Running with Hip Pain

Q: I run about 10 miles a week and have noticed some pain in my hip. What can I do? I don’t want to stop running.

A: Regular running can trigger various types of hip pain. One example is hip flexor tendonitis or a muscle strain. The hip flexor muscles are powerful and you use them when walking and running. Hip flexor pain can not only slow down your running and walking, it can also make it painful to do everyday activities like squatting, kneeling or walking up stairs.

There could be several other causes for the pain, including specifics of your running form (so called gait mechanics) or poor-fitting shoes. The length of the stride can play a role in how the muscles are being stretched as well as the force transmitted to the hips and legs. An average cadence (number of steps/minute) for adults is 160 to 180. A metronome can help you keep this cadence and there are smartphone apps that use metronomes. A physical therapist or sports medicine physician can watch you run and determine if it’s too long and offer suggestions on how to alter it. The right footwear is important when running. Make sure you buy quality shoes and replace them as they wear out. One rule of thumb is to replace shoes every nine months or 500 miles. Several stores offer shoe fitting for runners and this may be something you may want to check out to make sure you have the right shoe for your running style.

Evaluating your training schedule is also important. Do you run several days in a row without giving your body time to rest? Pay attention to how you feel during your run and scale back the length or frequency if the hip begins to hurt. Try to take a day off between runs and alternate your runs with another form of cardio to give the muscle a break. It’s also essential to warm up before running and then cool down afterwards to lessen muscle tension and improve flexibility. Stretching the hip flexor is also important. You can stretch it by bending one hip and knee backward and grab that ankle with the hand on the same side, slowly pulling the heal towards your backside until you feel a comfortable stretch in the front of your hip. You can ice the painful area for 20 minutes or so after training to also provide relief.

Although overuse muscle and tendon problems are common, there can be more significant issues going on with the hip such as a stress fracture or hip joint issues. If you have pain persisting more than a couple weeks, pain at rest or with walking, if you are getting clicking or catching in the hip, or if you are limping while running, you may want to seek care with your primary provider or a sports medicine/nonsurgical orthopedic physician experienced in treating runners.

By Erica Kroncke, MD, sports medicine physician with ThedaCare Orthopedics Plus in Appleton.