Unhappy Hips

They are the bane of so many runners and the reason for countless DNF’s and DNS’s.

In my sports injury clinic, it seems every second runner coming in has hip issues of some sort.

Why is it that hips can give so many runners the pips?!

The good news is that for the vast majority of people presenting with hip pain from running, it is not actually the hip joints that are the problem. Contrary to what a lot of people believe they are feeling, often the pain comes from muscles surrounding the hip. The most common in my experience being a pesky little muscle called Tensor Fascia Latae (TFL). This unassuming and quite short muscle can very easily produce pain that feels incredibly deep and “joint like”.  It can have even the most experienced runners wondering if all those people who told them running will give them arthritis, were actually right…

The TFL sits on the front outside corner of your hip and begins just under that bony bit on the front of your pelvis called the anterior inferior illiac spine. From there it extends down your leg and slightly backward to line up with and connect into your Iliotibial Band (ITB). This connection therefore means that whenever the TFL muscle gets tight, it pulls on and tightens your ITB. Any runner that has had ITB issues will know that this also is something you definitely want to avoid.

The TFL has multiple jobs, including hip flexion (bringing leg out in front of you), hip abduction (moving leg outwards away from your midline), internal rotation (turning your leg and foot inward) and lateral hip stability (working with your ITB to stop you getting sloppy through your hips while you are running).

Factors that can lead to the TFL being a nuisance are:

Overload – increasing your training to a point where something is unable to cope. If unconditioned, the TFL will often become extremely tight and overactive from having to lift the knee over extended periods or from too much uphill running.

Imbalance – when the TFL has to work too hard because it is making up for weakness somewhere else. The most common scenario is a weak Gluteus Medius muscle which leaves the hips unstable and the TFL having to make up the difference. CLICK HERE for a Glute Med strengthening exercise.

Poor technique – overstriding, too much rotation through the hips or low back and heavy heel striking can all increase the workload of the TFL.

While it is often surprising to find people who have spent months (or years) trying to get their hip pain fixed with little to no result, it can sometimes be incredibly simple to resolve when you know what you are looking for. The approach I take, generally involves 4 things:

1) Deep compression massage to the TFL and other hip flexors.

2) Identification of the muscles that are not pulling their weight and the use of specific exercises to get them functioning correctly.

3) Stretching to improve normal range of motion.

4) Analysis of running technique and recommendations for improvements in efficiency.

 

The best bit of advice I can give runners with this issue is to invest in a foam roller and get a spiky massage ball or even a tennis ball. These two tools can make a massive difference. All you need to do is spend 3-5 mins each day rolling out your ITB’s then getting the ball on your TFL and laying on it for a couple of minutes. This combination will do wonders for your hip pain and hopefully allow you to continue running. If running technique or muscle weakness is your causative factor, then getting some professional help to sort these out is highly recommended.

Don’t put up with hip pain. Find someone who knows what they are doing and get onto it before it becomes chronic and harder to resolve.

Here’s to many years of happy and pain free running!

 

Run long,

Shaun Brewster.

 

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