Lateral hip pain is a frequent complaint among runners, often turning a joyful activity into a source of frustration. This discomfort is located on the outside of the hip, typically near the bony prominence known as the greater trochanter. Repetitive motion from running places significant stress on the soft tissues in this area. The resulting irritation and inflammation signal that the body’s structures are being overloaded. Understanding the specific source of this pain is the first step toward getting back on the road comfortably.
The Primary Causes of Lateral Hip Pain
The most common diagnoses for pain on the outside of the hip in runners are Iliotibial Band Syndrome (ITBS) and Gluteal Tendinopathy, which often presents alongside Trochanteric Bursitis. While classically associated with knee pain, ITBS can also cause discomfort at its attachment point on the hip. When irritated, the iliotibial (IT) band typically causes a sharp, burning sensation that begins predictably during a run.
Gluteal Tendinopathy involves the tendons of the gluteus medius and minimus muscles, which attach to the greater trochanter. The pain is often described as an ache that is tender to the touch and can radiate down the outer thigh. This tendinopathy is frequently the primary driver of discomfort, though it can sometimes lead to inflammation of the nearby fluid-filled sac, the trochanteric bursa (Trochanteric Bursitis). Unlike ITBS, tendinopathy pain may also be noticeable when climbing stairs or lying on the affected side.
Training and Biomechanical Errors
The underlying cause for these soft tissue irritations often stems from training and biomechanical missteps. A rapid increase in weekly mileage, excessive hill repeats, or high-intensity speed work without adequate recovery can overload the hip structures. This sudden spike in training volume, often referred to as a training error, does not allow the tendons and muscles enough time to adapt.
A primary internal factor is the weakness of the gluteal muscles, particularly the gluteus medius and minimus. These muscles stabilize the pelvis during the single-leg stance phase of running. When they are weak, the hip on the opposite side may drop, and the thigh can collapse inward (hip adduction). This excessive movement increases strain and compression on the lateral hip tendons and the IT band, setting the stage for injury.
External factors also contribute, including uneven or cambered running surfaces, such as a sloping road, which forces one leg to absorb more impact. Running in worn-out footwear that no longer provides proper support can also alter foot and leg alignment, leading to poor control at the hip. These errors increase the mechanical stress on the lateral hip, pushing the tissues past their load capacity.
Immediate Steps for Pain Management
When lateral hip pain flares up, the priority is to modify activity to prevent further irritation. Continuing to run through pain will only worsen the condition, so temporarily reducing your running distance or taking a few days off is necessary to let the irritated tissues settle. Applying ice to the outer hip for 15 to 20 minutes several times a day can help reduce localized pain and inflammation, especially in the first 48 hours. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be used for temporary relief. Avoid positions that compress the painful area, such as sleeping directly on the sore side or sitting with your legs crossed. If the pain is severe, persists even when resting, or if you experience an inability to bear weight, consult a healthcare professional for a precise diagnosis.
Rehabilitation and Long-Term Prevention
Long-term recovery requires building the hip’s capacity to handle the repetitive load of running. This begins with strengthening exercises targeting the hip abductors and stabilizers, like the gluteus medius. Simple exercises such as clamshells, side leg lifts, and mini-band work are effective for isolating and strengthening these muscles. As strength improves, exercises should progress to functional, single-leg movements, such as single-leg squats or lunges, to mimic running demands.
While aggressive stretching of the IT band is often ineffective and can sometimes increase compression, foam rolling can release tension in the surrounding muscles, specifically the gluteals and the tensor fascia lata. Another long-term strategy involves reviewing your running technique, focusing on increasing your step rate, or cadence, by five to ten percent. A slightly higher cadence reduces the time spent on the ground and minimizes excessive hip movement, lowering the load on the lateral hip structures. Regularly replacing running shoes before they lose cushioning and stability is also important for prevention.