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Hip Pain When Running: Why It Happens and How to Fix It
- Dr. Matt
- 12 hours ago
- 5 min read
Hip pain during or after runs is common — but it’s not “just part of running”
Here’s the usual story: the first mile feels fine, then a dull ache creeps into the outside of your hip… or deep in the front of your hip… or even in your glute. You stretch, you rest, maybe you take a few days off — and it feels better.
Then you go for a run again and boom. It’s back.
If that sounds like you, you’re not alone. At Thrive HQ, we help runners every week who are stuck in this exact cycle. The good news: hip pain when running is fixable — once you know why it’s happening.
Let’s walk through the most common causes, and what actually works.
Why does hip pain show up when you run?
1. Weak or fatigued hip stabilizers
When you run, every single step is a single-leg squat. If your glutes (especially glute med) can’t control your hip and pelvis, the hip drops or shifts, and the tissues around the hip joint get overloaded.
What this looks like:
Your knee caves in or rotates in.
You get pain on the outside of the hip (often called “hip bursitis,” “IT band pain,” etc.).
Pain gets worse the longer you run or the day after long runs.
2. Poor single-leg control / pelvic control
If you can’t keep your pelvis level on one leg, load gets dumped into the front of the hip flexor or deep part of the groin. This often shows up as pinching in the front of the hip.
This is not always a flexibility problem. A lot of runners think “my hip flexors are tight,” when really the issue is that the hip flexors are doing work they shouldn’t be doing because the glutes/core aren’t doing their job.
3. Limited hip mobility
If your hip can’t actually move through the range you’re asking it to, your body cheats somewhere else.
Examples:
Tight hip flexors/short stride in front → more low back extension.
Stiff hip rotation → you swing your leg outward and load the outer hip with every step.
Limited posterior hip mobility → glute doesn’t load well, so running becomes quad-dominant and achy fast.
This is where loaded eccentric mobility and PAILs/RAILs (instead of just static stretching) become important.
4. Training load errors
This one is huge. You increase mileage, speed work, hill work, or volume too fast… and the hip just wasn’t ready yet.
Classic pattern we see:
“I felt great so I just added miles.”
“I jumped back into running after time off.”
“I added sprints/hills without building capacity first.”
Your tissues respond to stress over time. If the stress ramps up faster than your body adapts, your hip will tell you — loudly.
What doesn’t fix hip pain in runners (long-term)
❌ Just restingYou rest, pain calms down. You run again, pain comes back. That’s not progress, that’s a pause button.
❌ Static stretching aloneIt might feel good for 30 seconds, but it doesn’t change the way you load the hip while running.
❌ Foam rolling and hopingFoam rolling can help with short-term tightness, but it does not build control, strength, or durability.
❌ Being told “you’re just not built to run”No. Almost everyone can run. You may just need to change how you’re asking your body to do it.
What actually works to fix hip pain when running
1. Build single-leg strength and control
You have to get strong and stable on one leg, because running is single-leg loading over and over and over.
Try:
Lateral step-downs: 3 sets of 8–10 per side, slow 3–4 sec lower. Keep your knee tracking over your toes.
Single-leg RDLs: 3 sets of 8–10 per side, focus on hip hinge and keeping hips level.
Elevated split squat (slow eccentric): 3–4 sec down, slight forward shin angle, drive through front leg.
These build hip/pelvic control in the same pattern you use while running.
2. Train hip stability + core together
If your pelvis moves a ton with each step, your hip joint takes a beating to keep you upright.
Try:
Side plank (or side plank with top leg lift): 2–3 sets of 20–30 seconds per side.
Carry variations (suitcase carry or front-rack carry): 3–4 sets of 40–60 feet. Stay tall and level. This is huge for runners.
Dead bug (slow): Exhale, ribs down, reach opposite arm/leg without letting your low back arch.
This teaches your trunk and hip to work together instead of letting the hip flexor do everything.
3. Improve hip mobility — under load
Instead of yanking on your hip flexor and calling it a day, use techniques that actually expand usable range.
Try:
Half-kneeling hip flexor eccentric: Drop into a lunge/half-kneeling position, squeeze the glute of the back leg, and slowly shift forward with control for 4–5 seconds. 2–3 sets of 8.
90/90 PAILs/RAILs: Sit in a 90/90 hip position. Gently push the front shin into the floor (PAIL), then try to lift that same shin off the ground (RAIL). This helps you own internal/external rotation — huge for runners with outside-hip pain.
This combo gives you more motion and the ability to use that motion when you run.
4. Clean up your cadence and stride
If your stride is a big overstride (heel landing way in front of your body) or your cadence is super low, you’re basically “braking” with every step.
Try this:
Aim for a slightly higher cadence (often 165–180 steps/min for most recreational runners) to reduce impact per step.
Think “quick feet, soft landing under me” — not “reaching” forward.
Small changes in mechanics = big changes in tissue stress.
When to get help (this is important)
You should get assessed if:
You have sharp hip pain that changes your stride.
You’ve had the same hip pain for >2 weeks with no real improvement.
You’re changing how you run just to avoid pain.
You’re getting hip pain plus low back or groin pain at the same time.
Because at that point, it’s not just an “annoying tight spot.” It’s a pattern.
How Thrive HQ helps runners get out of the cycle
We don’t just say “stop running.” We start with a Pain Diagnostic Session that looks at:
Your hip mobility vs your hip control
How you’re absorbing load on one leg
Your running mechanics and cadence
Your current training plan / progression
Then we build a plan to keep you running — not shut you down.
“I went to another physical therapist first, and I was told to just stop running for a few weeks. I decided to get a second opinion from Thrive HQ. The diagnostic session was extremely in depth and they helped me fix my hip control and adjust my cadence — Allowing me to get back to running immediately. I’m back to running 5 days a week with zero pain.”— Sarah, St. Paul
Your next step
If you’re dealing with hip pain when running — and you’re tired of the rest/run/rest loop:
We’ll walk through what’s going on, talk about your goals, and map out what needs to change so you can keep running without guessing.