Hip Pain During Pregnancy and Postpartum: Causes, Treatment, and Relief

Hip pain during pregnancy and postpartum is a common complaint, but that doesn't mean it's normal or something you simply have to live with.

Some women develop pain during pregnancy as their body adapts to the physical demands of carrying a growing baby. Others don't notice symptoms until weeks or even months after delivery. Pain may be felt on the outside of the hip, deep in the hip crease, or in the back of the pelvis/buttock, and it can make everyday activities like walking, sleeping, climbing stairs, or caring for your baby uncomfortable.

The good news is that hip pain is often treatable once you identify what's actually driving the symptoms. While pregnancy and postpartum recovery create significant changes throughout the body, the source of pain is rarely the same for everyone. Understanding the root cause is the first step toward finding lasting relief.

What Does Pregnancy-Related Hip Pain Feel Like?

Hip pain can show up in several different ways during pregnancy and postpartum. Some women experience pain deep in the front of the hip or groin.

Others notice aching along the outside of the hip, pain in the buttocks, or discomfort deep in the back of the pelvis.

You may feel pain when:

• Walking

• Climbing stairs

• Standing on one leg

• Rolling over in bed

• Sitting for long periods

• Getting out of a car

• Carrying your baby

• Returning to exercise

While pubic symphysis pain can also cause groin discomfort during pregnancy, that's a separate condition that deserves its own discussion. In this article, we're focusing on hip-related pain that originates from the joints, muscles, connective tissues, and movement patterns surrounding the posterior/lateral pelvis and hips.

Why Does Hip Pain Happen During Pregnancy?

Pregnancy creates significant changes throughout the body.

As your baby grows, your center of gravity shifts. To accommodate these changes, your body naturally adjusts its posture and movement patterns. Sometimes the pelvis tips forward. Other times it shifts forward as the upper body compensates by leaning backward. These changes can alter how forces are distributed through the spine, pelvis, hips, and feet.

For some women, these changes are well tolerated. For others, they expose underlying weaknesses, stiffness, or movement habits that may have been present long before pregnancy.

A Quick Look at How the Hip Works

The hip is a ball-and-socket joint, meaning the rounded top of your thigh bone (femur) fits into a socket within your pelvis. This design allows the hip to move in many directions while also providing stability for standing, walking, climbing stairs, and carrying your baby.

Surrounding the hip are numerous muscles that work together to support and control movement. These include the gluteal muscles, hip rotators, hip flexors, hamstrings, quadriceps, and inner thigh muscles. Rather than working individually, these muscles function as a team to help stabilize the pelvis and control the position of the hip during movement.

One of the most important jobs of the hip muscles occurs when you're standing on one leg—even if it's only for a moment. Every step you take, every stair you climb, and every time you get dressed requires your body to briefly balance on one leg. During these activities, the muscles on the outside of the hip help control the position of the pelvis and prevent excessive dropping from one side to the other.

As pregnancy progresses, your center of gravity shifts and the forces traveling through the hips and pelvis change. The hip muscles are often asked to manage greater loads and different movement demands than they were before pregnancy. If the muscles aren't working together efficiently, or if another area of the body is contributing to the problem, pain can develop.

This is also why hip pain isn't always a hip problem. The hip works closely with the pelvis, sacrum, spine, core, knees, and feet. When one area isn't moving or functioning well, the hip often ends up compensating.

Why Pregnancy Can Expose Underlying Imbalances

Because the hip relies on so many muscles and joints working together, pregnancy can sometimes expose weaknesses or movement patterns that weren't causing problems before.

Pregnancy doesn't necessarily create muscle imbalances, but it can make existing ones more apparent.

When I say "imbalance," I don't necessarily mean someone is weak. Many women experiencing hip pain are quite active and may have plenty of strength. Instead, it may mean certain muscles are working harder than others, one side of the body is compensating for the other, or the demands of pregnancy have highlighted movement patterns that weren't causing problems before.

As the demands on your body increase, muscles that were already weak, tight, or not functioning optimally may begin to contribute to pain.

Common contributors include:

• Weak hip stabilizers

• Decreased core strength

• Limited hip mobility

• Tightness through the hips or lower back

• Reduced balance and stability during single-leg activities

This is one reason why two women at the same stage of pregnancy can have completely different experiences.

Hormones May Play a Role—But They're Usually Not the Whole Story

Hormonal changes during pregnancy are often blamed for pelvic and hip pain. While hormones can contribute to increased joint mobility and tissue changes, they rarely tell the entire story.

If hormones were the sole cause, physical therapy interventions wouldn't consistently improve symptoms. Yet many women experience significant relief when underlying movement dysfunctions, strength deficits, mobility restrictions, or joint mechanics are addressed.

Hormones may influence the environment, but they are often only one piece of a much larger puzzle.

Sometimes the Problem Isn't Actually the Hip

One of the most important parts of evaluating hip pain is determining where the symptoms are truly coming from.

Pain felt in the hip can actually originate from:

• The lower back

• The sacroiliac joints

• The sacrum

• The pelvis

• The feet and ankles

• Surrounding muscles and connective tissues

The body functions as an interconnected system. When one area isn't moving or functioning well, another area often compensates.

That's why simply treating the painful area doesn't always solve the problem.

Why Side-Lying Can Make Hip Pain Worse

Many pregnant women are told to sleep exclusively on their side. While side-lying is often recommended during pregnancy, spending hours in the same position night after night can sometimes aggravate existing hip symptoms.

If the tissues around the hip are already irritated, prolonged pressure on the side of the hip may continue to "poke the bear" and keep symptoms sensitive.

This doesn't mean side sleeping is wrong. It simply means that positioning strategies may need to be adjusted based on the individual and what their body is telling them.

Why Does Hip Pain Continue—or Start—After Delivery (Postpartum)?

Many women expect their hip pain to disappear once the baby arrives. Unfortunately, that's not always what happens. In some cases, symptoms persist long after delivery. For others, hip pain doesn't begin until weeks or even months postpartum, even if they had no symptoms during pregnancy.

Postpartum recovery presents its own unique challenges. While pregnancy-related changes may have contributed to symptoms beforehand, the demands of caring for a newborn can create new stresses on the body or expose underlying issues that weren't noticeable during pregnancy.

After a vaginal delivery, the pelvis and surrounding structures are recovering from the significant demands of labor and birth. The pelvis, sacrum, muscles, and connective tissues may still be adapting long after delivery.

Following a cesarean birth, scar tissue, abdominal weakness, and altered movement patterns can contribute to hip or pelvic discomfort.

In either scenario, new moms are often:

• Lifting and carrying a growing baby

• Feeding in awkward positions

• Spending long periods sitting

• Sleeping less

• Returning to exercise before rebuilding strength

These factors can all influence how the hips and pelvis function during recovery.

How Pelvic Floor Physical Therapy Can Help

The most effective treatment isn't a one-size-fits-all exercise program.

The first step is identifying why your pain is occurring.

A thorough evaluation should assess:

• Posture

• Walking mechanics

• Hip mobility

• Spine mobility

• Pelvic alignment

• Sacral mobility

• Core function

• Hip strength

• Flexibility

• Foot and ankle mechanics

• Daily movement habits

Just as importantly, understanding when your symptoms occur provides valuable clues.

Does the pain happen when you're sitting?

Walking?

Rolling in bed?

Standing on one leg?

Climbing stairs?

Holding your baby?

The answers help guide treatment toward the true source of the problem.

Depending on the findings, treatment may include:

• Strengthening the hips and core

• Improving mobility of the spine, pelvis, or hips

• Addressing foot and ankle mechanics

• Modifying aggravating movements

• Optimizing posture as your body changes

• Manual therapy techniques

• Strategies for sleeping, sitting, and daily activities

The goal is not simply to reduce pain—it's to help your body move more efficiently so symptoms stop returning.

You Don't Have to Wait Until After Pregnancy

One of the biggest misconceptions about pregnancy-related hip pain is that treatment should wait until after delivery.

In reality, many women experience significant improvement during pregnancy when the underlying causes of their symptoms are identified and addressed.

Whether you're pregnant, newly postpartum, or months beyond delivery, hip and groin pain deserves more than a generic recommendation to "just stretch" or "give it time."

Your body is changing, but pain isn't something you simply have to accept.

With the right evaluation and treatment approach, it's often possible to identify the root cause of your symptoms and create a plan that helps you move, exercise, sleep, and care for your growing family more comfortably.

Ready to Find the Root Cause of Your Hip Pain?

Whether your hip pain started during pregnancy, appeared after delivery, or has been lingering for months, you don't have to simply wait and hope it goes away.

The key to lasting relief is understanding why the pain is happening in the first place. Through a thorough evaluation, we can identify the movement patterns, strength deficits, mobility restrictions, or other factors contributing to your symptoms and create a treatment plan tailored specifically to you.

If you're ready to move more comfortably, sleep better, and feel more confident in your body again, I'd love to help.

Schedule your pelvic floor physical therapy evaluation today and let's get to the root cause of your hip pain.