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Published on Oct 26, 2021 / # min read
Do you experience hip pain when standing up after sitting? Discover the potential causes, tips for relief, and long-term solutions for hip pain, whether at the front, back, inside, or outside
Having hip pain when standing up after sitting can be difficult to deal with. You’re sitting every day (for more hours than you want to admit!) and you may feel 100 years older than your actual age.
Let’s move past the “I’m just getting old” excuse, and look at what’s actually happening in your body. In this article, you’ll get a better understanding of what happens while you’re sitting for long periods, how to get short-term relief, and address the root cause for long-term solutions.
Your posture ultimately reflects the way that you train your muscles to hold your bones and joints together in good alignment. This combination of muscle strength and muscle length on both sides of a joint affects whether or not it is in an “optimal” position.
Sitting places the hips into a flexed position, which changes the length of the hip flexors and the other surrounding hip muscles relative to when you’re standing upright. This seated position affects all sides of the hip joint.
The hip flexors at the front of the hip become shorter, creating an anterior pelvic tilt, resulting in an over-arch in the low back. The glutes and hamstrings, which connect to the back of the hip and pelvis, become stretched out and longer (and not in a good way!).
In this anterior pelvic tilt, your hips move differently in their ball-and-socket joint, leading to an internal rotation of the femur (thigh bone). The adductor and groin muscles, which connect to the inside of the femur and groin, become shorter and tighter. The abductor muscles on the outside of the hip then become longer.
With the amount of sitting that the average human being does on a daily basis, the hip muscles become accustomed to being in this position. As this pattern is repeated over the course of days, weeks, months, and years...your hip muscles will eventually tighten up.
The hip flexors and adductors become short and tight, while the glutes, hamstrings, and abductors become long and tight. When standing up after sitting, the shorter muscles may have difficulty lengthening and the longer muscles may have difficulty in activating.
Essentially, there are 2 simultaneous games of tug of war being played between the front and back sides of the hip and also the inner and outer sides of the hip.
This results in the muscles pulling on the hip joint in an imbalanced fashion, potentially contributing to hip pain when standing up after sitting. This hip pain may be felt in multiple locations, including pain in the front or back of the hip, pain in the groin or on the outside of the hip, and combinations resulting in hip pain felt on several sides of the joint.
Pain in the front of the hip when standing after sitting is most likely coming from tightness in the iliopsoas, your body’s main hip flexor that consists of the psoas and iliacus muscles. Both muscles come together where they cross the front of the hip joint and insert at the lesser trochanter of the femur.
Remember, these hip flexor muscles often become tight when sitting and may struggle to fully lengthen when standing if they are still holding tension. This may result in pain in the front of the hip when standing after sitting for an extended period of time due to the vertical pull and compression that a tight iliopsoas places on the hip joint.
Because the psoas muscle originates at and connects to the L1 through L5 vertebrae of the lumbar spine, pain may also be felt in the lower back when going from sitting to standing.
Pain in the back of the hip when standing after sitting may be coming from several different muscles: the glutes, hamstrings, and other deep hip rotators. When the hip flexor muscles on the front side of the hip become short and tighten up, it creates an anterior tilt of the pelvis. The glute and hamstring muscles, which attach to the back of the hip and pelvis, become longer than they want to be. While we often think of long muscles as optimal, these muscles have not lengthened in a healthy, active way. They’ve been yanked into a game of tug-of-war, where the posterior chain muscles (along the back of your body) may also tighten up to prevent further imbalance.
Ever get the feeling that your hamstrings are tight after sitting? There’s a good chance they’re involved in the same game of tug-of-war with the tight hip flexors that makes it feel like the hamstrings are short and tight, when they truly are not (they are long and feel tight). The same idea can apply when feeling tightness in your gluteus maximus, especially down closer to your sitting bones.
Similarly, the game of tug-of-war can impact the deeper hip rotators such as the piriformis muscle. This is because the much larger glute muscles, which have been lengthened beyond what is optimal, now have a harder time contracting and have developed weakness due to being overstretched by sitting for long periods.
Because the much smaller piriformis muscle is now required to perform more of the work that the glutes aren’t doing, it can lead to the muscle being overworked, fatigued, and tight. As the sciatic nerve runs beneath this muscle, a tight piriformis may compress the nerve and cause sciatica pain when standing up after sitting.
Groin pain when standing after sitting may be caused by tightness in the hip flexors. Remember that the psoas and iliacus muscles insert at the top and inside of the femur (thigh bone) near the groin area. Having tightness here impacts the alignment and function of the hip joint as it moves and may refer pain into the groin region when the hip joint isn’t aligned or moving smoothly.
Pain in the groin when standing can also be coming from tightness in the adductor muscle group, which consists of 5 muscles: the adductor magnus, adductor longus, adductor brevis, pectineus, and gracilis. Because the adductors originate along the pubis of the pelvis, they can pull on this area and cause pain and discomfort in the groin region.
It is quite possible that your pain is coming from issues with both hip flexors and adductors, as each of these muscles groups tends to become short and tight together, affecting the hip joint from multiple angles.
Lateral hip pain in the outer hip when standing after sitting may be caused by tightness in the abductor muscle group, which consists of 3 muscles: the gluteus medius, gluteus minimus, and the tensor fascia latae (or TFL). Each of these muscles connects along the outer surface of the ilium (your pelvic bone) and inserts at or near the greater trochanter (top of your femur/thigh bone).
When chronically tight, these lateral hip muscles create compression on the greater trochanter (top of your thigh bone) and can cause inflammation of the bursae in this area (called trochanteric bursitis or hip bursitis), leading to pain that is felt at the outer hip. Tightness at the outer hip, specifically the TFL muscles, can also cause pain in the IT band, a piece of connective tissue that runs along the outer thigh and down to the knee.
Here are 3 simple tips to help relieve some pain in your hips (and even your lower back) when going from sitting to standing.
Being inactive by sitting for longer periods of time makes your muscles “fall asleep” where they end up weakening and tightening as you repeat this day after day over time. Getting up from your couch or chair to move around a little bit helps to get some blood flow and activation into the muscles, keeping them “awake” and feeling better throughout the day.
If your hips tend to feel tight all the time and cause you pain when sitting, consider adding in some stretches for your hip muscles into your daily routine. Stretching can help to increase blood flow and circulation to these areas, helping the muscle to lengthen back out and provide some relief for your hips. The lunge stretch is one the best hip flexor stretches we know of and the figure 4 stretch is great for targeting the piriformis.
First things first, make sure you are sitting in an upright posture. This properly activates your core and hip muscles to strengthen them and also support you in this position. From there, adjust the height of your seat by moving it up (you can also sit on a cushion). This opens your hips up a tiny bit to help lengthen your iliopsoas, reducing how much it wants to pull on your hips and spine both while you are seated and also when standing up from sitting. (Sitting with your knees at a 90-degree angle to your body is a myth!) If neither of these options are available to you, another alternative would be to tuck your feet underneath your chair.
Why choose temporary relief when you can fix the problem!? Muscle tightness and imbalance are at the root of pain. When these kinds of issues exist around the hips, it can cause misalignment of the pelvis as well as restricted movement and range of motion in the hips. If left unresolved over a longer period of time, this can lead to the development of hip pain.
Imbalances and tightness in the muscles can be caused by old injuries, overuse in sports or other activities, repetitive patterns (e.g. sitting), and more. It is likely from a combination of several of these things, but the long-term solution remains the same.
Your muscles are what holds your joints together in the proper alignment and helps to create motion of the body. Tightness and imbalances in the muscles around your hips can contribute to aches and pains developing on all sides of the hip joint.
By releasing the tension being held in tight muscles – alongside the proper corrective strengthening and stretching exercises – you can begin to restore better strength-length balance around your hips, improve your alignment, and move with fewer restrictions.
Once tight and contracted, these tight hip flexor muscles rarely release by stretching alone. These muscles release best by applying direct, prolonged (at least 90 seconds) pressure. Some of the muscles along the back of the hip and glutes are easily accessible with the Hip Release Ball or other tool, and you can create a routine to provide pressure to the back of hip.
The iliopsoas muscles (the psoas and the iliacus) require a more specific tool to apply direct pressure. The Hip Hook is the only tool designed for both psoas release and iliacus release, due to the unique angled pressure. It’s like having a physical therapist at home with you, offering manual release therapy to these tight muscles.
Creating a routine that you can follow consistently is very important. The muscle tension and imbalances that you are working to correct in your body have likely been building up for some time now...likely over the course of YEARS. Therefore, it may take some time to sufficiently retrain the “muscle memory” in the muscles surrounding your hips to have them support you in better alignment.
Working with a personal trainer, physical therapist, or other skilled practitioners to address these issues can help you along the way and support you on your healing journey. You can (and probably should) also put in some work by yourself to accelerate this process — I cannot recommend this enough. Ultimately, you are the one in control of your body each day and must take ownership of what you need to do to improve your hip pain.
Set yourself up for success by having the necessary tools and equipment to make this happen. Using things like a hip flexor release tool, foam rollers, massage therapy balls, exercise bands, and other training equipment may be helpful to have available at home, making it easier (and more convenient) for you to help yourself stay accountable, put in the work consistently, and start making progress that turns into long-lasting results.
If this article describes what you may be currently feeling with your body, consider learning more about this topic by reading my book “Tight Hip, Twisted Core - The Key to Unresolved Pain”.
As a hip expert and holistic physical therapist of more than 20 years, I share my knowledge and expertise about how tightness and imbalances in your core and hip muscles affect the alignment, movement, and function of the entire body, leading to hip pain, back pain, knee pain, and more.
Hip pain from sitting is typically the result of tight and imbalanced muscles that are pulling on different sides of the hip joints or referring pain into the hip area. You may find relief and improvement with this pain through a combination of muscle release alongside corrective strengthening and stretching exercises to ease the pressure felt in the hips.
Your hip may hurt when getting up from sitting because your hip flexors and other surrounding hip muscles are too tight. Going from a seated position to standing requires those muscles to lengthen out. If they are holding tension and not functioning properly, the hip flexors may pull on the hip joint because they remain short and do not fully lengthen as you stand up.
If you are experiencing hip pain after sitting, you may find that the pain reduces after you get up and walk around for a couple of minutes. This is likely due to the increased blood flow and activation felt in the muscles surrounding your hips that helps create more movement in the joint. Take this as a sign that you should get up and move more frequently.