What Causes Pain in the Front of the Hip and Groin?

What causes pain in the front of the hip and groin?

Front of hip and groin pain usually comes from inside the hip joint itself. In active adults under 50, the common causes are femoroacetabular impingement (FAI) and hip labral tears. After 50, hip osteoarthritis leads the list. Hip flexor tendinitis, adductor strains and femoral neck stress fractures in runners round out the most frequent causes.

When the hip joint itself is the problem, most people feel it deep in the groin, often cupping the front of the hip with one hand when they describe it. That deep groin ache is the most common reason patients come to Dr. Stride. Many of them have been told it was a groin pull for months. Finding the real source is the first step back to the golf course, the pickleball court or a pain-free drive home on I-10.

Written and medically reviewed by Dr. Stride, MD, board-certified orthopedic surgeon
Last reviewed October 2026

Where it hurts

Get this checked →(713) 555-0168

How patients describe it

A deep ache in the groin after sitting through a long meetingGetting out of a low car seat sends a sharp pinch into the front of the hipPutting on socks and shoes on that side has gotten hardSomething catches or clicks deep in the hip when the leg pivotsThe groin feels tight and sore after a run or a round of golfPulling the knee toward the chest causes a pinch right in the crease of the hip

The most common causes

Femoroacetabular impingement (FAI)

Active adults roughly 18 to 50, especially those who played hockey, soccer, basketball or dance as teens

In FAI, extra bone on the ball (cam type) or on the rim of the socket (pincer type) makes the two bump together when the hip bends and turns. Over time that repeated contact can fray the labrum and the cartilage at the edge of the socket. Many people have the bone shape without pain; it becomes a problem when it starts causing symptoms.

The clue: A sharp pinch in the groin when the knee is pulled toward the opposite shoulder, as in getting out of a car, is the classic clue.

Hip labral tear

Runners, golfers, dancers, yoga practitioners and anyone with FAI or a shallow hip socket

The labrum is a rim of cartilage around the hip socket that deepens it and helps seal the joint. It can tear from impingement, a twisting injury or gradual wear. A torn labrum often causes a deep groin ache plus moments of sharp catching.

The clue: Clicking, locking or a catching sensation deep in the hip with pivoting movements points toward the labrum.

Hip osteoarthritis

Adults over 50, and younger adults with past hip injury, FAI or hip dysplasia

Osteoarthritis is the gradual loss of the smooth cartilage that lines the ball and socket. The joint gets stiff, loses rotation and aches with weight bearing. It tends to progress slowly over years, with good and bad stretches along the way.

The clue: Groin pain with stiffness first thing in the morning and growing trouble with socks, shoes and toenails is typical.

Hip dysplasia

Women in their teens to 40s, and people with a family history of shallow hip sockets

In hip dysplasia the socket is too shallow to fully cover the ball. The edge of the socket and the labrum carry too much load, which can lead to pain, a labral tear and early arthritis. Mild dysplasia often goes unnoticed until adulthood.

The clue: Groin pain with a sense that the hip is unstable or tired after standing, in a flexible young adult, suggests dysplasia.

Hip flexor (iliopsoas) tendinitis or adductor strain

Runners, cyclists, soccer players and anyone who recently increased kicking, sprinting or hill work

The iliopsoas tendon crosses the front of the hip and the adductor muscles attach high on the inner thigh. Overuse can irritate either one. These are muscle and tendon problems rather than joint problems, and they usually settle with rest and progressive strengthening.

The clue: Pain lifting the leg against resistance, or tenderness right where the inner thigh meets the pelvis, points to the tendon or muscle.

Femoral neck stress fracture

Distance runners, military recruits and women with low bone density or low energy intake

Repeated impact can cause a small crack in the neck of the thighbone, just below the ball. It may not show on X-rays early on, so an MRI is often needed. Some stress fractures need protected weight bearing and others need surgery to prevent a complete break.

The clue: Groin pain that builds during every run and starts to hurt with ordinary walking needs prompt imaging.

Get seen right away if

You cannot put weight on the leg after a fall, or the leg looks shorter and turned outward
Groin pain in a runner that now hurts with every step or at rest
Fever or chills with a hot, very painful hip that you cannot move
Sudden severe groin pain in someone with a history of long-term steroid use, heavy alcohol use or sickle cell disease

What to expect at your first visit

At the first visit Dr. Stride watches you walk and stand on one leg, then checks how far the hip rotates in each direction, since lost internal rotation is an early sign of both impingement and arthritis. The FADIR (flexion, adduction, internal rotation) test and the FABER test help separate joint pain from tendon pain, and a gentle log roll of the leg checks for irritation inside the joint. He presses along the hip flexor and adductor attachments and checks the lower back and knee, because both can send pain to the groin. Standing pelvis X-rays and a side view of the hip show the shape of the ball and socket, measure socket coverage and grade any arthritis. An MRI or MR arthrogram is ordered when a labral tear or stress fracture is suspected.

“Bring your outside X-rays and MRI. I’ll go through them with you, but how your hip moves on the exam table tells me just as much as the pictures.”
Dr. Stride, MD

The hip-spine connection

Could it start in your back?

Groin pain usually comes from the hip joint, but a pinched nerve high in the lower back can feel much the same. Dr. Stride checks the spine at every visit so the right problem gets treated.

Is it your hip or your back? →

Treatment options, from simplest to most involved

Step 1
Activity changes
Deep squats, low seats, long stretches of sitting and hard pivoting all load the front of the hip. Our team helps you adjust the movements that flare it while keeping you active, such as raising your desk chair or swapping the rowing machine for the bike.
Hip Activity & Weight Plan →
Step 2
Physical therapy
A focused program builds strength in the glutes and core and improves how the pelvis moves, which takes pressure off the front of the joint. Most patients with FAI or a labral tear give therapy about 3 months before deciding on anything else.
Hip Physical Therapy →
Step 3
Anti-inflammatory medicine
A short course of an anti-inflammatory can calm a flare when your stomach, kidneys and blood pressure allow it.
Hip Pain Medication →
Step 4
Image-guided injection
An ultrasound-guided injection of numbing medicine into the joint confirms whether the pain is coming from inside the hip. Adding cortisone can calm arthritis or a painful labral tear for weeks to months.
Diagnostic Hip Injection →
Step 5
Hip arthroscopy
When impingement or a labral tear keeps causing pain despite good therapy, and arthritis is minimal, Dr. Stride can reshape the bone and repair the labrum through small incisions.
FAI Surgery →
Step 6
Hip replacement for advanced arthritis
When the cartilage is worn away and pain limits daily life, arthroscopy is a poor fit and a hip replacement is usually the more reliable answer.
Total Hip Replacement →

What you can do at home now

Raise low chairs and car seats with a firm cushion so the hip does not bend past 90 degrees
Stand up and walk for a few minutes every 30 to 45 minutes when you sit for work
Skip deep squats, lunges and deep yoga hip openers until you have a diagnosis
Swing your legs out together when you get out of the car instead of twisting on one hip
Try gentle glute bridges and side-lying leg lifts, stopping if they cause a sharp pinch

Frequently asked questions

Is groin pain always a groin pull?

No, in adults a deep groin ache that keeps coming back usually comes from the hip joint itself. Impingement, labral tears and arthritis are often mistaken for a pulled muscle. If groin pain has lasted more than a few weeks or keeps returning with activity, a hip exam is worthwhile.

Can a hip labral tear heal without surgery?

A torn labrum does not usually heal back together on its own, but many people become pain free without surgery. Physical therapy and activity changes help most patients. Surgery is considered when catching and pain continue after about 3 months of good therapy.

What age does hip arthritis usually start?

Hip osteoarthritis most often causes symptoms after age 50, though it can appear earlier in people with FAI, hip dysplasia or an old injury. Standing X-rays show whether arthritis is present and how advanced it is.

Why does the hip hurt getting out of the car?

Getting out of a car combines deep hip bending with rotation, which is the exact position that pinches the front of the hip in FAI and labral tears. Arthritic hips also dislike that combined motion. Raising the seat and swinging both legs out together usually helps right away.

Should groin pain be seen by a hip specialist or a primary care doctor?

A primary care doctor is a fine place to start, and most PPO plans also let you see Dr. Stride directly. Groin pain that limits activity, catches or has not improved in a few weeks benefits from a specialist exam and proper hip X-rays.

Treatments for front of hip

Preservation

Hip Labral Repair

Hip labral repair is an arthroscopic surgery that reattaches a torn labrum, the ring of cartilage around the hip socket, using small anchors.

FAI Surgery

FAI surgery is an arthroscopic procedure that reshapes extra bone on the ball (cam) or rim of the socket (pincer) so the hip stops pinching when it bends and rotates.