Hip pain experienced during walking or running is common among active individuals, often signaling an underlying biomechanical or structural problem. The hip joint is a complex ball-and-socket structure, and pain felt during locomotion—a repetitive, weight-bearing activity—can originate from the bone, surrounding soft tissues, or be referred from distant areas. Understanding the specific nature of this pain is the first step toward effective management. This article explores the sources of hip pain aggravated by movement, provides guidance on self-management, and details pathways for diagnosis and prevention.
Understanding Common Sources of Hip Pain
Pain on the outside of the hip, particularly where the large thigh bone meets the pelvis, often indicates Trochanteric Bursitis. This condition involves inflammation of the bursa, a small fluid-filled sac situated over the greater trochanter. The bursa is repeatedly compressed or irritated by the overlying iliotibial band during the gait cycle. The pain is typically tender to the touch, worsens when lying on the affected side, and intensifies with the repetitive impact of running or prolonged walking.
Pain in the front of the hip or groin area points toward Hip Flexor Tendinopathy, frequently involving the iliopsoas muscle group. The iliopsoas muscle group can become strained or inflamed from overuse, especially in activities requiring high knee drive. Runners often feel this deep, aching pain when the leg is brought forward or when lifting the knee against resistance.
Deeper, sharper pain inside the joint may suggest a Labral Tear or Femoroacetabular Impingement (FAI). The labrum is a ring of cartilage that lines the hip socket, providing stability and cushioning; a tear can cause clicking, catching, or locking. Impingement occurs when the abnormal shape of the femoral head or the acetabulum causes premature contact. This premature contact leads to damage of the labrum and joint cartilage over time.
A less common, but severe, cause of movement-related pain is a Stress Fracture, often occurring in the femoral neck or the pelvis. This injury results from repetitive sub-maximal loading that exceeds the bone’s ability to repair itself. The pain is typically deep, progressive, and becomes constant, making weight-bearing activities difficult or impossible. Pain felt in the hip area may also be Referred Pain from the lower lumbar spine. Nerve root irritation in the lower back can transmit pain signals, leading to sensations of pain, tingling, or numbness perceived in the buttock or hip region.
Initial Self-Care and Activity Modification
Initial self-care focuses on reducing inflammation and protecting the joint from further stress. The RICE protocol (Rest, Ice, Compression, and Elevation) can be applied, though compression and elevation are often less practical for the hip. Applying ice packs to the painful area for 15 to 20 minutes several times a day helps reduce local swelling and dull acute pain.
The most important modification is relative rest, meaning stopping the activity that caused the pain, such as running or long-distance walking. Instead of complete inactivity, which can lead to stiffness, switch to low-impact alternatives like swimming, water running, or cycling. These activities allow the hip to move through a range of motion without the high impact forces that aggravate inflamed tissues.
Temporary relief can be achieved through over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs work by inhibiting the chemical pathways that produce inflammation. However, these should only be used for short periods to manage acute symptoms. They do not address the underlying structural or mechanical issue.
When to Seek Professional Diagnosis and Treatment
Certain symptoms are Red Flags that warrant immediate medical attention. These include sudden inability to bear weight, significant joint deformity, or pain accompanied by fever or intense night pain that wakes you from sleep. Pain that persists despite two weeks of diligent self-care and activity modification also indicates the need for professional evaluation.
Diagnosis begins with a physical examination to assess range of motion, muscle strength, and specific pain provocation tests. Imaging studies then visualize the internal structures of the hip joint and surrounding tissues. Plain film X-rays are often the first step, providing a quick assessment of bone structure. X-rays rule out fractures and identify bone spurs associated with impingement or arthritis.
If a soft tissue injury like a labral tear or severe tendinopathy is suspected, an MRI scan is frequently used. An MRI provides detailed images of the cartilage, labrum, and tendons, often enhanced by injecting a contrast agent (MR Arthrography). Based on the diagnosis, Physical Therapy (PT) is the most common and effective non-surgical treatment. PT focuses on restoring proper biomechanics by strengthening the muscles surrounding the hip and pelvis.
A core component of rehabilitation is strengthening the gluteal muscles and core stabilizers, which helps control the position of the pelvis during the gait cycle. For persistent inflammation, a physician may recommend a Corticosteroid Injection, delivering a potent anti-inflammatory medication directly into the joint or bursa under ultrasound guidance. Surgery, typically performed using minimally invasive arthroscopic techniques, is reserved for specific structural problems. This includes repairing significant labral tears or reshaping the bone in cases of severe FAI that have not responded to extensive physical therapy.
Strategies for Long-Term Prevention
Preventing recurrence centers on addressing the underlying muscular weaknesses and movement patterns that contributed to the initial injury. Developing robust Core Strength and stability is critical, as core muscles anchor the pelvis and spine, providing a stable platform for leg movement. Exercises that focus on bracing and maintaining a neutral spine during dynamic movements are particularly beneficial.
The Gluteus Medius muscle, located on the side of the hip, stabilizes the pelvis and prevents the opposite hip from dropping during the single-leg stance phase of walking or running. Specific strengthening exercises for this muscle, such as side-lying leg lifts and banded walks, can significantly improve hip mechanics and reduce strain on the soft tissues. Consistent activation helps maintain proper hip alignment throughout the gait cycle.
Analyzing a person’s Gait or running form can reveal abnormalities that place undue stress on the hip joint. Excessive pronation of the foot, or a narrow, cross-over running pattern, can translate into abnormal rotation or impact at the hip. Addressing these mechanical issues through targeted training or the use of specific Footwear and Orthotics can help to redistribute forces more evenly across the joints.