Hip Injury

The hip itself is rather straightforward. It’s basically a ball (the femur) and socket (the pelvic bone). It is also strong and stable due to the muscle and ligament systems that level the hips and pelvis and enable you to walk and run. However, while the hip itself is simple, everything else around it is rather complex. And with complexity comes more of a chance for hip injury.

The hip is made up of a ball (the femur) and socket (the pelvic bone), and hip pain is usually focused in this area. Illustration: Oliver Baker
The hip is made up of a ball (the femur) and socket (the pelvic bone), and hip pain is usually focused in this area. Illustration: Oliver Baker

Symptoms of a Hip Injury

Pain is the main symptom when it comes to hip injuries. The challenge to figuring out what type of hip injury you have is pinpointing the pain and determining when it hurts. This task is best left to a qualified medical professional. Pain will range from a dull ache to sharp and acute, depending upon the injury. It may hurt during a run, only when you run downhill or most of the time.

Causes of a Hip Injury

Of the joints in the leg that are commonly injured in runners, hip pain often poses the most difficult diagnosis. There are a couple of reasons for this: First, there are simply too many possible causes of hip pain, and a second, less obvious reason, relates to the frequency of these injuries.

In addition to iliotibial band friction syndrome (also known as an inflamed ITB), hip pain can be caused by muscle strains, tightness in the hip flexor, stress fractures and muscle tears.

Pain in the front of your hip may indicate a group of muscles called hip flexors are to blame. If the pain is more towards your inner thigh or groin, it could be your adductor. If your hip pain is acute and comes on suddenly, you may have a strain or tear.

Many hip injuries are a result of overuse or muscle imbalance, which could also lead to a strained or torn muscle. Paying attention to the pain and addressing it before it becomes chronic will limit potential injuries and subsequent downtime.

Iliotibial band syndrome is an overuse injury that involves the ligament that runs from the hip to knee along the outside of the thigh. This injury presents with nagging or dagger-like pain in the outside of the hip or knee. It can flare up when running downhill, especially during prolonged sessions when you aren’t necessarily conditioned for it.

Bursitis is caused by an overuse, but can also be the result of a tight IT band or hamstring. Pain occurs when the hip bursa (a fluid-filled sac that acts as a cushion between bones, ligaments and muscles) becomes inflamed or irritated, either through overuse or impact, such as from a fall.

Overuse is also to blame for stress fractures of the hip. These are caused over time in distance runners due to repetitive trauma and muscle imbalances.

Osteoarthritis is another potential cause of hip pain. It’s the result of wear and tear on the hip cartilage. This injury happens to runners and non-runners alike. The good news is that strengthening exercises can help to prevent it.

Hip Injury Treatment

Like many running-related injuries, treatment usually begins with taking a break. Rest and ice the affected area. As the pain lessens, consider getting a massage or Active Release Technique (ART) therapy to loosen tight muscles and break up scar tissue.

Hip pain is also a good indicator it’s time to visit your physical therapist or doctor to check for alignment and muscle imbalance issues. They will want to look at your running shoes to check wear patterns. Be sure to share any history of running injuries, as those can give insight into chronic misalignment issues.

Hip Injury Prevention 

The main way to prevent a hip injury is to make sure you have good hip and pelvic alignment. Start with a visit to a sports therapist. Strength train and add hip mobility exercises to your routine in order to overcome any imbalances. Strengthen your core with abdominal stabilization exercises (i.e. plank variations, etc.) as well. A weak core forces the hip adductors and flexors to overcompensate and overuse strains develop.

Be diligent about self-massage, regularly using a foam roller on large muscles groups. Try something smaller like a lacrosse ball to target harder to reach muscles, such as the psoas.

Look at where you run. Regularly running against traffic on a cambered road can actually lead to hip pain. Switch up your route by running on flat sidewalks or paths. Find soft surface, such as a dirt or gravel trail, as it puts less strain on your muscles.

Maintain good posture. Work towards having a strong core and all-over fitness to prevent stronger muscle groups from compensating for weaker ones.

Due to the large amount of sitting most of us do, we often develop tight hamstrings and hip flexors. Incorporate daily stretches of the hamstrings and try to take more standing, walking and stretching breaks during long bouts of sitting.

Sometimes benign everyday actions can cause alignment to become imbalanced. These can include actions such as carrying your wallet or phone in the same hip pocket or always carrying heavy loads on the same side. Alternating the way you approach daily tasks will help promote overall strength, making you less prone to injury.

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