Hip Pain After Running: What Runners Must Know
Hip pain after running is common, and the most frequent cause is overload — but arthritis, muscle strains, stress fractures, and nerve entrapment all present the same way. Runners with hip pain need a thorough assessment and often imaging, such as X-ray or MRI, for an exact diagnosis. Catching it early stops a niggle from becoming a chronic problem. This guide lists the common causes of hip pain after running and how to tell them apart.
For why running brings on hip pain in the first place, see our companion guide on hip pain from running; to find your pain by location, use the hip pain location diagram.
Muscle pulls and tears.
Acute pain in the front and inner groin often means an adductor muscle tear — sudden groin pain, difficulty walking, sometimes swelling or bruising. Most settle with physiotherapy; only a complete tendon tear needs surgery.
Hip labral tear
A hip labral tear involves the cartilage rim of the socket, usually from twisting or repetitive stress, and is linked to hip conditions such as impingement or dysplasia. Treatment is usually conservative — physiotherapy, sometimes an ultrasound-guided cortisone injection — with surgery reserved for certain tears.
Hip osteoarthritis
Hip arthritis wears the cartilage of the socket, exposing bone and causing inflammation and pain. Treatment runs from medication and physiotherapy to injections and, eventually, hip replacement.
Hip bursitis (greater trochanteric pain syndrome)
Greater trochanteric pain syndrome, often called hip bursitis, causes outer-hip pain from overload of the gluteal tendons. Activity modification and exercise usually suffice; injections help complex cases.
Osteitis pubis (pubic overload)
Osteitis pubis inflames the joints, bones, and tendons of the pubic symphysis, common in change-of-direction sports. It causes groin pain on one or both sides with weakness and limping, and usually settles with physiotherapy.
Iliopsoas tendonitis
Iliopsoas (hip flexor) tendonitis causes front-of-hip pain during sports that involve repeated hip flexion — dance, track, gymnastics. It’s often overdiagnosed, so we rule out other causes first. Treatment is usually conservative.
Piriformis syndrome
Piriformis syndrome — spasm of a deep buttock muscle near the sciatic nerve — causes buttock pain with sciatic-type leg symptoms. Physiotherapy comes first, then an ultrasound-guided injection if needed.
Hip stress fracture
A hip stress fracture is most common in long-distance runners, typically at the femoral neck or pelvic bones. A neck-of-femur stress fracture matters because it can progress to a complete fracture — so groin pain that worsens with running and lingers needs prompt assessment.
Hamstring tendonitis
Hamstring origin tendonitis causes buttock pain when sitting and running. We treat it with physiotherapy plus shockwave or an ultrasound-guided injection in stubborn cases.
Groin hernia
A hernia — inguinal, femoral, or a sports hernia — causes sharp groin pain and sometimes a lump with sport or coughing. Frequent or severe cases need surgery.
Gynaecological causes
In sportswomen, we also consider gynaecological causes such as ovarian cysts or endometriosis, especially when pain tracks the menstrual cycle or comes with heavy or irregular periods.
How do we diagnose hip pain after running?
A comprehensive history and examination of the back, hip, and groin come first. Imaging then clarifies the source: X-ray for the hip joint and pelvic bones, MRI for labral tears and tendon or bone problems, and ultrasound to assess tendons and guide injections. Sometimes, a diagnostic ultrasound-guided injection both confirms the source and relieves the pain.
Frequently asked questions about hip pain after running
Should I stop running if my hip hurts after a run?
Reduce rather than stop if the pain is mild and settles within a day. But stop and get assessed if the pain is sharp, worsens with running, wakes you at night, or makes you limp — these can signal a stress fracture, which, if you keep running, risks turning into a full break.
Why does my hip only hurt after running, not during?
Early tendon and joint problems often warm up during a run and ache afterwards once you cool down. As the problem progresses, pain tends to appear during the run too — a sign to get it assessed sooner rather than later.
How long should hip pain last after running?
A minor niggle should settle within a week or two of reduced load. Pain that persists beyond that or keeps returning deserves assessment to identify the cause and avoid a chronic problem.
Final word from Sport Doctor London about hip pain after running
Many conditions can cause hip pain after running, and sometimes more than one at a time. Don’t ignore it and hope it passes — see a doctor experienced in hip and groin diagnosis for an accurate cause and the right plan.
To book a one-stop assessment with Dr Masci in London, contact his team here or call +44 (0) 203 488 0350.
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