Do You Think There is Hope, Part 1: Hip Pain
I often hear this question from patients: "Do you think there’s hope for me?"
What they’re really asking is whether there’s a realistic path to achieving the pain relief and functional improvements they desperately need and want. Before answering that question, there are important factors we need to assess. However, one critical point stands out: many golfers spend months — even years — silently wondering if change is possible, without ever seeking expert help in rehab and performance. This delay can mean years lost, reduced longevity in the game, and missed opportunities to fully recover. The right guidance can help golfers reclaim their ability to play without the pain and limitations that have held them back.
Hip pain and function
Some people will need surgery, others do not. When we have hip pain, there is a long list of potential causes. Some of the most common is labrum injuries, arthritis, greater trochanteric pain syndrome, and referred pain from the low back. For the sake of this article, we will focus on arthritic pain and function loss, though similar principles apply across the board.
When we have severe function loss at a joint like the hip, commonly from arthritis, we will notice mobility loss at varying degrees of severity. Hip flexion, or bringing the knee towards the chest, is one of the first movements to see restriction and pain. After that, hip internal rotation will start declining, with hip external rotation following. Hip extension is commonly lost, but due to how common it is for people to be missing this critical range of motion already and how small the normal range of motion should be (and therefore difficulty measuring it), it is hard to see the direct impact the arthritic changes are having on it.
These are common initial symptoms that eventually lead to a hip replacement. Loss of range of motion and increasing pain often foes unaddressed until the symptoms get bad enough to justify a hip replacement. For those who already have had a hip replacement, we can get identical symptoms! The time following the surgery may be successful, or there are loss of range of motion that is still never regained. Or, years after the surgery and recovery, similar symptoms are notices with worsening range of motion and re-introduction of pain.
Both cases, before or after hip replacement, result in similar questions. Is there hope for me? Is there hope I can work through this without needing a major surgery and hip replacement? The symptoms are back with increasing severity, can I work through this and improve even though I’ve already had a hip replacement? The severity of symptoms will help tell the story.
What do we need from the hip in the golf swing?
We need to be able to flex at the hip and maintain this hip flexion position through rotation. The rotation required is internal rotation for the back side hip as we coil into the backswing, and external rotation from that same backside hip as we rotate out of that hip and towards the lead side. The lead side hip pushed the pelvis away creating external rotation in the backswing before internally rotating as the pelvis is explosively rotated towards and over the stable lead side hip. Both hips need to be able to produce and accept high explosive forces of internal and external rotation. Loss of this mobility or pain will create compensations to off load the hip and put that torque elsewhere, resulting in unfavorable and less predictable swings.
There is no way around it, the hips are vital for the golf swing. Missing mobility, strength, and overall function here is a critical problem for golfers as much as it is for daily life.
What can be done?
The most important thing to do here is get evaluated. Even if you feel like there is no hope of lining up a put again without pain, getting into that back swing position your pro wants you in, or waking up without pain, I assure you with confidence, there is more that can be done than you think. That I can promise. What I cannot promise is that a surgery is 100% avoidable. Sometimes it simply is the better option. I cannot promise everyone with a hip replacement that we can get back 100% of the range of motion we are looking for, sometimes we have to accept some motion will always be limited. But I can promise we can get more out of that hip than you think. The key is taking the time to understand the demands of the golf swing and the true capabilities of YOUR hip. A plan specific to your needs, your hip, and the surrounding joints is key to getting the most from the hip, which I promise is a great deal more than you believe.
Keys to hip mobility
Here are some keys to working through even the most severe of hip mobility restrictions.
1. Address bony architecture and restrictions.
a. This means we need to address mobility restrictions coming directly from the positioning of joints relative to each other. Whether we have had a full hip replacement, severe arthritis, or none of the above, we are always starting with joint and bone mechanics to drive more range of motion. This is a fantastic drill to start this process…
2. Address ligamentous and joint capsule restrictions
a. Every joint has a joint capsule. This is made up of passive or non-contractile tissue that responds to the loads placed on it. When we stop using the capacity of the joint, the joint capsule begins to restrict or tighten down in areas where it has not been needed. We need to re-introduce motion to these parts of the joint, improving our range of motion…
3. Address muscle tone and tightness
a. This is what most people think of when they experience range of motion loss, a “tight” muscle. Though there is much more going on here than a muscle that has “shortened”, I will keep it simple. There is more than one technique we can use to address the nervous system’s role in create muscle tightness. Making sure we don’t have antagonistic muscles playing a role in reducing our range of motion is critical. Give the drill a try to help address posterior chain tightness that can limit hip flexion (notice this is not a typical “stretch” you are commonly prescribed, I assure you that is a good thing!).
Conclusion
If you’re asking yourself, “Is there hope for me?” — the answer is yes, but it starts with action. Waiting only delays your potential to reclaim mobility, strength, and confidence both in life and on the golf course. Whether you’re facing early arthritis, recovering from a hip replacement, or struggling with persistent pain, there is more room for improvement than you realize. It all begins with a thorough evaluation, a clear understanding of your hip’s specific needs, and a structured plan tailored to you and the demands of your golf swing. While surgery is sometimes the right path, many golfers can avoid or delay it — and even after surgery, there is tremendous opportunity for better function. Don't let doubt keep you sidelined. With the right guidance, you can return to playing the game you love with greater ease, power, and enjoyment.
-Dr. Nick Curtis DC, MS, TPI, CSCS
If you would like to learn more about your body, pain, and performance, send Dr. Nick an email at contact@integratedrpc.com or call at (585)478-4379, or schedule a FREE discovery visit at Contact.
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