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Hip Dysplasia in Adults: Physical Therapy in Brooklyn for Pain and Stability

By Dr. Jack Engelberg, PT, DPT · · 4 min read

Many people think of hip dysplasia as something checked for in newborns. But milder forms often go unnoticed until adolescence or adulthood, when groin pain, clicking or a sense that the hip "isn't quite right" finally sends someone to a doctor. If you've recently been told you have hip dysplasia, physical therapy can play an important role in reducing pain and helping your hip work better, whether or not surgery is part of your plan.

What Is Hip Dysplasia?

The hip is a ball-and-socket joint. The ball (the head of the thighbone) normally sits deeply in the socket (the acetabulum, part of the pelvis). In hip dysplasia, the socket is too shallow or angled in a way that doesn't fully cover the ball.

With less bony coverage, the joint relies more on the surrounding soft tissues to stay stable. The labrum (a rim of cartilage around the socket), the joint capsule and the hip muscles all take on extra work. Over time, this can lead to labral tears, cartilage wear and early arthritis.

Hip dysplasia ranges from mild to severe and can affect one or both hips. It's more common in women and can run in families.

Common Symptoms

  • Pain in the front of the hip or groin, sometimes on the outside of the hip or buttock
  • Pain that increases with longer walks, standing or activity
  • Clicking, catching or locking in the hip (which may indicate a labral tear)
  • A feeling of instability or the hip "giving way"
  • Fatigue in the hip muscles
  • A limp, especially when tired
  • Pain with deep hip flexion or certain stretches

What Contributes to Symptoms?

The shape of the socket is something you're born with or develops in childhood. What often changes over time is how well the surrounding tissues handle load. Symptoms can be triggered by:

  • A jump in activity — new running routines, long walking days, dance or yoga
  • Hip muscle weakness, especially in the gluteal and deep stabilizing muscles
  • End-range positions — hanging into one hip, deep stretches and extreme ranges that stress the front of the joint
  • Labral irritation or tears
  • Pregnancy and postpartum changes in load and ligament laxity

How Physical Therapy Helps Hip Dysplasia

Because the bones themselves can't be changed without surgery, conservative care focuses on improving the "active" support around the hip and managing the loads you place on it.

Evaluation

Your therapist will review your imaging reports and history, assess strength and range of motion, look at how you walk, balance and transition from sitting to standing, and identify which positions provoke symptoms.

Treatment May Include

  • Hip stabilizer strengthening — the gluteal muscles, deep hip rotators and hip flexors, progressing from controlled exercises to functional and athletic movements
  • Core and pelvic control — so the pelvis stays stable under the hip
  • Activity modification — adjusting volume and avoiding provocative end ranges while symptoms calm
  • Movement retraining — walking, stairs, squatting and sport-specific patterns
  • Balance and single-leg control
  • Pre- and post-surgical rehab — for those who undergo a periacetabular osteotomy (PAO), hip arthroscopy or, later in life, hip replacement

What You Can Do at Home

  • Moderate your load. Break long walks into shorter outings while the hip settles.
  • Avoid "hanging" on one hip when standing; distribute weight evenly.
  • Be cautious with deep stretches like deep lunges, pigeon pose or extreme splits. More flexibility is usually not what a dysplastic hip needs.
  • Build strength gradually. Gentle bridges, side-lying leg lifts and standing hip exercises are common starting points. Stop if they cause groin pain.
  • Choose supportive surfaces and footwear for long days on your feet.
  • Track triggers. Notice which activities cause symptoms that night or the next day.

When to See a Physical Therapist

Consider an evaluation if:

  • You have groin or hip pain that keeps returning
  • You notice clicking, catching or instability in the hip
  • You've been diagnosed with hip dysplasia and want a conservative plan
  • You're preparing for or recovering from hip surgery

See a physician promptly if you cannot bear weight, if hip pain follows a fall, or if there is fever, significant swelling or sudden severe pain.

Frequently Asked Questions

Can physical therapy fix hip dysplasia?

Therapy can't change the shape of the socket, but it can reduce pain and improve function by strengthening the muscles that support the hip and changing how you load it.

Is stretching good for hip dysplasia?

Gentle mobility is fine, but aggressive stretching into end ranges can strain the front of the joint. Strength and control are usually the priority.

Is outer hip pain part of hip dysplasia?

It can be, since the hip muscles work harder. Outer hip pain can also come from gluteal tendons. See our guide to hip bursitis.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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