Resolving Hip Pain
What You Need to Know About Our Approach to Care
Hi, I’m Dr. Jason Gray — founder of My Rehab Connection and a chiropractor at Gray Chiropractic Spine & Joint Clinic in St. Catharines, Ontario. In this guide, I want to walk you through how I think about and treat hip pain. My focus here is on non-traumatic hip pain — conditions like piriformis syndrome, gluteal or hamstring tendinitis, bursitis, most hip impingement syndromes, and hip osteoarthritis. These conditions behave very differently from acute or traumatic hip injuries (a slip, fall, sports injury, or accident), where tissue damage happens suddenly, all at once. Understanding that difference is the key to treating non-traumatic hip pain successfully.
How Non-Traumatic Hip Pain Develops
Non-traumatic hip pain doesn’t start as an injury — it starts as a Cumulative Trauma Disorder (CTD). Like a traumatic injury, a CTD involves real tissue damage. But instead of happening all at once, that damage builds slowly, over months or even years, until symptoms finally appear. That’s why this type of hip pain can feel like it comes out of nowhere. There’s rarely a single cause. Symptoms often just show up one day, or seem to be triggered by something completely routine — the kind of everyday movement you’d never expect to cause a problem.
It Starts With Small, Unnoticed Problems
Long before pain shows up, subtle issues develop in how the hip moves — muscle weakness, limited flexibility, or muscle imbalances, especially in the deep muscles that stabilize the ball of the hip joint.
At first, you don’t notice any of this. Your body is remarkably good at adapting: if one muscle is weak, another compensates; if the hip lacks the flexibility for a normal stride, your gait shifts to work around it. In a sense, these compensations show off your body’s resilience — they let you keep walking, running, bending, and moving despite an underlying physical limitation.
But Compensation Has a Cost
Those same compensations create abnormal stress patterns that lead to microtrauma around the hip — small-scale tissue damage. On its own, microtrauma isn’t a big deal. But if the compensatory movement pattern continues unchecked, it accumulates over months or years into a full-scale injury.
This is the key insight: the condition doesn’t begin when symptoms appear. By the time you feel pain, the underlying problem has already been building for a long time — the pain is simply a sign that it’s now reached a significant level.
That’s the real reason this type of hip pain is so often misunderstood — and why treating it well means addressing two separate problems, not one:
Problem 1: The damaged tissue — the hip joint, muscles, tendons, or ligaments that need to heal and be rehabilitated.
Problem 2: The underlying movement problem — the strength and flexibility deficits driving the microtrauma in the first place.
Treat only the first, and the second one will keep causing damage. Resolving hip pain for good means addressing both.
How I Treat Non-Traumatic Hip Pain
In-Clinic Care: Hands-On Treatment
My primary hands-on techniques are Active Release Technique (ART) and Functional Range Release (FR) — specialized soft-tissue treatments that create a targeted stimulus in affected muscles, fascia, and ligaments to promote healing and remodeling of tight, damaged, or scarred tissue.
These techniques are effective for two reasons: they promote healing in damaged tissue, and they release tight muscles, ligaments, and joint restrictions that are limiting flexibility and normal hip motion. Because ART and FR are hands-on, they let me reach and target the deep stabilizing muscles of the hip far more precisely than exercise alone can — which is why they’re my go-to approach for this type of hip pain.
At Home: Your Rehabilitation and Movement Routine
In-clinic treatment alone isn’t enough. Home rehabilitation exercises are just as essential — and they need to do two jobs at once: help heal the injured tissue, and correct the underlying strength, flexibility, or movement imbalance that caused it.
The challenge is that these underlying mechanical problems are different for every patient. There’s no single movement flaw that causes piriformis syndrome, or bursitis, or hip impingement, or gluteal tendinopathy. Two patients with the exact same diagnosis can have completely different strength or flexibility deficits driving it.
This is exactly why generic exercise protocols — the same handout for every patient with the same diagnosis, or a routine borrowed from Instagram, TikTok, or YouTube — so often fail to resolve the problem. Generic exercises can’t correct a mechanical fault they were never designed to find.
Why a Proper Assessment Matters
The only way to identify your specific strength and flexibility deficits is to test for them directly. That’s why every patient goes through a full assessment in my clinic — not just to identify what hurts, but to uncover every mobility limitation, imbalance, and weakness that needs to be addressed.
That assessment is what allows me to build a stretching and exercise plan that’s genuinely specific to you — and to be precise about how each exercise should be performed. Done carelessly, exercise can simply reinforce the same compensations that caused the problem in the first place. Done right — the right exercises, the right way, at the right intensity — it corrects them.
To support you between visits, every patient gets access to My Rehab Connection, a free app I created that provides written instructions, photos, and video for your exercises at home.
Before You Book an Appointment
If this approach sounds like a good fit for a hip condition you’re dealing with, my staff would be glad to help you book. Before you call, here are a few things worth knowing.
First, this isn’t a quick fix. Healing tissue and rebuilding strength, flexibility, and muscle balance takes real time and effort. Typical treatment plans run about 6–8 weeks. In-clinic visits are usually twice a week early on, tapering off as you progress. And home exercises typically take about 30 minutes a day.
If your schedule doesn’t currently allow for that kind of commitment, it’s worth thinking through before starting this approach to care.
Are You Ready To Get Relief From Hip Pain
To learn more, or to book an initial appointment to see if we can help with your hip pain simply call our office at (905) 685-7227 – or book an appointment through our online calendar. For general questions you can call our office or send us an email at info@graychiropractic.ca.