Understanding the Real Source of Your Hip Pain

Most people dealing with unilateral hip pain—meaning pain that affects just one hip rather than both—are actually experiencing the downstream effects of pelvic positioning rather than a pure hip joint problem. This distinction matters tremendously because it completely changes how you should approach treatment and corrective exercise. When your pelvis rotates even slightly to one side, which often happens after heavy lifting injuries, accumulated sports trauma, or even prolonged sitting with poor ergonomics, your entire lower body mechanics become compromised in ways that create compounding stress patterns.

Consider what happens biomechanically when your pelvis rotates forward on one side. That forward rotation forces your femur—your thighbone—to externally rotate just so you can maintain normal walking mechanics and keep your foot pointed relatively straight ahead. This compensation might allow you to function in daily life, but it creates tremendous tension through the posterior hip capsule and the deep external rotators like your piriformis and the obturator muscles. These tissues essentially become locked short and develop painful trigger points because they’re constantly fighting against the rotational forces your pelvis is creating.

The tight, achy sensation you feel in the back of your hip during squatting or deadlifting is often these posterior structures crying out for space and relief. Meanwhile, the front of your hip may simultaneously feel pinched or restricted because the anterior joint capsule and hip flexor complex are compressed in the opposite direction. You might even notice that one hip appears to hike upward during certain movements, or that you shift your weight asymmetrically without consciously meaning to. Many people with this presentation have been told by healthcare providers that they have one leg longer than the other, but this is almost never actually the case—what appears as a leg length discrepancy is typically just pelvic rotation creating the illusion of asymmetry.

The Four-Exercise Protocol for Hip Pain Relief

The exercise sequence you’re about to learn addresses hip pain through four distinct but complementary mechanisms. First, you’ll create immediate space in the posterior hip capsule where that deep, nagging tightness lives. Second, you’ll strengthen the internal rotators of your hip that have likely become weak and inhibited from years of compensatory external rotation dominance. Third, you’ll develop strength through length in your adductor complex while simultaneously mobilizing the tissues that control pelvic position. Finally, you’ll build hip flexor strength and resilience through ranges of motion that most people never train, creating the stability necessary to maintain proper pelvic alignment during loaded movements.

Exercise One: The PRI Adductor Yield for Posterior Hip Capsule Release

This first movement creates immediate relief by opening space in the back of your hip capsule while simultaneously teaching your nervous system a new position for your pelvis. The exercise draws from Postural Restoration Institute principles, which focus on creating balanced positioning of the pelvis and ribcage through strategic muscle activation patterns. You’ll need several simple pieces of equipment: a small ball or firm pillow that you can squeeze between your thighs, a two to three inch block or stack of textbooks to elevate one foot, and a stable surface around hip to belly button height that you can hold onto for balance, such as a kitchen counter, sturdy table, or squat rack.

Begin by placing the ball between your inner thighs where you can create a firm squeeze without maximal effort—think about a three or four out of ten intensity where you’re generating tension but not straining. Take the block and position it under the foot of whichever hip is bothering you. If your left hip is the problem area, your left foot goes on the block. Assume a slightly staggered stance where your elevated leg is positioned slightly behind your other leg, though both feet should still be roughly in line with your hips rather than split wide apart. Your elevated foot should be placed so your toes are approximately at the midfoot level of your front leg.

Place your hands on your support surface in front of you and create that gentle squeeze on the ball between your thighs. Here’s where the magic happens: pull your belt buckle toward your face by engaging your abdominal muscles, allowing your low back to round slightly rather than maintaining a neutral or arched spine. This posterior pelvic tilt position is crucial because it prevents you from compensating through lumbar extension and ensures the movement targets your hip capsule rather than your spine. From this rounded position, push your hips backward as far as you can while maintaining that pelvic position, really reaching forward with your hands to maximize the hip hinge.

Now shift your weight toward the hip that’s elevated on the block—in our example, that’s the left hip. As you sit toward that hip, make absolutely certain that your front knee stays pointed forward and doesn’t cave inward, and keep both feet completely flat with your weight distributed evenly across your entire foot. You should feel an intense stretch deep in your glute on the elevated side, which indicates you’re creating space through the posterior hip capsule and the tight external rotators that have been causing your problems.

Hold this position and take a large breath in through your nose, then exhale completely through your mouth. As you exhale, actively push back into that hip that’s bothering you, trying to sink just slightly deeper into the stretch. Take another full breath in, and on the exhale, attempt to sit even more into that hip while maintaining all the other position requirements. Complete six to eight high-quality breaths in this position, focusing on the quality of each breath and your ability to progressively relax into the stretch rather than rushing through the repetitions. You can perform one to two rounds of this exercise, resting completely between rounds to allow your nervous system to integrate the new position.

Exercise Two: Prone Hip Abduction with Band for Internal Rotator Strengthening

After creating space in the posterior hip capsule, you need to address the muscular imbalances that allowed the problem to develop in the first place. Most people with unilateral hip pain have dramatically weak internal rotators on the affected side because their hip has been living in excessive external rotation for months or years. This exercise specifically targets the internal rotators while eliminating common compensation patterns that prevent those muscles from engaging effectively.

Gather a light resistance band—this should not be a heavy band as you’re not trying to create maximal force but rather sustained muscular activation. You’ll also need that same ball or pillow from the previous exercise and something to support your belly, such as an Ab mat, firm couch cushion, or folded towel. Lie down on your stomach and wrap the resistance band around your feet at approximately shoe level. Position the belly support directly under your navel so your spine stays neutral rather than hyperextending, then place the ball between your thighs just as you did during the first exercise.

Rest your hands wherever feels comfortable—you can place them under your forehead, out to your sides, or anywhere that allows your upper body to remain relaxed. Allow your head to drop toward the ground in a neutral position without forcing your chin down or straining your neck. Bend both knees to ninety degrees so your lower legs are perpendicular to the ground. Create a gentle squeeze on the ball between your thighs, then drive your feet outward into the band with about a four to five out of ten effort level.

This submaximal effort level is absolutely critical for this exercise’s effectiveness. If you push too hard into the band, your body will compensate by arching through your low back to generate more force, which completely defeats the purpose and can actually aggravate your hip pain. Your low back should remain completely relaxed throughout the entire hold, with all the work happening in your hips. Hold this position while taking slow, controlled breaths in through your nose and out through your mouth. Focus your attention on maintaining that gentle outward pressure against the band and the squeeze on the ball while keeping everything above your pelvis as relaxed as possible.

What makes this exercise so effective is the prone positioning, which prevents excessive hip flexion that would limit internal rotation range of motion. When your hip is in deep flexion, such as when you’re seated, you naturally lose access to internal rotation because the joint capsule becomes compressed. By lying face down, your hip remains in relative extension, which allows the internal rotators to work through their full available range without running into capsular restrictions. Additionally, because you’ve just created space in the posterior capsule with the first exercise, you now have more room for these internal rotators to engage and strengthen.

As the internal rotators develop strength and endurance, the tight external rotators on the backside must reciprocally relax to allow that internal rotation motion to occur. This reciprocal inhibition is a fundamental principle of neuromuscular function—when one muscle group contracts, its opposing muscle group must relax. Perform two to three sets of three to five full breath cycles, resting completely between sets. If you have asymmetrical hip pain, you’ll likely notice that maintaining the position feels significantly more challenging on your affected side, which confirms the muscular imbalance we’re trying to address.

Exercise Three: Prone Adductor Slides for Pelvic Mobility and Adductor Strength

The third exercise in this sequence addresses a commonly overlooked contributor to hip pain—restricted adductor length and poor control of adduction and abduction movements. Your adductors, the muscles along your inner thigh, play a crucial role in pelvic stability and positioning. When these muscles become chronically tight or weak, they can pull your pelvis into dysfunctional positions and contribute to the rotational patterns causing your hip pain. This movement combines active mobility work with strength development through the adductors’ full range of motion while simultaneously encouraging proper pelvic positioning.

You’ll need two furniture sliders, which you can purchase inexpensively at any hardware store, or you can substitute towels if you’re working on a hardwood floor or another slick surface that allows the towels to slide easily. Place the sliders under your knees and assume a hands-and-knees position with your knees directly under your hips and your hands under your shoulders. From this starting position, actively drive your knees outward as far as you possibly can while maintaining two critical position requirements: your hips must stay positioned forward over your knees rather than sitting back toward your heels, and your spine should remain neutral rather than hyperextending into a pronounced arch.

As you reach your knees outward to their maximum comfortable range, you should feel a substantial stretch through your inner thighs and groin area. This lengthening position addresses the chronic tightness many people develop in their adductors, which often contributes to groin discomfort and restricted hip mobility. Hold that lengthened position briefly, then actively squeeze your knees together, using your adductors to pull the sliders back toward your starting position. The squeezing phase is just as important as the lengthening phase because as you bring your knees together, your pelvis naturally wants to compress and stack properly, which helps retrain optimal pelvic positioning.

Perform the movement in a slow, controlled manner—this is absolutely not a race to see how many repetitions you can complete. The goal is progressive improvement in your range of motion with each repetition while maintaining excellent control throughout the entire movement. As you slide out, try to reach just slightly further than the previous rep. As you squeeze together, really emphasize that final contraction and the feeling of your pelvis coming into better alignment. You’ll likely notice, particularly if you have unilateral hip pain, that one side feels tighter or more restricted during the lengthening phase. Feel free to spend additional time working into that tighter side if needed.

Complete fifteen to twenty repetitions for one to two sets, focusing on quality over quantity. The combination of lengthening and strengthening your adductors while mobilizing your pelvis creates a powerful corrective effect that complements the hip capsule and internal rotator work you’ve already done. As your adductors lengthen during the sliding-out phase, the posterior hip structures we addressed in exercise one get additional relief. As you squeeze your knees together, those same posterior structures must relax to allow the pelvis to move into better position, further reinforcing the neuromuscular re-education we’re pursuing.

Exercise Four: Anchored Hip Flexor Drop for Hip Flexor Strength and Length

The final piece of this hip pain solution addresses what is arguably the most undertrained aspect of hip function in most strength athletes and general fitness enthusiasts—hip flexor strength through long ranges of motion under resistance. Your hip flexors, particularly your psoas and iliacus muscles, don’t just lift your leg toward your chest. They play a fundamental role in stabilizing your pelvis and controlling the relationship between your lumbar spine and your pelvis during loaded movements like squats and deadlifts. When one hip flexor is weak, which almost invariably happens on the side experiencing hip pain, your pelvis can shift and rotate in dysfunctional patterns because you lack the anterior control to maintain proper positioning.

This exercise requires equipment you’ll most likely find in a gym setting, though you can potentially recreate it at home with some creativity. You need a heavy kettlebell or dumbbell to anchor one foot—the weight should be heavy enough that it won’t slide around when you push against it. You also need a bench, box, or sturdy chair to sit on, and ideally something nearby to hold onto for balance, such as a squat rack upright or pole. Position yourself at the back edge of your bench and place the foot of your working leg into the horn or handle of the kettlebell. Pull your opposite knee toward your chest with both hands wrapped around that knee, though this hand position is optional based on your preference and balance capabilities.

From this starting position with one leg anchored and one knee pulled to your chest, slowly lower yourself down toward the ground by allowing your hip flexor complex to lengthen under the resistance created by your body weight. Think about actively reaching your chest toward the ground while keeping your spine in a neutral position rather than hyperextending through your low back. You should feel a deep, intense stretch across the entire front of your hip, from the top of your pelvis all the way down into your thigh. Lower as far as you comfortably can, then actively drive yourself back up to the starting position using your hip flexor complex to pull you up rather than pushing through your arms or compensating through other movement patterns.

The goal is progressive improvement in how far you can control the descent while maintaining excellent form. Each repetition should attempt to go slightly deeper than the previous one as your hip flexors warm up and adapt to the demand. The ascent phase is equally important—really focus on owning that range of motion by using your hip flexors to actively pull yourself up rather than just passively lowering and relying on momentum.

If this movement feels too challenging initially or if you’re concerned about your strength through these ranges, modify it to an isometric hold instead. Lower yourself down as far as you can until you begin to feel tension in your hip flexors, then hold that position for ten to twenty seconds. Return to the starting position, shake out your leg briefly, then attempt to go slightly further on your second repetition and hold again for ten to twenty seconds. On your third attempt, try to reach even deeper and hold for another ten to twenty second interval. This isometric approach allows you to build strength and confidence before progressing to the full dynamic version.

Perform this exercise on both sides regardless of which hip is experiencing pain, but complete one to two additional sets on your affected side to address the asymmetry. Most people discover that this movement reveals significant weakness in their hip flexors and that the affected side is noticeably weaker than the unaffected side, which directly correlates with the pelvic instability contributing to hip pain. As you strengthen these hip flexors both isometrically and through dynamic repetitions, you develop better control over pelvic position and create resilience through ranges of motion that typically don’t receive adequate training attention. The combination of strengthening and lengthening under load makes this an incredibly efficient exercise for addressing hip flexor dysfunction that you simply cannot replicate through traditional hip flexor stretches or standard leg raises.

Programming Recommendations and Implementation Strategy

The effectiveness of this four-exercise protocol depends heavily on appropriate implementation and progressive overload strategies. When you’re first beginning this routine, prioritize consistency over intensity. Perform the sequence two to three times per week on non-consecutive days, using the minimum effective dose for each exercise. This means six to eight breaths for the PRI yield, two sets of three breaths for the prone hip abduction, one set of fifteen repetitions for the adductor slides, and conservative ranges of motion for the hip flexor drops. This conservative approach allows your nervous system to adapt to the new movement patterns and prevents overwhelming your tissues with excessive demand.

As you become more familiar with the exercises and begin experiencing relief from your hip pain, gradually increase frequency to four to five days per week. Many people find tremendous benefit from incorporating this sequence as part of their pre-training warm-up before strength and conditioning workouts. Performing these exercises immediately before squatting, deadlifting, or other compound movements serves dual purposes—you address the corrective work your hip needs while simultaneously preparing your nervous system and tissues for the demands of loaded training. The whole sequence takes approximately ten to fifteen minutes once you become proficient with the movements, making it a reasonable time investment that pays enormous dividends in pain reduction and performance improvement.

For individuals who aren’t engaged in regular strength training and are simply seeking relief from chronic hip pain affecting daily life, this protocol works exceptionally well as a standalone routine. Perform the exercises on a consistent schedule, track your progress in terms of range of motion improvements and pain reduction, and be patient with the adaptation process. Meaningful change in chronic movement dysfunction doesn’t happen overnight—plan for a minimum of four to six weeks of consistent work before evaluating whether the protocol is delivering the results you need.

Target Applications and Audience Considerations

This exercise sequence provides particular value for powerlifters and strength athletes dealing with the aftermath of heavy squatting or deadlifting injuries that created persistent hip discomfort. The biomechanical demands of maximal loading in hip-dominant movement patterns make these athletes especially susceptible to developing the pelvic rotation and hip capsule restrictions this protocol addresses. Beyond competitive strength sports, athletes in sports requiring repetitive unilateral demands—such as baseball pitchers, tennis players, golfers, and soccer players—frequently develop asymmetrical pelvic positioning that manifests as hip pain, making this corrective sequence highly applicable.

The protocol also serves general fitness enthusiasts and recreational lifters who experience hip discomfort during training but haven’t sustained acute injuries requiring medical intervention. Often these individuals have gradually developed dysfunction through accumulated training stress, poor movement patterns, or simply the repetitive nature of their chosen activities. The educational component of understanding how pelvic rotation creates hip pain empowers these individuals to take ownership of their movement quality and make informed decisions about their training approaches.

Even individuals with minimal fitness backgrounds who are experiencing hip pain from occupational demands, prolonged sitting, or age-related movement pattern changes can benefit from this protocol. The exercises require minimal equipment, can be scaled appropriately for different fitness levels, and directly address the biomechanical factors creating discomfort. While anyone experiencing significant hip pain should absolutely consult with qualified healthcare providers such as physicians, physical therapists, or sports medicine specialists to rule out serious pathology, this exercise sequence provides a logical starting point for addressing mechanical hip pain that doesn’t stem from structural damage requiring medical intervention.

The Biomechanical Logic Behind the Exercise Sequence

Understanding why this particular combination and sequence of exercises creates superior results compared to random stretching or strengthening helps you execute the movements with greater intention and confidence. The protocol follows a logical progression from creating space, to building stability in new ranges, to developing strength through full motion. By starting with the PRI yield, you immediately address the primary complaint—posterior hip capsule restriction and the deep, achy tightness that limits movement. This creates both psychological satisfaction through immediate relief and physiological readiness for the subsequent exercises by opening ranges of motion that were previously restricted.

The prone hip abduction exercise capitalizes on that newly created space by strengthening the internal rotators, which are almost universally weak in people with unilateral hip pain from pelvic rotation. Strengthening these muscles in isolation, without allowing compensation through lumbar extension or other movement patterns, builds the foundation for long-term correction of the underlying pelvic positioning problem. The prone adductor slides then address the medial-lateral control of your pelvis while mobilizing tissues that often become chronically tight, creating a more balanced muscular system around your hip and pelvis.

Finally, the anchored hip flexor drop develops strength in the muscles responsible for anterior pelvic control while simultaneously building resilience through ranges of motion that typically receive zero attention in conventional training programs. This comprehensive approach—addressing posterior capsule restriction, internal rotator weakness, adductor mobility and strength, and hip flexor function—creates redundant pathways to pelvic stability and optimal positioning that pure stretching or isolated strengthening simply cannot achieve.

The beauty of this protocol lies not just in the individual exercises but in how they complement and enhance each other. The space you create in exercise one allows better positioning for exercise two. The internal rotator strength from exercise two supports the pelvic mobility work in exercise three. The adductor mobility and strength from exercise three enhances your ability to control your pelvis during the hip flexor work in exercise four. This synergistic relationship between the movements creates results greater than the sum of the individual parts, which explains why people experience such dramatic improvements when they commit to the full sequence rather than cherry-picking favorite exercises.

Your hip pain doesn’t have to be a permanent limitation on your training, athletic performance, or quality of life. By understanding the biomechanical factors creating your discomfort and systematically addressing those factors through intelligent corrective exercise, you can reclaim pain-free movement and return to the activities you love. Implement this four-exercise protocol with consistency and patience, trust the process of neurological and tissue adaptation, and prepare to experience the relief and improved function that comes from giving your body what it actually needs rather than just treating symptoms with endless stretching and foam rolling.