Hip pain in runners rarely announces itself dramatically. It tends to creep in as a dull ache on the outside of the hip after longer runs, or a pinch at the front when climbing stairs, and it’s easy to write off as tightness that a bit of stretching will sort out. Sometimes it does. Often it’s a sign that something specific needs attention.
Because the hip connects the trunk to the legs and absorbs load with every single stride, pain there can come from several different structures, the joint itself, the surrounding muscles and tendons, or even be referred from the lower back. Working out which one is behind the pain changes the treatment completely.
What are the most common causes of hip pain in runners?
A few patterns come up again and again in runners:
- Gluteal tendinopathy, pain on the outside of the hip, often worse lying on that side at night or after sitting for a long time
- Hip flexor strain or tendinopathy, a deep ache at the front of the hip, often after hill work or speed sessions
- Labral irritation, a pinching or catching sensation in the groin, sometimes with a click
- Referred pain from the lower back or sacroiliac joint, which can feel like hip pain but originates elsewhere
- Piriformis or deep gluteal irritation, which can mimic sciatica with pain running into the buttock
Weak glutes are a common thread through several of these. When the muscles that stabilise the hip and pelvis during running aren’t strong enough, other structures end up absorbing load they weren’t built for, which is often where the tendinopathy or strain pattern begins.
Why does hip pain often show up only during running?
Running is a single-leg activity, repeated thousands of times per session. Every time one foot is on the ground, the hip on that side has to control the whole body’s weight and stop the pelvis dropping to the other side. If glute strength or control isn’t quite enough for the volume being asked of it, that repetitive single-leg demand is exactly where things start to break down, which is why the pain often doesn’t show up walking or at rest.
How is hip pain in runners diagnosed?
A physiotherapist will usually start with a detailed history, when the pain started, what movements bring it on, whether it’s sharp or dull, and where exactly it’s felt. Combined with specific tests for hip strength, range of motion and provocation tests for the different structures, this is often enough to identify the likely source without needing imaging straight away. Scans are reserved for cases where symptoms are severe, not improving, or where something more specific like a labral tear or stress fracture is suspected.
What does treatment usually involve?
Treatment is built around the specific diagnosis, but common elements include:
- Progressive strengthening for the glutes, particularly the muscles controlling side-to-side pelvic stability
- Manual therapy to reduce tension in overworked hip flexors or the deep gluteal muscles
- Temporary adjustments to running volume or hills while symptoms settle
- Running technique review, since overstriding or poor cadence can increase hip loading
- Addressing lower back or sacroiliac contributions if that’s where the pain is actually coming from
Gluteal tendinopathy in particular responds well to a structured loading programme, but it needs patience. Pushing through pain or resting completely both tend to slow recovery compared with a well managed, gradual return to load.
Should you stop running if your hip hurts?
Not always, but it depends on the type and severity of pain. Sharp, worsening pain, or pain that changes your gait, warrants a proper assessment before continuing. A dull, low-level ache that doesn’t worsen during the run can sometimes be managed with modified training while the underlying cause is treated, but that call is best made by someone who has actually assessed it.
Frequently asked questions
Why is my hip pain worse at night?
This is a classic sign of gluteal tendinopathy, where lying on the affected side compresses the irritated tendon and increases pain.
Can weak glutes really cause hip pain?
Yes, insufficient glute strength is one of the most common underlying factors in runners’ hip pain, since these muscles control pelvic stability with every stride.
Is hip pain in runners always a tendon issue?
No, it can come from the joint itself, referred pain from the back, or muscle strain. That’s why an accurate assessment matters before starting treatment.
How long does gluteal tendinopathy take to improve?
With a consistent loading programme, many runners see meaningful improvement within 6 to 12 weeks, though full resolution can take longer for established cases.
Should I get a scan for hip pain straight away?
Usually not necessary initially. A thorough clinical assessment can identify the likely cause in most cases, with imaging reserved for specific or non-improving presentations.
If hip pain is starting to limit your running, a sports physiotherapy assessment is worth booking to find out exactly what’s driving it rather than guessing. You can book a session here.
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Marcos Jusdado is a physiotherapist and osteopath at Kinesis Clinic, Vida Emirates Hills, in the heart of Dubai. With 9 years of experience and over 12,000 sessions, he specialises in sport physiotherapy, functional neurology (P-DTR), vestibular rehabilitation and chronic pain, working with everyone from busy professionals to competitive athletes. His approach focuses on finding the root cause of pain rather than just treating the symptoms, helping his patient to achieve long-lasting results.
