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Hip Dysplasia & Hip Instability

Adult hip dysplasia and hip instability are under-recognised causes of hip and groin pain. In simple terms, the socket may be a bit too shallow or the soft tissues too loose to give the hip its usual “contained” feeling. That can stress the labrum, capsule, and joint cartilage, leading to pain, clicking, or a sense of the hip not feeling secure.

 

This page explains how structural hip dysplasia and hip microinstability typically behave in adults, how they’re diagnosed, what conservative rehab can reasonably achieve, and when surgical options are discussed. It’s written for active adults in Camberwell and inner-east Melbourne who want clear, realistic guidanc.

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What you’ll learn on this page

  • How to recognise a hip dysplasia / instability pattern in adults

  • When X-rays, MRI, and specialist review are usually considered

  • Where physiotherapy, activity changes, and surgery each fit into the picture

Typical symptoms & patterns

“Hip dysplasia” means the hip joint is shaped in a way that offers less coverage or stability than usual, often a shallower socket (acetabular dysplasia). “Hip instability” covers a spectrum from clear structural under-coverage through to subtler microinstability from capsular laxity or soft-tissue factors.

 

Common adult patterns include:

  • Deep groin pain or aching at the front of the hip, sometimes with sharp “pinch” episodes

  • A feeling the hip is loose, sliding, or might give way, especially in certain positions

  • Clicking, clunking, or catching inside the hip with movement

  • Pain or fatigue with:

    • Walking longer distances or on uneven ground

    • Standing or sitting for long periods

    • Positions of deep hip flexion or rotation (e.g. cars, low seats, some yoga/gym moves)

  • Symptoms that may have been present for years and mislabelled as “hip flexor strain”, “groin strain”, or FAI only

 

Some adults with dysplasia also have early labral tears or cartilage wear, which can add to catching, sharp groin pain, or “giving way” feelings.

Why it happens

In hip dysplasia, the socket (acetabulum) is too shallow or maloriented to provide normal coverage for the femoral head. This reduces the bony stability of the joint and increases stress on the labrum and cartilage, especially at the edge of the socket.

 

Hip instability / microinstability can arise from:

  • Bony architecture – such as acetabular dysplasia or excessive femoral/acetabular version

  • Soft tissue laxity – generalised hypermobility, capsular stretching, or previous surgery

  • Muscle weakness or poor neuromuscular control, so the hip relies on passive structures more than it should

 

Over time this can contribute to:

  • Repeated labral irritation or tears

  • Edge-loading of cartilage and increased risk of earlier osteoarthritis in some people

  • Persistent feelings of insecurity, fatigue, and pain with everyday or sporting loads

 

Not everyone with dysplasia or microinstability will develop OA, but the risk is higher than in structurally normal hips, especially if symptoms are ignored.

When to see someone and when to scan

When to see a physio or GP

It’s reasonable to seek help if:

  • You’ve had hip or groin pain for months or years, especially if diagnosed as “hip flexor” issues that never fully settle

  • You feel your hip is loose, clunky, or not securely in the socket

  • Certain positions or activities consistently provoke a sense of instability or subluxation

  • You’ve been told you have a labral tear or “shallow hip” and you’re unsure what to do next

A physio with hip experience can help differentiate instability/dysplasia from FAI, tendinopathy, lumbar referral, GTPS, or hip OA, and can screen for red flags.

 

When imaging is useful (X-ray, MRI)

For suspected structural dysplasia/instability, weight-bearing X-rays are usually the first-line imaging to assess acetabular coverage and alignment.

MRI or MR arthrogram may be considered to look at:

  • Labral tears and cartilage

  • Capsular status or other intra-articular pathology

Imaging is particularly helpful when:

  • Symptoms are persistent and clearly hip-joint driven

  • You’re being considered for hip preservation surgery (e.g. periacetabular osteotomy) or arthroscopy

  • There’s diagnostic uncertainty or concern about other causes (e.g. stress fracture, tumour, infection)

 

When to consider specialist review

Referral to a hip preservation / orthopaedic surgeon is usually considered when:

  • There is confirmed dysplasia with significant symptoms and functional limits

  • Conservative management has been tried and symptoms remain clearly limiting

  • Imaging shows structural issues likely to progress or that might benefit from surgical correction (e.g. suitable candidacy for periacetabular osteotomy).

How we assess & plan at The Hip and Knee Physio (Camberwell)

​In your first consultation, we’ll typically:

  • Talk through your story – where the pain is, what brings it on, what you’ve tried so far, and what you want to get back to

  • Check how your hip and knee move under load – stairs, squats, step-downs, and walking or jogging patterns, within your tolerance

  • Test strength and control around the hip, knee, and ankle

  • Screen for other causes of hip pain (like labral injuries, tendon issues, or arthritis) and for any red flags that might need GP or specialist input

 

From there, you’ll leave with:

  • A clear explanation of what’s most likely driving your pain

  • A prioritised plan (not a long list of exercises) focused on load tweaks, key strength work, and technique changes

  • An idea of what progress might look like over the coming weeks, acknowledging that everyone responds at a different pace

 

If scans or a surgical opinion are appropriate, we’ll discuss that openly and liaise with your GP or orthopaedic specialist.

 

You can read more about broader hip care on the Hip Physiotherapy page and related blogs, then come back here when you’re ready to book.

FAQs –
Hip Dysplasia/ Hip Instability

1. Can hip dysplasia appear in adults even if it wasn’t picked up as a baby?

Yes. Some people have milder acetabular dysplasia that is not detected in childhood and only becomes symptomatic in adolescence or adulthood, often when activity loads increase.

 

Many adults report years of hip pain and multiple clinicians before a correct diagnosis is made.

 

2. Is hip instability the same as a dislocating hip?

No. Hip microinstability refers to subtle excessive movement of the ball in the socket that causes pain and a sense of looseness, but not necessarily full dislocation.

True dislocation is more dramatic and usually related to high trauma or significant structural problems.

 

3. Can physiotherapy fix hip dysplasia?

Physiotherapy cannot change bony shape or socket depth, but it can:

  • Improve muscle strength and control

  • Optimise posture, gait, and movement patterns

  • Reduce edge-loading and repeated pinching

 

For many people with mild–moderate dysplasia or microinstability, this can significantly improve pain and function, and may delay or reduce the need for surgery.

 

4. When should I consider surgery for hip dysplasia?

Surgery is usually considered when:

  • Structural dysplasia is confirmed on imaging, and

  • Symptoms are significant and activity-limiting, and

  • You’ve had an adequate trial of targeted conservative management, and

  • A specialist believes hip preservation or replacement is likely to improve long-term function

 

It’s a shared decision made with your surgeon, GP, and physio – not something to rush into based on an X-ray alone.

 

5. Will hip dysplasia or microinstability definitely lead to arthritis?

Not definitely, but the risk of earlier hip osteoarthritis is higher than in structurally normal hips, especially if there is ongoing pain, labral damage, or poor load management.

 

That’s why early recognition, sensible activity choices, and good strength/control work are important, whether or not surgery is ever needed.

Local practicals – Camberwell clinic

​The Hip and Knee Physio consults from 1/3 Prospect Hill Road, Camberwell, a short walk from Camberwell Junction and public transport. The building offers good access and facilities, including accessible entry and amenities, and there is parking available nearby.

Book Now

If you’ve been told you have a “hip dysplasia” or "hip instability" and you recognise this pattern of groin pain, catching, or clicking, and it’s starting to impact your sport or daily life, a structured assessment can help clarify your options.

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  • Book a hip dysplasia consult in Camberwell – Book Now Hip and Knee Physio

  • Prefer to talk first? You can contact the clinic to discuss whether an appointment is appropriate for your situation

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