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, to be used for preventing injury and strengthening the area:
“Lie on your back on the edge of a table or high bed and drop the outside leg off the edge. Lunging with the back leg fully extended will also stretch the hip flexors. An easy way to strengthen the hip flexors is to perform leg lifts. Leg weights or use of a sports cord will add resistance.”
If you have an ache near your groin or the front of your hip that worsens after your run, you could be suffering from femoral acetabular impingement (FAI). FAI is particularly serious and requires physical therapy or even surgery to resolve. Active.com explains the cause of this condition: “FAI occurs when the ball of the hip joint doesn’t fit into the socket; the grinding tears the cartilage lining the socket.” Painful, certainly. Though it can be fixed.
Knee and hip pain from running
One of the most common causes of hip pain from running, and pain in general from running, is ITB or iliotibial band syndrome. The iliotibial band is a length of connective tissue that connects the hip to the shin bone. On its way, it hits two bony protuberances: one on the hip and one on the knee. Dr. Lewis Maharam on New York Daily News explains how this can lead to pain:
“Loose ITBs slide harmlessly past the two obstructions. Tight ones rub against them, get irritated, and react with a sharp pain on the outside of the knee or hip that usually does not become bothersome until a couple of miles into your workout.”
Dr. Maharam’s article goes on to describe a very thorough and valuable stretching routine for this particular type of hip pain from running.
Other causes of hip pain when running
Other causes of hip pain from running can come down to sports injuries or chronic conditions. Read more on each of these conditions on our website:
- Hip tendonitis
- Hip osteoarthritis
- Sports injuries, such as groin pulls and tears and hamstring strains
Other conditions that can lead to hip pain, but originate elsewhere include Achilles tendonitis, plantar fasciitis, or patellofemoral pain syndrome.
With all injuries, the most important thing you can do it take time off from running so you don’t worsen your condition. From there, you can talk to a doctor for the best treatment for hip pain from running for you.
Treatments for hip pain from running
At-home treatments for hip pain from running are your first line of defense. At the first twinge of pain, try these techniques to reduce pain or further injury.
- Rest for a few days; don’t push through the pain
- Ice the painful area and take non-steroidal anti-inflammatory medications to calm inflammation
- Try cross-training by swimming or cycling after your rest period
- Once you get back to running, always perform a proper warm-up and cool-down using the stretches described below
- Perform stretching and strengthening exercises to build up flexibility and strength around the hip
- Rethink your routine by incorporating new trails or programs to correct imbalances
- Self massage painful areas with tennis balls or a foam roller
- Consider having a professional assessment of your running gait to check for imbalances or problem areas
- During your gait analysis, ensure that you’re wearing the right shoes for you and your level of training
6 hip pain stretching routines for runners
These stretches for hip pain from running are among the best online, and can go a long way to helping you prevent or manage pain. These are all great options to prevent hip pain from running from occurring in the first place. They may also be useful if you have mild and intermittent hip pain from running and are used in combination with rest and icing to treat the pain. However, if you have hip pain that is moderate to severe, or chronic in nature, it’s always best to talk to a doctor for help.
- Hip strengthening exercises to reduce hip strain from Everyday Health
- A five-stretch routine from LiveStrong.com to improve strength and open up the hips
- Hip strengthening exercises from Active.com that focus on loosening hip flexors and strengthening hip muscles
- Exercises specifically made for long-distance and endurance runners from Athletico.com
- Strengthening hip pain exercises from Runners Connect
Finally, this video from Running Injury Free Revolution discusses how to use a foam roller to treat hip pain from running.
Treatments for chronic or severe hip pain
If mild stretching and rest don’t help with your hip pain, or if the pain is moderate to severe, it’s important that you talk to a doctor. Your doctor can diagnose the source of your pain and give advice on specific ways to treat your pain. They may recommend working with a sports chiropractor, physical therapist, or sports massage therapist. They may also recommend active release techniques. In many cases, these therapies can effectively treat and reduce any future occurrences of hip pain from running.
For more severe cases of hip pain, your doctor may recommend hip injections. A hip injection is a quick outpatient procedure that consists of injecting an anesthetic and combination steroid into the affected area. A hip injection is a procedure that can be used to diagnose the cause of your pain and help provide pain relief. Its especially useful for cases of hip osteoarthritis and other chronic conditions.
Finally, some conditions and injuries may require surgery. Your doctor will work directly with you and try less invasive therapies before pursuing this option.
If you suffer from hip pain from running and are ready to talk to a doctor in your area, click the button below. A specialized pain doctor can help you reduce your pain and get back on the trail. Pain isn’t normal. There are things you can do today to help relieve your pain tomorrow.