Hip Imbalances–The Hidden Cause of Pain

October 29, 2025

Mojo Chat is the virtual physical therapy platform brought to you by Mojo Health

Have you ever inspected your body posture while walking, or when waiting in a line? If you have a tendency to lean mostly to one side or the other, that could indicate an imbalance of the hips. This might not seem like a big deal, but as you go through life a hip imbalance can cascade, causing overuse and misuse of other body areas. In cases of chronic lower back pain, middle and upper back pain, knee pain and foot pain, the root cause can oftentimes be traced back to a hip imbalance.

Elite athletes push their bodies to their limits, and this causes them to purposefully address any imbalances that are affecting their performance. As for those of us who are not elite athletes, we tend to happily ignore weaknesses and imbalances. As life goes on, however, we all experience injuries and pains in various areas of the body. When doing so most of us wind up treating the symptoms, sometimes perpetually, rather than diagnosing the root cause and correcting that. If we diagnose and correct the root cause, the symptoms go away over time, as well as the need for perpetual treatments. Let’s take a look at some of the common injuries and pains that result from a hip imbalance:

  • Lower back pain
  • Trapezius strain
  • Knee pain on the inside of the knee
  • Knee pain on the outside of the knee
  • Ankle pain and plantar fasciitis

The “W” word–Weakness

To someone who is new to studying anatomy and biomechanics, these injuries may seem entirely unrelated to a hip imbalance. But the common theme that unites them all is essentially a terrible, scary word that starts with the letter “w” – weakness. That’s right, weakness. Let’s all just take a minute and say that word out loud together. Here we go, ready? Say it with me now, “weakness.”

“Weakness” is a word that nobody likes to hear when discussing the root cause of their body pains. But the reality is that a hip imbalance will cause us to favor one side of our body, leaving the other side to atrophy and become weaker over time. This scenario causes overuse of some muscles and underuse of others. Incorrect transfer of strength and energy through the body’s kinetic chain can cause problems down stream, over time.

Lower Back Pain

Lower back pain is usually persistent. Due to the centrality of the lower back’s body area, pain here affects us throughout our day. Whether we are sleeping, waking, sitting or walking, the lower back is involved. Chronic pain in the lower back drags us down physically and also mentally and emotionally.

One additional difficulty is that when addressing back pain people tend to think first about their spine and vertebrae. But addressing balance and strength of the hips and back is a much easier task than investigating skeletal issues. When we allow a physical therapist to start with the basics, we are oftentimes surprised by the rapid relief and long term healing that results.

Upper Back Pain

The same root cause analysis can be true for the upper back and the trapezius muscles. Now, if you don’t know what the trapezius muscles are exactly, just think about someone who is hunched over a computer keyboard, stressed out, and they constantly have pain on one side of their neck and into the area between the neck and shoulder. They secretly long for someone to squeeze this area and give them a deep massage there.

When a friend or professional masseuse gives them a powerful shoulder massage, they are instantly transported into the realm of delightful pain, not able to hold back moans and groans as they start to feel deep relief. Welcome to the trapezius muscles! As wonderful as this type of quick healing feels, the relief will be short lived unless we address the root cause, which is oftentimes weakness and imbalance in the hips.

Knee Pain

Now imagine the knees and how they function. The kneecap needs to float along a vertical track, without friction on either side of the rails of that track. Smoothly moving along the rails allows for movements such as walking, running, standing, sitting down, climbing and descending stairs, and lots more. But if there is friction along either side of the rails of the track that support the kneecap, pain will ensue for sure.

When experiencing knee pain, it is all too common for people to think that the meniscus has worn thin due to years of using their knees. But a trained doctor of physical therapy will be able to first inspect the muscles that surround and support the knee. If those muscles are overused or underused, the knee will not track correctly and the pain will ensue.

This path can be a game changer. We can treat the pain and train the muscles to regain healthy knee movement, and the pain goes away. The next step is to determine why those muscles were out of balance in the first place, and it can many times be traced back to a hip imbalance. Get the hips right, and we find that health and strength correctly flow downstream to the muscle groups of the leg, and then into the knee.

What’s happening from a clinical perspective is that weakness or tension in the gluteus medius muscle gets things started. Normally the gluteus medius stabilizes lateral (sidewards) motion at the hip. But if this is lacking then the adductor (inner thigh/knee) or vastus lateralis (outer thigh/knee) overload or strain. This can actually happen on either knee, regardless of which side the gluteus medius is weak or tense.

Foot and Ankle Pain

The connection to ankle pain and foot pain is less obvious, but the same principles apply. Weaknesses and imbalances up higher in the body, closer to the core of weight distribution and strength production, continue to flow downstream. The area where the rubber meets the road is the ankle and the foot.

The imbalances and weaknesses from the distant hip area produce a magnified effect at the end of the kinetic chain, all the way down into the ankle and foot. It’s no wonder that 20% of adults experience ankle or foot pain, with that number rising to 50% for people over 50 years of age.

Once again, we can treat the immediate pain area for fast results, but we need to diagnose the root cause and correct that. Otherwise we will be perpetually plagued by recurring ankle and foot pain. This ends up causing us to walk with less load on the heel, attempting to offset the hip load. This is a common occurrence, and it will most definitely lead to overload of the achilles tendon or heel.

Long Term Healing Is Here For You

The good news is that the root cause of so many injuries is fairly easy to diagnose. An elite level physical therapist will be able to first treat the symptoms that are most acute, but please keep on the path to address the underlying problems! Mojo Chat does this automatically by checking your progress after each case, at day 14 of treatment, and guiding you to continue care according to your progress. Your Mojo Chat case always includes a primary diagnosis, and oftentimes it also includes a causative diagnosis. This helps you to understand the path to healing, while allowing our doctors of physical therapy to continue to guide you along the journey.

You’re In Great Hands

At Mojo Health, we detect and retrain hip imbalances and weaknesses all the time, and our patients swear by our results. With our online physical therapy platform Mojo Chat, you can start recovery from home at any time, 24 hours a day and 7 days a week. Mojo Chat begins with easy to answer questions about your pain—the exact same questions our physical therapists ask when they see you in person. Then, you can record a short video to show our physical therapists exactly where it hurts, explain how it started, and ask any questions or concerns you may have.

A licensed physical therapist reviews everything and delivers a clear diagnosis, plus a tailored 14-day treatment plan you can start immediately. Mojo Chat guides you daily, lets you ask questions to our doctors via text or video, and adjusts your plan as you heal. Our therapists and care team track your progress to ensure you’re on the right path. And get this... 86% of users who follow the full 14-day treatment plan report significant to full healing. For users who need more help, Mojo Chat guides them to the best in-person physical therapy clinics nearby.

Don’t Put Up with Hip Imbalances

More good news is that you don’t have to be an elite athlete to retrain how your body moves. Even if the root cause is determined to be in such a fundamental body area as the hips, you can make changes and put in the work to rectify the situation. The result can be a dramatic transformation of posture, energy and core bodily capabilities. If this sounds appealing to you, don’t wait. Start a Mojo Chat case today and take the next step toward relief. If your employer offers Mojo Chat, check with Human Resources for a coupon code. Or, simply use a credit card to get started.

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