Hip Pain? These Muscles Could Be To Blame

James, a 38-year-old office worker, wasn't exactly known for being active. He spent most of his days at a desk, and while he occasionally went for walks or played with his kids, regular exercise wasn’t part of his routine. One Saturday afternoon, however, he decided to join some friends for a casual game of soccer. He hadn’t played in years but figured it would be fun and a good way to spend the day outdoors.

The game was intense, and James gave it his all, running, kicking, and trying to keep up with his more active friends. By the end of the game, he was exhausted but happy. However, the next morning, he woke up with a sharp pain in his hip that made even the simplest movements—like getting out of bed or sitting down—feel uncomfortable.

At first, James brushed it off as typical soreness from doing something out of the ordinary. But as the pain lingered, he started to worry. Could he have pulled something? Was it a strain or worse, a serious injury? After a few days of no relief, James decided to reach out to a friend of his who was a massage therapist.

The therapist found several muscles in his hips, glutes, and lower back had been overworked during the soccer game, leading to tightness and discomfort. After relaxing these muscles, most of the pain disappeared. The therapist also recommended that James start a regular exercise program to help strengthen his body to help prevent further pain or injuries.

What muscles were responsible for James’s hip pain? Could they be causing your discomfort as well? In this article, we’ll look at the muscles that may contribute to hip pain and offer solutions for finding relief.

How Can Muscles Be To Blame?

When a muscle is overused—held in a tight or constricted state for too long—it becomes fatigued and tense, much like you might feel after a stressful, overbooked week. Over time, the muscle can lock into this tight position, forming painful knots known as trigger points. These knots don’t just cause localized pain; they can pull on surrounding muscles, restrict movement, and even contribute to hip disfunction.

Much of the information in this article is inspired by Myofascial Pain and Dysfunction: The Trigger Point Therapy Manual by Dr. Janet G. Travell and Dr. David G. Simons. This comprehensive two-volume set revolutionized my approach to massage, helping me provide lasting relief to my clients. If you're looking for a more accessible, hands-on resource, I highly recommend The Trigger Point Therapy Workbook by Clair Davies, NCTMB, which breaks down the concepts into an easy-to-follow, self-treatment guide.

Muscles That Can Create Hip Pain

Now that we've explored how muscles can contribute to or even cause hip pain, let's take a closer look at the specific muscles that may be responsible. While there's much more to say about each one, I've highlighted the key points that you should know. If any of these symptoms sound familiar, be sure to check out the section below on what you can do to find relief.

1. Quadratus Lumborum

Commonly referred to as the "QL," this four-sided muscle extends from the bottom rib to the top of the pelvis. It functions to support the entire upper body, controls movement of the waist, and inables forced exhalation and when coughing or sneezing.

Symptoms It Can Cause:

• Pain in the low back, hips, or buttocks, sometimes agravated by coughing or sneezing.

• Sciatica symptoms

How It Can Be Overused:

• A leg that is shorter than the other

• Accidents or falls

• Twisting the body or being off balance when lifting

• Weak or stiffened gluteal muscles

2. Gluteus Maximus

This is the largest muscle of the buttock. Its function is to extend the hip, such as when running, climbing, and walking fast.

Symptoms It Can Cause:

• Pain in the low back, outer hip, tailbone

• Discomfort in buttocks when sitting

• Stiffness in the hips

How It Can Be Overused:

• Unaccustomed exertion of the muscle, such as returning to the gym after a break or beginning a running routine

• Swimming with the flutter kick

• Sitting on hard surfaces or for too much time

3. Gluteus Medius

This muscle is located at the top of the hip, just above the belt line. Its primary function is to support upright walking by momentarily bearing the body's weight with each step.

Symptoms It Can Cause:

• Pain above the belt line that extends into the buttocks and hips

• Hip and low back pain in the later months of pregnancy

How It Can Be Overused:

• Being overweight or carrying a heavy weight while walking

• Carrying a child on one side

• Standing or sitting still for long periods

• Foot instability

• Sitting cross-legged

4. Piriformis

This is the largest of the six short hip rotator muscles, extending between the sacrum and the middle of the buttocks. Its primary function is to rotate the leg outward.

Symptoms It Can Cause:

• Pain in the sacrum, buttocks, and hip

• Appearance of a short leg

• Difficulty crossing the legs or rotating the leg inward

• Sciatica

How It Can Be Overused:

• Quick changes in direction, as in sports activities like tennis, soccer, etc.

• Twisting while lifting

• Sitting for too much time

5. Tensor Fasciae Latae

This muscle extends from the dip of the hips to the top of the femur. Its function is to assist in bending the knee and hip and to stabilize the pelvis and knees during walking and running.

Symptoms It Can Cause:

• Pain in the side of the hip and upper thigh

• Difficulty in straightening the hip

• Forward pelvis tilt

• Appearance of having a short leg

How It Can Be Overused:

• Too much walking, running, or climbing, especially when followed by long periods of inactivity.

6. Adductor Longus and Adductor Brevis

These muscles are right beside each other and function as a single muscle. They attach to the pubic bones and to the back of the upper femur. They function to move the leg forward and inward.

Symptoms It Can Cause:

• Pain deep in the hip joint

• Groin pain

• Hip stiffness

  
  

How It Can Be Overused:

• Taking overly long steps

• Slipping and falling

  
  

How Do We Fix Triggered Muscles?

The good news is that triggered muscles can often be relatively quick and easy to "un-trigger." However, if you continue the activity that caused the issue in the first place, the muscle will likely become triggered again. Consider how you can modify or mediate these triggers—for example, creating a balance between moving and sitting. For activities that cannot be changed, consistently applying the following two steps can help keep your pain significantly reduced.

Step 1: Relax the Muscle

The first step in releasing a triggered muscle is to relax it. Whether through foam rolling your legs, self-massage with tennis balls or your hands, or seeking the help of a professional massage therapist, massage is the most effective way to ease muscle tension and restore movement. If you're interested in learning more about self-massage, I highly recommend The Trigger Point Therapy Workbook by Clair Davies, NCTMB.

Step 2: Strengthen and Stabilize

Relaxing the muscle alone is not enough. The reason it became overworked in the first place is often due to weakness—either in the muscle itself or in surrounding muscles that failed to provide adequate support. Developing a targeted corrective exercise routine to strengthen and stabilize your hips is essential for long-term relief. These exercises don’t require a gym and usually take just a few minutes each day, but the benefits will be well worth the effort!

If you are currently dealing with hip or buttock pain, schedule a consult with me today to see how we can work together to help you feel and move better!

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