Runners’ bodies undergo a lot of pounding that can lead to medical conditions that cause hip or thigh pain. Diagnosis can be challenging because more than one condition can be present at a given time.
A patient can help his or her doctor make an accurate diagnosis by noting the pattern of symptoms, including exact location of pain, when it occurs, and what makes it go away.
Greater trochanteric bursitis (Hip bursitis)
This type of bursitis tends to cause tenderness and pain on the outside of the hip. As symptoms progress, pain may radiate down the outside of the thigh and occasionally to the buttock, groin and low back.
The greater trochanter is a bony prominence on the femur (thighbone). The trochanteric bursa is a small, fluid-filled sac that serves as both a cushion and lubricant between the greater trochanter and the iliotibial (IT) band, a thick piece of connective tissue that extends from the hip to the top of the tibia (shinbone).
In runners, the trochanteric bursa can undergo frequent “mini-traumas.” Over time, the bursa becomes inflamed, causing painful symptoms. A tight IT band can exacerbate hip bursitis.
Stress fracture in the hip
A traumatic bone break is caused by a one-time injury, but a stress fracture is caused by repetitive strain on a bone. The impact of jogging can cause a small crack to develop in the femoral head (hip). Runners who have osteoporosis are at a greater risk of stress fractures.
The pain of a stress fracture will gradually increase and become more pronounced. Pain is more noticeable during and after activity and less noticeable after sleeping, when the bone has had time to rest. Pressing down on the skin over the hip may cause pain.
If a stress fracture is suspected but not confirmed, a doctor may recommend beginning non-surgical treatment right away. A definitive diagnosis may require advanced imaging, such as and MRI or bone scan.