What could be causing my hip pain?

Matt PhillipsQ: I have been running for about a year but in the last three months I have had pain in my hip joint. The side of my hip is tender after a run, and I am worried it is osteoarthritis. I am doing stretching exercises but they don’t help. I rested for three weeks but when I ran again the pain returned.

A: Hip pain can be a common problem for runners, and although I cannot offer you specific advice without assessing you, I hope the following information helps. Though research is still a little unclear as to what causes osteoarthritis (the most commonly quoted are age, being overweight and previous injury), what we do know is that distance running does not increase the risk of osteoarthritis for healthy people. In fact, some studies suggest that distance running may even have a protective effect against osteoarthritis. That said, given that you have experienced pain in the hip region for three months, I recommend you see a medical professional so they can assess and diagnose you, and ensure you get the right treatment.

Painful hip

Osteoarthritis of the hip typically includes groin pain as well as hip restriction, with many sufferers finding it hard, for example, to put socks on. If this is not the case for you then it may be something else. You mentioned that the side of your hip is tender to the touch, and that you find it difficult to get comfortable at night. If this is the case and you are not experiencing pain anywhere else (such as down the rest of the leg or in the lower back) then it may be that what you are suffering from is gluteal tendinopathy where the tendons of the glute medius and minimus that attach to the bony protuberance at the top of the thigh bone (the sensitive bit you can feel when you push into the side of the hip) have become irritated. Other symptoms can include pain when you cross your legs or stand on one leg.

Over-running

In contrast to osteoarthritis, gluteal tendinopathy can be caused by over-running, especially if you have poor hip stability. Every time you take a step, the leg on the ground has to support the weight of the rest of your body. If it is not strong enough to do this, the tendon of the glute can become compressed against the end of the thigh bone, and this can lead to the pain
and sensitivity.

If what you are suffering is a case of gluteal tendinopathy, then stretching may be making it worse. Depending on what position your body is in, the stretch may be pushing the tendon into the bone and irritating it more. This is why it is important to be assessed properly; to ensure that the rehabilitation you are doing is suitable. In the case of tendinopathy, rest is typically not enough to promote recovery. A suitably graded strength program to slowly load the tendon is what commonly helps kick start recovery and get you back on track, once again ensuring that the selected exercises are not going to cause further compression and irritation of the tendon.

I hope this information is of use to you. My recommendation would be to go get assessed properly and if it is gluteal tendinopathy then hopefully this reply will be of assistance to you.

Our expert, MATT PHILLIPS, is a Running Performance Coach & Injury Specialist at StrideUK & Studio57clinic. Follow Matt on Twitter: @sportinjurymatt