Hip Pain During Pregnancy: Common Causes and How Physical Therapy Can Help

Hip pain during pregnancy can be surprisingly common — and surprisingly uncomfortable. It might show up as a deep ache in the side of your hip, a sharp pinch at the front, pain around the buttock, or a “catching” feeling when you roll in bed. For some people it’s mild and annoying. For others it can affect sleep, walking, exercise, and day-to-day confidence.

The reassuring news: hip pain in pregnancy is often related to normal changes in your body — and there are usually practical ways to reduce symptoms and stay active. This guide is educational (not diagnostic), and it’s designed to help you understand what might be going on and what your options are.

Why pregnancy can trigger hip pain

Pregnancy changes how your body carries load. Even if you’ve had no hip issues before, a few common factors can make the hips and pelvis work harder:

• Load and posture changes: As your centre of mass shifts, your hips and pelvic muscles often have to stabilise in new ways.
• Soft tissue and joint sensitivity: Hormonal changes can affect how joints and connective tissues tolerate stress (this doesn’t automatically mean “loose joints,” but it can change sensitivity and support demands).
• Altered movement patterns: People naturally move differently as pregnancy progresses (stride length, stance, turning, getting up from chairs, rolling in bed).
• Muscle fatigue: Glutes, deep hip rotators, and pelvic stabilisers may fatigue more quickly, especially with long days on your feet.
• Previous injuries or baseline asymmetry: Old ankle, knee, or back issues can change how load gets distributed through the hips.

None of this means you’ve “done something wrong.” It usually means your body is adapting — and sometimes it needs a bit more support and strategy.

Common hip pain patterns in pregnancy

Hip pain can feel different depending on what tissues are most irritated and how you’re loading the pelvis and hips day to day. Some common patterns include:

Side-of-hip pain (outer hip ache):

This may feel sore when standing on one leg, walking longer distances, climbing stairs, or lying on the painful side. It’s often linked to how the hip stabilisers (like the glutes) are coping with load.

Front-of-hip pain (pinchy or catching at the groin/hip crease):

This can feel like a pinch when lifting the knee, stepping into a car, climbing stairs, or getting up from low chairs. Sometimes it’s related to hip flexor overload or the hip joint being irritated by certain positions.

Buttock or deep posterior hip pain:

This may feel like a deep ache around the back of the hip/pelvis and can overlap with pelvic girdle pain patterns.

Pain that flares with rolling in bed or getting dressed:

If one-legged movements (like pulling on pants) or rolling in bed consistently trigger pain, it can be a sign your pelvis and hips are sensitive to single-leg loading or twisting during this stage of pregnancy.

These categories are not a diagnosis — they’re just common ways pregnancy-related hip pain shows up.

Positions and movements that often flare hip pain in pregnancy

Many people notice hip pain is less about one single “bad” thing and more about repeated daily positions. Common flare triggers can include:

• Sleeping on one side for long periods (especially without support pillows)
• Rolling in bed or getting out of bed quickly
• Single-leg tasks like stairs, getting dressed, getting in/out of the car
• Long walks or standing for extended periods
• Deep squats or wide stances (for some people, not all)
• Twisting while weight-bearing (pivoting with feet planted)

A helpful approach is to notice patterns: What positions set it off? What makes it worse later that day? Those clues help guide what to modify and what to strengthen.

What a physical therapy assessment looks like

A pregnancy-focused physical therapy assessment is usually very practical and respectful. The goal is to understand what’s driving your pain and what will make daily life easier.

A physical therapist will typically explore:

• When the pain started, how it behaves, and what triggers it
• Your daily routines (sleeping, sitting, walking, work demands)
• Movement patterns like walking, stairs, sit-to-stand, and rolling mechanics
• Hip and pelvic muscle capacity (strength and endurance in a pregnancy-safe way)
• Mobility and sensitivity of the hips/pelvis (gently, and within comfort)
• Whether symptoms overlap with pelvic girdle pain patterns

If you’re seeing a pregnancy-trained clinician, they’ll usually also talk through your comfort preferences, consent, and what feels safe for you at each step.

What your personalized treatment may include

Physical therapy during pregnancy is often a mix of symptom relief and capacity building — so you can keep moving without feeling like you’re constantly “setting it off.”

Depending on your situation, treatment may include:

• Movement modifications for common flare activities (like rolling in bed, stairs, getting dressed)
• Targeted strengthening for glutes, hip stabilisers, and trunk support (scaled and safe for pregnancy)
• Gentle mobility work (especially if stiffness is contributing)
• Load management strategies (how to pace walks, reduce flare cycles, and build tolerance)
• Support options such as pillows for sleep positioning, or guidance on supports that may help certain people
• Education and reassurance about what’s common, what’s worth monitoring, and how to stay active safely

Importantly, “treatment” should feel like it supports you — not like a long list of rules. The best plans usually focus on small, high-impact changes that fit your day. If you’re ready to get some relief, find a local pregnancy-friendly physical therapist near you.

Practical and safe movement principles during pregnancy

Pregnancy isn’t a time you need to stop moving — but it is a time to respect symptoms and choose movements that feel supportive.

Some generally helpful principles include:

• Let any symptoms guide intensity: aim for “comfortable effort,” not pushing through sharp pain.
• Reduce repeated one-sided loading when symptoms are flared (e.g., break up long stair sessions, sit to get dressed if needed).
• Use support for sleep if side-lying is painful (pillow between knees, support under bump if helpful).
• Keep your walking dose flexible: shorter, more frequent walks can be easier to tolerate than one long one.
• Strength > stretching for many people: when joints are sensitive, gentle strength work often feels more stabilising than aggressive stretching.
• Progress gradually: the goal is steady improvement, not “perfect days.”

If you’re unsure what’s safe for you, a pregnancy-trained physical therapist can help tailor these principles to your specific symptoms and trimester.

Photo by João Paulo de Souza Oliveira on Unsplash