Jeju Hip Pain — Is It the Groin or the Buttock That Hurts?

Common hip cases in Jeju

• CASE 01Someone in their 20s to 40s whose groin catches when sitting cross-legged or getting out of a carWe look for impingement syndrome, where bone hits bone when the hip is deeply flexed and rotated inward, and for labral tears. Common in people who play soccer, do martial arts, or practice yoga.
• CASE 02A pulling pain at the front of the groin after climbing an oreumOn steep climbs, strain concentrates on the hip flexors and the front of the joint. We determine whether it is a joint problem or a muscle problem.
• CASE 03A middle-aged woman who loses sleep because the outer hip hurts when lying on her sideWe first look at the tendons and bursa around the bony prominence on the outer thigh (greater trochanteric pain syndrome). This is a more common cause than the hip joint itself.
• CASE 04Pain in the lead-leg hip after a golf swingDuring the swing, the lead hip rotates inward forcefully, which can cause impingement or muscle injury. We look at the swing and the hip's rotation range together.
• CASE 05Groin pain when walking and a feeling that one leg has become shorterWe check on X-ray for changes in the joint itself, such as hip osteoarthritis or avascular necrosis of the femoral head. We are especially careful if there is a history of alcohol use or steroids.
• CASE 06A driver with deep buttock pain and leg numbness after sitting for long periodsWe distinguish between gluteal muscles such as the piriformis irritating the sciatic nerve and a nerve problem in the lower back.

What it can be confused with

The location of the pain is the first clue. We start by pinning down whether it is the groin, the side, or the back.

• CauseMain featuresHow we check
• Hip impingement / labrumGroin catches and hurts with deep flexionImpingement provocation test, bone shape on X-ray, MRI
• Hip osteoarthritisGroin pain with walking, stiffness in the morningJoint space on X-ray, gait analysis
• Avascular necrosis of the femoral headWorsening groin pain with no injuryX-ray, MRI in the early stage
• Tendon / bursa on the side of the hipPain when lying on your sideSite of tenderness, ultrasound
• Gluteal muscles such as the piriformisDeep buttock pain with sitting, leg numbnessProvocation test, distinguished from the lower back
• Pain from the lower backHip tests normal, changes with lower back postureLumbar nerve exam
• Growing hipsA child limping with groin or knee painX-ray, KidsUp Growth Clinic

How Jeju Team Doctor Orthopedic Clinic approaches it

Hip and lower back symptoms overlap, so seeing both on the same day is the fastest route.

• Pinning down where it hurtsWe ask whether it is the groin, the side, or the back; how it feels when sitting cross-legged, sitting, or walking; any injury, alcohol use, or steroid history; and which sports you play.
• Hip and lower back in one visitFlexion and rotation range, impingement tests, tenderness on the side of the hip, strength, leg length, and a lumbar nerve exam, all together.
• Measuring how you walkAt the Gait Analysis Center we see in numbers whether the pelvis drops and where your weight is loaded.
• Imaging and ultrasoundX-ray for joint space, bone shape, and necrosis; ultrasound for tendons and bursae. If a labral tear or early necrosis is suspected, we recommend an MRI.
• Deciding what to avoidWe explain whether it is the joint itself, the surrounding tissue, or the lower back, then set the movements to avoid and the order of treatment.

How treatment proceeds

With the hip, treatment begins with learning 'how to avoid the painful movements.'

• Controlling painMedication and physical therapy reduce acute pain and inflammation.
• Changing movements firstFor impingement syndrome, we first teach ways of sitting and exercising that avoid deep flexion and inward rotation.
• Loosening what is stiff and building the gluteal musclesManual therapy restores range of motion, and strengthening the glutes and core takes load off the joint and tendons.
• Shockwave for tendons and bursaeConsidered for lateral hip pain syndrome.
• Injections under ultrasound guidanceGiven when needed, with the position confirmed. Decided after the exam.
• When surgery is the right callAdvanced arthritis, necrosis, and large labral tears are referred to a partner hospital in Jeju or on the mainland, with rehabilitation before and after surgery done here.

What to keep in mind while recovering in Jeju

The benchmark for hip recovery is 'can you stand on one leg without groin pain.'

• No groin pain when walking or on stairs
• Standing on one leg, the pelvis does not drop toward the other side
• You can squat and sit cross-legged without pain, or you know and respect the angles to avoid
• Return to oreum and hiking on gentle courses first, and to golf with half swings
• Switch from floor living to chairs, and avoid low sofas

These symptoms need prompt evaluation

• You cannot bear weight on the leg after a fall — in older adults, rule out a hip fracture first
• Worsening groin pain and a limp with no injury — necrosis
• A child suddenly limping with groin or knee pain
• Fever and complete inability to move the hip

It is remarkably common for what was thought to be the back to be the hip, and for what was thought to be the hip to be the back. That is why we always look at both, and measure how you walk, to confirm the source.

Frequently Asked Questions

Conditions in other areas

A guide to pain by body area from Jeju Team Doctor Orthopedic Clinic. View all conditions

• Jeju Knee Pain — Knee Conditions
• Jeju Ankle Sprain · Plantar Fasciitis — Foot · Ankle Conditions
• Jeju Back Pain · Herniated Disc — Lower Back Conditions
• Jeju Cervical Disc · Neck Pain — Neck Conditions
• Jeju Shoulder Pain · Frozen Shoulder · Rotator Cuff — Shoulder Conditions
• Jeju Carpal Tunnel Syndrome · Wrist Pain — Hand · Wrist Conditions
• Jeju Tennis Elbow · Golfer's Elbow — Elbow Conditions