Why does my hip hurt when I run?

One of the great things about being a Reno Physical Therapist is that I have great access to some beautiful trails. It's one of the perks about living in Reno!

So if you love running like I do, hip pain is not something you want to have to deal with.

Hip pain is common amongst runners and here are a few reasons why:

When we run, anywhere from 3-5x our bodyweight goes through our joints EVERY time our leg makes contact with the ground. If you weight 150 lb, then that's about 450 - 750lbs of force!

Two muscles (the tensor fasica latae and gluteus medius) are very important when it comes down to shock absorption and preventing hip pain. They help to stabilize the pelvis any time our foot is on the ground. As a matter of fact, most of our muscle energy is spent supporting our body while our foot is on the ground, NOT while it is in the air. 

This means that our hips need to be STRONG to handle those loads over and over. A lot of runners have weak hips (sorry, the truth hurts) which predisposes us to hip pain, arthritis, and muscle strains.

If you're weak in these muscles, then over time the hip will fatigue which can lead to pain, arthritis, and muscle and joint damage.

Hip pain? Click here to schedule your running analysis!

So what can we do about it?

One of the first things I do with runners is get them on a running biomechanics analysis.

Performing a running analysis on myself to assess hip drop.

Why would this help?

Breaking down running mechanics can help us figure out if there is something that's causing more strain on the hips, including what's called a "pelvic drop."

Here you can see how my right hip drops 4 degrees, while my left side dropped only 1 degree. This is because I have left sided weakness and I also favor that side.

This right sided pelvic drop is because of a few things:

1. My left hip is weaker

2. My left knee is weaker

3. My left knee is less stable (I have a left ACL tear from a jiu jitsu injury)

4. I favor the right leg and subconsciously guard against putting more weight on the left leg.

These are things I figured out from strength, balance, and plyometric testing; plus self report of sxs.

A 3-5 degree drop is considered "normal," but we also have to take into account the individual's symptoms. I started developing left sided hip pain after racing two Ironmans in 2024. Even your local Reno Physical Therapist gets the occasional "niggle!"

So currently, my plan of care consists of:

1. Heavy strength training for my hips and knees, consisting of barbell back squats and deadlifts: This will improve to loading tolerance of my hips.

   
   

2. Running mechanics retraining: To make my stride more efficient.

   
   

3. Eccentric loading for my quads: To help strengthen my knee for the downhills.

   
   

4. Core strength: Back and pelvic support.

   
   

5. Plyometrics for left leg stabilization: So my left knee is no longer "afraid" of loading.

   
   

6. Run programming and cross-training: To avoid overtraining and injury.

Like most runners, I don't have any plans on quitting running. As a matter of fact I am currently training for a 100 mile ultramarathon and have Ironman, Lake Placid scheduled for this July.

I am passionate about these sports, which is why Clinch Performance and Recovery is passionate about helping runners get back to doing what they love.

Looking to improve on your running? Click here to schedule your running analysis.

Thanks for reading and as always, forward progress my friends!