Hip Dysplasia: An Overlooked Cause of Long-Term Hip, Knee and Back Pain
Click on the image to watch the video 👆
Hip dysplasia is a condition that is far more common than most people realise, yet it is often under-recognised and under-diagnosed. Laura Rutterford - Chartered Physiotherapist at Quay Kinetics Physio is sharing her expert knowledge about hip dysplasia in the video above for you.
In clinic, we regularly see people who have lived with hip pain, knee pain or back pain for years, often cycling through treatment after treatment, without ever getting a clear explanation for why their symptoms keep returning.
This article explains:
what hip dysplasia is
common symptoms and risk factors
why it can cause pain in areas beyond the hip
and what the next steps look like if it’s something you suspect
(Watch the full video above for a detailed explanation.)
What is hip dysplasia?
Hip dysplasia occurs when the ball-and-socket joint of the hip doesn’t provide enough bony stability.
In a healthy hip, the socket (called the acetabulum) sits snugly over the ball of the femur, creating a stable joint. In hip dysplasia, there is under-coverage of the ball, meaning the socket doesn’t fully support it.
That lack of coverage can occur:
from the side, or
from the front of the joint
When this happens, stability has to be “picked up” by other structures.
The labrum plays a key role in hip stability, this short video explains how that suction effect works and why it matters.
Why does hip dysplasia cause pain?
When the socket doesn’t fully cover the ball:
The labrum (a ring of cartilage around the socket) is placed under increased stress
The labrum may become inefficient or tear
Surrounding muscles are forced to work much harder to stabilise the joint
Over time, this can lead to:
This is why people with hip dysplasia often present with symptoms in multiple areas, sometimes without realising the hip is the root cause.
Signs and risk factors to be aware of
Understanding your birth and family history can be extremely helpful. Some recognised risk factors include:
Birth-related factors
Being a large baby
Reduced amniotic fluid during pregnancy (oligohydramnios)
Breech birth
Being late to walk as a child
Family history
Hip problems occurring earlier than expected
A stronger prevalence in the female line, though all genders can be affected
Early childhood clues
Use of “double nappies” or multiple diapers (historically used to support unstable hips)
Uneven skin creases around the hips or thighs
Known hip dislocation at birth
Many adults only learn these details later in life — asking parents or family members can sometimes unlock important clues.
Could hip dysplasia explain long-standing symptoms?
If you’ve experienced:
symptoms that haven’t fully resolved with standard rehab
recurring flare-ups despite “doing everything right”
…and some of the risk factors above resonate with you, hip dysplasia may be worth investigating.
How is hip dysplasia diagnosed?
The gold standard for diagnosing hip dysplasia is X-ray imaging.
Importantly, the referral needs to be specific. Rather than requesting a generic hip X-ray, we would recommend asking your GP to:
“Rule out hip dysplasia”
This ensures:
the correct views are taken
the appropriate angles are measured
weight-bearing or non-weight-bearing images are used where relevant
Hip dysplasia can be classified as mild, moderate or severe, depending on these measurements.
Do I need an MRI as well?
Sometimes, yes.
While X-rays assess the bony structure, MRI scans allow us to evaluate:
the labrum
muscle and tendon overload
inflammation or compensatory changes
Depending on what we find in clinic, we may recommend:
X-ray alone
X-ray + MRI
MRI alone
This is always guided by symptoms, examination findings, and your individual presentation.
What happens next?
If hip dysplasia is confirmed, the next steps focus on:
understanding the severity
optimising strength and stability
managing load and activity appropriately
and, where necessary, liaising with medical specialists
The key is addressing the underlying cause, not just chasing symptoms.
When to seek assessment
If you suspect hip dysplasia may be relevant to you, a physiotherapy assessment is a good place to start. From there, we can advise on:
appropriate imaging
referral wording for your GP
and a clear plan tailored to you
👉 You can book an appointment at Quay Kinetics Physio to explore this further.