That Deep Ache in Your Hip Isn’t Something to Walk Off: What NYC Athletes Need to Know

The moment summer arrives in New York, the city moves differently. Central Park fills with runners by 6 a.m. The Hudson River Greenway becomes a cycling corridor. Rooftop pickleball leagues form. Weekend warriors who spent the winter at their standing desks are suddenly logging ten-mile runs and back-to-back tennis matches — and for many of them, a nagging hip doesn’t slow them down until it absolutely has to.

Hip pain is one of the most commonly undertreated conditions that Manhattan sports medicine patients present with, in part because the hip joint is remarkably tolerant of dysfunction in the short term. Patients compensate, adjust their stride, take more ibuprofen, and push through — until a morning arrives when they genuinely can’t. By that point, what started as an addressable soft tissue issue has often become something considerably more involved.

At Manhattan Sports Therapy, Dr. Rolland Miro and Dr. Rachel Berenbaum work with performance athletes and everyday active New Yorkers to identify and treat hip pain before it derails the activities that make life in this city worth living. The approach is non-surgical, non-invasive, and built around getting patients back to full function — not just managing symptoms.

The Hip’s Complexity Is Why It’s So Easily Mismanaged

The hip is the largest ball-and-socket joint in the body, designed to manage the combined demands of weight-bearing stability and multi-directional mobility. It’s surrounded by multiple layers of muscle, supported by several ligament structures, and relies on precise coordination between the glutes, hip flexors, adductors, and core to function efficiently under load.

When that coordination breaks down — from overuse, muscle imbalance, poor movement patterns, or acute injury — the joint absorbs forces it wasn’t designed to handle alone. The result is pain that can manifest in surprising locations: deep in the groin, at the outer hip, in the low back, or radiating down the thigh. This referred pain pattern is one reason hip dysfunction is frequently misidentified. Patients come in convinced they have a back problem, a hamstring issue, or knee pain — and the underlying driver is hip mechanics.

Identifying the actual source requires a thorough hands-on evaluation, which is where the clinical experience of Dr. Miro and Dr. Berenbaum becomes essential. Dr. Miro, a board-certified practitioner using some of New York’s most advanced hands-on techniques, approaches each case with the diagnostic rigor that elite athletes have come to rely on. Dr. Berenbaum, who completed a Ph.D. and Master’s degree in nutrition from the University of Bridgeport College of Chiropractic with honors, brings a holistic perspective that considers the interconnected systems contributing to musculoskeletal pain.

Common Causes of Hip Pain in Active New Yorkers

Hip pain in the athletic population rarely has a single cause — it’s typically the result of accumulated stress on tissues that were already under strain. That said, several patterns come up repeatedly in the Manhattan Sports Therapy clinical setting:

• Hip Flexor Strain and Tightness: The hip flexors — particularly the psoas — shorten and tighten with prolonged sitting, which describes the working life of most Manhattan professionals. When those tight muscles are then asked to power through a long run or a hard cycling session, the mismatch in tissue length and demand creates both acute strain and chronic aching that doesn’t resolve with stretching alone.
• Labral Tears: The labrum is a ring of cartilage that deepens the hip socket and provides additional stability. Labral tears are increasingly recognized in active populations — especially runners, dancers, and hockey players — and present as a catching, clicking, or deep aching sensation deep in the groin. Many labral tears respond well to conservative care, particularly when identified before significant joint degeneration has occurred.
• Greater Trochanteric Pain Syndrome (Hip Bursitis): The bursa on the outer side of the hip cushions the IT band and gluteal tendons as they pass over the greater trochanter. When these tendons become irritated — a common consequence of running volume increases, gait asymmetry, or weak hip stabilizers — the bursa inflames, producing that distinctive tenderness on the outer hip that hurts when lying on that side at night.
• Snapping Hip Syndrome: The audible or palpable snapping that many athletes notice around the hip is typically caused by a tight iliotibial band or iliopsoas tendon moving over a bony prominence. It’s often painless initially but can progress to discomfort if the underlying tightness isn’t addressed.
• Referred Pain from the Lumbar Spine: The L2-L4 nerve roots, which exit the lower lumbar spine, send sensation to the hip and groin area. Lumbar disc problems or facet joint irritation can mimic hip pathology convincingly, which is why a proper evaluation always includes assessment of spinal mechanics alongside the hip itself.

What Treatment Actually Looks Like

The goal at Manhattan Sports Therapy is not to put patients in a passive recovery program and wait for things to settle down. That approach might be appropriate for rest-based recovery, but it doesn’t address the mechanical reasons the injury occurred in the first place — and it means that when a patient returns to activity, the same conditions that created the problem are still there.

Active Release Technique (ART), one of Dr. Miro’s core treatment methods and a technique that has made Manhattan Sports Therapy a destination for professional and competitive athletes, is particularly effective for hip issues involving adhesions and restricted tissue mobility in the surrounding musculature. By applying precisely directed tension while moving the affected tissue through its full range of motion, ART breaks down the adhesions that prevent normal gliding between tissue layers — restoring range, reducing pain, and improving the hip’s ability to function under load.

Chiropractic care for hip pain addresses the joint mechanics of the hip, sacroiliac joint, and lumbar spine that collectively influence how the hip loads and moves. When joints are restricted in their normal movement patterns, surrounding muscles compensate — and those compensations become injury patterns. Restoring proper joint motion allows muscles to work in the positions they were designed for.

Rehabilitation programming builds on manual treatment by addressing the strength deficits that typically underlie hip dysfunction: weak glute medius, inhibited hip external rotators, poor single-leg stability. These aren’t incidental findings — they’re the mechanical explanation for why the injury happened, and correcting them is what prevents recurrence.

Summer in Manhattan Is Too Short to Spend It Sidelined

The stretch of outdoor activity from June through September is genuinely finite in New York, and the patients who wait until September to address hip pain that started in June have spent three months managing a problem they could have resolved. Runners who push through have more races to account for in their outcome. Cyclists accumulate volume on a compromised joint. Weekend athletes aggregate tissue stress that compounds weekly.

An evaluation at Manhattan Sports Therapy identifies exactly what’s driving the pain and lays out a realistic recovery timeline — so patients can make informed decisions about their summer plans rather than just hoping the hip will work itself out.

The practice is located at 515 Madison Avenue, FL 22A in Midtown Manhattan. Call (212) 310-0100 to schedule your appointment with Dr. Miro or Dr. Berenbaum. Don’t spend another summer working around a hip that’s working against you.