Why Does the Front of My Hip Hurt When I Sit, Squat, or Get Out of the Car? A Physical Therapist Answers

By Nova Physical Therapy | North Hollywood, CA

You sit through a long drive, then feel a pinch deep in the front of your hip as you get out of the car. Maybe a deep squat at the gym produces the same discomfort. Putting on shoes, climbing into a low seat, or bringing your knee toward your chest may also feel restricted.

People often call this a “tight hip flexor,” but front-of-hip or groin pain can have several possible sources. One is femoroacetabular impingement (FAI) syndrome, a hip-related condition associated with symptoms, examination findings, and characteristic imaging changes. Hip flexor-related pain, hip joint conditions, and referred symptoms from other regions can overlap.

At Nova Physical Therapy in North Hollywood, California, we evaluate physical impairments and functional limitations that affect sitting, walking, squatting, exercise, and daily activity. Our outpatient orthopedic and musculoskeletal rehabilitation services are relevant to patients in North Hollywood and nearby Burbank, Toluca Lake, Studio City, Valley Village, and the greater Los Angeles area. Learn more about Nova Physical Therapy services.

Patient Question

“I feel a sharp pinch in the front of my hip when I sit too long, squat, or get in and out of my car. Could it be hip impingement, and can physical therapy help?”

The Short Answer

Possibly. Position-related pain in the front of the hip or groin is one presentation seen with FAI syndrome, especially when hip flexion or rotation reproduces familiar symptoms. But pain location or one positive test cannot establish FAI syndrome. International consensus requires compatible symptoms, clinical signs, and imaging findings for a medical diagnosis.

Physical therapy may help appropriately selected patients improve strength, activity tolerance, and daily function. A July 2026 randomized trial involving 154 adults with FAI syndrome found meaningful improvements in hip-related quality of life in both a targeted-strengthening group and a standardized-stretching group after six months. Strengthening was not superior for the primary quality-of-life outcome, although a secondary analysis favored strengthening for perceived pain improvement and hip muscle strength.

Why Does the Front of My Hip Hurt When I Sit?

Sitting places the hip in flexion. For some people with hip-related pain, particularly in low seats or during long car rides, that position may reproduce discomfort near the groin or front of the hip. Symptoms can also arise from tissues outside the joint, so the position alone does not identify the cause.

Notice whether the discomfort occurs immediately or only after prolonged sitting, whether standing changes it, and whether it feels different in a higher chair. Those details can guide an evaluation without assuming there is one “perfect” sitting posture.

Why Does Getting In or Out of the Car Hurt?

Getting into a car often combines hip bending and rotation. Getting out may require rotating the leg, shifting weight, and standing from a low seat. If these positions reproduce symptoms, the difficulty may be more noticeable after a long Los Angeles commute.

Temporarily turning the whole body before moving both legs together, adjusting the seat position, or using a slightly higher seat may make the movement more tolerable. These are practical activity modifications, not treatments for a confirmed structural diagnosis.

Why Does a Deep Squat Cause a Pinching Sensation?

A deep squat places the hips in substantial flexion, often with additional rotation depending on stance and movement. Some people with hip-related pain report a familiar pinch near the bottom of the squat. Others tolerate squatting well and only experience symptoms with running, pivoting, or prolonged sitting.

A painful squat does not prove that the hip bones are colliding or that the labrum is torn. A physical therapist may examine squat depth, stance, loading, strength, mobility, and symptom response. Adjusting depth or load temporarily can help someone continue training while their tolerance is evaluated and progressed.

What Is Femoroacetabular Impingement Syndrome?

FAI syndrome is a motion-related hip disorder in which symptoms and clinical findings are associated with particular shapes of the femoral head-neck region, the acetabular rim, or both. These shapes are commonly described as cam and pincer morphology.

Importantly, having cam or pincer morphology on an X-ray does not automatically mean someone has FAI syndrome. Structural variations can exist without symptoms. The Warwick international consensus emphasizes that a medical diagnosis requires a combination of symptoms, clinical signs, and relevant imaging findings.

Is Hip Impingement the Same as a Labral Tear?

No. The labrum is a ring of tissue around the hip socket that contributes to joint function. Labral changes may coexist with FAI syndrome, but the terms are not interchangeable. Clicking, catching, or pain during rotation can occur with several hip conditions and cannot independently confirm a tear.

A medical provider may consider imaging when the clinical picture warrants it. Physical therapy focuses on relevant physical impairments, activity restrictions, and whether a rehabilitation plan is appropriate.

Could It Be a Hip Flexor Problem Instead?

Yes. Pain related to the hip flexor muscles or tendons can sometimes occur at the front of the hip, especially during activities requiring repeated hip flexion. Adductor-related groin pain, hip joint disorders, lumbar-related symptoms, and other conditions may also overlap.

During an evaluation, the clinician may compare symptoms during resisted hip flexion, passive movement, functional tasks, and other tests. No single finding should be treated as definitive.

Does Clicking or Popping Mean Something Is Torn?

Not necessarily. Some hip clicks come from tendons moving around nearby structures and are not associated with significant injury. Clicking accompanied by pain, catching, loss of motion, or repeated locking deserves closer assessment, but the sound itself does not establish a labral tear.

Should I Stretch My Hip Flexors More?

Stretching is not automatically the solution to every sensation of tightness. Some people benefit from selected mobility exercises, while others find that aggressive end-range stretching repeatedly provokes the same painful region. The appropriate choice depends on the examination and response to movement.

Similarly, it is not necessary to force a painful deep squat or repeatedly test the most uncomfortable position. Temporary adjustments can support continued activity while a progressive plan is developed.

What Exercises May Be Included in Rehabilitation?

Exercise selection depends on symptoms, goals, examination findings, and the demands of work or sport. A rehabilitation program may include progressive hip and trunk strengthening, single-leg functional exercises, graded squatting, walking or aerobic conditioning, and return-to-sport activities when appropriate.

There is no universal requirement to “fix” one movement pattern or activate a particular muscle before a patient can improve. The aim is to build useful capacity and confidence in meaningful activities.

Can Physical Therapy Help?

For selected patients with hip-related pain, physical therapy may help address muscle performance, mobility, activity tolerance, functional movement, and gradual return to exercise. Treatment may include education, progressive strengthening, appropriate mobility work, and modifications to aggravating activities.

For one person, the goal may be sitting through work without repeatedly shifting position. For another, it may be squatting at the gym, getting in and out of the car, hiking, running, or returning to a recreational sport. Improvement should be measured against the patient's actual goals, not only a pain score or a single range-of-motion measurement.

What Does Research Say?

July 2026: The PhysioFIRST Randomized Trial

Kemp and colleagues studied 154 adults aged 18–50 with FAI syndrome, comparing six months of physiotherapist-led targeted strengthening with standardized stretching. Both groups improved their hip-related quality of life by clinically meaningful amounts, with no significant between-group difference in that primary outcome. In a secondary analysis, 72% of the strengthening group versus 52% of the stretching group reported improvement in pain; strengthening also produced larger hip muscle-strength gains. These findings support exercise-based care while not proving that one program is universally superior.

2025: Rehabilitation Protocols Vary

A 2025 scoping review identified 24 studies and analyzed 30 physiotherapy protocols for FAI syndrome. Strengthening, manual therapy, and stretching were common, but treatment descriptions and approaches varied. That limits the ability to identify one ideal protocol for every patient.

2023: Many Patients Respond to Nonsurgical Care

A systematic review of nonarthritic hip-related pain included 26 studies with 1,153 patients. Its pooled estimate suggested that approximately 54% reported a satisfactory response to nonsurgical treatment, although the confidence interval was wide and the populations included several hip-related conditions—not FAI syndrome alone. This is an average across studies, not an individual prediction.

2025: Surgery and Rehabilitation Are Not Identical Options

A 2025 meta-analysis compared outcomes reported for conservative care and hip arthroscopy in randomized trials. Some hip function measures favored arthroscopy statistically, but the reported between-group differences did not reach the authors' thresholds for minimal clinically important differences. Surgery may be appropriate for selected patients after medical evaluation, but a scan showing hip morphology does not automatically mean surgery is necessary.

2026: Patient Education Matters

A 2026 qualitative systematic review involving eight studies and 409 participants described the physical and psychosocial effects of FAI syndrome, unmet expectations, and varied experiences with physical therapy. Its findings reinforce the importance of clear explanations, shared goals, and avoiding frightening claims about hip anatomy.

What Happens During a Physical Therapy Evaluation?

At Nova Physical Therapy in North Hollywood, a physical therapy evaluation for front-of-hip or groin pain may include the symptom history, hip and lumbar movement, muscle performance, walking and functional tasks, and screening for findings that require medical referral.

Depending on the presentation, we may examine:

• When symptoms occur during sitting, driving, squatting, walking, or exercise.
• Hip range of motion and symptom response to different positions.
• Hip and trunk muscle performance and functional strength.
• Single-leg tasks, gait, squatting, or sport-related movement when appropriate.
• Relevant lumbar and neurological findings, with referral when indicated.

Some hip provocation tests, including flexion-adduction-internal rotation (FADIR), may reproduce familiar pain, but they are not specific enough to establish a medical diagnosis by themselves. The evaluation helps determine whether rehabilitation is appropriate and what functional outcomes to track.

When Should You Seek Medical Attention?

Seek urgent medical assessment for severe hip pain after a fall or other trauma, inability to bear weight, a visibly deformed hip, or rapidly worsening pain. A hot, swollen hip with fever or systemic illness also requires prompt medical attention. New major neurological deficits or other concerning systemic symptoms warrant medical assessment.

Persistent groin pain, recurrent painful locking, worsening loss of function, unexplained night pain, or symptoms that do not follow a typical musculoskeletal pattern should also be discussed with an appropriate medical professional. Physical therapy is not a substitute for necessary medical evaluation or imaging.

Why Patients Choose Nova Physical Therapy

We Care.

Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, serving people with appropriate orthopedic, musculoskeletal, movement, and rehabilitation needs. Our location is convenient to patients in Toluca Lake, Burbank, Studio City, Valley Village, and surrounding Los Angeles communities.

We do not assume every patient with front-of-hip pain has the same problem. One person may struggle after sitting in traffic, another during a deep squat, and another while walking or getting dressed. Some presentations may require medical evaluation before or alongside physical therapy.

Our approach emphasizes individualized physical therapy evaluation, evidence-informed exercise, functional goals, patient education, and appropriate referral. We Care means understanding what the symptoms prevent you from doing and making those activities central to the rehabilitation plan.

Frequently Asked Questions

Why does my hip pinch when I sit?

Hip flexion may reproduce symptoms in several hip-related conditions, including FAI syndrome. The position alone cannot identify the cause.

Why does the front of my hip hurt when I get out of the car?

Getting out of a car combines hip rotation, weight shifting, and rising from a seated position. These demands can aggravate some hip-related presentations.

Why does my groin hurt during deep squats?

Deep hip flexion can provoke symptoms in some people with hip-related pain, but it does not prove FAI syndrome or a labral tear.

What does hip impingement feel like?

People may describe motion-related groin or front-of-hip pain, stiffness, or occasional catching. Symptoms vary and overlap with other conditions.

Does a positive FADIR test mean I have FAI?

No. FADIR is not sufficiently specific to establish FAI syndrome alone. Medical diagnosis requires compatible symptoms, clinical findings, and imaging.

Is hip impingement the same as a labral tear?

No. They are different concepts and may coexist. Symptoms alone cannot confirm either condition.

Does hip clicking mean my labrum is torn?

Not necessarily. Clicking can occur for several reasons, including tendon movement. Painful catching or locking deserves evaluation.

Should I stop squatting?

Not always. Temporarily adjusting depth, load, or stance may help while symptoms and capacity are assessed.

Should I stretch my hip flexors?

Only when appropriate to the examination. Repeatedly forcing painful end-range positions is not a universal solution.

Can physical therapy help hip impingement?

Exercise-based physical therapy may improve function and hip-related quality of life in selected patients. The 2026 PhysioFIRST trial supports meaningful improvement with two different physiotherapist-led exercise approaches.

Do I need an MRI for front-of-hip pain?

Not everyone needs an MRI. A medical provider determines whether imaging is indicated based on the history, examination, and clinical concerns.

Does hip impingement always require surgery?

No. Rehabilitation is a reasonable nonsurgical option for many appropriately selected patients, while surgery may be considered in some cases after medical evaluation.

Schedule an Evaluation

If front-of-hip or groin pain is limiting sitting, driving, squatting, walking, work, or exercise, an individualized physical therapy evaluation can help identify relevant impairments, functional goals, and whether rehabilitation is appropriate.

Nova Physical Therapy in North Hollywood, CA provides outpatient physical therapy for appropriate orthopedic and musculoskeletal concerns, serving North Hollywood and nearby Toluca Lake, Burbank, Studio City, Valley Village, and greater Los Angeles. Explore our physical therapy services.

Disclaimer

This article is educational and is not medical advice, an individualized diagnosis, imaging interpretation, or exercise clearance. Front-of-hip pain, groin pain, clicking, or a painful squat cannot independently establish FAI syndrome, a labral tear, tendinopathy, arthritis, or another medical condition. California physical therapists evaluate and treat physical impairments and functional limitations within the Physical Therapy Practice Act; a PT license does not authorize diagnosis of disease. Appropriate medical referral is necessary when indicated. No intervention guarantees pain relief, anatomical change, avoidance of surgery, or return to sport.

References

1. Kemp JL, et al. Physiotherapist-led treatment for femoroacetabular impingement syndrome (the PhysioFIRST study): an assessor-blinded, limited disclosure randomised controlled trial. Br J Sports Med.2026;60(13):951–961. https://doi.org/10.1136/bjsports-2025-110986
2. Griffin DR, et al. The Warwick Agreement on femoroacetabular impingement syndrome: an international consensus statement. Br J Sports Med. 2016;50:1169–1176. https://doi.org/10.1136/bjsports-2016-096743
3. Berguerand C, Rossi N, Caliesch R. Evaluation and synthesis of physiotherapy protocols for femoroacetabular impingement syndrome: a scoping review. Arch Physiother. 2025;15:165–173. https://doi.org/10.33393/aop.2025.3381
4. What is the rate of response to non-operative treatment for hip-related pain? A systematic review with meta-analysis. 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10176100/
5. Ramadanov N, et al. Conservative treatment versus hip arthroscopy in patients with femoroacetabular impingement: a multilevel meta-analysis of randomized controlled trials. Bone Jt Open. 2025;6(4):480–498. https://doi.org/10.1302/2633-1462.64.BJO-2024-0198.R1
6. Hibbert E, et al. Lived experiences and health care perspectives of people with femoroacetabular impingement syndrome: a systematic review of qualitative studies. J Orthop Sports Phys Ther.2026;56(7):413–426. https://doi.org/10.2519/jospt.2025.13404
7. Stanford Health Care. Femoroacetabular impingement symptoms. Stanford Health Care clinical information.
8. Physical Therapy Board of California. Physical Therapy Practice Act. https://www.ptbc.ca.gov/laws/pt_practice_act.shtml