Hip Pain And Running: Causes, Treatments, And Prevention

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Getting to the bottom of hip pain while running or post-run can be difficult, but knowing the root cause is essential to treating it properly.

Hip pain can be a sign of an injury to the hip joint, or it could be pain from an injury somewhere else. But because the hip is where the two most significant parts of your running anatomy meet—the legs and the core—it’s a good idea to find the root cause of your hip pain.

Here’s what we know about how the hip functions while running, common causes of hip pain, and our tips for treating and preventing hip pain.

How the Hip Functions During Running

The hip is a ball-and-socket joint, meaning you get an enormous range of motion. During your running stride, the hip plays a big role in propelling you forward and stabilizing you as you run.

When your foot is on the ground, your hip is flexed, adducted, and internally rotated. This is a safe position for impact absorption and adds an element of stability to your body. At this point, however brief, the hip is supporting your body weight.

As your foot leaves the ground, the hip extends as your push-off foot is behind your body. Once the foot starts to come forward, the iliopsoas muscle flexes the hip joint to bring the leg forward.

The hips play a significant role in energy transfer from the upper to the lower body. They also absorb some shock and impact your balance.

The glutes, quads, and hamstrings are all involved in hip movement. Your hip flexors are another important muscle that help you move at the hip. Weakness or tightness in any of these muscles can change your gait, resulting in injury and reduced running efficiency over time.

Common Causes of Hip Pain in Runners

Hip pain can have many causes. Finding out what’s behind yours is the first step to treating and preventing it from happening.

Overuse Injuries

Overuse – i.e. running too much, too soon – is one of the most common reasons for hip pain during and after running. Without enough time to rest in between workouts, the hip takes on enormous amounts of pressure, which can injure the tissues, muscles, and tendons in and around your hip.

This is most common in new runners or runners upping their mileage to train for a half or full marathon. When you suddenly increase the number miles you run, your body can’t adapt fast enough. We advise a slow, steady build-up with rest weeks when increasing miles.

Muscle Strains and Tears

If you experienced a sudden, sharp pain in your hip while running, it’s possible you strained or tore a muscle. It may be accompanied by swelling and bruising in the area and difficulty walking. This is more common in the front and inner hip/groin.

In many cases, you’ll continue to ache even when not running, and it will get worse when you increase your activity intensity. This warrants a visit to the doctor or physio before you try to run through the pain.

Tendonitis

If you’re feeling pain just below your glutes in the hip, it could be tendonitis of the large hamstring tendon. RICE, physiotherapy, and rest from running for a short time could be the best way to treat this.

Bursitis

Bursitis often causes pain on the outside of the hip. It occurs when the bursae, small fluid-filled bubbles that cushion the joints, become inflamed, often due to the overloading of the tendons or ligaments they protect.

Stress Fractures

If the pain is inside your hip, it could be a stress fracture. This is a potential cause if you run on hard, unforgiving surfaces, and it can be exacerbated if your shoes aren’t supportive or cushioned enough.

If you suspect a stress fracture, see a doctor immediately. Continuing to run may make it worse, and with a stress fracture, you’re already looking at six to eight weeks of healing. Stick to low-impact forms of exercise until you can confirm if a stress fracture is what’s causing your pain.

Hip Impingement

Hip impingement happens when the ball and socket of the joint become misaligned and restrict movement. In some cases, this is due to abnormal joint movement, but in others, bone spurs form on the joint, preventing it from moving through its full range of motion.

Surgery may be the best option, but your physician will confirm. You may be able to open up your range of motion with focused exercises and stretches, but you’ll need a professional opinion on what treatment is best.

Improper Footwear

Wearing shoes without shock-absorbing cushioning can cause the hip joint to be jarred, leading to pain and damage. Shoes that don’t support your feet properly can also allow your gait—from your feet to your hips—to move out of alignment, causing pain.

Symptoms: When to See a Doctor

Before attempting any kind of home treatment, see a medical professional if you:

  • Have pain that radiates from the hip to the back, thigh, or the knee
  • Feel or hear a clicking or snapping sound in the hip when you move
  • Have swelling, redness, or warmth to the touch in the hip area
  • Can’t walk or run with your usual posture due to pain or range of motion
  • Feel instability in the hip joint or like you can’t put weight on it
  • Continue to feel pain even when you’re at rest

How to Treat Hip Pain

Try these treatment options to reduce pain, ease inflammation, and help your hip recover quickly.

Immediate Care: The R.I.C.E Method

After your run, ice your sore hip and rest it for at least a few hours. You can also apply compression if you have an appropriate piece of gear for your hip. This alone eases the pain in your hip quite effectively.

Nonsteroidal Anti-Inflammatory Drugs

If you have a lot of pain, you can use NSAIDs to relieve it and lower inflammation. However, we recommend NOT running while on pain medication, as it can cause you to push yourself too hard and worsen any injury.

Physical Therapy

If your hip pain is severe or doesn’t ease up within a few days of rest, it might be worth visiting a physiotherapist.

Not only will they be able to work with you to assess a possible cause and figure out the best treatment, but they’ll be able to give you stretches and exercises to do at home.

Stretches for Hip Pain

Stretching is essential to keep the muscles, ligaments, and tendons around the hip loose and pain-free. Consider incorporating a few stretches into your daily routine.

Hip Flexor Stretch

The hip flexor stretch is an essential stretch for anyone who spends a lot of time sitting. Kneel on the floor with one knee on the ground. Keep your chest up and your core tight.

Keeping your knee and foot firmly on the ground, move your body forward until you feel a stretch in the front of the hip of the knee on the floor. You don’t want to feel pain—just a slight stretch.

Hold it here for 30 to 60 seconds. Then, slowly move back to the starting position and repeat three times on each side.

Butterfly Stretch

Sit on the ground, keeping your back straight. Bring your feet together so their soles touch each other and your knees are out to the side. Bring your feet as close as possible to your pelvis and lower your torso, aiming to bring your chest as close to the ground as possible.

Gently push your knees downward, but don’t force them if it’s painful. Push them as far as they can, then leave it there. Over time, your range of motion should improve.

Iliotibial Band Stretch

Lie on your side, with the bottom knee bent to help keep you stable on the ground. Grab the ankle of your top foot and pull it towards your buttocks like a quad stretch.

Then, lift the bottom foot and place it on the knee of the top leg. Using your foot, gently pull the knee downwards towards the floor. You should feel the stretch in the side of the kneecap, where the IT band crosses it.

Hold for 10 to 30 seconds and then let it go. Repeat the stretch three times on each side and as often as needed.

Piriformis Stretch

Lie on your back on a comfortable but firm surface. Bend both your knees and place our feet flat on the floor. Cross one of your legs over the other, resting your ankle bone on the thigh, just above the knee, where it’s comfortable.

Wrap your hands around the thigh of your bent knee and pull it upwards towards your chest. The leg that’s on top should feel a deep stretch near the buttocks.

Hold for up to 60 seconds and then release for a short while. Perform this stretch three times on each side for best results.

How to Prevent Hip Pain from Running

Once you’ve figured out how to treat your hip pain, the key is to take action to prevent it so you don’t have to treat the same problem again. Here are some steps you can take to make sure your hip pain doesn’t come back.

Warm Up and Cool Down Properly

Skipping your warm-up means you might be going into your run with cold, unprepared muscles. Don’t let this be a potential problem—just 5 minutes of light walking and dynamic stretching can get the blood flowing and warm up the muscles.

Cooling down also allows the body time to flush out waste products that accumulate due to exercise. Don’t just sit or lie down after your run—walk slowly for 5 minutes to give your body a chance to relax.

Gradual Increase in Intensity and Mileage

Increasing the intensity of your runs or upping your mileage (or doing both!) can put a lot of strain on your body. Increase one or the other at a time, and try to increase by no more than 5 or 10 percent per week.

This will give your body time to adjust so your tissues, joints, and muscles can ease into the new activity level without being overwhelmed.

Wear Supportive Shoes

Your shoes make a big difference in how running affects your joints. You need adequate cushioning to absorb shock because the impact force on every step can travel up to the hip and cause pain.

You also need shoes that support your foot. If you’re an overpronator, you’ll need a stability shoe that stops your foot from rolling inwards. This rolling motion can twist the leg from the foot to the hip, causing it to move unnaturally and strain the hip joint.

Investing in the right shoes for hip pain—enough support, enough cushioning, and a sturdy heel counter—can make a big difference to your hip pain.

Check Your Running Form

Every runner should assess their form regularly, as you might not even notice if it’s starting to slip a little. You can ask a friend to videotape you running and assess it later, use an app, or invest in the services of a professional coach.

Being mindful about your form can help you to maintain it as you run. Make sure you’re not overstriding, which can place a lot of pressure on the hip joint. Your front foot should land underneath your pelvis, your core should be engaged, and your torso should be straight and tall.

Cross-Training

Cross-training between your runs gives your legs and hips a break from the high-impact force of running. Opt for low-impact forms of cross-training, like cycling, swimming, or rowing—you’ll get a great workout and strengthen your “running muscles” but without the added stress of impact.

Include Strength Training Exercises

Some strength training exercises can help build muscle in the glutes, quads, and hamstrings, stabilizing the hip joint and reducing the possibility of pain.

Here are some to try:

Glute Bridges

Lie on your back on a firm surface. Place each foot flat on the floor, with your knees bent and your hands by your sides, palms on the floor. You can use a small pillow or a rolled-up towel under your neck for extra support.

Squeeze your glutes and lift your pelvis off the floor. Be sure to keep your shoulders on the floor and keep your hands flat, but without pushing. You should feel the squeeze in your glutes.

Hold it for 5 seconds at the top, and then lower your pelvis slowly back to the floor. Repeat it 8 to 10 times.

Clamshells

Lie on your side on a comfortable but firm surface. Your knees should be bent together and have a firm resistance band around your lower thighs just above your knees.

Lift your top leg, rotating it outwards as high as it can. Make sure your torso doesn’t twist to help you with the movement. Pause momentarily at the top of the movement, then lower your knee slowly to the starting position.

Perform 8 to 10 reps on each side for 2 to 3 sets.

Fire Hydrants

Begin on the ground on all fours. Your hands should be underneath your shoulder joints, your knees should be underneath your hip joints, your spine should be neutral—not arched—and your neck should stay in line with your spine so you’ll be looking at the ground.

Lift your right knee up and out to the side. Take care not to rotate your torso—the leg is the only thing that should move. In case you were wondering about the name of this exercise, it’s because the movement is like a dog lifting its leg on a fire hydrant!

Keeping your core tight, lift your leg as high as it can go. The moment your torso starts to twist, bring it back down in a controlled way. Do 8 to 10 reps, 2 to 3 sets on each leg.

Single-Leg Romanian Deadlifts

This is a great exercise to increase hip mobility and improve balance. Stand on one foot with your knees soft—not locked out. You can do this without weight, but holding a dumbbell in your opposite hand is more effective.

Keep your core tight and your spine straight as you hinge at the hips. Bring your torso to a point parallel to the floor, and allow the hand with the weight to naturally travel out in front of your legs and your other leg to lift up behind you.

Contract your glutes and stand up, keeping your back straight. Do 2 or 3 sets of 8 to 10 reps on each leg.

Lateral Step-Up

Stand next to a box, bench, or high step. You’ll want some weight to this movement, so grab a dumbbell, weight plate, or anything with some weight behind it and hold it in front of your chest.

Make sure it’s not too heavy that you end up straining your shoulders, arms, and back muscles just holding it, but it should be heavy enough to add challenge to this movement.

Tense your core, place your foot on the box or bench to the side of you, and push up so you stand up straight on the platform. Then, lower yourself again, controlling the descent so you don’t just fall quickly and miss the muscle activation.

Do 8 to 10 reps on each side, for 2 to 3 sets in total. This works the glutes, the quads, and the hamstrings, and also improves your core strength, which in turn better support the hip joint.

Reverse Lunges

Stand with your feet about hip-width apart and tighten your core. Keep your hands on your hips, or if this makes you feel unstable, you can extend them out in front of you or to the sides for better balance.

Step backward with your right foot, a comfortable distance. Lower your body in a slow, controlled movement until your knees are at about a 90-degree angle. Try not to hit your lower knee on the ground as you come down, and try not to let your front knee travel over the line of your toes.

Then, pressing into the ground with the heel of your front foot, push yourself upwards to a standing position, bringing your right foot back to the starting position.

Perform 8 to 10 repetitions on each leg, all in a row or alternating between legs. Make sure to control every movement and keep your core tight throughout. You can also hold dumbbells if you want to add some resistance to this movement.

Standing Hip Abductions

Start by standing beside something you can use to support yourself—a wall or chair is ideal. Place your feet together and tighten your core, stabilizing yourself with one hand.

Lift your outer leg to the side, keeping it straight and your toes slightly pointed. Control the movement carefully and lift it as high as it will go without causing pain. Avoid leaning to the side as you do so.

Lower it again in a slow, controlled manner. Perform 8 to 10 repetitions. You should notice that the range of motion in your hip improves over time.

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AUTHOR

Ben is an avid road and trail runner, and has completed multiple marathons and ultras. A former running store owner, he now shares his knowledge and experience writing these articles.