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Hip Pain After Running – Causes and Treatments

Do you often get hip pain after running? It’s more common than you may realize and it can happen for a variety of reasons.

If you continue to run on a painful hip without taking steps to fix the underlying problem, you may be open to worse injury. It’s in your best interest to find the cause of the pain so you can go ahead and treat it appropriately.

Let’s have a look at some of the causes and treatments of hip pain after running.

Why Do You Feel Pain in Your Hip After Running?

Hip pain is common in runners and has many different causes!

The hip is the largest multiaxial joint in the body, and it’s surrounded by large muscles, tendons, and ligaments.

Working together, they support the hip so that it can provide a wide range of motion. This includes making large or small circles of movement, bringing the leg up above the level of the waist, and moving the leg towards or away from your body.

When you run, your hips provide both balance and drive, while a huge amount of force is being exerted through the hips.

But if your hips aren’t moving effectively because of weak core strength, muscle imbalances in the legs, poor movement patterns, or compensatory patterns, it can place excessive stress on the joint.

This can lead to inflammation of the soft tissues or swelling around the joint, which can cause pain in your hip.

It could also be that your hips are tight, making them less flexible, which can place the joint under strain causing pain.

Most Common Causes of Hip Pain in Runners

In most cases, overuse is the main cause for hip pain after running, as the muscles, tendons, and ligaments become overworked.

Overuse can lead to a variety of conditions that can cause runners to experience hip pain after a run, and unfortunately diagnosing it isn’t always straightforward.

The following are the four most common causes for hip pain in runners:

1. Hip Bursitis

Causes

Bursitis is caused by overuse, or a tight hamstring or iliotibial band, which leads to the bursa becoming irritated and inflamed.

But it can also be caused by underlying factors, such as poor running form, differences in leg lengths, and repetitive motion.

The repetitive motion of running can put the bursa under excessive pressure, causing them to become inflamed and painful.

Bursa are small, fluid-filled sacs that are located between the soft tissues and bones. They help cushion and reduce friction as the muscles, tendons, and ligaments glide smoothly over bone.

Your hip has two major bursa, with the one covering the bony knob of your hip—trochanteric bursa—where the upper thigh curves outward, and the other—the iliopsoas bursa.

The iliopsoas bursa is located in front of the hip beneath the iliopsoas muscles on the inside—groin side—of the hip.

The repetitive motion of running can put the bursa under excessive pressure, causing them to become inflamed and painful.

Symptoms

If you’re experiencing pain in the groin region or the front of the hip that radiates down the front of your thigh to the knee, then it’s possible that you have Iliopsoas bursitis.

At first the onset of pain will be gradual, but if left untreated the symptoms will get worse. It could start out as stiffness in the morning that subsides throughout the day.

You’ll find that the pain will increase when you get up from a seated position, walk up stairs, or bring your knee up to your chest.

The area around the iliopsoas bursa may be swollen and can be tender to the touch. To try and reduce the symptoms of pain, you may find yourself limping or taking smaller steps than usual.

With trochanteric bursitis, you’ll experience pain on the outside of your hip or thigh but the pain usually extends to the buttocks as well.

When the symptoms first start, the pain can be sharp and intense and over a few days it can become more of a dull ache that’s spread across a large area of the hip.

The pain may increase when you apply pressure to the outside of the hip. You may notice that the pain is worse at night, especially when you’ve been lying on the affected hip.

But the pain can also get worse if you’ve been sitting for a while and get up, if you do a lot of walking, or while you climb stairs.

Treatments

The best way to treat hip bursitis is to take a break from running for a few days or until you feel better.

Apply ice several times throughout the day to the affected area, as this will help alleviate pain and reduce inflammation.

Depending on the severity of your pain, you can take over-the-counter non-steroidal anti-inflammatories as needed. With that being said, if the pain is severe and you’re battling to walk, then your doctor may recommend corticosteroid injections.

You’ll want to take it slow after an injection and you can start gradually building up to your normal activity level after a week.

If there’s a difference in leg lengths, then you may want to look at getting fitted for an insole, as this will reduce the load on the bursae.

2. Stress Fractures

Causes

Stress fractures develop gradually from repetitive microtrauma to the hip that leads to cracks developing in the bone.

They usually occur near the ball at the top of the femoral neck—femur—from overuse, running in worn-out shoes or shoes that don’t provide adequate support, or a sudden increase in running time or intensity.

You may be more susceptible to developing a stress fracture if you have a medical condition such as osteoporosis or a vitamin D deficiency.

Running frequently on hard surfaces like concrete or asphalt will also increase your risk for developing a stress fracture.

It would be best to see your doctor if you suspect that you have a hip stress fracture. If you ignore it and the stress fracture gets worse, this can lead to a displaced fracture.

A displaced hip fracture can cause the blood supply to the bone to be cut off or reduced, causing severe damage to bone, such as hip osteonecrosis or bone death. To help avoid this, it helps to wear good shoes for hip pain.

Symptoms

If you have a stress fracture, you’ll experience pain and discomfort in the groin as well as the front part of your thigh. This pain will get worse if you hop or run on your affected leg.

The pain will subside with rest and you may find that you’re able to run pain-free on some days, while on other days, the pain is so severe you have to stop running.

But with that being said, if you ignore the pain, the stress fracture will get worse and the pain will then become persistent.

Treatments

If you have a stress fracture, you’ll need to stop running and rest for about six to eight weeks.

Depending on the severity of the stress fracture, you may be able to do low-impact cross-training such as swimming or using a stationary bike to maintain your fitness level.

Your doctor may recommend that you use crutches to reduce the stress that’s placed on the hip for a few weeks.

Once the stress fracture has healed, you may have to go to physical therapy to help correct any muscle imbalances or biomechanical issues that could cause the excessive loading of your hip.

3. Cartilage Tears

Causes

The socket of your hip joint is called the acetabulum, and it has a ring of cartilage called the labrum on the outside rim.

The labrum plays an important role in keeping the ball and socket joint together and it cushions the hip joint. When you move the hip joint, it reduces friction and lets the femoral head move smoothly.

A labral tear is most often caused by overuse from repetitive motion like long distance running, wear and tear of the joint, structural abnormalities of the hip joint, or traumatic injuries.

But you may be more prone to a labral tear if you have extra bone in the hip, which is known as femoroacetabular impingement—FAI—that repeatedly pinches the cartilage when you move.

You may be at an increased risk to tear the cartilage if you have a shallow socket or dysplasia, where the socket doesn’t fully cover the ball portion of the femur.

Symptoms

You may experience a deep, dull ache when you’re resting and a sharp, burning pain in the groin and buttocks area when you walk or run.

The hip may also feel stiff, as though it’s “catching” on something, or you may hear a clicking sound coming from the hip area when you move.

You may feel as though your hip joint is unstable or that you feel unsteady on your feet. The pain may get worse if you’ve been sitting, standing, or walking for a long period.

But with that being said, some people may not have any symptoms with a hip labral tear.

Treatments

It’s important to note that hip labral tears won’t heal on their own, but it’s possible to manage the symptoms of a minor tear.

You would need to rest your affected hip and you can take over-the-counter pain medications like ibuprofen—Motrin or Advil— to reduce inflammation.

If you have severe pain, your doctor may recommend a corticosteroid injection into the hip joint to help alleviate the symptoms.

Your doctor may recommend that you see a physical therapist, who can provide you with exercises and stretches to strengthen the surrounding hip muscles.

This will help stabilize the hip joint, increase your range of motion, and it may help alleviate the pain.

With that being said, if your symptoms get worse or if the tear is severe, then your doctor may recommend surgery.

In most cases, it’s a minimally invasive surgery known as arthroscopic surgery, which allows you to go home the same day it’s done.

4. Iliopsoas Tendonitis

Causes

Iliopsoas tendonitis is often caused by the overuse of the muscle that’s located deep within the hip.

The iliopsoas tendon plays a vital role in raising your knee, as it’s the strongest flexor of the hip joint which raises your knee.

It’s located in front of the hip joint and can become irritated and inflamed with repetitive movements such as running. This would be caused by overuse of the Iliopsoas muscle, which would pull on the tendon, leading to inflammation and pain.

You may develop Iliopsoas tendonitis if you’ve suddenly increased your mileage, running longer distances, or doing speed work. You can also develop the condition if you don’t take enough rest days to allow your muscles to heal between runs.

Symptoms

With iliopsoas tendonitis you’ll have a deep, aching pain in the front, inside of your hip in the crease. You’ll experience pain when you walk or run, and your hip may feel weak.

You may also notice a clicking sensation or sound when you lift your knee up and flex your hip.
The pain may increase or be sharp after you’ve been sitting or standing for a prolonged time.

Treatment

The best thing you can do if you have iliopsoas tendonitis is to rest your leg as much as you can. You can also apply ice to the affected area, as this will help to reduce inflammation and pain.

Your doctor may recommend that you see a physical therapist who will guide you through a number of range of motion exercises and stretches to help alleviate the symptoms.

You can also take over-the-counter pain medications like ibuprofen to alleviate pain and reduce inflammation.

In severe cases, your doctor may recommend steroid injections to alleviate the symptoms.

However, if that doesn’t decrease the pain and inflammation, then your doctor may recommend a minimally invasive surgery.

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