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Hip pain that’s not that happy

Jan 10th, 2014

David asked The Guru for the following Physiotherapy Advice:

I am a keen runner with many half marathons under my belt and one full marathon (Dublin Oct 2010 3hrs 18mins), but am now in training for the London Marathon in less than 6 weeks.

A few weeks ago I introduced hill work and speed sessions into my training but they aggravated my hips (in particular my right), a day or two of rest and I was fine again. However, 3/4 weeks ago the pain got worse in my right hip and now won’t go away. The problem has moved into my thigh and feels almost like a nerve problem. the discomfort comes and goes but won’t clear up completely.

I’ve been able to continue running on it (although I have rested quite a bit too) and the discomfort reduces when I run – only last weekend I ran a steady 11miles and felt great afterwards, now a few days later the pain is worse again. It’s difficult to pin point the pain, self massage and using a tennis ball seems to have no effect although using a roller in the gym I was able to feel a couple of acute points of pain in my thigh (front mid point).

Gym instructors have suggested it could be my hip flexor but the fact that it comes and goes suggests it is not muscular as surely the pain would be more constant.

Any suggestion you may have would be greatly appreciated.

Many thanks

David

The Guru Responded:

Hi David

I agree, it doesn’t sound like a hip flexor problem but more like a (femoral) nerve issue from hill training.

The problem about hills (and you’ve already got a great pedigree for marathon running) is that you lean backward or forwards excessively, causing more shearing force around your lumbar spine – this doesn’t need to be painful.

I’d avoid stretching, unless you can stabilise your lumbar spine. I’d concentrate on form and function, especially getting more thoracic spine mobility. Running tall and not over striding is a must.

The idea about getting more thoracic spine mobility is to take the excessive load (and shear) away from you lumbar spine, the potential source of the referred pain.

If you’re using tennis or spikey balls, go for your gluts. If you’ve got a foam roller go for your thoracic spine….

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