Why Does My Hip Hurt After Running?

Hip pain often occurs with running. While some level of soreness is normal after exercising, pain can also mean that you have injured yourself. Hip pain can be caused by injury to your muscles, bone, tendons, or other structures in your hip.

This article discusses the most common causes of hip pain after running, factors that contribute to these injuries, what the typical symptoms are, and how these injuries are treated.

Common Causes of Hip Pain After Running

Hip pain after running can be caused by a variety of conditions, and some are more serious than others.

Muscle Strains

Muscle strains, or "pulled" muscles, can occur from running. This injury results when tiny tears develop in your muscles from too much training or running farther or faster than you are used to.

For example. straining your gluteus medius muscle, located under your large buttock muscle called the gluteus maximus, can cause hip pain. You will most likely feel this pain on the outside and/or back of your hip. This muscle is important for absorbing shock when your foot hits the ground while running.

A gluteus medius injury can also cause pain during other daily activities, such as climbing stairs, jumping, and sitting for long periods of time.

Other muscles that move your hip can be strained with running, but they might not cause pain in your hip. Muscle strains typically affect the widest part of these muscles, causing pain along the front or back of your thighs.

Tendonitis

Tendonitis is one of the conditions that can cause hip pain after running. This condition is caused by inflammation in your tendons—the structures that attach your muscles to your bones. Typically, this happens if you run longer distances than you're used to, or if you aren't taking enough rest days to allow your muscles to fully heal between exercise sessions.

Tendonitis can affect several different tendons in your hip, including:

• Hip flexors: These muscles move your leg forward and are heavily used while running. These muscles must work extra hard when you're running uphill or sprinting. Hip flexor tendonitis typically causes pain at the front of your hip joint.
• Adductors: These muscles move your leg in toward your body. When you're running, they help to stabilize your pelvis and thigh bone (the femur). Adductor muscles are more active when you are running uphill or downhill or when you are sprinting. Adductor tendonitis causes pain in your groin and inner thigh.
• Hamstrings: Your hamstrings are a group of three muscles on the back of your thighs. These muscles come together and attach at one tendon to your ischial tuberosity—the bone that you sit on. Running-related hamstring tendon injury often occurs when you are pushing off the ground, or if you come to a sudden stop while running. Pain can also occur with prolonged sitting, squatting, and lunging.

Bursitis

Bursae are fluid-filled cushions that are located around the joints throughout your body. These structures can become inflamed from repeated pressure or friction, causing a condition called bursitis. There are two bursae that can cause hip pain after running.

The iliopsoas bursa is found on the front of your hip, near your groin. The trochanteric bursa is located behind the boney point of your hip that can be felt near the top of your thigh, below your pelvis.

Trochanteric bursitis causes pain right at its location (the hip). This condition can cause pain with running, climbing stairs, squatting, and standing up from a chair after you've been sitting for a long period of time. However, pain from trochanteric bursitis is often worse at night—particularly if you roll onto the affected hip.

Iliopsoas bursitis is less common and causes pain in the groin area.

Labral Tears

Your hip is a ball-and-socket joint. The ball at the top of your femur fits into a socket on your pelvis. The labrum is a ring of cartilage that runs around the edge of the socket to help stabilize your joint.

Tears in the labrum can occur from wear and tear during repetitive activities, such as running. These injuries usually cause sharp pain in the front of the hip, near your groin. Other symptoms can include difficulty moving your hip, feeling like your hip is going to give out, clicking in your hip joint, or feeling like your hip is locked up.

Osteoarthritis

Osteroarthritis (OA) is a condition that occurs when the cartilage, or padding between bones in and your joints, gradually wears away. Ultimately, your bones can rub against each other causing severe pain.

OA develops over time and is more common with older age. It also tends to run in families. You are also more likely to have OA in your hip if you've had other hip injuries, including labral tears.

Early on, you might only notice pain only after weight-bearing activities, such as running. Your hip might be stiff after you've been sitting for a while, or when you first get up in the morning. Eventually, pain can also occur even when you aren't active.

Stress Fracture

Hip stress fractures are cracks in your bone that develop from repetitive stress—such as running. Most commonly, these occur near the ball at the top of the femur rather than in the socket of your hip joint.

Symptoms of a hip stress fracture include an achy-type pain in the front of your hip and groin. This pain gets worse with walking or running, but it improves with rest. However, severe stress fractures can cause pain all the time.

How Are Hip Injuries From Running Treated?

There is a variety of treatments for treating hip pain after running. Treatment depends on the extent of your injury and the how long you have had your symptoms.

Conservative Treatment

Many injuries that cause hip pain after running can be treated conservatively, particularly if you address your symptoms early. Treatments include:

• Ice and rest: Mild muscle strains and tendonitis can often improve if you avoid running for a week or two. You can apply ice to your hip for 15–20 minutes at a time every one to two hours to help decrease pain and inflammation. Gentle range-of-motion exercises can also decrease stiffness that occurs with these conditions.
• Keep your weight off it: Stress fractures take longer to heal—about six to eight weeks. You will have to keep weight off your leg during that time with crutches.
• Physical therapy: Physical therapy is a common treatment for hip pain after running. A physical therapist will treat your symptoms but also analyze your running technique to see if there are weakness in other areas of your body that are contributing to your hip problems.
• Over-the-counter (OTC) pain medications: Medications can also help relieve hip inflammation and pain after running. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen), Advil (ibuprofen), and Bayer (aspirin), are available without a prescription. Tylenol (acetaminophen) can also help reduce pain.
• Prescription medications: In some cases, prescription-strength pain relievers or oral steroid medications are also used to treat hip injuries.

Injections

If oral medications are not effective, your healthcare provider might choose to inject medications directly into your hip. Corticosteroids are strong anti-inflammatory medications that are frequently injected to treat conditions such as tendonitis, bursitis, and osteoarthritis.

Typically, these medications begin to work two or three days after the injection. However, they are not always effective, and can only be performed two or three times in the same area. The overuse of steroids actually can cause further damage to your tissues.

Hip osteoarthritis can also be treated with hyaluronic acid injections. This substance helps to lubricate the hip joint and decrease stiffness that often occurs with this condition.

Surgery

Severe hip injuries might require surgery. Significant muscle or tendon tears need to be repaired to restore full function. Labral tears that don't respond to conservative treatment might require surgery to smooth out frayed edges that are causing issues with your joint.

Advanced osteoarthritis in the hip is often treated with surgery, such as debridement (cleaning up rough edges) or a total hip replacement.

How Can I Prevent Hip Injuries?

While there's no surefire way to prevent hip injuries from running, there are steps you can take to decrease your risk, including:

• Warm up: Do five to 10 minutes of low-intensity activity prior to starting your run to increase blood flow to your muscles.
• Stretch: Perform leg stretches after your run (when your muscles are already warmed up) to improve flexibility.
• Add some strength training: Perform resistance training exercises two times per week to strengthen the muscles used during running to help prevent fatigue-related injuries.
• Follow a training schedule: Vary your distance and speed during your weekly running workouts and schedule regular rest days to allow your muscles to recover properly.

Summary

Hip pain after running can be caused by many different conditions, such as muscle strains, tendonitis, bursitis, labral tears, and osteoarthritis. Treatment depends on the severity of your injury. Symptoms can sometimes be managed with activity modification, medications, and physical therapy. More severe injuries or conditions can require surgery. Your risk of hip injury can be reduced with proper warm-ups, stretching, strength training, and proper training.

A Word From Verywell

If you have hip pain after running, don't ignore your symptoms and hope they will just go away. Having a "no pain, no gain" attitude can lead to significant injuries. If your symptoms don't resolve after rest and other conservative measures, consult your healthcare provider or physical therapist. If you have severe pain, difficulty moving your leg, or are unable to bear weight on your leg, seek immediate medical attention.