Are you an avid runner and wondering why you’re having hip pain during running? I’m going to cover THREE of the most common causes of hip pain during running. I’ll teach you where you might feel the pain with each injury, what causes it, and a key exercise to begin recovering from it. Keep in mind that there are a lot of things that can cause hip pain, but runners typically show similar patterns of injury.

If you’re looking to figure out why you have hip pain during running and how to recover from it, this is a great post for you. I’ll give you expert advice based on my experience as a runner myself, and a chiropractor for hip injuries in runners.

You may feel like you may have one of these three injuries. If so I’d recommend seeing a chiropractor who’s experienced in running injuries. Many times these injuries will get better with home exercises and modifications, but treatment can significantly reduce the recovery time.

Hip Flexor Pain During Running

Hip flexor injuries are one of the most common causes of hip pain that’s bothersome when running. Hip flexor injuries are also called internal snapping hip, iliopsoas tendinitis, iliopsoas tendinosis, iliopsoas tendinopathy, iliopsoas bursitis, or iliopsoas syndrome.

Hip Flexor Pain Location: Hip flexor pain is felt in the front of your hip. Typically, it’s bothersome on one side but it can also affect the front of both of your hips. Since the iliopsoas (the primary hip flexor muscle) attaches to the low back it’s also common to have pain in the low back along with pain in the front of your hip.

The Problem: Psoas tendinopathy is the most common cause of hip flexor injury in runners. Repeated hip flexion, the motion of lifting your leg forward and off the ground, is one of the primary movements of running. With frequent running, especially long-distance running, your hip flexor can become excessively tight. You may notice snapping of the hip flexor tendon over the front of your pelvis too. Over time, hip flexor tightness when running creates microtrauma in the muscle-tendon, and a repetitive trauma or overuse injury develops. Initially, there will be some acute inflammation. In the long run, pain is driven by a failed healing response and tendon degeneration.

How to Relieve Hip Flexor Pain During Running: The easiest beginner treatment for hip flexor pain during running is to stretch the iliopsoas. Stretching the hip flexor will, over time, relieve the tightness and snapping in the front of your hip. You may need more treatment or a comprehensive rehab plan. However, if you’re only doing one exercise for your hips this is the one you should do.

chiropractor for it band pain
rehab exercises for high hamstring injury

Hip Abductor Pain During Running

Your hip abductor muscles, especially your gluteus medius, have the most most significant role in stabilizing your hips. You may be able to run comfortably with weakness in some hip muscles. However, hip abductors are too influential to ignore and weakness can result in an abnormal running stride.

Hip Abductor Pain Location: Hip abductor weakness produces pain in the back and side of your hip. The gluteus medius is located at the top of your buttocks and towards the side of your hip. This issue can also cause subsequent pain in your IT band or the side of your knee.

The Problem: Your gluteus medius is responsible for 70% of your hip leveling. If you stand on one leg while looking in the mirror and see your pelvis drop down on the side of the lifted leg then you have hip abductor weakness. The weakness will be on the opposite side of the dipping hip. Pelvic unleveling causes an imbalance in how you move, and other muscles in your low back and leg to adapt in an attempt to make up for it. Research has shown that it can lead to further problems that are common in runners. These include shin splints and foot/ankle pronation. Ultimately, it causes you to develop a super dysfunctional running gait and standing position.

How to Relieve Hip Abductor Pain During Running: Since your gluteus medius is weak, you need to do some activation and strengthening of this muscle. There are a lot of easy exercises to get the gluteus medius active working to keep the pelvis level again. The number one exercise I prescribe for hip abductor weakness is a simple bridge or clamshell with a mini (loop) band. If you have pelvis unleveling when standing or with running you may need more than this, but this is a good place to start.

High Hamstring Pain During Running

Causes of high hamstring pain during running include high hamstring strain, high hamstring tendinitis, and high hamstring tendinopathy. I’ve seen many of these injuries in runners, but the good news is they typically respond well to a structured rehab and treatment program.

High Hamstring Injury Location: High hamstring injuries most commonly cause pain in the crease right below your buttocks on your “sit bone.” This is where the hamstrings attach to the pelvis. Hamstring strains can cause pain in the musculotendinous junction. Pain from this injury is typically the upper part of the back of your leg.

The Problem: These injuries most often develop from repetitive strain. During the terminal swing phase, when your leg is coming forward and about to hit the ground, the hamstring is under maximal tension and working the hardest. In running, your high hamstring may undergo repetitive microtrauma to the tendon and become painful and damaged. The hamstring tendon has a difficult time healing due to limited blood supply and continuing to run without addressing the problem.

How to Relieve High Hamstring Pain During Running: These injuries can be difficult to rehabilitate without guidance, as there are multiple phases of rehab that are important to healing your hamstring injury. For tendon injuries in the high hamstring, eccentric strengthening exercises provide significant benefit. If you’ve done some active hamstring stretching or feel like your hamstring is flexible enough, the most important exercise I’d recommend is a nordic hamstring curl. This exercise will help you build adequate load capacity in your hamstring tendon so you can get back to running without pain.

Treatment for Hip Pain During Running

If you’re having hip pain during running, there’s a high likelihood that it’s being caused by one of these injuries. The mechanics of running make these more injuries more common in runners versus other types of athletes. Remember that the exercise guidance I give is a great place to start, but you should be doing more to recover. A chiropractor familiar with running injuries can really help in providing treatments to relieve hip pain and address the muscular or joint issues that are at the root of the problem.

Don’t hesitate to reach out and ask me questions about your hip injury if you’re unsure whether we can help. You can also schedule an exam and have me take a look at your injury by booking online here. I understand you might be skeptical of chiropractic care and how the treatments we provide can help. Our number one goal is to get you back to hitting your running distance and time goals.

Dr. Jason Williams DC is a chiropractic physician practicing at AccessHealth Chiropractic in Cary, NC. He treats neuromusculoskeletal pain and injuries using chiropractic manipulation, dry needling, acupuncture, rehab exercise strategies, and other supportive therapies. Primary areas of focus include back pain, neck pain, muscular pain, extremity pain, and orthopedic injuries. Dr. Williams is experienced in treating athletes, especially those in the CrossFit, running, Brazilian Jiu-Jitsu, Muay Thai, and MMA communities.