Hip pain is a common condition that plagues many runners.[1] Running places a major strain on the structure of the hips, resulting in muscle tightness or pain. If the pain goes untreated, hip injury may follow. The treatment of hip pains depends on the cause of the pain.
Symptoms of hip pain in runners
The symptoms of hip pain vary depending on what structure in the hip has been damaged. Common symptoms include groin pain, loss of movement, swelling over the hip, tenderness to the touch, limping or an inability to put weight on the hip, and difficulty sleeping on the painful side.[2]
What causes hip pain in runners?
There are many reasons hip pain can develop. Some hip pain is temporary, while other pain may be long-standing or chronic. Previous injuries, running with the wrong shoes, or tightness of muscles in the back or legs may also contribute to the development of hip pain.
Other common causes of hip pain in runners include:
1. Tendonitis
Tendons are the thick bands that connect the muscles to the bones. Tendonitis is inflammation or irritation of the tendons. Tendonitis develops as a result of overuse of the muscles that surround the hip. Although any of the tendons surrounding the hip can become inflamed, the most common type of tendonitis is iliotibial band syndrome.
Tendonitis is typically treated with the application of ice a number of times a day. Non-steroidal anti-inflammatories such as ibuprofen may also be prescribed to reduce the pain and inflammation. In severe cases, you may consider consulting a physiotherapist who will treat the tendonitis with massage and hip mobilisation, and prescribe stretches and strengthening exercises to improve the hip function.
2. Iliotibial band syndrome
The iliotibial band or ITB is the tendon that runs from the side of your hip and connects just below your knee. Running can cause this band to become tight, which creates a burning sensation in the hip and sometimes in the knee.[3] You may also hear a clicking or popping sound when you move.
The treatment for iliotibial band syndrome is similar to tendonitis. Ice and non-steroidal anti-inflammatories may be prescribed, and you may need to visit a physiotherapist. In addition to massage and hip mobilisation, your physiotherapist will prescribe glut (buttock) strengthening exercises and stretches for the muscles on the outside of the hip. Your physiotherapist may also suggest using a foam roller to roll the tendon to reduce the tightness.
3. Muscle strain
Repetitive activities like running put strain on the muscles that surround the hip joints. When they become inflamed due to overuse, they cause the hip joint to become tight and prevent normal hip movement.
In order to treat a muscle strain, you will have to rest from running activities until the pain has improved significantly. Ice the area a few times a day, and take nonsteroidal anti-inflammatories to reduce the inflammation. Visit a physiotherapist, who will release the tightness of the muscle through massage or other manual therapy techniques, and prescribe stretches and strengthening exercises.
4. Bursitis
Bursae are fluid-filled sacs that prevent the tendons of the hip from rubbing on the underlying bones. Tight muscles and tendons compress the underlying bursa, causing pain and inflammation, a condition known as Bursitis. There are two different types of bursae - trochanteric bursae, which lie on the side of the hip, and the iliopsoas bursae, which lie on the front of the hip.
If you suspect you may have hip bursitis, rest from any running activities. Ice the area a few times a day and take non-steroidal anti-inflammatories such as Ibuprofen. Visit a physiotherapist who will release all the tight muscles in the area and prescribe specific stretches and strengthening exercises.
5. Hip Labral Tear
The labrum is the ring of cartilage that surrounds the hip joint, providing cushioning and stability. It also secures the top of the thigh bone into the socket of the hip. Repetitive movements such as running may cause a tear in the labrum, resulting in pain and sometimes clicking, or a catching sensation when you move. Other symptoms include hip stiffness and feeling unbalanced on your feet.
If you suspect a labral tear, you should visit your doctor, who may refer you for further investigation, including X-rays, and possibly an arthroscopy. Corticosteroid injections non-steroidal anti-inflammatories may be prescribed. You will also have to visit your physiotherapist. If you do not see an improvement, surgery may be required.
6. Stress Fractures
Stress fractures often occur at the neck of the femur (just below the hip joint) and are due to overtraining. They can be partial or full breaks and are felt as severe pain in the groin when weight is put on that side.
If you feel you may have a stress fracture, visit your doctor immediately. Your doctor will perform a thorough medical examination and will send you for X-rays. However, stress fractures do not always show up on an X-ray. Sometimes an MRI is the only way to assess whether a stress fracture is present. Surgery will only be required if the fracture is displaced. You will need to wait until the fracture has healed before returning to any sport.
7. Arthritis
Osteoarthritis and rheumatoid arthritis are common causes of hip pain, especially among older runners. Arthritis is essentially the result of inflammation in the joint that leads to the breakdown of the cartilage that cushions the bones. Arthritis causes pain and stiffness in the hip that is often felt in the groin.
The treatment of arthritis should start as early as possible. Your doctor will prescribe anti-inflammatory medications and physiotherapy to improve the mobility and flexibility of the hip. Severe cases of arthritis may require surgery.
Preventing hip pain in runners
As they say, prevention is better than a cure. While it is not always possible to prevent hip issues from running, you should act fast if you notice tightness or any niggles around your hips. Other ways to prevent hip pain include:
-
Taking a break from running if you are experiencing hip pain. When you feel better, start gradually increasing the distance and intensity of your running. The key is to start slowly - many running injuries recur when you jump back into your usual running routine too quickly.
-
Warming up and stretching before and after you run.
-
Wearing the correct footwear. Not all shoes are right for all feet. Find shoes that suit your feet and enhance your running. You may want to consult a specialist such as a podiatrist to ensure that you are wearing the correct running shoes, or to prescribe orthotics, if necessary.
-
Performing specific strengthening exercises for your gluteal muscles (buttock muscles), core stabilisers, quadriceps (thigh muscles), and lower back.
-
Consulting a running coach who will provide you with a specific training program to prevent injury. They will also give you specific running exercises to help strengthen the correct muscles for optimal performance.
Outlook
Hip pain can be debilitating and frustrating for anyone, especially runners who are used to an active lifestyle. Running can lead to different types of hip pain, including degenerative conditions like arthritis, muscle strains and tendonitis, bursitis, and even stress fractures. Your doctor will likely prescribe non-steroidal anti-inflammatories, ice, and recommend that you rest until you have pain-free hip movement. You can prevent hip pain by stretching and warming up before you run, in addition to performing specific strengthening exercises. You should also ensure that you are wearing the correct footwear and you may consider consulting a running coach to provide training advice.
