Injury clinic: hip pain

Physio Stuart Mailer explains how to overcome running-related hip pain

hip pain running


“After about 30-40 minutes of steady running, the muscle that connects to the hip bone on the side of my right thigh begins to hurt. After stopping, it’s generally OK but the following day, there’s a constant dull ache. I’ve rested for a few days but the problem is still there? It’s really frustrating as it’s preventing me from running and I don’t know why it’s hurting. Any suggestions?”
Tom Wencel, via email

What is it?

The muscle at the side of the hip that has been causing you pain is probably the Tensor Fascia Latea (TFL). The TFL is a small muscle at the hip connected to the upper portion of the pelvis and inserts onto the illiotibial band (ITB), which is the long band of tissue on the outside of the leg. The TFL can abduct, flex and also internally rotate the hip, which means it can to lift the leg outward, upwards and rotate the hip inward.

When running, the TFL is under a high amount of stress when you land on the leg to help stabilise the pelvis and femur. Thus, if it is weak, tight or you have a weaker gluteal muscle or a muscle imbalance, the TFL can become overloaded, causing pain. Unfortunately, rest does not always resolve our injuries and we have to treat the dysfunction, causes, and rehabilitate.

I would advise that you see your physiotherapist to give you the correct diagnosis, treatment and rehabilitation.


1) Reduce the intensity and duration of runs; if you do this, it should be pain free during the run and the day after.

2) Stretch your TFL for 3 x 30secs. For the right TFL: start in a standing position and cross the right leg behind the left so the right foot is outside your left foot. Lean your weight over the right foot allowing the hip to drop slightly until you feel the stretch. To increase the stretch, raise your right arm up above your head and lean over to the left side.

3) Ice the area to help reduce pain and any inflamation. Aim to do this for 10-15mins, three times a day.

4) Gluteal exercises:
– Lie on your side, hips bent to 45 degrees and knees at 90 degrees with ankle together. Lift the top knee up and hold for 6secs, lower and repeat 10 times.
– Lying on your side, straighten both legs, knees and ankles together. Lift top leg and hold for 6secs lower and repeat x 10.

5) Check your balance. See if you can stand on one leg for 30 secs; practise daily 5 x 10-30secs. To make the exercise more difficult, try to do this while standing on a stability ball or with your eyes closed.

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