If you’ve laced up your running shoes this spring, you may have noticed an unwanted companion on the trail: hip pain. Since the hip joint plays a crucial role in balance, momentum, flexibility, and power during running, it is one of the most reported areas of pain for runners. Strength imbalances, hip alignment issues, injuries, and other chronic pain conditions can all play a role in causing hip pain. Luckily, there are ways to prevent and manage hip pain from running. We’ll discuss what causes hip pain and then talk about the six stretching exercises that could help you, as well as more advanced pain management options.
10 causes of hip pain from running
Hip pain from running can be difficult to diagnose, because many of the causes share similar symptoms. The hip is also a complex joint, so pain in the hamstrings or back of the leg could actually indicate issues in the hip.
The most common causes of hip pain from running include:
- Strength imbalances
- Hip alignment issues
- Hip bursitis, either trochanteric or iliopsoas
- Piriformis syndrome
- IT band syndrome
- Hip flexor strains
- Femoral acetabular impingement (FAI)
- Groin pulls or tears
- Hip tendonitis
How hip pain from running occurs
The hip is a ball and socket type joint. The “socket” is called the acetabulum, a shallow bowl-like feature that forms the pelvis. This lines up with the top of the femur, a “ball”-like mass of bone. These structures are coated with protective cartilage material. Cartilage is a resilient, flexible material similar to connective tissue. In addition, structures containing synovial fluid surround the joint. These protect the joint by reducing friction from direct contact between bony surfaces, act as a shock absorber, and blunt impacts on the joint.
Hip pain from running occurs when there are damage, disorders, inflammation, or injuries to any of these tissues or bones that comprise the hip joint.
Common forms of hip pain when running
The most common causes of hip pain from running occur due to strength and flexibility imbalances in the body. They can lead to hip alignment issues, or strains or tears that result in pain. Hip alignment issues in particular lead to more strain and force on one hip more than the other. This can even create a functional leg length discrepancy, as one leg overcompensates and experiences a greater impact and force, while the other “shorter” leg can experience issues related to plantar fasciitis or Achilles tendonitis.
Hip, or pelvic, alignment issues have a number of causes. They can be caused by:
- Poor posture, or leaning more to one side both during running and throughout the day
- Favoring one leg over the other due to prior injuries
- An improper running technique
- Running shoes that don’t work for you
- Cambered roads
Active.com describes one of the more prevalent causes of hip alignment issues: running on cambered roads:
“Since we have all been taught to run (or walk) against traffic, we tend to go to the left (in the U.S.) side of the street. This causes our left leg to have to reach down a little farther than our right, since roads have a slight camber to help water drain off.”
Thankfully, these causes of hip pain from running are generally easy to resolve with rest, careful attention, hip pain stretches, and strengthening exercises. We’ll describe some hip pain stretches and exercises later in this post, but for mild cases of hip pain, it’s important to check out your shoes, check out your form, and check out your route. If you’re following the same trail every day, try hitting a different road or track, or run against traffic to help fix the discrepancy.
Pain on the outside of the hip
If you feel pain on the outside of the hip during or after running, it could be due to hip bursitis. Hip bursitis has two forms: troncharetic and iliopsoas. You’ll feel troncharetic bursitis as an aching or burning sensation on the outside of your hip while running. Iliopsoas bursitis presents as a clicking or snapping sensation when the hip flexes. RunnersWorld.com explains the effects and treatments for hip bursitis:
“Bursitis is caused by overuse, or a tight hamstring or iliotibial band (the ligament that runs along the outside of the thigh). You may feel a dull ache, burning, rubbing, or popping sensation on the outside of your hip. Initially pain appears during or after a run. Reduce your mileage, stretch your hamstrings and ITB after a run, apply ice, and take anti-inflammatories.”
Our video on hip bursitis explains other options for treatment if rest and stretching don’t help.
Pain in the back of the hip
Hip pain from running that is felt in the back of the hip and radiates down the leg and up into the lower back could be caused by piriformis syndrome. Other symptoms of this condition include:
- Pain that gets worse after prolonged periods of sitting
- A dull and achy pain located in the buttocks
- Numbing sensations within the feet
- Pain walking up stairs or a hill
- Difficulty walking or running
- Reduced range of motion within the hip joint
- Abdominal pain, pelvic pain, or groin pain
- Muscle spasms
- Pain during bowel movements
- In women, pain during intercourse
“The piriformis is a small muscle that runs from the sacrum to the outside of the hip. For a small muscle it can cause big problems when inflamed or overused. Because it runs over the sciatic nerve, the piriformis has a nasty habit of putting pressure on this nerve and causing exquisite pain in the glute and posterior hip area when it swells or spasms. Aside from addressing any mechanical issues that might be exacerbating the problem the main way to treat piriformis syndrome is by stretching the muscle out as much as possible.”
At the end of this post, we’ll give more resources for hip pain stretches you can try at home or under the guidance of a physical therapist.
Pain on the front of the hip
There are numerous causes of hip pain from running that is felt on the front of the hip, including:
- Stress fracture
- Hip flexor strain
- Femoral acetabular impingement (FAI)
Run And Become explains how a stress fracture occurs:
“A stress fracture can occur in the neck of the femur (femoral neck) as a result of overtraining, or as a result of incorrect training, using inappropriate footwear. A stress fracture is a break in the bone and it can be a partial break or complete break. It can be felt as groin pain when performing any weight-bearing activity.”
If you’re suffering from a stress fracture, it’s important that you rest and stop activity until you talk to a doctor. Stress fractures are insidious and take time to manifest symptoms, but they typically present as a dull ache either in front of or behind the hip.
Hip flexor strains can be a particularly difficult injury to treat. You’ll feel it as a stab near your leg crease while running, and it will hurt more when you lie down and pull your knee to your chest. They are typically caused by tight hip flexors or a backwards slippage of the foot that occurs when running on a slick surface, such as snow. RunnersWorld.com recommends these particular hip flexor stretches,