It started out rather insignificantly. My early-morning running partner of five years began to complain one day about a slight pain in her left hip. It wasn’t enough to deter her from our morning runs – frequently disguised as therapy/gripe sessions – but after a few months, I noticed that she had somewhat of a limp to her gait. She did mention that the pain had intensified, even to the point where after a long run, if she sat for an appreciable amount of time and had to stand up, it was very painful. We opted to walk for a few mornings, then alternated our runs with frequent walks to help alleviate her discomfort.
Fortunately for myself, I have never experienced anything quite like that in my running career. In fact, I have remained healthy over the years in that regard, and am very grateful for the manner in which my body endures its daily torture! However, hip pain is a very common complaint among runners, and it can run the gamut, from very severe (stress fractures or arthritis) to milder pain (muscles strains or bursitis).
It is important to note that any pain that inhibits or limits your ability to run should be evaluated by a doctor trained in sports medicine. I know if I had to skip just one day of running, I would be moody, irritable, and would probably have to be caged for the remainder of the day. We don’t even want to go there!
So, where does hip pain originate in runners? It comes from a variety of sources, including the bones, joints, muscles, tendon, and bursa, which consist of the fluid-filled sacs that decrease friction at the bony intersections.
Many muscles attach to the pelvis and the hip, and all of them are important in running. Those powerful hip flexors attach in the front and flex or bend the hip. The abductor set of muscles includes the tensor fascia lata and the gluteus medius and minimus, which serve to pull the leg away from midline.
The location of the hip pain can be very helpful for the doctor’s diagnosis, as he can understand from where it originates. Anterior hip, groin, or thigh pain typically arises from the hip joint or from one of the flexors. The hip joint is essentially a ball and socket joint connecting the femur to the pelvis. Common problems associated with the hip joint include arthritis, labral tears, which is the cartilage rim of the socket, and avascular necrosis, which is a decrease in blood supply to the ball.
A few common hip injuries in runners include hip bursitis, snapping hip, and ITBS, which is itiotibial band syndrome.
Hip bursitis creates pain on the outside of the upper thigh. The term comes from the word “bursa,” and this fluid-filled sac allows for smooth movements between two uneven surfaces, such as the bones.
With bursitis, the pain will be on the outside of the hip and a bony presence may be felt there. Pain and swelling may be present as well. While most runners may simply exacerbate this condition by continuing with their training, they should take immediate action and ice the area, take a break from running for a few days, and massage the muscles with cross friction massage on the outside of the hip. In some cases, a doctor may recommend a course of cortisone injections.
Snapping hip does what its name implies. The runner may experience a snapping sensation from the hip, and it may even be audible. The snapping is typically triggered by tendons catching on bones protruding at the hip. This can be the result of the itiotibial band snapping, the iliopsoas tendon snapping, or a hip labral tear, which is the least common cause of snapping hip.
For treatment of snapping hip, anti-inflammatory injections can help. Physical therapy has also proven to be beneficial as muscles and tendons are stretched. Surgical intervention is rare, unless the pain is so severe and lasts for a long time.
Finally, itiotibial band syndrome, or ITBS, is initiated by inflammation of the itiotibial band, which runs down the outside of the leg, from the hip to the shin, ending just below the knee joint. With the thigh muscles, this band provides stability to the outside of the knee joint. ITBS occurs when the band becomes irritated or inflamed. The associated pain naturally gets worse with continued exercise and improves with rest.
Injuries such as these are frequently brought on when runners suddenly increase the number of miles in their workouts, or when they run them at a more intensified pace than normal. For best results after healing, work towards variation in the training paces to prevent re-occurrence.
As for my friend, about the time her hip pain intensified, she moved away, so our morning runs together came to a sad end. I still communicate with her, and those runs for her have given way to walks and other forms of workouts. As for me, well, the open road and my running shoes are my sole partners these days. I aim to remain pain-free until the day I die. Once running gets into your soul, it tends to stay there, and I honestly don’t know what I’d do if I had to sideline myself for a few days. A padded room, perhaps?
(Information for this article was found at http://www.marathon-training-schedule.com/hip-pain-in-runners.html and at http://www.beginnertriathlete.com/cms/article-detail.asp?articleid=1383)