Putting on socks requires the hip joint to perform an extreme movement: a combination of deep hip flexion and rotation. This deep bending brings the knee toward the chest and involves rotation to bring the foot into reach. When this movement causes sharp or aching pain, it signals an underlying mechanical issue within the joint or surrounding soft tissues. This pain indicates that joint structures are being compressed or strained beyond their comfortable limit.
Mechanical Issues Causing Hip Pain
The most common cause of pain during this movement is Femoroacetabular Impingement (FAI), where abnormally shaped bones of the hip joint abut one another. This occurs when the ball of the femur or the socket (acetabulum) has extra bone growth, causing structures to pinch the cartilage rim (labrum) during deep hip flexion and rotation. The resulting pain is felt deep in the groin or the front of the hip joint.
Another frequent cause is Hip Osteoarthritis (OA), a degenerative condition characterized by the breakdown of joint cartilage and narrowing of the joint space. This loss of cushioning restricts the range of motion, making the deep flexion required to reach the foot painful and difficult. Individuals with hip OA often find that internal rotation, a necessary component of the dressing maneuver, is particularly limited.
Issues with the iliopsoas muscle and bursa also cause pain, as this muscle is the primary hip flexor located at the front of the joint. Iliopsoas tendinitis or bursitis involves inflammation of the tendon or the fluid-filled sac (bursa) that reduces friction. Since putting on a sock demands maximum engagement of this muscle, the inflamed tissue is compressed, leading to pain in the groin.
Trochanteric bursitis, or inflammation of the bursa on the outer hip, is less likely to restrict the range of motion needed for dressing but can still be aggravated by the movement. Deep hip flexion and rotation place increased tension on the tendons and muscles that pass over this inflamed bursa, causing pain on the outside of the hip. The location of the pain—groin versus outer hip—often provides a clue to the underlying problem.
Immediate Strategies and Adaptive Solutions
Since pain is triggered by extreme motion, immediate relief can be found by modifying the dressing technique to avoid deep hip flexion. Instead of pulling the foot toward the chest, try crossing the ankle of the affected leg over the opposite knee while sitting in a sturdy chair. This position uses external rotation, which may be more comfortable than internal rotation for certain conditions, and reduces the degree of forward bending required.
Adaptive equipment is often the simplest and most effective solution for maintaining independence. A sock aid is a device, usually a plastic trough with long cords, that holds the sock open and allows the user to pull it onto the foot without bending over. Similarly, a long-handled shoehorn eliminates the need to reach down for footwear, and a reacher tool can assist with pulling up pants or retrieving dropped items.
Before attempting to put on socks, a gentle warm-up can prepare the hip joint for the task. Performing small, non-painful range-of-motion movements, such as seated ankle circles or gentle hip rotations, can temporarily improve joint lubrication and muscle flexibility. Always perform these movements slowly and within a comfortable range, stopping immediately if sharp pain is felt.
Medical Treatment Pathways and Red Flags
When hip pain interferes with daily activities like dressing and persists despite home modifications, seeking a professional diagnosis is necessary for long-term resolution. The initial diagnostic pathway includes X-rays to visualize bone structure, which can confirm conditions like advanced osteoarthritis or bony abnormalities associated with FAI. Further imaging, such as an MRI, may be ordered to assess soft tissues, including the labrum, tendons, and bursae.
Treatment for hip mechanical issues begins with conservative measures, including non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. Physical therapy is recommended to strengthen supporting hip and core muscles, improving joint stability and allowing movement within a non-painful range. Targeted injections, such as a corticosteroid delivered into the joint or bursa, can provide significant, temporary pain relief and serve as a diagnostic tool.
Certain “red flag” symptoms warrant immediate medical attention, as they may indicate a severe injury or infection requiring urgent intervention. These symptoms include a sudden inability to bear weight on the affected leg or a visible deformity of the hip joint. Other urgent signs are intense, unremitting pain, especially at night or at rest, and any sign of infection, such as fever, chills, or warmth and swelling around the hip.