Patients frequently seek chiropractic care for hip-related conditions—such as femoroacetabular impingement, developmental dysplasia of the hip, labral tears, and cartilage injuries—often in hopes of preventing or delaying surgery. Fortunately, treatment guidelines for these and many musculoskeletal conditions typically recommend non-surgical approaches as the first line of treatment. But which manual therapies provided by chiropractors are most effective for painful and disabling hip conditions?

Active therapies involve patient participation, requiring movement or resistance to movement. Examples include stretching and strengthening exercises to correct muscle imbalances, resistance training through a full range of motion, and movement pattern exercises to enhance proprioception. In contrast, passive therapies are administered solely by the chiropractor. These include spinal manipulation and mobilization to restore joint function, myofascial release to alleviate muscle tension, massage to promote relaxation and circulation, and trigger point therapy to relieve muscle knots.

A November 2023 study recruited 33 young adults with hip-related groin pain and divided them into two treatment groups. The passive treatment group underwent joint mobilization therapy aimed at reducing pain and improving mobility. The active treatment group engaged in exercises aimed at correcting abnormal movement patterns while performing various tasks. Assessments completed by patients in both groups at the conclusion of the treatment period revealed both experienced significant improvement in hip-related pain and disability. Another study compared two active treatments—the approach used in the prior study and a more general strength training and stretching regimen. Both methods led to improvements in hip strength, muscle volume, and reduced fat infiltration in the muscle.

These findings suggest that both active and passive therapies benefit patients with hip conditions. Chiropractors often utilize one or more of each type as part of a comprehensive treatment plan. Of course, the specific therapies used will depend on several factors including patient history, examination findings, patient preference, and their chiropractor’s training and clinical experience. If a patient does not respond to treatment, adjustments can be made to optimize outcomes.