Hip pain when running: diagnosis and causes
Hip pain is one of the most common complaints in triathletes . We can feel pain in the front hip, in the groin, on the outside of the hip or in the back, in the buttock. These pains and symptoms are often difficult to diagnose and treat correctly since they can come from different structures, either within or from the part that surrounds the hip.
The hip is one of the largest joints in our body and is responsible for connecting the thigh bone (head of the femur) with the acetabulum, a cavity located in the pelvis. This carries all the weight of the body (up to six times more when we run) and all the strength of the muscles of the legs and the hip itself. It is one of the joints with the greatest range of motion and flexibility. Muscles, ligaments and tendons support it, as well as some fluid-filled sacs known as bursae.
As we can see there are many things that can go wrong in the hip, but most of the problems are simple and lie in overuse or tendinopathies of the muscles that adhere to it . The first thing is to go to a physiotherapist who will do a good exploration and corresponding study, in order to rule out more common ailments such as the iliotibial band syndrome or the periphrome syndrome. When these possibilities are ruled out, we can think that some deeper structure is the one that is damaged and is responsible for the pain . We are going to review three common injuries and their symptoms and signs .
What is it? The hip is a joint composed of a ball-like articulating surface and a socket. The edge of the socket is lined with a ring of cartilage called the labrum. It protects the bone and helps insulate the joint. Tearing of this layer can irritate the hip joint, cause pain, and limit movement. The labrum can break or become irritated during a bicycle fall, but this injury is more commonly caused by repetitive trauma to the hip joint. This can be associated with poor biomechanics or muscle decompensation.
What causes it? Hip labrum tear is often caused by a sudden turning motion, but it can also cause it. Overstretching the lower limb or squatting can also cause a tear. Bony abnormalities in the hip joint (hip impingement); hip muscle tension; hip muscle weakness; or poor biomechanical technique with repetitive activities; as well as high volumes of running may also be responsible.
Signs and symptoms include: deep pain in the front of the hip or groin, painful snapping at some hip movement, increased pain when sitting for a long time, a sharp pain in the greater range of hip flexion. Pain in the groin, buttock, or lower back can also be symptoms.
What is it? A fracture that has not been produced by a single trauma, but is the result of small trauma or repetitive loads on the same area. During operation the hip joint has to absorb a large amount of load. This coupled with overuse can lead to a stress fracture of the hip, most commonly the neck of the femur.
What causes it? Sudden increases in training load and volume, training with too much fatigue, poor running technique, use of inappropriate footwear, nutritional factors such as low vitamin D levels or poor muscle conditioning can all be responsible for a fracture due to stress.
Signs and symptoms include: mainly pain in the front of the hip or groin, as well as swelling in the area.
Trochanteric hip bursitis
What is it? The bursae that we mentioned at the beginning of the article are small sacs of fluid that are found between bones and soft tissues, mainly tendons. They protect soft tissue from rubbing against bone, minimizing friction. If the overlapping tissues are too tight or biomechanically ineffective, the bursa itself can sometimes become inflamed and irritated.
There are a lot of bursae around the hip joint, but the one most commonly injured is the trochanteric bursa. It is located on the outside of the hip, on a bony protrusion of the femur (the greater trochanter), and separates the bone from the iliotibial band.
What causes it? Overuse or repeated friction, large increases in the volume of kilometers, too stiff muscles, poor biomechanics of the lower extremities, lack of gluteal strength or direct trauma to the area.
Signs and symptoms include: pain on the outside of the hip, increased pain after running and radiating down the side of the thigh, pain when lying on the injured side, pain on palpation directly over the bursa site or swelling on the side of the hip.