Q+A: What’s this hip pain? Should I stretch?

Q I have only just been bitten by the running bug, and although I feel no pain while running, the next day I get a niggling discomfort on the outside of my left hip. It doesn’t hurt when I touch it or when I’m sitting down, but I’m aware of it when walking. Is there a hip stretch or exercise that I should be doing?

A There are three muscles on the outside of the hip which stop the pelvis dropping as each leg swings forward. One of these (tensor facia lata) is a short muscle with a long tendon passing all the way down the outside of the thigh and attaching below the knee. This muscle is important in stabilising the pelvis in running and often becomes tight and inflamed, especially as a result of hill training. The other muscles lie behind the tensor facia lata and are called gluteus medius and minimus. These muscles are often weak in inexperienced runners and can lead to dominance and overstrain in the tensor facia lata. Efficient running requires good strength in all three muscles.

If your pain is above the bony prominence on the outside of the hip and behind the bony prominence at the front of the hip, this is the likely cause. You can strengthen the gluteal muscles very simply by doing the following exercise:

1. Lie on your side on the floor. Bend the underneath leg up until the thigh is at 90° to your body and the lower leg at 90° to the thigh. Use the upper arm to stabilise your upper body by placing your hand on the floor. Prop your upper body up on the under arm with a bent elbow. Ensure that the upper leg is taken backwards so that it’s in line with your body or just behind it. Pull your foot and ankle up until it feels locked and straighten the knee. Lift the leg slightly and turn the whole leg inwards so that the toes are pointing down to the floor. Lift the leg until it is parallel with the floor. From this position lift and lower the leg, ensuring that the knee remains straight, the foot locked up and the whole leg is turned in with the leg in line with your body.

2. Lift the leg until you feel an ache in the side of the pelvis towards the back. If you don’t feel this ache after repetitive lifting, the leg is too far forward. Try starting with 20 lifts and build up by two lifts every two days until you can do 50 lifts comfortably.

If this does not resolve your problem, seek the advice of a chartered physiotherapist regarding a possible bursitis (friction blister) or a deeper-seated biomechanical problem.

Judith Pitt-Brooke, chartered physiotherapist at the East Midlands Physiotherapy Clinic and On Trak Movement Analysis Centre