How to treat my hip pain after running?

Overview

Hip pain after running is a common issue that can stem from various factors such as muscle, tendon, or bone injuries. It may also be linked to weak core muscles, poor movement patterns, or an old injury. While some soreness is normal after intense exercise, persistent or severe hip pain indicates potential injury. Runners often experience this due to repetitive strain on the hip, which can lead to conditions like hip bursitis, where the bursa sac becomes inflamed. Tight hip muscles, especially the iliotibial band, and hip muscle weakness are common contributors. Fortunately, most cases of hip pain are treatable, and pain can be prevented through proper care, stretching, and strengthening exercises.

Why does my hip hurt after running?

Hip pain after running is a common issue many runners face, and the right guidelines can help you prevent it. There are several reasons why you might experience hip pain, ranging from muscle strains to more severe conditions like stress fractures. Below are the most common causes of hip pain after running and their symptoms.

Muscle strains

Muscle strains, often referred to as “pulled muscles,” occur when small tears develop in the muscle fibers. This can happen due to overuse, excessive training, or pushing your body beyond its usual limits. A key muscle prone to strain during running is the gluteus medius, which is located beneath the larger gluteus maximus. When strained, the gluteus medius often causes pain on the outside or back of the hip. Since this muscle plays a crucial role in absorbing shock each time your foot strikes the ground, any injury to it can lead to significant discomfort during or after running.

Strained muscles may also impact daily activities like climbing stairs, sitting for long periods, or jumping. Other muscles around the hip, like those that move the thigh forward or backward, can also be strained, though the pain may manifest in the front or back of the thighs instead of the hip itself.

Tendonitis

Tendonitis occurs when the tendons, which connect muscles to bones, become inflamed due to overuse. This condition is common in runners who increase their mileage or intensity without allowing enough time for recovery. Several tendons in the hip are susceptible to tendonitis, each causing pain in different areas:

• Hip flexor tendonitis: The hip flexors are critical for moving your leg forward during running, especially when sprinting or running uphill. Inflammation in this tendon usually causes pain at the front of the hip.
• Adductor tendonitis: These muscles stabilize the pelvis while running, and inflammation here often causes pain in the groin or inner thigh, particularly when running on uneven terrain.
• Hamstring tendonitis: Located at the back of the thigh, hamstring tendons can become inflamed during quick acceleration or sudden stops while running. This type of tendonitis often results in pain near the sit bones and can worsen with activities like squatting or prolonged sitting.

Bursitis

Bursitis is an inflammation of the fluid-filled sacs (bursae) that cushion the bones and tendons around your hip joint. Running’s repetitive motion can irritate these sacs, particularly in two key areas:

• Trochanteric bursitis: This affects the bursa on the outer side of the hip, causing sharp, localized pain that worsens with running, climbing stairs, or sitting for long periods. The pain often becomes more intense at night, especially if you lie on the affected side.
• Iliopsoas bursitis: This is less common but occurs in the front of the hip, near the groin. The inflammation in this area leads to groin pain, which may intensify with physical activity.

Labral tears

The hip joint is stabilized by a ring of cartilage called the labrum. Over time, repetitive movements like running can cause wear and tear on the labrum, leading to a tear. A labral tear typically causes a sharp, stabbing pain in the front of the hip near the groin. Other symptoms can include a sensation that the hip is locking or clicking, difficulty moving the hip, and a feeling of instability as if the joint might give out during activity.

Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease where the cartilage between the bones gradually wears down, causing the bones to rub against each other. Although OA is more common in older adults, younger runners can also develop the condition, particularly if they’ve had previous hip injuries like labral tears. Early symptoms of OA include stiffness and pain in the hip after weight-bearing activities such as running. Over time, the pain may persist even during rest, making everyday activities more challenging.

Stress fractures

A stress fracture in the hip is a tiny crack in the bone caused by repetitive impact, often from running long distances without adequate rest. Stress fractures typically develop in the femoral neck, near the ball of the hip joint. Runners with this condition often experience a dull, achy pain in the front of the hip or groin that worsens with activity but improves with rest. However, if left untreated, a stress fracture can worsen, leading to constant pain, even during non-weight-bearing activities.

Each condition presents its own set of symptoms, and recognizing the type of pain you’re experiencing can help diagnose the issue and find appropriate treatment.

How to fix hip pain from running?

Hip pain from running can be frustrating, but the good news is that there are several ways to treat and prevent it. The key is to address the issue early and follow a proper treatment plan. Below are some effective strategies to help manage and fix hip pain after running.

Strengthening hip abductor and external rotator muscles

To prevent hip pain, it’s crucial to strengthen the muscles responsible for stabilizing your hips, particularly the hip abductors and external rotators, which include the glutes. The hip abductors are a group of muscles located on the outer side of your thigh, responsible for moving your leg away from your body. The external rotators are a set of five muscles situated deep within the gluteal region. These short external rotators help stabilize the hip joint by keeping your pelvis and hips steady during activities like running. Enhancing the strength of these muscles, especially the glutes, improves your overall running form and reduces the strain on your hip joints, which helps prevent injuries.

Reduce the number or length of runs

Listening to your body is important if you’re experiencing hip pain after running. Reducing the frequency or distance of your runs can help manage symptoms and prevent further injury. Sometimes, taking a step back allows your body the recovery time it needs to heal.

Rest and ice therapy

Resting and applying ice to the affected area can significantly reduce inflammation and pain. Ice your hip for 15–20 minutes every one to two hours, especially after a run. This treatment works well for minor conditions such as hip bursitis or tendonitis.

Adjust sleeping position

If you experience hip pain after running, sleeping on your side can be uncomfortable. To reduce discomfort, lie on the non-painful side and place a pillow between your knees to keep your hips aligned.

Conservative treatment

Most hip pain from running cases can be treated conservatively if caught early. Some conservative treatment options include:

• Weight offloading: Stress fractures usually heal in six to eight weeks. During this period, keeping weight off the affected leg with crutches is crucial for recovery.
• Physical therapy: Another effective treatment is working with a physical therapist. They can help correct your running technique and address any weaknesses contributing to your hip pain after running.
• Over-the-counter pain medications: Medications like NSAIDs (Aleve, Advil, and aspirin) effectively reduce pain and inflammation. Acetaminophen (Tylenol) can also be used to manage discomfort.

Prescription medications and injections

If OTC medications aren’t enough, prescription-strength pain relievers or oral steroids may be necessary. Sometimes, your healthcare provider may inject corticosteroids directly into your hip to relieve inflammation caused by tendonitis, bursitis, or osteoarthritis. While effective, corticosteroid injections should be used sparingly, as overuse can damage tissues.

Hyaluronic acid injections may be recommended for hip osteoarthritis. These injections help lubricate the joint and reduce stiffness, making movement more comfortable.

Surgery for severe hip injuries

In more serious cases, surgery may be required. Severe muscle or tendon tears, labral tears, or advanced hip osteoarthritis might require surgical intervention to restore function or reduce pain. Surgery could involve repairing the tear or, in cases of severe arthritis, a total hip replacement might be necessary.

By addressing your hip pain after running early and following appropriate treatment protocols, you can return to your running routine while minimizing the risk of future injury. 

Can you continue to run with hip bursitis?

Yes, it is possible to continue running with hip bursitis, but it’s important to modify your approach to manage symptoms and reduce pain. One effective method is using a walk or jog interval program, alternating between walking and jogging. This approach helps to decrease the strain on your hips while still allowing you to stay active.

Modify running mechanics

Adjusting your running mechanics can also alleviate pain. Increasing your cadence (the number of steps per minute) and aiming for a softer, quieter foot strike will reduce the impact and stress on your hip bursae. These changes help minimize the load that your hips and core muscles need to absorb while running.

Cross-training options

If running continues to cause discomfort, consider alternative activities to maintain your fitness. Swimming is an excellent cross-training option that allows you to keep up your cardiovascular fitness without impacting your hips. It provides a full-body workout and gives your hips the rest they need from high-impact activities.

Strength and flexibility training

Improving your muscle strength and flexibility can also benefit your running routine. A physical therapist or rehab professional can help fine-tune these aspects, ensuring you can run more efficiently and manage your hip bursitis symptoms effectively.

What exercises are good for hip pain when running?

Gently stretching your hips can alleviate pain and enhance mobility, helping to prevent future hip pain when running. Incorporating specific stretches into your routine can support flexibility and reduce discomfort.

Butterfly stretch

This stretch targets the inner hips and groin:

• Sit on the floor and bend your legs, bringing the soles of your feet together.
• Allow your knees to fall outward toward the ground.
• Scoot your feet as close to your pelvis as possible, then lower your chest toward the floor.
• Bounce your knees up and down gently like butterfly wings for a deeper stretch.

Leg swings

Leg swings promote hip mobility and flexibility, especially after running:

• Stand next to a sturdy object (such as the back of a couch or rail) for support.
• Swing one leg across your body like a pendulum, ensuring your torso stays stable.
• After several swings, switch legs and repeat.

Lunge stretch

The lunge is an excellent stretch for hip flexors, which often become tight after running:

• Kneel on the ground and bring one leg forward so your thigh is parallel to the floor.
• Stretch your other leg behind you into a low lunge position.
• Keep your hips square and your chest lifted.
• Rock your hips gently forward and back to deepen the stretch, then switch legs.

Incorporating these stretches into your routine will help relieve hip pain and improve overall flexibility, allowing you to continue running comfortably.

How long does it take for a runner’s hip to heal?

The recovery time for a runner’s hip depends on the severity of the injury and the treatment approach.

• Minor injuries, such as muscle strains or mild cases of hip bursitis, can heal within a few weeks with rest, ice, and physical therapy.
• Moderate conditions, like tendonitis, may take longer, typically requiring several weeks to a few months for full recovery.
• Severe injuries, such as hip fractures or labral tears, often require more intensive treatment, potentially including surgery, and can take several months to heal completely.

Following a proper treatment plan and gradually reintroducing activity can help speed recovery and prevent re-injury.

How do I know if my hip pain is serious?

You should seek immediate medical attention if you experience any of the following symptoms:

• Acute hip pain caused by a serious fall or injury
• A deformed leg or visible signs of severe bruising or bleeding
• Inability to move your leg or hip
• Inability to bear weight on the affected leg
• Intense pain that doesn’t improve with rest
• Sudden swelling in the hip or surrounding area

These could be signs of a serious condition requiring prompt medical attention, such as a fracture, severe strain, or infection.

FAQs about hip pain after running