Hip pain is common after running. The most common cause of hip pain after running is due to overload syndromes, but other reasons, such as hip joint arthritis, muscle strains, and nerve trapping, are also to blame.
Runners with hip pain require a thorough assessment and imaging such as X-ray and MRI scans to get an exact diagnosis.
Generally, we recommend runners pay attention to hip pain when it first begins to prevent it from becoming a chronic issue. So, we’ve listed the common causes of hip pain after running and how you can diagnose it quickly.
Muscle pulls and tears
Acute pain in the front and inner aspect of the groin is often due to a tear of the adductor muscles. Symptoms include sudden pain in the inner groin, difficulty walking, and localised swelling or bruising. Usually, most cases involve a tear of the adductor muscle. However, the tendon can be pulled off the bone. In severe and rare cases, Treatment is generally physiotherapy except in a complete tendon tear, which needs surgery.
Hip labral tear as a cause of hip pain after running
Generally, a hip labral tear occurs when the cartilage of the edge of the hip tears. These injuries occur due to an acute twisting injury or repetitive stress on the hip joint. Also, labral tears are associated with specific hip shapes, such as hip impingement or hip dysplasia.
Overall, treatment is usually conservative, including physiotherapy. Other treatment options include an ultrasound-guided cortisone injection. However, certain types of labral tears may need keyhole or open surgery.
Hip osteoarthritis as a cause of hip pain after running
Hip arthritis occurs when the smooth cartilage of the hip socket wears down, leaving bone-on-bone exposure. This bone contact leads to inflammation and pain. Treatment of hip arthritis includes medication, physiotherapy, injections, and hip replacement surgery.
Hip Bursitis
Hip bursitis, also known as greater trochanteric syndrome or trochanteric bursitis, is a common cause of pain outside the hip. Bursitis occurs due to an overload of the tendons on the outside of the hip. Generally, simple treatments such as activity modification and exercise therapy are usually adequate. However, in complex cases, injections can be used.
Osteitis pubis (pubic overload)
Osteitis pubis, also known as pubic overload, is a term used to describe inflammation of the joints, bones, and tendons of the pubic symphysis. Sports involving a repeated change of direction, such as hockey, rugby, and football, can place excessive pressure on these structures. Usually, sportspeople present with pain in the groin on one or both sides with associated weakness and limping.
Generally, this condition is managed with physiotherapy. Occasionally, we inject into the pubic symphysis joint or tendons.
Iliopsoas tendonitis
Inflammation of the large hip flexor tendon also called the iliopsoas tendon, causes pain at the front of the hip. Sports involving repeated hip movements, such as track and field, dance, and gymnastics, can lead to overload and inflammation of the tendon. This condition is often overdiagnosed, and other causes of hip pain are often the culprits.
Generally, treatment is conservative with exercise therapy and medications. Occasionally, a cortisone shot into the psoas tendon sheath can help.
Piriformis syndrome
The piriformis is a small muscle at the back of the hip joint close to the sciatic nerve. We think that spasm of the piriformis muscle causes buttock pain and sciatic nerve irritation with numbness and pins and needles down the leg. Therefore, we name this condition piriformis syndrome.
Generally, we recommend physiotherapy followed by an ultrasound-guided muscle injection if there is no improvement.
Hip stress fracture
Stress fractures of the hip are more common in long-distance runners. Bone stress occurs due to the breakdown of bone from excessive running. Common locations include the femoral neck and the pelvic bones. Neck of femur stress fractures is important to diagnose because of the risk of a complete fracture.
Usually, treatment consists of rest from activity and a slow return to running guided by your doctor.
Hamstring tendonitis
The large hamstring tendon attaches to the hip bone at the start of the buttock. Overload of the tendon or hamstring tendonitis causes pain in the buttock while sitting and running.
Generally, we suggest physiotherapy combined with either shockwave or an ultrasound-guided cortisone injection.
Groin hernia as a cause of hip pain after running
A hernia is a small hole in the abdomen wall leading to an outpouching of fat or abdominal contents. This outpouching causes sharp pain and a lump with sport or coughing. Examples include inguinal, femoral or umbilical hernia.
If symptoms are frequent or severe, then we suggest surgery.
Gynaecological causes of hip pain after running
We must consider gynaecological causes such as ovarian cysts or endometriosis as a cause of hip pain in sportswomen. Usually, pain is associated with the menstrual cycle and can occur with excess bleeding or irregular periods.
Final word from Sportdoctorlondon about hip pain after running
There are many possible causes of hip and groin pain in runners. Sometimes, there may be more than one cause. Therefore, seeing a doctor specialising in diagnosing hip and groin pain at the first visit is essential.
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