and with single-leg loading
- Hip joint–related pain: groin or front-of-hip pain, stiffness, limited rotation
- Deep gluteal and proximal hamstring tendon pain: sitting-related pain at the base of the buttock, worse with hills and speed work
- Referred lumbar involvement: buttock and hip-region symptoms driven from the low back
- Load-related muscle strains from sprinting or court sports
Why lateral hip pain lingers
- Positions that compress the tendons — side sleeping, crossing legs, low chairs — continuing all day
- Aggressive stretching of the outer hip, which often provokes rather than helps
- Gluteal strength and single-leg control never being rebuilt
- Walking, hill or running volume ramping faster than tolerance
- The label 'bursitis' leading to repeated short-term symptom management
Conservative care and where shockwave may fit
Care usually centers on reducing compressive provocation, progressive gluteal loading, single-leg control work and a graded return to walking, running or sport.
Systematic review of shockwave therapy in lower-limb conditions has reported some of the more favorable patient-rated pain reductions in plantar heel pain and greater trochanteric (lateral hip) pain, which is why lateral hip presentations are reasonable to evaluate for it.
What an evaluation involves
- Locating symptoms — outer hip, groin, buttock — and their behavior with load and position
- Single-leg loading, hip range of motion and gluteal strength testing
- Low back screening where referral is suspected
- A plan discussion including whether SoftWave applies
When to seek prompt medical attention
- Hip pain after a fall, or inability to bear weight
- Groin pain with a history of trauma, cancer, or long-term steroid use
- Fever, night pain unrelated to activity, or unexplained weight loss
- Progressive leg weakness, numbness, or changes in bowel or bladder function — seek urgent care
Who may not be appropriate for shockwave
- Suspected hip fracture, stress fracture or joint infection
- Undiagnosed groin pain that has not been examined
- Open wounds, active infection or suspected tumor at the treatment area
- Presentations determined unsuitable at clinical evaluation