Whether it’s a little niggle or a deeper ache, hip pain is just one of many ailments runners are prone to.
So what should you do to avoid getting it? And how is it treated? Don’t fret – Beate Stindt, consultant physiotherapist and clinic director at Six Physio, is here to help you out.
What types of hip pain can you suffer and how do I identify the problem?
The hip is a complex joint and thus, pain in the area can come in various guises – but it’s most likely to be down to one of two issues.
1. Hip flexors
“The main issues we see are a result of tight hip flexors, the muscle through the front of the thigh into the groin,” says Stindt. “Office workers sit for 10-12 hours a day often, which can cause your hip flexors to shorten, making it more difficult for your muscles at the back, most importantly your glutes, to activate correctly when you run, while also causing your pelvis to tilt forward.
“Think of your pelvis as a ring at the top of a bucket and if you tilt forward you are tipping the water out of the bucket. This increases the arch of your lower back and puts strain on it.
“Hip flexor problems are indicated by pain in the front of your hip or towards the groin.”
“Known as piriformis syndrome, this is indicated by pain in the buttock region,” says Stindt. “If that muscle is put on strain it could irritate the sciatic nerve in the hip – this can then cause pain through the leg and back.
“Pain on the side of your hips is also usually indicative of glute muscle strains, or it can indicate problems with your Iliotibial Band (ITB), a ligament which runs down our leg and often also causes knee pain.”
How do I treat and prevent hip pain?
Assuming your problem is muscular – e.g. a problem with your glutes or hip flexor – stretching will help.
“Foam rolling your quads will stretch out your hip flexors,” says Stindt. “You can also use a foam roll to stretch out your glutes if they are tight.”
The video below from Howcast explains how to use foam rollers to aid you as a runner.
If you don’t have a foam roll to hand? Have no fear, let The Prehab Guys explain some very basic hip flexor stretches:
However, Stindt has this to add: “Tightness of a muscle is often indicative of weakness – so you should stretch them out and then strengthen them.”
So how do I strengthen my hips?
There are various exercises runners can do to strengthen their legs and get themselves in the right condition to prevent injury.
“Running is essentially a one-legged sport,” says Stindt. “We never have two feet on the ground so your body needs to be strong enough to withstand the impact, support you and propel you forward.”
With any of these exercises, don’t feel the need to use weights, instead perform them with your own body weight.
“Good exercises include any form of squat, but you must get your form correct,” says Stindt. “You need to activate the muscles properly.”
For further details on how to squat properly, check out this explainer from BodyBuilding.com.
You should apply these principles to one-legged squats – ensuring both legs are strong enough. For a single leg, try putting your resting leg out in front of you for balance.
“Once you can squat well on both legs, then progress to a lunge,” says Stindt.
Lunges are similar to a running position, getting you to step forward with one leg while bringing the other knee close to the floor.
“Lunge alignment should have your hip, knee and foot in line,” says Stindt. “But as you bend your knee, it needs to track either in line with, or to the outside of, your second and third toe.
“It shouldn’t go on the inside of your big toe – that might overload your knee and wont help your glutes.”
3. Calf raises
“Runners should be able to do 25-30 heel raises on a single leg in a row without fatiguing, making sure not to go forward on your heel raises but to go directly upwards,” says Stindt.
With calf raises, simply stand on one leg and lift your body by extending your foot upwards, bringing your heel off the ground. Here’s a helpful video from Six Physio on calf muscles.
“Hamstring strength is also important,” says Stindt. For information on exercises to strengthen your hamstrings, check out this helpful explainer from Runner’s World.
What other tips and tricks can help?
“We often forget our upper back,” says Stindt. “You need to be running upright so your upper back needs to be mobile enough.
“Also, a strong upper back can help when swinging your arms when you run – which you should be doing for efficiency and speed. The neck and shoulder area should be strong also to keep your head and arms up. Lower back strength is also important.”
Upper back exercises include pull ups, and any form of row while the lower back can be targeted with hip raises – by lying on your back, knees bent and feet on the floor, and lifting your pelvis in the air.
What if one leg is stronger than the other?
“An injury will usually happen unilaterally (on one side),” says Stindt. “If you have bilateral hip pain, that’s most likely a bit of over use or fatigue.”
“You need to look at asymmetry for these unilateral problems though,” adds Stindt. “Sometimes the pain is on your weaker side but quite often it’s the other side because it’s having to compensate.”
So should having a weaker side affect the way you strengthen?
“I would say especially when you’re doing body-weight exercises it’s best to work on both sides equally by working each leg individually, but an equal amount,” says Stindt. “You won’t over develop one side, your body will just balance it out.”
When should you see a specialist?
“The odd niggle every now and then is normal,” say Stindt. “But maybe if you’ve rested it from running, had a sports massage and done some strengthening but still can’t get back to your normal running, then I would see a physio.
“We should be able to diagnose it and see if you need to see a consultant, or if it is something which can be treated with manual therapy and rehab.”
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