Hip pain that won’t go away can be frustrating—especially if you’re an athlete or an active individual involved in sports that involve a lot of lunging. You might be doing everything right: foam rolling, stretching, resting. And yet, hip pain won’t go away—nagging you during workouts, lingering after games, and slowly impacting your performance and quality of life.
So why won’t your hip pain go away? And more importantly, what can you actually do about it?
In this article, we’ll explore why your hip pain won’t go away, particularly that aching discomfort on the side of the hip that radiates down the leg. We’ll also show you how to identify what’s truly going on in your body—and what steps can finally bring you lasting relief.
The Common Culprit Everyone Assumes: IT Band Syndrome
If you’re feeling pain on the outside of your hip that travels down your leg toward your knee, your first thought might be: This must be my IT band.
That’s a reasonable assumption. The iliotibial band (ITB) is a thick strip of fascia that runs down the outside of the thigh, and it’s often blamed for lateral leg pain. Foam rolling, stretching, and massaging the IT band are popular go-to strategies. But for many people, those techniques only offer temporary relief—or no relief at all.
Why? Because in many cases, the IT band isn’t the real problem. It’s a symptom of something deeper.
The Real Source of the Pain: Deep Gluteal and Hip Muscles
Many athletes and active individuals suffer from pain that mimics IT band syndrome, but the root cause lies deeper—in the gluteal muscles, particularly gluteus medius, gluteus minimus, and other deep rotators around the hip.
These muscles are responsible for hip stability and control during activities like lunging, running, and pivoting. When they become overworked, weak, or imbalanced, they can develop trigger points or spasms that refer pain down the side of the leg—almost exactly along the path of the IT band.
In short: it’s not your IT band that’s the issue. It’s the muscles underneath and around it.
What Causes Muscle Spasms and Imbalances?
Trigger points and chronic tightness often develop as a compensation for other muscle imbalances or poor movement mechanics.
Here’s how it happens:
- A deep hip stabilizer (like gluteus medius) becomes weak or underactive.
- Other muscles start to compensate for that weakness.
- Over time, those compensating muscles become overworked and develop trigger points or spasms.
- These spasms cause pain, limited motion, and poor hip control—especially during lunging or single-leg activities.
And the cycle repeats.
Understanding the Anatomy: Why Alignment Matters
The hip joint is deeply interconnected with the pelvis, spine, and core muscles. Muscles from all directions—front, back, and sides—attach to and influence the function of the hip. This includes:
- Hip flexors
- Adductors (inner thighs)
- Quadriceps
- Abdominals
- Diaphragm
- Pelvic floor muscles
When there’s imbalance, tightness, or weakness in any of these regions, the pelvic alignment shifts. This misalignment changes the way the hip joint functions, and it can lead to faulty movement mechanics, especially during activities like lunges.
Signs Your Pelvis May Be Misaligned
When pelvic alignment is off, certain movement patterns become dysfunctional. One of the most common examples is poor knee positioning during a lunge.
In ideal alignment:
- The knee should track in line with the second toe.
With poor pelvic control:
- The knee might fall inward or outward.
- This causes strain up the leg and through the hip.
Over time, this poor biomechanics adds wear and tear to the hip muscles and joints—especially during sports that require quick direction changes, lunges, or squats.
The Overlooked Link: Pelvic Floor and Core Stability
Here’s where things get even more interesting: Your hip problem might actually be rooted in your core or pelvic floor.
There are 14 muscles in the pelvic floor, and two of them attach directly to the hip joint. Dysfunction in these muscles can:
- Pull the pelvis out of alignment
- Alter hip biomechanics
- Cause pain that mimics musculoskeletal issues
Surprisingly, issues like constipation, bladder dysfunction, testicular or vaginal pain, or pain during intercourse can signal pelvic floor involvement. These aren’t just “unrelated symptoms”—they can be part of the same root cause contributing to your chronic hip pain.
Why Stretching and Foam Rolling Alone Won’t Solve It
If your approach so far has been to stretch your IT band, use a foam roller, or apply heat or massage—those things might help temporarily, but they don’t fix the root issue.
Why not?
Because:
- You’re treating the symptom, not the source.
- The true issue may lie in muscle coordination, core stability, or pelvic alignment.
- Tightness often occurs because of weakness elsewhere.
- Unless you address the cause of the compensation, the problem keeps coming back.
A Better Approach: Holistic Assessment and Targeted Treatment
So, what’s the solution?
The key to resolving stubborn hip pain is a holistic evaluation of your:
- Pelvic alignment
- Muscle strength (especially glutes, hip flexors, and deep core)
- Movement mechanics (especially during lunging or sport-specific motions)
- Pelvic floor function (if relevant)
Once the underlying dysfunction is identified, treatment can involve:
- Targeted release of specific tight muscles (beyond the IT band)
- Strengthening weak stabilizers
- Neuromuscular re-education to improve control during movement
- Pelvic floor therapy, if deeper muscle involvement is suspected
- Postural correction and movement retraining
What You Can Do Right Now
Here are some practical steps you can take today:
- Stop focusing only on the IT band.
Begin exploring soft tissue release techniques higher up in the gluteal region and near the pelvis. - Use a massage ball or trigger point tool
to target gluteus medius and minimus, especially near the top of the hip bone. - Assess your lunging mechanics.
Use a mirror or video yourself—check if your knee is collapsing inward or shifting off alignment. - Start strengthening the glutes and deep core.
Try exercises like clamshells, bridges, dead bugs, and controlled lunges. - Consider pelvic floor dysfunction.
If you’re experiencing related symptoms (bladder, bowel, or sexual health issues), this could be an important piece of the puzzle.
When to Seek Professional Help
If you’ve tried stretching, foam rolling, and strengthening but the pain keeps coming back, it’s time for a more comprehensive approach.
At our clinics in Center City Philadelphia and Narbeth, PA, we specialize in treating complex hip, pelvic, and spinal dysfunctions. We evaluate you from head to toe and create a personalized plan to address every contributing factor.
For those not local to our clinics, we also offer online consultations and self-guided programs designed to target these imbalances from home. We have specific tracks for both men and women, especially helpful for those with combined hip and pelvic pain.
Why Your Hip Pain Won’t Go Away – Final Thoughts
Persistent hip pain—especially that radiates down the leg—often isn’t what it seems. The IT band might get the blame, but more often than not, it’s deeper dysfunction in the glutes, core, or pelvic floor.
By shifting your focus from symptom relief to root cause resolution, you can finally break the cycle of pain and get back to your sport stronger than ever.
Remember: Your body is one interconnected system. Solve the puzzle—not just the piece.
Also Read: Why You Feel Heaviness After Delivery (It’s Not Prolapse)
I’m Hina Sheth. I have been treating complex orthopedics, sports and pelvic floor physical problems for over 25 years with amazing results. Now I want to bring my knowledge to the global community so I can spread my knowledge to you.
Our bodies are complex systems of 600 muscles and organs intertwined in a fascial system that all work together. Imbalances in this system such as trigger points, visceral and myofascial restrictions can lead to joint, pelvic, and organ issues.
Factors like nutrition, exercise, sleep, and stress play a crucial role. Unfortunately, our current healthcare model does not look at our bodies as a whole and oftentimes compartmentalize musculoskeletal injuries and dysfunctions.
At Rebalance, our goal is to holistically treat this complex system to restore harmony in the body. By addressing these imbalances, we help clients improve their overall health and well-being. Our vision is to empower individuals to create a healthier lifestyle for themselves.
