Hip pain from running can be confusing because it can come from a range of structures: muscles, tendons, joints, or even referred pain from the lower back. The good news is that most hip pain in runners responds well to physiotherapy with the right diagnosis and a structured plan.
In this guide, we walk you through the most common causes of running-related hip pain, where each type tends to sit, and how to know when to see a physio.
Common Causes of Hip Pain in Runners
Gluteal Tendinopathy
Pain on the outside of the hip, often felt when lying on that side, climbing stairs, or after long runs. Gluteal tendinopathy is one of the most common hip complaints in runners and relates to overload of the tendons attaching to the greater trochanter. Treatment focuses on progressive loading of the gluteal muscles and reducing aggravating positions.
Hip Flexor Strain or Tendinopathy
Pain in the front of the hip or groin, often worse with running uphill or sprinting. The hip flexors lift your leg with every stride, and they can become irritated with sudden increases in training, hill work, or sprint intervals. Strengthening through full hip range and managing training load are the cornerstones of recovery.
Femoroacetabular Impingement (FAI) and Labral Irritation
Pain in the front or deep in the hip, sometimes with clicking, catching, or stiffness. FAI occurs when there is extra bone in the hip joint that can irritate the labrum (a cartilage rim around the hip socket). Most cases respond well to physiotherapy, although surgical options exist for more severe presentations.
Hip Bursitis
Pain on the outside of the hip, often grouped together with gluteal tendinopathy under the broader term “greater trochanteric pain syndrome”. Treatment is similar to gluteal tendinopathy, with a focus on hip strengthening and load management.
Referred Pain From the Lower Back
Some runners experience lower back and hip pain together. The lumbar spine and sacroiliac joint can both refer pain into the hip and buttock. A thorough physio assessment can help differentiate between hip-driven and back-driven pain and guide treatment appropriately. If your pain extends down the leg, see our sciatica guide.
Where Is Your Hip Pain?
- Outside of the hip: most likely gluteal tendinopathy or greater trochanteric pain syndrome
- Front of the hip or groin: most likely hip flexor strain, FAI, or labral irritation
- Deep, central hip pain: possible FAI or labral involvement
- Buttock or back of the hip: gluteal, hamstring origin, or referred pain from the back
- Hip and lower back together: likely lumbar spine involvement
What Causes Hip Pain in Runners?
- Sudden increases in training load, particularly distance or hill work
- Weak glutes and core, leading to poor pelvic control during running
- Tight hip flexors from prolonged sitting before training
- Reduced hip mobility that increases load on surrounding tissues
- Asymmetries: one leg working harder than the other due to past injury
- Footwear or surface changes that alter your gait
How a Physio Treats Running-Related Hip Pain
Assessment
A thorough history, hands-on examination of the hip and surrounding areas, screening of the lower back, and a running gait analysis where appropriate.
Pain Relief
Manual therapy, soft tissue work, taping, and short-term load modification help settle the early stages of recovery.
Strength and Rehab
Progressive strengthening of the glutes, deep hip stabilisers, hip flexors, and core. Gluteal tendinopathy in particular responds well to heavy slow loading. Most hip rehab takes between six and twelve weeks of structured work.
Return to Running
A graded return to running, typically starting with walk-runs and progressing volume before pace and hills.
Exercises for Hip Pain From Running
While exercise prescription should be individualised, the following are commonly used for runners with hip pain:
- Side-lying hip abduction for gluteus medius strength
- Single-leg bridges for posterior chain control
- Step-ups and step-downs for hip control under load
- Hip flexor stretches for runners with anterior hip tightness
- Single-leg balance work for proprioception
- Heavy slow squats and deadlifts as part of progressive loading
Your physio will tailor these to your specific diagnosis, current capacity, and training goals.
Preventing Hip Pain When Running
- Build mileage gradually using the 10 percent rule
- Strength train the hips, glutes, and core at least twice per week
- Avoid prolonged sitting before training where possible
- Vary your terrain and avoid only running camber-heavy surfaces
- Address niggles early rather than running through them
Frequently Asked Questions
How Do You Get Rid of Hip Pain From Running?
The best approach depends on what is causing the pain. In general, recovery involves identifying the underlying driver with a physiotherapist, addressing strength deficits and load management, and gradually returning to running. Most cases settle within six to twelve weeks with the right plan.
Why Does My Hip Hurt When I Run but Not When I Walk?
Running places significantly higher loads on the hip than walking. If your hip is irritated but has enough capacity for low-load activities like walking, it may only become symptomatic when running. This often points to a strength or load tolerance issue that responds well to targeted rehab.
Should I Stop Running With Hip Pain?
Not necessarily. Mild discomfort that settles in the first ten minutes and does not worsen during the run may be acceptable, but sharp, persistent, or worsening pain is a sign to back off and get assessed. Continuing to run through hip pain often makes it worse and harder to settle.
Do Hip Flexor Stretches Help Running Pain?
Hip flexor stretches can be helpful for some runners, particularly those with anterior hip tightness from prolonged sitting. They are best used alongside strengthening rather than as a standalone fix. Your physiotherapist can advise whether they are appropriate for your situation.
Could My Hip Pain Be Coming From My Back?
Yes. The lumbar spine and sacroiliac joint can both refer pain into the hip area. A thorough physiotherapy assessment can help determine whether your pain is hip-driven or back-driven, and treatment will differ accordingly.
What Causes Hip Pain When Running?
Hip pain when running is usually caused by a gradual build-up of load rather than a single moment of injury, most often a sudden increase in distance or hill work. Weak glutes and core, tight hip flexors from prolonged sitting, reduced hip mobility, and asymmetries left over from a past injury all add to what the hip absorbs with every stride. Footwear and running surface changes can contribute as well. A physiotherapist can assess which of these is driving your pain and where to start.
Hip pain when running is common and usually very treatable. If yours has been hanging around for more than a couple of weeks or is interfering with your training, our sports physiotherapy team can help identify what is driving it and build you a recovery plan.
We see runners across our Burwood, Newington, Top Ryde, and Eastgardens clinics. For a broader overview, see our common running injuries guide.
Book your appointment today and let us help you run pain-free again.