A Trail Runner’s Guide to Hip Pain

Heading out the door? Read this article on the new Outside+ app available now on iOS devices for members! Download the app.

Runners deal with all kinds of injuries and at some point or another. Pain in your hips can be some of the trickiest and most uncomfortable. Maybe you’ve been lucky—your hip pain was minor, you were smart, you rested—and it went away quickly. But that isn’t the case for everyone.

Most runners tend to be more familiar with knee pain and injuries, but hip problems are also a huge issue, especially for women. Several things can go wrong and problems can be exacerbated by running.

What’s the Deal with Hips?

Before we can delve into what hurts and why, it’s important to be on the same page about the human anatomy we’re discussing.

The hips include the area on each side of the pelvis. The hip joint is made up of the top of the thigh bone, where it sits inside a special socket within the pelvis (called the acetabulum). This joint is what allows you to bear body weight on your legs, while allowing for motion and stability. In fact, the hip joint is one of the most stable in the whole body, but because of the incredible pressure it takes on it is also more likely to develop arthritis.

The ligaments in the hip are strong and each play a role in preventing hyperextension, preventing dislocation, and reinforcing the hip joint.

And as for muscles, the hip joint relies on a lot of them. These include the hip flexors, the extensors, the adductors, abductors, internal rotators, and external rotators.

When You Have Hip Pain, Get Help

First and foremost, if you’re in pain, stop running and go see a doctor. The internet will almost always convince you that you have a tumor or another worst-case doomsday health scenario, so seeking a medical professional’s opinion is the smartest thing you can do.

There are a few different reasons your hips could hurt. Much of the reason will depend on when, where, and how they hurt. That is, if they hurt during or after a run—or both, where the hip pain comes from and what that pain feels like.

It’s common to feel hip pain in the front of the joint, making it hard to move your leg at the hip or put weight on the leg. You might also experience swelling in the joint. But hip injuries can also present with pain in the lower part of your glutes and higher up on the back of the thigh.

Each cause of pain has a different reason, so it’s important to pay attention and figure out why it’s happening. Otherwise, you might re-injure yourself. If you do go to the doctor, you’ll have a better awareness of what to tell them. It could save some guesswork on a diagnosis.

causes of hip pain
Photo: Getty Images

Causes of Hip Pain and Injuries

Treating hip pain can be tricky to manage because there are many potential biomechanical and anatomic causes that can sometimes be hard to properly diagnose. But, as stated earlier, the best course of action regardless is to take time off if you’re experiencing pain in your hips.

Most running injuries are common and simple to fix. If you have a minor running injury, you’ll probably be fine so long as you take the time to treat it properly and rest.

Here is a quick look at some of the causes of hip pain.


One of the most common causes of hip pain is overuse. Running is fun and amazing, but it’s also hard on your body. This overuse of muscles can lead to bursitis, which feels like a burn or ache, rubbing or popping sensation on the outside of your hip. You’ll probably start by feeling this after a run and that’s the first sign to slow it down.

If you take it easy, ice your hips, and take some anti-inflammatories for about a week, you should be good to go. In the future, keep an eye on your distances. Your body can only take so much.

But what if you don’t feel better after some rest and relaxation? You could have a different, more involved issue.

Strength Imbalance Issues

Strength imbalances in your hips can also cause issues. Almost everyone has one leg that’s slightly longer than the other, and that’s totally normal. Unfortunately, it can really make itself known if you’re running long distances. It can also be the result of an old injury.

A professional should be able to determine if imbalance is the cause and offer help. Either exercises to strengthen one leg, or massage to loosen and relax one, can be really helpful.

Good posture when running is also really, really important. You know that holding your shoulders and head up are important, as well as proper stride distance, but keeping your hips in line is a big factor as well.

You can see a professional for the fastest course of treatment, but simply focusing on it and making an effort to maintain good posture can also help. Yoga is a great one for this, and the low-impact exercise will help counter the high-impact running.

For complete and regular access to more in-depth stories (like the 7 Key Rules for Proper Recovery), plus exclusive interviews and access to one-on-one service from top coaches and experts,  join Women’s Running Pass or Active Pass.

Stress Fractures

If you notice that the pain is coming more from the inside of your hip, and you tend to run on hard surfaces like the road, then it could be a stress fracture.

If this is what you have, running will definitely make it worse. Don’t let it sit until you physically can’t run anymore and can only limp around the house. Go to the doctor to be sure. Like any broken bone, it’ll take about six to eight weeks to heal, which means no running. You could do some swimming or easy biking, but only if your doctor clears it first.

Swimming is an amazing exercise to balance out a serious running routine and prevent injuries like stress fractures. If you’re recovering from injury, its low intensity balanced with a great deal of resistance helps you build strength without aggravating injuries. When swimming, you’re up to 80 percent weightless, which drastically reduces the wear and tear on your joints. For runners, it’s vital to build and maintain muscle. Swimming can help you do that, even when you’re recovering from an injury. Just make sure to take it easy and that your doctor says it’s OK.

Cartilage Tears

A cartilage tear in the hip, sometimes called a labral tear, also takes time to heal properly. The most obvious sign of this injury is a clicking or catching feeling when you run, especially when coupled with occasional pain. This is even more likely if you’ve recently had a fall or twisted your hip.

Again, stop running and get yourself to a doctor. This kind of injury requires medical advice, as the treatment will depend heavily on how bad the tear is. Some people can recover with a bit of rest and physical therapy, while more severe tears could require surgery.

Don’t Make It Worse

The first thing you should always do when you get pain from running is to stop running. There’s a lot of people who want to “run through the pain” or “walk it off.” That might help in some cases, but you won’t know what those cases are if you haven’t talked to an expert—like a doctor.

Taking a day or two off won’t destroy your fitness. The sooner you rest, the less time you’ll be off your feet.

Want to Know What It Takes to Finish at Western States? Just Ask Hellah Sidibe.

Find out what happened when this six-year run streaker and HOKA Global Athlete Ambassador took on an iconic ultramarathon in California's Sierra Nevada