Running loads the hip hard, and hip pain from running can come from the muscles, tendons, joints, or bones. What are the common causes of hip pain when running? Why does running trigger them, and how do we reach a diagnosis quickly? This guide focuses on the mechanism and the main culprits.

For a fuller list of causes you might feel after a run, see our companion guide on hip pain after running; to pinpoint your pain by site, use the hip pain location diagram.

Why does running cause hip pain?

Running is a repetitive, high-load activity. Each stride sends force through the hip muscles, tendons, joint, and bone. Loaded gradually, these structures adapt and strengthen. Loaded too fast — a sudden jump in mileage, intensity, or hill work, or too little recovery — they fatigue and become painful. So most hip pain from running is, at root, an overload problem. That’s why the fix usually starts with load, not rest alone.

Common causes of hip pain when running

Hip muscle pull or strain

Overloading a muscle causes microtears, swelling, and pain. The site tells the story: an adductor tear hurts in the groin or inner thigh, a gluteus tear in the outer hip or buttock. Hip flexors (iliopsoas, rectus femoris) and the upper hamstring are also commonly strained.

Hip tendonitis

Tendon overload from too much training or too little recovery affects three main groups:

Hip flexors (iliopsoas, rectus femoris): work hard running uphill or jumping; pain at the front of the hip.

Hip abductors (greater trochanteric pain syndrome): stabilise the hip during running; pain on the outer aspect of the hip.

Hamstring origin: works hardest late in a long run; buttock or posterior-thigh pain.

Hip arthritis

Hip osteoarthritis causes cartilage loss and bone-on-bone pain, mostly in older runners — though early-onset arthritis occurs in the thirties and forties. Expect stiffness after running first, then pain during impact as it progresses.

Femoroacetabular impingement

Hip impingement is a motion-related condition from an abnormally shaped ball-and-socket joint. Bony spurs pinch at the extremes of hip movement — exactly what running and jumping demand — causing swelling and pain.

Hip stress fracture

A hip stress fracture is a crack from repetitive load, most often at the femoral neck, but also the pubis and sacrum. Pain starts after activity and, as it worsens, appears with walking — sometimes with a limp. A neck-of-femur stress fracture needs urgent diagnosis.

Rarer causes

Nerve entrapment

Nerves from the pelvis and spine can become trapped, causing hip and groin pain: the pudendal nerve (buttock), obturator nerve (adductor and groin), ilioinguinal nerve (suprapubic, inguinal), and lateral femoral cutaneous nerve (outer thigh numbness). Scans are often normal, so we rely on diagnostic injections, nerve hydrodissection, or nerve conduction studies.

Referred pain from the spine and pelvis

Problems in the lumbar spine or sacroiliac joints can refer pain to the side or front of the hip.

Frozen hip

Frozen hip is a rare cause of pain and stiffness, like a frozen shoulder, and is a diagnosis of exclusion.

How do we diagnose?

A comprehensive history and examination of the structures around the hip come first. Investigations then clarify the source: X-ray for the hip joint and pelvic bones, MRI for labral tears and tendon inflammation, and ultrasound to assess tendon movement and guide accurate injections. When used well, ultrasound-guided injections both identify and treat the cause.

Frequently asked questions about hip pain from running

Can I run through hip pain?

Sometimes, if the pain is mild, it doesn’t alter your gait and settles within a day. Reduce mileage and intensity rather than stopping completely. But sharp pain, a limp, or night pain means stop and get assessed, especially to rule out a stress fracture.

Will changing my running form help?

It can. Overstriding and a sudden load spike are common causes of hip pain in runners. Building mileage gradually, increasing cadence slightly, and strengthening the glutes and hip muscles all reduce the load that triggers pain.

How do I prevent hip pain from returning when I run?

Address the cause, not just the symptom: build load gradually (no more than ~10% per week), maintain hip and glute strength work, and respect early pain rather than pushing through. Most running-related hip pain is preventable with sensible load management.

Final word from Sport Doctor London about hip pain when running

Hip pain when running is challenging because many conditions can cause it, and most are, at heart, overload problems. Don’t ignore the symptoms h, hoping they pass. An experienced sports and exercise physician can diagnose the cause and help you get back to running.

To book a one-stop assessment with Dr Masci in London, contact his team here or call +44 (0) 203 488 0350.

Common Causes of Hip Pain from Running Explained