person jumping on beach after recovering from hip pain

Managing Hip Pain: Essential Exercises For Runners

You have probably clicked on this page for one or two reasons, you enjoy running, or you are dealing with hip pain. Maybe you’re a runner and have hip pain at the same time? Nevertheless, you came to the right place!

In this article we will go through the function of the hips during running. Talk about some common hip related running injuries, with strategies how to manage them, but also prevent them from happening in the future.

man running

Hip Anatomy And Physiology

Let’s start with the front of the hip.

What muscles attach there?

What is their function?

What are the most common injuries?

How do we fix it?

When we look at the hips from the front view, we have many powerful muscles which originate from this region. Quadriceps, psoas major, iliacus, to name a few. The latter two you might know as hip flexors or iliopsoas.

Just so that you can visualise, flexing the hip is essentially bringing your knee towards your chest. The quadricep are also a hip flexors, however only one of the four quads are responsible for flexing the hip. This muscle is called rectus femoris and is usually the most frequently injured quadricep muscle as it is biarticular, meaning it provides movement over two joints.

We’re talking about the front of the hips first as this is the area where a lot of runner’s report feeling “tightness, pain, a pinch sensation, or shooting pain”. If this is you, then you have probably seen many videos which teach you how to stretch your hip flexors. For some this is all they need.  However, sometimes this might only bring a temporary relief of symptoms.

anatomy of the hip

How Do You Fix Hip Pain?

Well, if you think about it, running is essentially single leg jumping. This is because when we run there is a period where both legs will be off the ground. We know the quads are the only muscles in the human body which extend the knee joint, and this is essential for running/jumping.

We also know that the rectus femoris attaches onto the hip. This means that we must use our quads a lot during running. So, if you’re trying to hit PB’s, or run your first marathon, maybe stretching your hip flexors just isn’t enough, and we ought to strengthen your quads through a variety of resistance exercises!

You can see examples of a couple of them right here. I will attach examples to each section of the blog, but if you need more information about them, you can sign up to our  performance centre, where you can see videos and descriptions!

shin splints

Anatomy Of The Posterior (Back of the) Hip

What muscles attach there? What is their function? What are the most common injuries? How do we fix it?

Glutes!

These are one of the biggest and strongest groups of muscles in the human body, and they are also important muscles when it comes to running. We will talk about the glutes as a group for simplicity of this article, however we do have three of them, gluteus; maximus, medius, and minimus.

The glutes have a few origin points from the back of the hip bone and attach onto the side and back of our thigh bone, otherwise known as the femur.

These muscles extend and externally rotate the hip, which is vital for running mechanics. However, when it comes to running injuries, the glutes also stabilise our hips whenever we only have one leg in contact with the floor.

hip exercise: squat with weight

What Forces Go Through The Hip?

This is important as when we run, our lower limb joints experience more forces going through them, due to the jumping example I mentioned earlier. From our understanding, the hip joint experiences forces between 1.5 to 2.5 of body weight.

So, if you’re 70kg, you will be putting at least 105kg of force through just one side of the hip. Now that means that your gluteal muscles must work pretty hard to allow this to happen, sometimes for hours without stopping.

If we don’t allow sufficient recovery, we can develop something called gluteal tendinopathy, which is essentially specific pain around your glute tendon on the side of your hip. Some symptoms of gluteal tendinopathy include:

 

  • Pain with standing on one leg or walking
  • Tenderness over the side of the hip
  • Stiffness in the glutes
  • Weakness of the glutes
  • Swelling around the side of the hip
  • Night pain
bulgarian split squat for hip pain

What To Do If You Can't Run?

How do we fix it?

If you get to the stage where you can’t run anymore, and you’re getting pain at night, we have to think about offloading the area to allow symptoms to calm down. Modifying activities, and using modalities such as pain relief, ice packs, or heat, help to manage the pain.

When the symptoms have reduced it’s important that we start to load the area through a progressive exercise protocol.

Exercises selection might include:

  • Clamshells, bridges
  • The running man
  • Deadlift
  • Squat variations.

Cross train ing can be a great way of staying for when an are is injured. Within clinic we may recommend swimming, cycling or offloaded exercises so that you are not losing fitness whilst allowing the aggravated tissue to settle.

Single leg stand from plinth for hip pain

Hamstrings

We have one more really important group of muscles which originate at the back of the hip. They are called the hamstrings, and just like the glutes, play a vital role in propelling our body forward. However, when it comes to running, the hamstrings act almost like breaks in a car. They help to decelerate our body and absorb some of the shock.

We have three hamstring muscles, and similar to the quadriceps, only one of them crosses over two joints. This muscle is called the bicep femoris, and similarly to the rectus femoris, this one is also commonly known to sustain injuries during running. This is because when we strike the floor whilst running, the bicep femoris along with the other
hamstrings works eccentrically to control knee extension and absorb the load.

 

Eccentric exercises for hip pain

Eccentric Exercises For Hip Pain

Eccentric contractions happen when the muscle is lengthened, as it allows the body to produce greater forces. Hamstring  related pain in runners can be problematic, and it works on a similar basis as the gluteal pain, in that we can develop a tendinopathy where the hamstrings attach to just under our bum cheeks. This pain can be very dull in nature, and some symptoms might include:

 

  • Pain with sitting or getting up from sitting after a period of time.
  • Tenderness over bottom of bum cheek
  •  Stiffness in the back of the thigh
  • Weakness of the hamstrings
  • Night pain
hip thrust with weight for hip pain

How Can We Fix Hamstring Weakness?

The protocol will be very similar to that of gluteal tendinopathy. Meaning we have to manage pain initially, before we can work on conditioning the tendon. This will of course vary from person to person, and the severity of symptoms. So, if you have just developed this pain, great, we can get straight to work. Some exercises which will be good at rehabilitating this injury are

 

  • Lying hamstring curls
  • Good mornings
  • Deadlift variations
  • Hip thrusts.

When Should I See A Medical Professional For Hip Pain?

Seeking medical care for hip pain is advisable in several situations to ensure proper diagnosis and appropriate treatment. Here are some indicators that warrant seeking medical attention for hip pain:

 

  • Severe pain
  • Sudden onset of pain
  • Difficulty bearing weight
  • Limited range of motion
  • Persistent pain or swelling
  • Pain at night or at rest
man running

How Can I Prevent Hip pain As A Runner?

As you can tell from this article, the hip is complex, and it’s never a one size fits all. However, some things you can start implementing in your routine from today are regular conditioning on the side of your running, making sure that your program allows you to have enough rest between runs, maintaining a good diet and body weight, staying well hydrated as when we exercises we can lose a lot of water through sweating, and being realistic with your goals… If you’re new to running, allow yourself time to build up your milage before entering any big races.

If you are looking for help please book your free discovery call to learn how we can help virtually, face to face or through our sports performance centre.

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