Why Your Hip Hurts After Running—And Where the Pain Starts Matters Most

Hip pain after running is incredibly common, affecting up to 17.5% of recreational runners according to a 2023 study of 616 athletes published in the International Journal of Environmental Research and Public Health. The reason is simple physics: your hip joint absorbs roughly 5 times your body weight with every running stride, which means roughly 390 kilograms of force (for a 165-pound runner) slamming through the joint with each step. The good news? Most cases are muscular and respond well to targeted strengthening and load management without surgery or injections.

Tips for Identifying the Source of Your Running Hip Pain

The location of your hip pain is actually your fastest route to the right diagnosis and treatment. Rather than guessing from a long list of possible causes, pinpointing where you feel discomfort narrows things down significantly. Front-of-hip pain usually means something different than outer hip pain, which is different again from deep buttock pain. Each location points to specific structures that need attention.

• Front of hip or groin: Sharp pain when lifting your leg or pushing off during a run typically indicates hip flexor strain. The iliopsoas muscle group does heavy work during the swing phase of running and is often the first thing to strain when you increase mileage or pace too quickly. You'll notice it most when climbing stairs, getting out of a car, or during high knee drills.
• Outside or lateral hip: A dull, achy pain over the bony point on the outside of your hip is the most common hip complaint in runners. For years this was diagnosed as trochanteric bursitis, but research has moved on. A study from Cambridge University Hospitals reports that isolated bursa inflammation accounts for only 2% of lateral hip pain cases. The real culprit is usually gluteal tendinopathy, where the tendons of your gluteus medius and minimus become irritated at their attachment point.
• Back of hip or deep buttock: A deep ache in your buttock that might travel down the back of your thigh often gets called sciatica, but in runners the piriformis muscle is frequently the source. This small muscle sits deep in your glute and can tighten from repetitive rotational forces of running. When it spasms, it presses on the sciatic nerve and mimics sciatica symptoms.
• Deep inside the joint: Catching, clicking, restricted rotation, or stiffness after sitting may indicate hip impingement or labral tear. If the pain feels like a pinch in the crease of your groin when you bring your knee toward your chest, that could be labral irritation from repetitive flexion during running.

Why Is Gluteal Tendinopathy So Common in Runners?

Gluteal tendinopathy is the most common lower limb tendinopathy overall, affecting up to 23.5% of women and 8.5% of men aged 50 to 79, though runners of any age can develop it. Research suggests a 12% prevalence specifically in distance runners. The condition is worse after long runs, when lying on the affected side at night, and during single-leg activities like lunges or stair climbing.

"Progressive loading is the primary treatment principle," explains Dr. Alison Grimaldi, a physiotherapist and researcher whose work on gluteal tendinopathy has been published across multiple peer-reviewed journals. "Tendons require mechanical stimulus to rebuild tolerance. Passive rest without rehabilitation exercises typically results in recurrence, not recovery". This means that simply resting the injury isn't enough—you need targeted strengthening exercises to help the tendons adapt to running demands.

When Should You See a Healthcare Provider?

Most running-related hip pain resolves with proper load management and targeted exercises. However, certain warning signs suggest you should get professional assessment. You should see a physiotherapist or doctor if pain lasts more than 2 weeks, stops you from walking normally, or involves clicking, catching, or sharp jolts. These symptoms may indicate structural issues like labral tears or hip impingement that need professional evaluation.

The key takeaway is that weak glutes and training errors cause the majority of running hip pain, and strengthening combined with smart load management can fix them without medical intervention. By identifying where your pain is located and understanding what that location typically means, you can take targeted action to address the real problem rather than treating symptoms. If you're increasing your running volume, doing so gradually and maintaining strong glute muscles through targeted exercises can help prevent many common hip complaints before they start.