HIP CONDITIONS
Trochanteric Bursitis
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A bursa is a small, synovial fluid-filled sac. There are more than 150 bursae throughout the body, and they provide a cushioning between the bones and tendons/muscles surrounding our joints. Healthy bursae provide lubrication to joints, allowing for smooth gliding and painless movement.
Bursitis is the inflammation of these bursae, due to irritation or infection. When the bursae become inflamed, they swell with fluid and put pressure on the joints. This results in painful or restricted movement of the joint, as well as muscle stiffness. Shockwave therapy has been shown to be an effective treatment option for bursitis, as an alternative to corticosteroid injections or in conjunction with home training strategies.
In a systematic review by the British Medical Bulletin, it was found that 4 months after treatment began, 34% of home training patients, 49% of corticosteroid patients, and 64% of shockwave patients had returned to previous levels of activity. Furthermore, 15 months after treatment began, these numbers had improved to 74-80% for shockwave and home therapy, a drastic improvement on corticosteroid injection patients at only 48%. Shockwave therapy is becoming an increasingly attractive long-term recovery option for bursitis pain.
Bursitis is the inflammation of these bursae, due to irritation or infection. When the bursae become inflamed, they swell with fluid and put pressure on the joints. This results in painful or restricted movement of the joint, as well as muscle stiffness. Shockwave therapy has been shown to be an effective treatment option for bursitis, as an alternative to corticosteroid injections or in conjunction with home training strategies.
In a systematic review by the British Medical Bulletin, it was found that 4 months after treatment began, 34% of home training patients, 49% of corticosteroid patients, and 64% of shockwave patients had returned to previous levels of activity. Furthermore, 15 months after treatment began, these numbers had improved to 74-80% for shockwave and home therapy, a drastic improvement on corticosteroid injection patients at only 48%. Shockwave therapy is becoming an increasingly attractive long-term recovery option for bursitis pain.
Piriformis Syndrome
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The piriformis is a flat muscle located in the buttocks, near the top of the hip. It is important for rotating the legs away from the body (abduction), stabilizing the hips, and keeping balanced. The sciatic nerve is the largest and longest nerve in the human body, starting in the lower back, travelling through the buttocks, and running down the lower leg. This nerve passes in under the piriformis muscle, and in some individuals fibers of the nerve may even pass directly through the piriformis!
When the piriformis muscle is very tight, it may compress the sciatic nerve. This results in tingling, numbness, pain, and tenderness in the buttocks and radiating down the leg. This pain can be triggered from running, sitting for extended periods, or any activity that may activate the piriformis muscle. The pain can be quite debilitating, with some individuals reporting an inability to sleep or find a comfortable stance. Often times there are issues in both the low back and in the piriformis and this can lead to compression of the nerve in more than one location.
Additionally, trigger points (small knots in muscles that send or “refer” pain to other areas of the body) can cause symptoms similar to that of sciatica or piriformis syndrome.
Thankfully all our therapists at Granville Physio will be able to find the true cause of your pain. Your therapist will be able to use shockwave therapy and tailored exercises to relieve the compression on the sciatic nerve, which means no more pain! In fact, studies have shown that in some cases, a complete absence of pain and symptoms are reported after only four sessions!
When the piriformis muscle is very tight, it may compress the sciatic nerve. This results in tingling, numbness, pain, and tenderness in the buttocks and radiating down the leg. This pain can be triggered from running, sitting for extended periods, or any activity that may activate the piriformis muscle. The pain can be quite debilitating, with some individuals reporting an inability to sleep or find a comfortable stance. Often times there are issues in both the low back and in the piriformis and this can lead to compression of the nerve in more than one location.
Additionally, trigger points (small knots in muscles that send or “refer” pain to other areas of the body) can cause symptoms similar to that of sciatica or piriformis syndrome.
Thankfully all our therapists at Granville Physio will be able to find the true cause of your pain. Your therapist will be able to use shockwave therapy and tailored exercises to relieve the compression on the sciatic nerve, which means no more pain! In fact, studies have shown that in some cases, a complete absence of pain and symptoms are reported after only four sessions!
Rectus Femoris
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The rectus femoris is one of the four quadriceps muscles at the front of the thigh and is unique because it crosses both the hip and knee joints. This dual function allows it to play a major role in hip flexion and knee extension—important movements for walking, running, squatting, and nearly every lower-body activity. Because it is active during so many daily and athletic movements, the rectus femoris is particularly vulnerable to tightness, strain, and overuse injury.
When the rectus femoris becomes tight or irritated, it can create a pulling sensation along the front of the hip or thigh. In more severe cases, people may feel sharp pain during kicking, sprinting, or rising from a seated position. Since this muscle attaches at the pelvis, excessive tension can also tilt the pelvis forward, placing strain on the lower back. Many individuals experience referred pain into the knee as well, because the rectus femoris plays such a large role in stabilizing the knee joint during movement. These symptoms may worsen after prolonged sitting, high-intensity exercise, or sudden increases in training load.
Trigger points—small, hypersensitive knots within the muscle—can form in the rectus femoris and often mimic or contribute to hip and knee pain. These trigger points may limit mobility, reduce strength, and cause discomfort with everyday activities such as climbing stairs, bending, or standing from a low surface.
At Granville Physio, your therapist will assess the underlying cause of your discomfort and create a tailored plan to restore optimal muscle function. Treatment may include manual therapy to release tightness, targeted exercises to improve strength and flexibility, and postural correction to reduce strain on both the hip and knee. Shockwave therapy may also be used to break down stubborn trigger points, increase blood flow, and accelerate healing—often providing significant pain relief in just a few sessions.
With proper guidance and a structured treatment approach, most patients experience major improvements in mobility, strength, and overall comfort—helping you return to work, sport, and daily life with confidence.
When the rectus femoris becomes tight or irritated, it can create a pulling sensation along the front of the hip or thigh. In more severe cases, people may feel sharp pain during kicking, sprinting, or rising from a seated position. Since this muscle attaches at the pelvis, excessive tension can also tilt the pelvis forward, placing strain on the lower back. Many individuals experience referred pain into the knee as well, because the rectus femoris plays such a large role in stabilizing the knee joint during movement. These symptoms may worsen after prolonged sitting, high-intensity exercise, or sudden increases in training load.
Trigger points—small, hypersensitive knots within the muscle—can form in the rectus femoris and often mimic or contribute to hip and knee pain. These trigger points may limit mobility, reduce strength, and cause discomfort with everyday activities such as climbing stairs, bending, or standing from a low surface.
At Granville Physio, your therapist will assess the underlying cause of your discomfort and create a tailored plan to restore optimal muscle function. Treatment may include manual therapy to release tightness, targeted exercises to improve strength and flexibility, and postural correction to reduce strain on both the hip and knee. Shockwave therapy may also be used to break down stubborn trigger points, increase blood flow, and accelerate healing—often providing significant pain relief in just a few sessions.
With proper guidance and a structured treatment approach, most patients experience major improvements in mobility, strength, and overall comfort—helping you return to work, sport, and daily life with confidence.
Tensor Fasciae Latae (TFL)
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The tensor fasciae latae (TFL) is a small but influential muscle located on the outer front portion of the hip. Despite its size, it plays an important role in stabilizing the pelvis, especially during walking, running, and standing on one leg. The TFL helps lift the leg outward (abduction), rotate the leg inward, and—through its connection to the iliotibial band (ITB)—helps maintain proper alignment of the knee and hip.
Because the TFL attaches directly into the thick ITB, tightness or overuse of this muscle can create tension that travels down the outside of the thigh, sometimes contributing to pain on the outer hip, lateral knee, or even the low back. Activities such as running—especially uphill or on uneven surfaces—cycling, prolonged sitting, and any movement that repeatedly uses hip flexion can cause the TFL to become overactive and tight.
When the TFL becomes dominant or strained, it may compensate for weaker gluteal muscles. This can lead to biomechanical imbalances, increased stress on the ITB, and irritation of nearby structures. Many individuals describe sharp or aching pain along the outer hip, tightness that won’t go away with stretching, or discomfort while lying on their side.
Additionally, trigger points (small, irritable knots within the muscle) can develop in the TFL and refer pain down the side of the thigh toward the knee—often mimicking ITB syndrome or general lateral hip pain.
Thankfully, all of our therapists at Granville Physio are trained to identify the true source of your discomfort. Using hands-on techniques, shockwave therapy, and customized exercise programs that strengthen the glutes and reduce TFL overactivity, we can help restore balance, reduce tension, and relieve pain. Many patients experience significant improvement in just a few sessions—and for many, complete relief is absolutely achievable!
Because the TFL attaches directly into the thick ITB, tightness or overuse of this muscle can create tension that travels down the outside of the thigh, sometimes contributing to pain on the outer hip, lateral knee, or even the low back. Activities such as running—especially uphill or on uneven surfaces—cycling, prolonged sitting, and any movement that repeatedly uses hip flexion can cause the TFL to become overactive and tight.
When the TFL becomes dominant or strained, it may compensate for weaker gluteal muscles. This can lead to biomechanical imbalances, increased stress on the ITB, and irritation of nearby structures. Many individuals describe sharp or aching pain along the outer hip, tightness that won’t go away with stretching, or discomfort while lying on their side.
Additionally, trigger points (small, irritable knots within the muscle) can develop in the TFL and refer pain down the side of the thigh toward the knee—often mimicking ITB syndrome or general lateral hip pain.
Thankfully, all of our therapists at Granville Physio are trained to identify the true source of your discomfort. Using hands-on techniques, shockwave therapy, and customized exercise programs that strengthen the glutes and reduce TFL overactivity, we can help restore balance, reduce tension, and relieve pain. Many patients experience significant improvement in just a few sessions—and for many, complete relief is absolutely achievable!
Psoas Muscle
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The psoas is one of the deepest and most influential muscles in the body. Located in the front of the lower spine, it runs from the lumbar vertebrae, passes through the pelvis, and attaches to the top of the femur. Together with the iliacus, it forms the iliopsoas—your primary hip flexor. This muscle plays a major role in lifting the leg, stabilizing the spine, supporting posture, and coordinating nearly every movement involving the hips and lower back.
Because of its deep location, the psoas is highly sensitive to prolonged sitting, stress, poor posture, and repetitive lifting. When the psoas becomes tight or overactive, it can pull the spine forward, compress the lumbar discs, and create pain in the lower back, pelvis, groin, or even the front of the hip. Some individuals also experience referral patterns that mimic other conditions such as hip impingement or sacroiliac joint dysfunction. In severe cases, people report difficulty standing fully upright, trouble walking, or sharp pain with hip flexion.
Additionally, trigger points—small, hyperirritable knots in the muscle—can produce symptoms like deep aching in the abdomen, sharp pain in the groin or upper thigh, or a sense of tightness that never quite goes away. Because the psoas lies so close to the lumbar nerves, irritation or tension in this muscle can also contribute to nerve-like symptoms.
Thankfully, all therapists at Granville Physio are trained to identify whether the psoas is the true source of your discomfort. Using a combination of shockwave therapy, manual techniques, and individualized corrective exercises, your therapist can release tension in the psoas, improve hip and spinal mechanics, and restore full, pain-free movement. Studies have shown that patients with chronic hip or low back pain often experience significant improvement—and in some cases complete resolution of symptoms—after just a few targeted sessions.
Because of its deep location, the psoas is highly sensitive to prolonged sitting, stress, poor posture, and repetitive lifting. When the psoas becomes tight or overactive, it can pull the spine forward, compress the lumbar discs, and create pain in the lower back, pelvis, groin, or even the front of the hip. Some individuals also experience referral patterns that mimic other conditions such as hip impingement or sacroiliac joint dysfunction. In severe cases, people report difficulty standing fully upright, trouble walking, or sharp pain with hip flexion.
Additionally, trigger points—small, hyperirritable knots in the muscle—can produce symptoms like deep aching in the abdomen, sharp pain in the groin or upper thigh, or a sense of tightness that never quite goes away. Because the psoas lies so close to the lumbar nerves, irritation or tension in this muscle can also contribute to nerve-like symptoms.
Thankfully, all therapists at Granville Physio are trained to identify whether the psoas is the true source of your discomfort. Using a combination of shockwave therapy, manual techniques, and individualized corrective exercises, your therapist can release tension in the psoas, improve hip and spinal mechanics, and restore full, pain-free movement. Studies have shown that patients with chronic hip or low back pain often experience significant improvement—and in some cases complete resolution of symptoms—after just a few targeted sessions.
Tendinapathies
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Tendinopathies refer to a group of conditions involving irritation, degeneration, or dysfunction of a tendon—the strong, fibrous tissue that connects muscle to bone. Tendons are built to withstand significant stress, but when they are overloaded repeatedly or subjected to sudden increases in activity, their collagen fibers can begin to break down. Instead of healing properly, the tendon may become thickened, weakened, or disorganized, leading to persistent pain and stiffness.
Tendinopathies often develop gradually, especially in areas that are repeatedly strained such as the Achilles tendon, patellar tendon, rotator cuff, elbow tendons, or wrist flexors and extensors. People may notice a localized ache, morning stiffness, tenderness to touch, or pain that worsens after activity. In some cases, the tendon may develop small nodules or thickened regions as the tissue attempts to repair itself, which can further limit movement. Without proper treatment, symptoms can persist for months or even years, and performance or daily activities may become increasingly difficult.
In more severe or long-standing cases, tendons can undergo degenerative changes known as tendinosis, where the tendon fibers lose their normal structure and strength. These changes can make the tendon less capable of handling load, increase the risk of partial tearing, and contribute to chronic discomfort.
Fortunately, effective treatment options exist. At Granville Physio, your therapists can accurately diagnose the type and stage of your tendinopathy and guide you through a comprehensive recovery plan. This may include targeted loading exercises to rebuild tendon strength, manual therapy to improve mobility, and biomechanical corrections to reduce strain on the tendon during activity. Shockwave therapy has also shown excellent results in stubborn or chronic tendinopathies. Early research demonstrates significant reductions in pain, improved tendon structure, and faster return to function—even in cases that previously failed other treatments.
With the right approach, tendinopathies can heal successfully, allowing you to regain strength, mobility, and confidence in your everyday activities or sport.
Tendinopathies often develop gradually, especially in areas that are repeatedly strained such as the Achilles tendon, patellar tendon, rotator cuff, elbow tendons, or wrist flexors and extensors. People may notice a localized ache, morning stiffness, tenderness to touch, or pain that worsens after activity. In some cases, the tendon may develop small nodules or thickened regions as the tissue attempts to repair itself, which can further limit movement. Without proper treatment, symptoms can persist for months or even years, and performance or daily activities may become increasingly difficult.
In more severe or long-standing cases, tendons can undergo degenerative changes known as tendinosis, where the tendon fibers lose their normal structure and strength. These changes can make the tendon less capable of handling load, increase the risk of partial tearing, and contribute to chronic discomfort.
Fortunately, effective treatment options exist. At Granville Physio, your therapists can accurately diagnose the type and stage of your tendinopathy and guide you through a comprehensive recovery plan. This may include targeted loading exercises to rebuild tendon strength, manual therapy to improve mobility, and biomechanical corrections to reduce strain on the tendon during activity. Shockwave therapy has also shown excellent results in stubborn or chronic tendinopathies. Early research demonstrates significant reductions in pain, improved tendon structure, and faster return to function—even in cases that previously failed other treatments.
With the right approach, tendinopathies can heal successfully, allowing you to regain strength, mobility, and confidence in your everyday activities or sport.
Hip Flexor Strain
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The hip flexors are a group of muscles located at the front of the hip, responsible for lifting the knee, stabilizing the pelvis, and supporting nearly every movement involving walking, running, or bending. This group includes the iliopsoas (psoas + iliacus), rectus femoris, and smaller stabilizers such as the sartorius and pectineus. Because these muscles cross both the hip and, in some cases, the spine or knee, they are highly active throughout the day and prone to becoming tight, overworked, or strained.
When the hip flexors become irritated or overloaded—often due to repetitive activities, prolonged sitting, heavy lifting, or sudden changes in training volume—the muscle fibers can develop micro-tears, inflammation, and increased resting tension. This heightened muscle tone restricts blood flow to the deeper layers of the tissue, causing the body to lay down extra fascial adhesions. As this fascia thickens, it further limits hip extension and contributes to stiffness in the pelvis and lower back.
Over time, this cycle of tension, inflammation, and restricted movement can lead to pain at the front of the hip, groin discomfort, difficulty straightening the hip fully, or a pulling sensation when lifting the leg. Some individuals also experience referral patterns into the thigh or lower back. If the hip flexor restriction is severe, it can alter gait mechanics, increase compression at the hip joint, and place additional strain on the lumbar spine and surrounding musculature. Reduced mobility also means the joint receives less lubrication and nourishment, potentially contributing to irritation or early degenerative changes if left unaddressed.
At Granville Physio, we work to identify which specific hip flexor muscle is involved and why the dysfunction developed. Treatment may include manual release techniques, targeted stretching, and corrective strengthening to restore balance around the pelvis. Shockwave therapy can be especially effective for chronic or stubborn hip flexor issues by reducing fascial adhesions, decreasing muscle tone, and re-establishing healthy tissue mobility. With proper treatment, patients typically notice improved hip extension, reduced pain, and a smoother, more natural stride.
If hip flexor tightness or discomfort is limiting your daily function, our team can help restore healthy movement and get you back to your activities with confidence.
When the hip flexors become irritated or overloaded—often due to repetitive activities, prolonged sitting, heavy lifting, or sudden changes in training volume—the muscle fibers can develop micro-tears, inflammation, and increased resting tension. This heightened muscle tone restricts blood flow to the deeper layers of the tissue, causing the body to lay down extra fascial adhesions. As this fascia thickens, it further limits hip extension and contributes to stiffness in the pelvis and lower back.
Over time, this cycle of tension, inflammation, and restricted movement can lead to pain at the front of the hip, groin discomfort, difficulty straightening the hip fully, or a pulling sensation when lifting the leg. Some individuals also experience referral patterns into the thigh or lower back. If the hip flexor restriction is severe, it can alter gait mechanics, increase compression at the hip joint, and place additional strain on the lumbar spine and surrounding musculature. Reduced mobility also means the joint receives less lubrication and nourishment, potentially contributing to irritation or early degenerative changes if left unaddressed.
At Granville Physio, we work to identify which specific hip flexor muscle is involved and why the dysfunction developed. Treatment may include manual release techniques, targeted stretching, and corrective strengthening to restore balance around the pelvis. Shockwave therapy can be especially effective for chronic or stubborn hip flexor issues by reducing fascial adhesions, decreasing muscle tone, and re-establishing healthy tissue mobility. With proper treatment, patients typically notice improved hip extension, reduced pain, and a smoother, more natural stride.
If hip flexor tightness or discomfort is limiting your daily function, our team can help restore healthy movement and get you back to your activities with confidence.
