Evidence-based care at Vantage Point
Hip Physiotherapy in Bondi Junction
Assessment and treatment for hip and groin pain, from tendon and joint problems to sports injuries and arthritis, with a clear explanation of what is going on and a plan built around strength and load.
- APA Musculoskeletal Physiotherapists
- Hip and groin strength testing with VALD dynamometry
- Rehabilitation before and after hip surgery
Symptom profiles
Which best describes your symptoms?
Hip pain presents in distinct ways, and where you feel it often points to different structures and a different starting point for treatment. Select the one closest to yours.
Gluteal Tendinopathy (Outer Hip Pain)
Pain on the outside of the hip that can spread down the side of the thigh, often worse lying on that side, climbing stairs or standing on one leg. It is most common in women over 40, and is often labelled bursitis.
You might notice
- Pain lying on your side at night
- Pain on stairs, hills or getting out of the car
- Tenderness over the bony point on the side of the hip
What is usually happening
The gluteal tendons that attach to the side of the hip have become sensitive to load, often compressed when the leg crosses the body or the hip drops to one side. The bursa beside them can react too, but the tendon is usually the main problem, which is why treatment focuses on load and strength. Education and exercise did better than a cortisone injection at both 8 weeks and a year (Mellor et al., 2018).
Common causes
Gluteal tendinopathy
The gluteus medius and minimus tendons on the side of the hip, irritated by compression and load.
Trochanteric bursitis
Often named on scan reports, but usually alongside a tendon problem rather than the main cause.
Pain referred from the back
The lower back can refer pain to the side of the hip, so we always check it.
What we look at in your assessment
Hip strength measured with VALD dynamometry, tendon loading tests, a lower back screen, and the positions you sit, sleep and stand in during the day.
How treatment usually starts
Education on positions that compress the tendon, such as crossing your legs or hanging on one hip, then progressive hip strengthening, measured as you go.
Related services
Hip Joint Pain (Front of the Hip and Groin)
Deep pain at the front of the hip or in the groin, often with clicking, catching or a sense of pinching when you sit low, squat or bring your knee towards your chest.
You might notice
- Pain sitting in low chairs or getting in and out of the car
- Pinching at the front of the hip when squatting
- Clicking or catching inside the hip
What is usually happening
In some hips, the shape of the ball or socket causes them to pinch at the end of range, irritating the joint and the labrum, the ring of cartilage around the socket. Hip shape changes are common in people without pain, so we diagnose hip impingement on your symptoms, examination and imaging together, not a scan alone.
Common causes
FAI syndrome (hip impingement)
Pinching between the ball and socket at the end of range, causing groin pain with sitting and squatting.
Labral tear
Irritation or tearing of the cartilage ring around the socket, often with clicking or catching.
Hip dysplasia
A shallower socket that places more load on the front of the joint, often in younger women.
What we look at in your assessment
Hip range of movement and impingement tests, hip and trunk strength with VALD dynamometry, and how you sit, squat and train. If imaging would change your plan, we arrange it through your GP or a sports physician.
How treatment usually starts
Changes to the positions and activities that pinch the hip, then progressive hip and trunk strengthening and movement retraining. If you are not improving, we refer you to an orthopaedic surgeon to discuss surgery.
Related services
Groin Pain in Athletes
Groin pain that comes on with kicking, sprinting, changing direction or skating, common in football, AFL, rugby and hockey, and often building over a season.
You might notice
- Pain kicking or changing direction
- Pain squeezing the knees together
- Stiffness and soreness the morning after training
What is usually happening
Sports with kicking and quick changes of direction put large, repeated loads through the muscles and tendons around the groin. An international consensus classifies groin pain in athletes by where it comes from, which points to the right treatment: adductor, iliopsoas, inguinal, pubic or hip-related. More than one can be present at once, and adductor strength is one of the most useful things to measure and build (Weir et al., 2015).
Common causes
Adductor-related groin pain
The most common type, from the inner thigh muscles where they attach near the pubic bone, painful with squeezing the knees together.
Iliopsoas-related groin pain
Pain from the hip flexor at the front of the hip, often with kicking and sprinting.
Inguinal-related groin pain
Pain in the inguinal canal area, often worse with sit-ups, coughing or sneezing, without a hernia you can feel.
Pubic-related groin pain
Pain directly over the pubic bone, where the two sides of the pelvis meet.
Hip-related groin pain
Pain from the hip joint itself, such as hip impingement or a labral tear, often with pinching in deep flexion.
What we look at in your assessment
Adductor squeeze and hip strength with VALD dynamometry, your training load and running and kicking technique, and a screen of the hip joint and lower back.
How treatment usually starts
Load management and a modified training plan agreed with your coach, progressive adductor and hip strengthening, and a graded return to sport based on milestones.
Related services
Hip Osteoarthritis
Groin or hip pain with stiffness, often worse first thing in the morning or after sitting, and difficulty with tasks such as putting on socks, cutting toenails or getting out of the car.
You might notice
- Stiffness on getting up that eases once you are moving
- Groin pain after walking or standing for a while
- Difficulty reaching your feet
What is usually happening
Cartilage thinning and changes in the joint are a common part of ageing, and they are not always painful. Exercise and education are the first-line treatment for hip osteoarthritis, and strength and movement can improve at any age. If pain and function keep getting worse, we discuss a referral for a surgical opinion.
Common causes
Hip osteoarthritis
Wear in the hip joint, with groin pain, stiffness and loss of range.
Pain referred from the back
The lower back can refer pain to the hip and groin, and can sit alongside arthritis.
What we look at in your assessment
Range of movement, strength with VALD dynamometry, walking tolerance and balance, and a review of your X-rays in the context of your symptoms.
How treatment usually starts
Progressive strengthening, a walking or activity plan you enjoy, and hands-on treatment to ease stiffness. Where longer-term conditioning would help, we work collaboratively with exercise physiologists.
Related services
Deep Buttock Pain
Pain deep in the buttock, sometimes spreading into the back of the thigh, that can come from the hip, the lower back or the hamstring tendon.
You might notice
- Pain sitting for long periods, especially on hard chairs
- Pain at the sit bone when running or lunging
- Pain that changes with back movements
What is usually happening
Several structures share the buttock, so pain there needs careful sorting. The lower back and sacroiliac joint often refer pain to the buttock, while pain right at the sit bone, worse with sitting and running, points to the hamstring tendon.
Common causes
Pain referred from the lower back
The most common cause of buttock pain, often changing with back movements.
Sacroiliac joint pain
Pain where the spine meets the pelvis, felt low in the back and buttock.
Proximal hamstring tendinopathy
Pain at the sit bone, worse with sitting, running and lunging.
What we look at in your assessment
A lower back and sacroiliac screen, hip and hamstring loading tests, and hamstring strength with VALD dynamometry.
How treatment usually starts
Changes to sitting and training load, then progressive hip, hamstring and trunk strengthening, measured as you go.
Related services
Recovery After Hip Surgery
Rehabilitation before and after hip surgery, from joint replacement to arthroscopy and fracture repair, starting when your surgeon advises and following their protocol.
You might notice
- Stiffness and weakness after your operation
- Uncertainty about which movements are safe
- Wanting to get back to walking, work or sport
What is usually happening
The muscles around the hip lose strength quickly after surgery, and early, protected movement within your surgeon's limits helps restore walking and confidence. Strength comes next, staged to protect the repair while it heals.
Common surgeries
Hip replacement
Replacement of a worn joint, with early walking and a staged return to activity.
Hip arthroscopy
Keyhole surgery for hip impingement or a labral tear, with a protected, staged rehabilitation.
Hip fracture repair
Rehabilitation after a fracture is fixed or the joint replaced, focused on walking and balance.
Periacetabular osteotomy
Reshaping of the socket for hip dysplasia, with a long, staged return to activity.
What we look at in your assessment
Your surgeon's protocol, range of movement, walking and balance, and baseline strength testing once it is safe to test.
How treatment usually starts
Before surgery, prehab builds strength and prepares you for recovery. Afterwards, protected movement and walking come first, then staged strengthening within your surgeon's limits, progressed by measured milestones. We communicate with your surgeon throughout.
Related services
Pain in your lower back as well as your hip or buttock? See back pain physiotherapy.
Understanding hip pain
The Quick Fix and the Long Run
Pain on the outside of the hip is one of the most common reasons people see us about their hip, and it has some of the clearest research of any hip condition.
An Australian trial of 204 people compared education and exercise, a cortisone injection, and waiting. Education and exercise did best at 8 weeks and was still ahead at a year, while many people who had the injection lost their early gains.
Outer hip pain: share of people who reported improving
At 8 weeks
At 52 weeks
204 people with gluteal tendinopathy in Brisbane and Melbourne (Mellor et al., 2018).
Hip impingement: surgery or physiotherapy?
UK trial of 348 people with FAI syndrome
Both groups improved. Hip arthroscopy improved hip-related quality of life by about 20 points on a 100-point scale, and physiotherapy-led care by about 14 points. The difference of 6.8 points was only just above what patients notice as meaningful (Griffin et al., 2018).
What it means for you
Physiotherapy is a reasonable first step for most people with hip impingement, and surgery remains an option if you are not improving.
Your treatment
Five Steps, Each With a Clear Goal
Every consultation is 45 minutes. Your plan is built around what matters to you, whether that is sleeping on your side, walking the coast or getting back to the field.
- 1
Assess
A detailed history and examination of your hip, groin and lower back, including screening for anything that needs a medical opinion.
Goal: A clear diagnosis
- 2
Explain
What is causing your pain, what to expect, and which activities are safe to keep doing.
Goal: Confidence to keep moving
- 3
Settle
Hands-on treatment, dry needling where it helps, and changes to how you sit, sleep and load the hip to calm things down.
Goal: Pain under control
- 4
Strengthen
Progressive exercise for your hips, trunk and legs, with VALD dynamometry to measure hip and groin strength.
Goal: Strength targets met
- 5
Stay well
A long-term program and a flare-up plan, so you know what to do if pain comes back.
Goal: Managing on your own
Cortisone injections
Where Injections Fit
Cortisone injections are often offered for pain on the outside of the hip, sometimes described as bursitis on a scan report. The research gives a clear picture of what to expect.
We do not give injections ourselves, but we often see people who are considering one, and we work with the GP, sports physician or specialist who provides it.
Outer hip pain
Faster than waiting, behind exercise
A cortisone injection helped more people than waiting at 8 weeks, but fewer than education and exercise. At a year, injection results were no better than waiting (Mellor et al., 2018).
How we work with injections
Buying time to do the rehab
If you do have an injection, we treat any relief as a window to build strength and change how you load the hip, so you are better prepared when its effect wears off.
The research
What the Research Tells Us
Outer hip pain
Education and exercise did best
In 204 people with gluteal tendinopathy, education and exercise led to more improvement than a cortisone injection or waiting, at both 8 weeks and a year (Mellor et al., 2018).
Hip impingement
Surgery helped a little more than physiotherapy
In 348 people with FAI syndrome, hip arthroscopy improved hip-related quality of life by 6.8 points more than physiotherapy-led care at 12 months, just above the smallest change patients notice (Griffin et al., 2018).
Groin pain in sport
One exercise reduced groin problems
Across 35 semi-professional football teams, adding a single adductor strengthening exercise based on the Copenhagen adduction exercise led to 41% lower odds of groin problems over the season (Harøy et al., 2019).
Hip pain often settles with the right load at the right time. That is why we measure your hip strength and build your plan around it, rather than relying on rest or a single treatment.
Fees and funding
Consultations and Rebates
Every consultation is 45 minutes. The number of consultations you need depends on your hip and your goals, so we discuss your plan with you at your first visit.
Book an AppointmentWays to claim
- Private health: rebates claimed on the spot with HICAPS
- Medicare: rebates with a GP referral
- Workers compensation: fees set by SIRA, with approvals coordinated with your case manager
- CTP: fees set by SIRA
Common Questions
My scan says bursitis. Is that what is causing my pain?
Often it is part of the picture rather than the whole story. Pain on the outside of the hip usually involves the gluteal tendons, and the bursa can react alongside them. That is why treatment focuses on how you load the tendons, which did better than a cortisone injection in a trial of 204 people (Mellor et al., 2018).
Should I get a cortisone injection for my hip?
It is a decision for you and your doctor. For pain on the outside of the hip, an injection helped more than waiting in the short term, but education and exercise did better at both 8 weeks and a year (Mellor et al., 2018). We are happy to talk it through with you and your GP or specialist.
Do I need surgery for hip impingement or a labral tear?
Not usually as a first step. In a large trial, hip arthroscopy gave a small extra benefit over physiotherapy-led care at 12 months (Griffin et al., 2018). Most people start with physiotherapy, and if you are not improving, we refer you to an orthopaedic surgeon to discuss surgery.
Do I need a scan before I see a physio?
Usually not. We can assess most hip pain clinically. If your assessment suggests an X-ray or MRI would change your plan, we arrange it through your GP or a sports physician.
When should I see a doctor urgently?
Seek urgent medical care if you cannot put weight on your leg after a fall, if your hip is hot, swollen and painful with a fever, or if a child or teenager develops a limp or hip or knee pain without a clear cause.
How many sessions will I need?
It depends on your hip, how long you have had symptoms and your goals. We give you an estimate at your first visit and review it as you meet each step's goal.
Can I claim my physio through private health?
Yes. Rebates are claimed on the spot with HICAPS. Medicare rebates are available with a GP referral, and workers compensation and CTP claims are accepted once approved.
What research is this page based on?
The studies referenced on this page are listed below.
- Griffin DR, Dickenson EJ, Wall PDH, Achana F, Donovan JL, Griffin J, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018;391(10136):2225–2235.
- Harøy J, Clarsen B, Wiger EG, Øyen MG, Serner A, Thorborg K, Hölmich P, Andersen TE, Bahr R. The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. Br J Sports Med. 2019;53(3):150–157.
- Mellor R, Bennell K, Grimaldi A, Nicolson P, Kasza J, Hodges P, Wajswelner H, Vicenzino B. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. 2018;361:k1662.
- Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan KM, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015;49(12):768–774.
- Clinically reviewed by David Cohen and Zachary Ehrenfeld, APA Musculoskeletal Physiotherapists and Directors of Vantage Point Physiotherapy. Last reviewed October 2026.
