Don't Let Hip Pain Sideline You

By: Sherwin S.W. Ho, MD

Many a marathoner’s dream of glory has been sidelined by hip pain. Sports medicine specialists often see more patients with hip pain in the months and weeks leading up to major events like a marathon or a triathalon. The good news is that many causes of hip pain can be treated without surgery.

If you’re an athlete experiencing pain in your hip, the body’s largest ball-and-socket joint, it most likely comes from one of these structures:

  • Labrum: the cartilage rim of the hip socket (the acetabulum) which helps deepen the socket and makes it conform better to the ball of the hip joint, the femoral head. Repetitive hip flexion that occurs during the running motion can lead to labral tears, causing groin pain and even catching and locking when the hip is flexed.

  • Iliopsoas tendon (hip flexor): the main hip flexor tendon, located directly over the front of the hip joint. Inflammation and the movement of the tendon back and forth over the front of the hip joint can produce a snapping or clicking sensation in the deep groin area of the hip. This is termed “internal snapping hip syndrome.” 

  • Iliotibial band (ITB): a large, wide band of a tendon that arises from the pelvic rim laterally and runs down the side of the thigh to insert on the bone just below the knee joint.  When tighter than usual, it can rub and snap over the greater trochanter (GT), the larger bony prominence on the side of the hip. This is known as “external snapping hip syndrome” and may eventually cause a painful bursitis—the inflammation of the small, fluid-filled sac that acts as a cushion between the ITB and GT.   

Repetitive hip flexion, or overuse of the hip area, causes most of the hip problems seen in runners. However, you can avoid or reduce this pain with exercises that emphasize opposite movements and structures. Start by learning how to stretch the tight anterior and lateral structures, the iliopsoas and ITB tendons, and strengthen the opposing hip extensors and abductors.

Talk to your local physical therapist or certified athletic trainer about an exercise and strength regimen that can help you correct or prevent hip pain. If your pain is particularly bad, consider having an MRI arthrogram to help define your injury. If necessary, surgery for the above three injuries can have you back on a running program and crossing the finish line in record time.

Sherwin S.W. Ho, MD is an expert in sports medicine, specializing in minimally invasive arthroscopic procedures of the shoulder, elbow, hip, knee, and ankle.