Blog 5: The Athlete’s Guide to Hip Pain: From Anatomy to Performance (The Final)

Part 5: Rehabilitation & Long-Term Hip Health

Welcome to the final blog in our hip pain series! Over the last four parts, Dr. Keirstyn of Endurance Therapeutics covered hip anatomy, anterior pain, lateral pain, and movement patterns that create problems. Now it's time to tie it all together: how to rehab hip pain and keep your hips healthy for decades.

Whether you're currently dealing with hip pain or want to prevent it, this blog gives you the framework for long-term hip health.

The Rehabilitation Framework: A Phased Approach

Hip rehab isn't linear. You don't just "stretch and strengthen" and expect it to heal. Effective rehab follows phases based on tissue healing and pain levels.

Phase 1: Pain Management & Load Reduction (Weeks 1-2)

Goal: Reduce pain and inflammation, allow tissue to begin healing

What to Do:

• Modify or reduce aggravating activities (not complete rest)

• Avoid compressive positions (lying on affected side, crossing legs)

• Gentle mobility work (hip CARs, gentle range of motion)

• Isometric strengthening (no movement, just muscle activation)

What NOT to Do:

• Aggressive stretching or foam rolling

• Pushing through sharp pain

• Maintaining full training volume

Phase 2: Progressive Loading & Strengthening (Weeks 3-6)

Goal: Build strength and capacity in weakened tissues

What to Do:

Gradual return to training (start at 50% volume, increase 10-15% per week)

Progressive strengthening (bodyweight → resistance bands → weights)

Address contributing factors (bike fit, running form, movement patterns)

Phase 3: Return to Sport & Performance (Weeks 7-12+)

Goal: Rebuild sport-specific capacity and prevent re-injury

What to Do:

• Gradual return to full training volume

• Sport-specific strengthening and power work

• Continue maintenance strength work (2x/week minimum)

• Monitor for early warning signs

Return to Sport Guidelines:

• Pain during or after activity remains at or below a 3/10

• Equal strength both sides (tested via single-leg exercises)

• Full range of motion without compensation

• Can perform sport-specific movements without fear or hesitation

Specific Rehab for Common Hip Issues

For Anterior Hip Pain (Impingement, Labral, Hip Flexor):

Focus:

• Improve hip extension and glute strength (counteract flexion dominance)

• Avoid deep hip flexion initially

• Strengthen hip rotators for joint stability

Key Exercises:

• Hip extension work (glute bridges, hip thrusts)

• 90/90 hip mobility (improves internal rotation)

• Dead bugs (core stability without hip flexion)

• Clamshells and side-lying hip rotations

For Lateral Hip Pain (GTPS, Gluteal Tendinopathy):

Focus:

• Progressive loading of glute med/min (not stretching or foam rolling)

• Avoid compressive positions

• Build single-leg stability

Key Exercises:

• Isometric hip abduction (Phase 1)

• Side-lying hip abduction (Phase 2)

• Single-leg deadlifts (Phase 2-3)

• Single-leg squats (Phase 3)

• Lateral step-ups (Phase 3)

Avoid: Aggressive foam rolling, stretching into pain, cortisone injections

Building Long-Term Hip Health: The Maintenance Plan

Once you've rehabbed your hip, the goal is to never go back. Here's how to keep your hips healthy for decades.

1. Consistent Strength Training (2-3x/Week)

Hip health requires ongoing strength work, not just during rehab.

Essential Exercises:

• Hip abduction work (glute med/min)

• Hip extension work (glutes)

• Single-leg stability (deadlifts, squats, step-ups)

• Core anti-rotation work

The Rule: If you're training 5-6 days/week in your sport, 2 days should include targeted hip strength work.

2. Movement Variability

Single-sport specialization creates repetitive stress. Build variability:

• Runners: Add cycling, swimming, strength training

• Cyclists: Add running, hiking, yoga

• Dancers: Add low-impact conditioning, strength work

• Hockey players: Off-ice training, varied movement patterns

Why: Different movement patterns distribute stress across tissues instead of overloading the same structures repeatedly.

3. Mobility Work (Daily, 10 Minutes)

Mobility isn't just stretching — it's controlled movement through full range.

Daily Routine:

• Hip CARs: 5 each direction, each leg

• 90/90 hip stretch: 30 seconds each side

• Hip flexor stretch (in lunge): 30 seconds each side

• Deep squat hold: 60 seconds

Why: Maintains joint health, prevents capsular restrictions, keeps tissues mobile.

4. Load Management

• Track your training volume and intensity. Avoid sudden spikes.

• The 10% Rule: Don't increase weekly training volume by more than 10%

Monitor:

• Weekly mileage (runners)

• Weekly hours (cyclists, skaters)

• Training intensity (easy vs hard days)

• Total training load across all sports

5. Address Issues Early

Don't let minor tightness or discomfort become chronic pain.

Early Warning Signs:

• Stiffness that requires extra warmup

• Asymmetrical tightness (one side always tighter)

• Fatigue in specific muscles (glutes, hip flexors)

• Subtle changes in movement quality

Action: Book a session with Dr. Keirstyn for assessment before it becomes an injury.

Nutrition for Hip and Joint Health

What Helps:

• Protein: 0.7-1.0g per lb body weight (supports tissue repair)

• Omega-3 Fatty Acids: Anti-inflammatory (fish, flax, walnuts)

• Vitamin D & Calcium: Bone health (dairy, fortified foods, sunlight)

• Collagen: Supports connective tissue (bone broth, collagen supplements)

• Hydration: Maintains tissue quality and joint lubrication

What Hurts:

• Chronic under-fueling (RED-S) → weakens bones and soft tissues

• Excessive processed foods and sugar → increases systemic inflammation

• Alcohol in excess → impairs tissue healing

When to Get Professional Help

Proactive Care (Preventing Issues):

• Pre-season movement screening (including gait analysis)

• Bike fit assessment (cyclists)

• Gait analysis (runners)

• Quarterly maintenance check-ins during heavy training

Reactive Care (Addressing Issues):

• Pain lasting >2-3 weeks

• Recurrent hip issues

• Pain limiting training or performance

• Post-injury return to sport guidance

At Endurance Therapeutics:

• Comprehensive hip assessments

• Sport-specific movement analysis

• Individualized rehab programs

• Long-term maintenance plans

Series Wrap-Up: The 5 Keys to Healthy Hips

Let's recap what we've covered:

Part 1: Hip anatomy and pain locations — understanding where pain comes from

Part 2: Anterior hip pain — impingement, labral issues, hip flexor strains

Part 3: Lateral hip pain — GTPS, gluteal tendinopathy, IT band issues

Part 4: Movement patterns that break hips — sport-specific faults and training errors

Part 5: Rehab and long-term health — how to fix and prevent hip pain

The 5 Pillars of Hip Health:

• Strength: Consistent hip and glute strengthening (2-3x/week)

• Mobility: Daily mobility work to maintain joint health

• Load Management: Avoid sudden training spikes

• Movement Quality: Address faulty patterns early

• Proactive Care: Don't wait for pain to seek professional help

Your Next Step

If you're currently dealing with hip pain:

Book an assessment with Dr. Keirstyn at Endurance Therapeutics. We'll identify the root cause, create a tailored rehab plan, and get you back to pain-free training.

If you want to prevent hip issues:

Schedule a movement screening. We'll identify weak links and give you a plan to keep your hips healthy for decades.

Don't let hip pain sideline you. With the right approach, most hip issues are fixable — and preventable.

📍 Endurance Therapeutics | Oakville, Ontario

📞 905-288-7161 | 🔗 https://endurance.janeapp.com/#staff_member/1

Thank you for following this series!

Train smart. Move well. Stay healthy.