Running: Anterior Hip Pain FAQs

Revive Your Run: A Runner's Guide to Overcoming Anterior Hip Pain

Are you feeling sidelined by nagging anterior hip pain that just won't quit? If you're a runner, this discomfort can be particularly frustrating, putting a damper on your training and goals. But fear not! Let's dive into the world of rehabilitation and discover how you can reclaim your stride and say goodbye to anterior hip pain. 

Anterior hip pain is essentially just a broad term for pain at the front of the hip. It can feel quite broad around the whole area of the hip or also quite specific. The signs and symptoms can vary quite a bit, but this is all still in the realm of anterior hip pain.

What could be causing my hip pain?

Anterior hip pain, while a common complaint among runners, can stem from various sources. It often arises from structures at the front of the hip joint, including the hip flexors, iliopsoas tendon, or the labrum—a cartilage ring that lines the hip socket. Factors such as overuse, poor running mechanics, muscle imbalances, or hip joint abnormalities can all contribute to the development of this pesky ache.

Woah, what are all those structures?

The hip flexors are a group of muscles. They cross have attachments on the pelvis and spine, cross the hip joint and attach onto the femur (the thigh bone). They do what their name implies - flex the hip joint (the movement of bringing your foot forward in front of you or bringing your knee towards your chest). You will do this a lot in running as you bring your foot forward in front of you with each stride. Say you're running at 150-170 strides per minute for 10km (~1 hour). 160SPM (strides per minute) x 60(minutes) = 9600 strides. That's a lot of hip flexion! These guys work hard.

The labrum is a cartilage ring that surrounds the hip joint. It help support the hip joint, adding some stability and a little bit of cushioning to the hip joint as you stride. It generally adapts pretty well and gets stiffer and more resilient as you build up your running, but it can be a sensitive structure if things aren't working too well. 

What are the signs and symptoms of anterior hip pain?

How do you know if you're dealing with anterior hip pain? Keep an eye out for the following symptoms:

  • Discomfort or tenderness at the front of the hip, especially during or after running.
  • Stiffness or reduced range of motion in the hip joint.
  • Pain that worsens with activities like climbing stairs, sitting for prolonged periods, or performing hip flexor stretches.
  • A sharp pain when you bend your hip or bring your knees towards your chest.

Rehabilitation Strategies for Anterior Hip Pain:

Now, let's roll up our sleeves and tackle anterior hip pain head-on with these effective rehabilitation strategies:

Rest and Modify Activities:

Temporarily, it is wise to give your hip a chance to heal and recover by reducing or modifying your running routine. Cross-training with low-impact activities like swimming or cycling can help maintain cardiovascular fitness while minimising stress on the hip joint. This will allow aggravated and sensitive tissues to settle down and be primed for tolerating load again. This is especially important if the injury is quite acute. General movement of the hip with low impact activities help reduce stiffness and promote tissue healing and load tolerance, so keep moving!

Stretch and Mobilise:

Targeted stretching and mobility exercises can help alleviate tightness and improve flexibility in the hip flexors and surrounding muscles. Incorporate dynamic stretches, foam rolling, and mobility drills into your routine to promote tissue relaxation and joint mobility. This can be helpful as it applies a low load to the area and non painful (or low pain) sensations to the affected and surrounding tissues.

Strengthen Weak Muscles:

Identify and address muscle imbalances that may be contributing to your anterior hip pain. Focus on strengthening exercises for the hip flexors, glutes, and core muscles to improve stability and support around the hip joint. Squats, bridges, static and dynamic balance exercises are a good idea here in addition to your normal running exercise routine. In general, it is a good idea to be strong around your body to improve its ability to handle what you throw at it. You can't go wrong getting strong!

Address Running Mechanics:

Work with a running coach or physiotherapist to assess and correct any faulty running mechanics that may be placing excessive strain on your hip joint. Adjustments to stride length, foot strike pattern, or cadence can help reduce impact forces and alleviate stress on the anterior hip. Generally, your body is quite good at selecting a good running style. Gone is the old 'you shouldn't heel strike when you run'. But sometimes, if a running style is causing you pain, some specific adjustments can be quite helpful to de-load sensitive structures to keep you running volume up as much as possible whilst you recover.

Gradual Return to Running:

As pain is subsiding and, strength and flexibility improve, gradually reintroduce running into your routine. Start with short, easy runs on flat surfaces, paying attention to any signs of discomfort. Progress slowly and listen to your body, adjusting intensity and duration as able. This step is the most critical to avoid loading the structures in the anterior hip too much too soon (the most common factor in overuse injuries such as this).

Remember, rehabilitation is a process that requires patience and persistence. By addressing underlying issues, improving strength and flexibility, and modifying your training approach, you can overcome anterior hip pain and get back to doing what you love—running strong and pain-free.

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