Hip Pain

Jan 11th, 2014

Victoria asked The Guru for the following Physiotherapy Advice:

Dear Guru

I am a 32 year old woman, doing outdoor fitness classes twice a week for about three years with no injuries or complaints. Prior to this I did very little sport or organised exercise. About a year ago I started running once or twice a week, almost exclusively on grass and trail and no more than 3 or 4 miles at a time. My friend persuaded me in May to take a spare place in a fairly flat off-road half marathon in July, and for training I upped the running to 6-8 miles three times a week with one fitness class.

Late July about three weeks after the half I noticed my left hip was occasionally aching a little, and this progressed until about three weeks ago it had reached the point where it was constant and quite painful. After trying ice and cutting back with no change, I stopped exercising completely and have rested for three weeks which has seen some improvement but not much. It feels like it is the outside of my hip/upper thigh, and is tender to press in to. Lying on my left side hurt initially, but has improved with the 3 weeks rest, and going up/down stairs also causes discomfort. Sitting down for more than a short period results in the left hip being stiff and achey for about a minute until I get moving about, then it eases off. It does not hurt more during running, but before I stopped classes there were exercises that started to hurt, one example being leopard crawl.

Any idea what I’ve done, and is it a result of upping the mileage too fast? I’d really like to do another off-road half marathon in March if possible, so any advice would be gratefully received!

Jan 11th, 2014

The Guru Responded:

Hi Victoria

I think you are partially on the right track about doing too much too
soon, but it could also be that you body isn’t ready for distance
exercise, yet.

It sounds as if you’ve got a trochanteric bursitis. This is a little
fluid filled sac that sits just below the boney bit on your outer
thigh. A band of tissue (ITB) flicks back and forwards over this when
running, and especially going down hill IF you can’t control the
amount of rolling in your thigh does when taking weight on it…

This rolling in is controlled (amongst a few other things) by your
glut med muscle at the top of your butt, an this is where the problem

Rest will not improve the control (you don’t need strength) of your
glut. So you need to improve your control (which is influenced by foot
posture and spinal alignment) by doing things like lunges, ballistic
lunges, single knee squats, running man etc. You need to have great
control with on-the-money alignment and form. It’s not about how far
you can go into range or how many but about the control.

Have a look on YouTube for the above and work on those suggestions for
the next few weeks (little and often) then restart running on the
flat. Walk for 1 min run for 1 min for 5 cumulative minutes. 2 days
rest and repeat. After a week increase running to 2 minutes for 10
minutes running, then after 2 sets run for 15 mins and off you go…….

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