Hip Pain After Running

Hip Pain After Running

In this article, we review some of the most common causes of hip pain in runners along with their symptoms, treatments, and prevention.In most cases, you can reduce the pain with the right exercises.

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Juhi Modi Medical Writer
Medically reviewed by 

Hip Pain After Running

Runners occasionally have to deal with injuries – it’s an “occupational hazard,” even when you’re smart with your training. One of the most common symptoms of injury in athletes, especially runners, is hip pain.

Often hip pain can be exacerbated if you continue running. That’s why it’s important to know what’s going on. At Injurymap, we understand how frustrating hip pain can be for runners. We are here to help you better understand the most common causes of hip pain after running and how to deal with it.

There are many different reasons for the hip to hurt during and after running. The cause of the hip pain determines when the pain occurs (during or after running or both). It also affects the location of the pain (inside, outside, in the thigh or groin) and other associated symptoms such as stiffness and/or reduced range of motion.

Injurymap is here to help you deal with running-related hip pain with this comprehensive guide. Remember, if your symptoms are severe or persistent, you should always seek medical care.

Hip joint anatomy

The hip is a ball-and-socket type of joint – the largest of its kind in the body. The “ball” in the joint is a knob-like protuberance at the top of the thigh bone. This ball fits into a socket or cup-like indentation in the pelvic bone.1 A cartilage called the labrum lines the joint. There are many muscles, tendons, and ligaments that attach to the bones and allow the hip joint to go through a range of motions, including:

Movement

  • Flexion (bending the leg toward the trunk)
  • Extension (moving the leg behind the body)
  • Adduction (moving the leg sideways toward the body)
  • Abduction (moving the leg sideways away from the body)
  • Internal rotation (twisting the thigh inward so that the toes point away from the body)
  • External rotation (twisting the thigh outward away from the rest of the body)

Many of these movements are activated when you run. Flexion and extension are needed to move the legs forward and back. Rotation stabilizes the hip joint and improves running form.

Types of hip joint injuries

The hip joint is designed to allow for smooth movement of the leg. It is a large joint that can withstand a fair amount of wear and tear. When you run, various structures (cartilage, bursas) help the joint move without friction. The hip joint is not immune to injury. Runners are especially prone to different types of damage. The muscles and tendons can be overused. The cartilage can get worn down or damaged. Bones can break due to a fall or injury2. Any of these injuries can cause hip pain in runners.

The Injurymap app has a range of exercises for the hip that strengthen the muscles around the joint and help avoid such injuries.

If you are a runner and have hip pain, it’s important to understand what could be causing the discomfort and how to get relief. You don’t have to live with discomfort or stop running due to hip pain. Here are five of the most common causes of hip pain in runners along with their treatment and prevention.

1. Trochanteric bursitis

Causes

A bursa is a fluid-filled lubricating sac that reduces friction between bones, tendons, and muscles. There are about 150 bursae located near the various joints in the body. The trochanteric bursa, located at the tip of the thigh bone, allows the hip joint to move smoothly. Frequent repetitive motions, such as running, can cause this bursa to become irritated and inflamed.3 Bursitis is a common cause of hip pain.

Trochanteric bursitist

Symptoms: What does Trochanteric bursitis feel like?

The pain from Trochanteric bursitis is usually located outside the hip or thigh and worsens with activities like running, walking, going up stairs, and getting out of a car or deep chair. Trochanteric bursitis pain may be worse at night from lying on that side, which puts pressure on the area.3 A hallmark sign of Trochanteric bursitis is tenderness to touch on the side of the hip.4,5

Is it ok to run with Trochanteric bursitis?

Trochanteric bursitis is often an overuse injury (it can also sometimes occur due to trauma, such as a fall on the hip). If you suspect your hip pain is due to bursitis, it’s a good idea to reduce mileage or stop running for a short period of time. If you do decide to continue running, proceed with caution and run only if it does not worsen the pain.6

Treatment / relief

The mainstay of Trochanteric bursitis treatment is rehab exercises to strengthen and stretch the hip muscles. It’s recommended to start with gentle stretching exercises and doing strengthening exercises when the sharp pain reduces.

Other treatments include icing and pain medications to manage symptoms. In some cases, an injection of steroid and local anesthetic may be recommended for pain relief. Surgery is the last option for recalcitrant Trochanteric bursitis, during which the surgeon takes the pressure off the bursa or removes the bursa itself.5

Recovery time and prevention

While you are recovering from Trochanteric bursitis, you may need to change your activity to one that does not worsen symptoms, for example, swimming. A mildly inflamed bursa can improve in a few weeks. A significantly inflamed bursa can take a few months to get better.7

To prevent recurrence, always remember to warm up and stretch before a run. Physical therapy exercises can effectively heal Trochanteric bursitis and strengthen the joint to prevent future injuries.5

2. Hip flexor strain

Causes

Hip flexors are muscles that allow us to bend and lift the leg, kick high, and bend at the waist. A strain in the hip flexors is a stretch or tear in these muscles due to overuse.8 It is a common injury in athletes, especially those who jump, run, or participate in activities that involve forceful kicking, such as soccer.

Symptoms: What does strain of hip flexors feel like?

The most common symptom of strain in the hip flexor muscles is pain in the area where the thigh meets the trunk.

Hip strain

Is it ok to run with hip flexor strain?

It is recommended to stop doing activities that cause pain to give the muscles a chance to heal. If you want to keep up with your training, you may need to go swimming, or cycling instead of running.8

Treatment / relief

Physical therapy stretching and strengthening exercises can help strained hip flexor muscles to heal.8 Regular stretching keeps the muscles loose and can help prevent injuries.

There are several effective stretches for hip flexors that can be performed standing, kneeling, and lying down. Icing and pain medication may also help if the hip flexors are strained.

Recovery time and prevention

Mild strains usually heal within a few weeks. More severe strains can take 6 weeks or longer to improve.8 The key to preventing strains in the hip flexor muscles is to do warm-up exercises before running. It’s also important to perform strengthening exercises to keep the muscles from getting injured.

3. IT band syndrome

Causes

The IT (iliotibial) band is a thick band of fibrous tissue that runs along the outer thigh from the pelvis to the calf, crossing both the hip and knee joints. IT band syndrome is a condition that is closely linked to hip bursitis and occurs when the IT band is too tight, leading to friction near the hip and causing inflammation and pain.

IT band syndrome is a common overuse injury among runners and can affect both new and seasoned runners. A sudden increase in the level of activity, such as an increase in mileage, increases the risk of IT band syndrome in runners9. Wearing worn-out shoes and running downhill are other risk factors.1010

Symptoms: What does IT band syndrome feel like?

Symptoms of IT band syndrome are similar to hip bursitis and include pain and discomfort on the outer side of the leg. The pain typically increases with activity. Some people experience a clicking or rubbing sensation.

Is it ok to run with IT band pain?

The best way to treat IT band pain is to rest the hip by running shorter distances or completely stop running. Without rest, IT band syndrome can become chronic (longstanding). While taking a break from running, you can continue training with other activities like swimming, cycling, and rowing.10

Treatment / relief

IT band syndrome is treated with rest,, stretches, icing, anti-inflammatory medications like ibuprofen, and a temporary reduction in training. Steroid injections may be prescribed in more severe cases. Exercises and stretches can help prevent IT band syndrome and keep it from getting worse.

Recovery time and prevention

Preventive measures for IT band syndrome include proper conditioning, warming up and stretching before and after running, and gradually increasing mileage. You should always wear proper shoes. Talk to your trainer about possibly shortening your running stride if the problem is recurrent.9 Complete healing from IT band syndrome usually occurs in about 6 weeks.

4. Iliopsoas tendinitis

Causes

The Iliopsoas is a muscle located deep within the hip. The Iliopsoas tendon is a band of tissue that attaches the muscle to bone. Overuse can lead to a pull on the tendon and cause it to become inflamed and painful. Iliopsoas tendinitis is common in runners who increase their mileage or do speed work1 Other activities that predispose to Iliopsoas tendinitis include dancing, ballet, cycling, rowing, soccer, and gymnastics.1111

Iliopsoas tendinitist

Symptoms: What does Iliopsoas tendinitis feel like?

The pain from Iliopsoas tendinitis is present on the front of the hip or groin and may radiate down toward the knee. It typically occurs with lifting up the leg, getting out of a car, and walking up stairs.12 The pain is usually gradual in onset. It may occur after a specific aggravating activity and resolve when the activity is stopped. As the condition progresses, the pain may be present during both activity and rest.

Is it ok to run with Iliopsoas tendinitis?

As with most soft tissue injuries, the return-to-running program for Iliopsoas tendinitis is pain-mediated, i.e., you should gradually return to running as pain allows. The tendon needs time to heal. This can take from a few days to a few weeks, depending on the severity of the injury.13 When you start running again, you should gradually build up speed and mileage.

Treatment / relief

The goal of the treatment for Iliopsoas tendinitis is to reduce inflammation and pain. This can be accomplished with rest, ice application, and physical therapy consisting of stretches and range of motion exercises. Pain medications and steroid injections may also work to decrease pain and inflammation. In rare cases, a minimally invasive (keyhole) surgery may be needed if other treatments have not been effective.12

Recovery time and prevention

Recovery from Iliopsoas tendinitis can take a few weeks. A progressive hip strengthening program with rehab exercises can help reduce stress on the Iliopsoas muscle and prevent future problems.13

5. Hip labral cartilage tears

Causes

The hip labrum is a strong, flexible cartilage that lines the socket of the hip joint. A tear in this cartilage can occur due to repetitive high-impact sports like running.14 Like many running injuries, labral tears can occur due to running too much without enough strength training exercises to make the legs strong.15

Labral tear

Symptoms: What does a hip labral tear feel like?

In runners, symptoms usually appear gradually over many months and consist of pain in front of the hip, around the side of the hip, or in the groin area. The pain is typically a deep, dull ache at rest and a sharp, stinging pain during running.14 There may also be a clicking, catching, or locking sensation. Some runners also experience hip instability (a feeling that the leg is about to give way) when running.14

Is it ok to run with a hip labral tear?

Running puts a lot of stress on the hip. Before you return to running or any high-impact activity, you should make sure your muscles and tendons are strong. This will ensure they can absorb the impact of running and prevent the joint from getting injured. If you have a tear in the hip labrum, it’s a good idea to focus on strengthening exercises for some time and let running take a back seat.15

Treatment / relief

Nonsurgical treatments for a hip labral tear include rest, pain medicines, steroid injections directly into the hip joint, and physical therapy. Exercises to strengthen the buttocks, thigh, and back muscles and improve hip stability are a safe and effective treatment for labral tears. If conservative measures do not relieve symptoms or the labral tear is severe, a doctor may recommend surgery.14

Recovery time and prevention

Symptoms of hip labral tear typically improve in 10 to 12 weeks with rehabilitation exercises. One of the best ways to prevent this injury from occurring is proper stretching, warm-up, and strengthening. When runners have strength and endurance in the legs, hips, and core, they reduce the risk of injuring the labrum and the rest of the hip joint.

Exercises to relieve hip pain after running

Strengthening exercises can help prevent hip injuries and hip pain in runners. Experts recommend starting a session by warming up and increasing the intensity and frequency of your rehabilitation exercises. It’s recommended to check with a physician before starting any new exercise program. Here are some examples of exercises that can help prevent injuries and hip pain in runners.

  1. Hip flexor strengthening with exercise band I
    10 reps x 3 sets

    This browser does not support the video element.

    • Tie an exercise band to a solid object.
    • Stand with one leg in front of the other and the exercise band around the ankle of the back leg.
    • Stand on the opposite leg and support yourself by placing your hands on a chair if necessary.
    • Pull the leg with the exercise band forward in front of the body as if you have to kick a ball with the outside of your foot.
    • Perform 3 sets of 10 repetitions with each leg.
  2. Hip bend I
    5 reps x 3 sets

    This browser does not support the video element.

    • Sit on a chair with your legs bent.
    • Keep your back straight by tightening your stomach and back muscles.
    • Keep one leg bent 90 degrees in the knee and lift it up into the air so that it is completely free of the chair.
    • Keep the other leg relaxed on the floor and avoid using it to push away from the floor.
    • Push down on the thigh with as much force as possible while being able to hold the position for 10 seconds.
    • Perform 3 sets of 5 repetitions in each direction.
  3. Inner hip stretch
    30 sec. x 3 sets

    This browser does not support the video element.

    • Take a broad stance with your toes pointing straight ahead.
    • Keep one leg stretched while you bend the other leg and slide your body over the outstretched leg.
    • Hold the stretch for 30 seconds and perform 3 repetitions with each leg.

Red flags: When to see a doctor about hip pain?

Minor hip pain can often be relieved by rest, pain medicines, icing, and rehab exercises. However, in certain situations, it is important to seek immediate medical attention. You should see a doctor about hip pain when:12,17

  • The hip pain interferes with normal daily activities.
  • The symptoms do not improve despite self-treatment.
  • There are recurrent or repeated bouts of pain.
  • The hip joint appears deformed.
  • You cannot move your leg or hip.
  • You cannot bear weight on the affected leg.
  • The pain is intense.
  • There is sudden swelling around the joint.
  • You have signs of infection, such as fever, chills, and/or tenderness.

Running has many benefits, but it can also cause injuries that lead to hip pain. Your hip pain should not keep you from doing what you love – running. The Injurymap app offers several rehab exercises to improve conditioning and strength and heal the injury causing the pain. Injurymap makes rehabilitation and strengthening exercises accessible to you in your home, allowing you to perform them at your convenience so you can continue running without that nagging pain in your hip.

Treat your pain with Injurymap

Download the app to get a customized program that addresses your specific pain with exercises.

About the author

Juhi Modi has two decades of experience as a medical writer with varied interests and an enduring passion for health, biology, and science. She uses her educational background in medicine to write science-backed articles for clients around the world

References:


  1. https://www.runnersworld.com/advanced/a20820002/my-hip-hurts/ 

  2. https://www.webmd.com/pain-management/guide/hip-pain-causes-and-treatment#1 

  3. https://my.clevelandclinic.org/health/diseases/4964-trochanteric-bursitis 

  4. https://www.ncbi.nlm.nih.gov/pubmed/8642885 

  5. https://runnersconnect.net/bursitis-pain-running/ 

  6. https://www.milesplit.com/articles/218073/hip-bursitis-for-runners-is-a-painful-but-easily-remedied-injury 

  7. https://www.summitmedicalgroup.com/library/adult_health/sma_trochanteric_bursitis/ 

  8. https://www.summitmedicalgroup.com/library/adult_health/sma_iliopsoas_tendonitis/ 

  9. https://www.upmc.com/services/sports-medicine/conditions/it-band-syndrome#overview 

  10. https://www.runnersworld.com/health-injuries/a19576110/iliotibial-band-syndrome/ 

  11. https://emedicine.medscape.com/article/90993-overview#a7 

  12. https://arthrohealth.com.au/psoas-tendinopathy/ 

  13. https://runnersconnect.net/psoas-and-hip-flexor-injuries-in-runners/[^14:] https://www.sports-health.com/sports-injuries/hip-injuries/coping-hip-labral-tears 

  14. https://www.runnersworld.com/health-injuries/a29425202/hip-labral-tear/ 

  15. https://www.webmd.com/fitness-exercise/features/hip-tendonitis#1 

  16. https://www.mayoclinic.org/symptoms/hip-pain/basics/when-to-see-doctor/sym-20050684