5 ★
65 Reviews
13+
Years Exp
£60
Intro Rate

Or book via Treatwell

13+
Years Experience
Sports & remedial massage
L5
BTEC Qualified
Highest vocational grade
65
Five-Star Reviews
All personal · Google
KT3
New Malden
Private practice
Hip Pain & SI Joint

Why hip pain is rarely just a hip problem.

Hip pain is one of the most frequently mislocated complaints in musculoskeletal therapy. The ache in the buttock, the deep groin pain and outer thigh restriction can all originate in the piriformis, TFL, hip flexors or gluteals rather than in the hip joint itself. When these muscles become tight or imbalanced, they alter pelvic position, load the SI joint and create referred pain that extends into the lower back, groin, outer thigh and sometimes down the leg.

The connection to lower back pain is direct: tight hip flexors create anterior pelvic tilt, which compresses the lumbar spine. Tight piriformis can compress the sciatic nerve, producing symptoms that mimic disc-origin sciatica. TFL and glute med tightness loads the IT band and contributes to knee pain. Treating the hip cluster effectively often resolves multiple apparently separate complaints at the same time.

  • Deep one-sided ache in the buttock, SI joint or lower back
  • Anterior hip or groin pain, worse on stairs or after sitting
  • Restricted hip rotation: difficulty crossing your legs or bending
  • Pain into the outer thigh or down toward the knee
  • Stiffness on first movement after rest, easing as you warm up
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Three Presentations Treated

The hip conditions seen most often.

Piriformis Syndrome & SI Joint Dysfunction

Tight piriformis pulls the sacrum into rotation, stressing the SI joint and compressing the sciatic nerve. The result is a deep buttock ache with possible leg referral, frequently misdiagnosed as disc-origin sciatica. Releasing piriformis, quadratus femoris and the external hip rotators directly addresses both the SI joint loading and the sciatic compression.

Hip Flexor Tightness & Anterior Hip Pain

Psoas and iliacus shorten from sustained sitting and cycling, creating anterior hip tension and anterior pelvic tilt. This overloads the lumbar spine and reduces hip extension — a key contributor to lower back pain and hamstring tightness. Deep psoas release produces dramatic improvement in both hip mobility and lower back comfort.

TFL & Gluteal Tightness

Tensor fasciae latae and gluteus medius are heavily loaded in runners and cyclists. TFL tightness drives IT band tension, producing lateral hip and outer knee pain. Gluteus medius weakness creates pelvic drop and asymmetric loading through every stride. Treating both allows proper load distribution across the hip and knee complex.

Who Gets It

Who hip pain affects — and why.

Three distinct populations presenting regularly at the New Malden practice. Each presents with different loading patterns but overlapping hip muscle dysfunction.

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Runners

TFL overload and piriformis tightness are the two most common hip presentations in distance runners. TFL compensates when glute med is weak, creating IT band loading and lateral hip pain. Piriformis tightens from the asymmetric rotation of the running gait, producing deep buttock ache that worsens on hills and long efforts. Both respond well to targeted release alongside hamstring and glute work.

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Cyclists

The cycling position sustains hip flexion for hours, chronically shortening psoas and iliacus. Combined with the cleat-fixed foot position, this creates significant hip flexor tightness and anterior pelvic tilt. The Hampton Court cycling routes and the active road cycling community around Surbiton and Kingston bring a consistent stream of cyclists to the practice with hip and lower back complaints. For cyclists wanting regular maintenance rather than reactive treatment, see sports performance maintenance.

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Desk Workers

Prolonged sitting shortens hip flexors, inhibits glutes and creates SI joint loading through pelvic asymmetry. South West London commuters add 60-90 minutes of seated hip flexion before and after a full day at a desk. Many present with what feels like lower back or SI joint pain that is substantially driven by psoas and iliacus tightness on one or both sides.

What to Expect

What a session for hip pain involves.

Assessment covers hip rotation range, pelvic position, and palpation of piriformis, TFL, psoas and the gluteal muscles to identify which structures are most restricted. This directs the treatment rather than using a generic hip protocol.

Treatment typically includes piriformis and external rotator release, psoas and iliacus work (accessed anteriorly or via the lateral lumbar approach), TFL and IT band release, and gluteus medius activation techniques. For deep posterior hip restriction or longstanding SI joint dysfunction, deep tissue massage reaches the deeper hip rotators more effectively. The 90-minute session allows sufficient time to address the full hip-lower back-hamstring chain in one treatment.

You will leave with specific hip flexor release and glute activation exercises. These are the most important self-management tools for preventing the pattern from reasserting between sessions.

  • Hip rotation, pelvic position and muscle palpation assessment
  • 60 or 90-minute sessions at Beverley Road, New Malden KT3 4AW
  • Piriformis, external rotator and TFL release
  • Deep psoas and iliacus work where indicated
  • Hip flexor release and glute activation exercises
  • ☀️ First session from £60 until 31 August 2026

Or book via Treatwell · View all rates →

About Your Therapist

Nick Monczakowski — BTEC Level 5.

13+ years treating hip pain, SI joint dysfunction and piriformis-related complaints. Ewell Chiropractic clinical background — 4 years treating complex hip, pelvis and lower back cases alongside chiropractors, where hip and SI joint dysfunction were among the most common referrals. Clinical background at Nuffield Health New Malden and Epsom.

  • BTEC Level 5 Sports & Remedial Massage — highest vocational grade
  • Ewell Chiropractic — 4 years treating complex hip & pelvis cases
  • Nuffield Health — New Malden & Epsom clinical background
  • RockTape certified — kinesiology taping for hip & pelvic stability
  • MSMA Member — Sports Massage Association (SMA)
  • 65 personal five-star Google reviews
Read more about Nick →
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MSMA Member — Sports Massage Association (SMA)

If you hold private health insurance, you may be able to claim sports massage sessions back. Check with your provider. A detailed receipt is provided on request.

Client Reviews

What clients say about their results.

All 65 reviews →
⭐⭐⭐⭐⭐

"Nick was recommended by a good friend and I couldn't have asked for a better service. He explained the plan he had for me in a very reassuring way. Will be seeing him again once my cricket season is over."

Gary
Active client · Google Review
⭐⭐⭐⭐⭐

"Have been going to Nick for a few months and he has really helped me with the problems I have with my back, shoulders and legs. After sitting in a typist's chair for seventeen years I was struggling with pain and aching joints."

Alison
Long-term client · Google Review
⭐⭐⭐⭐⭐

"Nick gets to the root of the problem every time — I always leave feeling like a completely different person. His technique is the best I have ever experienced."

Paul
Cyclist · Google Review
Common Questions

Before you book for hip pain.

Yes. Most hip pain — including SI joint dysfunction, piriformis syndrome, hip flexor tightness and TFL-related lateral hip pain — responds well to targeted soft tissue release. Treatment addresses the specific muscles driving the restriction rather than just the area of pain. Most clients see significant improvement within 2-3 sessions.
Hip pain typically presents as a local ache in the buttock, lateral hip, groin or outer thigh. Sciatica is referred pain that travels from the lower back into the leg, often past the knee. Piriformis syndrome bridges both: tight piriformis compresses the sciatic nerve, producing deep buttock pain with leg referral that closely mimics disc-origin sciatica. Nick will assess your presentation to distinguish between them before treatment begins.
Yes. SI joint pain is usually driven by muscular imbalance — tight piriformis and external rotators, inhibited glutes and restricted hip flexors creating asymmetric loading across the joint. Soft tissue release of the surrounding musculature addresses the primary drivers. Most clients notice significant relief within 2-3 sessions, often with improved pelvic symmetry and lower back comfort as a secondary benefit.
In most cases yes, with specific modification. The goal is to identify which movements are provocative and reduce those while maintaining general activity. For runners, this usually means temporarily reducing hill work and long efforts while the piriformis and TFL recover. Complete rest is rarely necessary. Nick will advise on specific modifications for your activity after the first session.
Beverley Road, New Malden, KT3 4AW. A short walk from New Malden railway station with free street parking nearby. Open Monday to Friday 10am-7pm and Saturday 10am-3pm. Clients come from Kingston, Wimbledon, Raynes Park, Surbiton and Worcester Park, all within 10-15 minutes.
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