Front of Hip Pain in Runners

The primary sources of pain along the front of the hip, particularly in the groin area, observed in runners are often attributed to labral irritation/tear and hip flexor strain. Following is information on injuries related to front of the hip pain.

Labral Tear of the Hip

hip labral tearIs a tear to the cartilage lining of the hip joint, called the acetabulum.  This injury can result from overuse, trauma, or structural abnormalities in the hip joint. Runners with a labral tear may experience pain, clicking, or locking sensations in the hip, limiting their ability to run comfortably.  Symptoms may come on suddenly following an impact or trauma. But can also develop gradually if your joint progressively degenerates. Diagnosis often requires imaging studies like MRI, and treatment may involve rest, physical therapy, and in some cases, surgical intervention to repair the torn labrum. More information on Labral Tear of the Hip.

 

Hip Flexor Strain

The hip flexor is prone to overuse and injuries like muscle or tendon tears, collectively termed a hip flexor strain. The initial issue often involves inflammation, followed by damage to the muscle or tendon, primarily resulting from overuse. Runners may encounter hip flexor strains during cross-training or uphill running. Additionally, overstretching the hip flexor can also contribute to the development of a strain.  Symptoms include:

  • Abrupt and intense pain in the hip region
  • Muscle stiffness, weakness, and cramps in the upper leg
  • Swelling near the injury site
  • Pain during leg lifting
  • Muscle spasms in the hip or thigh
  • Discomfort during movement

More information on Hip Flexor Strain in Runners

 

Hip Impingement

hip impingementHip impingement, or femoral acetabular impingement (FAI), arises when excess friction occurs between the thigh bone (femur) and the hip socket (acetabulum) within the hip joint. This condition leads to hip pain, diminished mobility in one or both hips, and potential damage to surrounding cartilage. Running can exacerbate the issue, causing pinching of the neighboring tissues and potentially resulting in labral tears, which are injuries to the strong cartilage around the hip socket.

There are three main types of hip impingement:

  1. Cam: characterized by a bony overgrowth on the head of the femur.
  2. Pincer: involves a bony overgrowth on the acetabulum.
  3. Mixed: a combination of both cam and pincer types.

Hip impingement affects particularly the young adult population and cam-type impingement is more prevalent in men, whereas women are more prone to experiencing pincer-type impingement.

Common exercises that may cause pain include deep squats and lunges.  More information on hip impingement.

 

Synovitis of the Hip

Synovitis of the hip is a condition characterized by inflammation of the synovial membrane—the lining of the hip joint. This inflammation can lead to pain, swelling, and restricted movement in the hip. Common causes include underlying conditions such as arthritis, injury, or overuse. Symptoms may range from discomfort and stiffness to noticeable swelling in the hip area

This condition can also affect young children and be linked to the presence of a virus.  Diagnosing and treating the original cause or co-existing condition is the key to recovering from hip synovitis.

 

Osteoarthritis of the Hip

Osteoarthritis is ‘wear and tear’ (degeneration) of the hip joint. The hard cartilage on the ends of the bone wears away and eventually, the bone starts to wear away also. Symptoms include:

  • Hip pain
  • Reduced joint mobility,
  • Joint inflammation and your hip joint will feel hot and inflamed.

It is common in older people over the age of 50, especially women. Although there is no cure, osteoarthritis can be managed with various treatment options.

 

Rectus Femoris Tendon Injury

The rectus femoris is one of the powerful quadriceps muscles at the front of the thigh. A strain or tear in the tendon can occur at its origin at the front of the hip. Symptoms include:

  • A sudden sharp pain at the front of the hip or groin.
  • Pain usually occurs whilst doing an explosive-type activity such as sprinting or jumping.
  • Swelling and bruising may occur with pain when lifting the knee up against resistance.
  • Tenderness will be felt when pressing in where the muscle attaches at the front of the hip.

 

Hip Pointer/Contusion

A hip pointer occurs following a direct impact or trauma to the front of your hip. It is common in contact sports like rugby or American football. There will often be bruising and pain at the point of impact which can be eased by ice and compression.

Symptoms of a hip pointer include:

  • Pain and tenderness over the front of your hip.
  • Pressing in on the point of injury will be painful.
  • There is usually some obvious bruising or swelling.

A full assessment should be undertaken to rule out the possibility of damage to intra-abdominal organs.  More information on hip pointer injury.

 

Pelvic Stress Fracture

A pelvic stress fracture is a hairline-type fracture in the large pelvis bone. This is due to repetitive impacts or forces, rather than one sudden impact or accident. They are more common in women and normally occur in the pubic rami, where the hamstring and groin muscles attach. Symptoms include:

Tenderness over the inferior pubic ramus at the bottom of the pelvis.
Pain is felt in the groin or hip which increases with exercise but eases or gets better with rest.  You will experience reduced strength and movement in the pelvic area.