From Hip Pain to Running Again: What Does Rehabilitation Involve?
Hip pain after running can be frustrating because it rarely gives you a clear answer about what to do next. You may be comfortable walking and sitting, only for the discomfort to return a few kilometres into a run. Or the pain may appear afterwards, making stairs, getting out of a car, or lying on one side uncomfortable.
The important point is that hip pain is not one diagnosis. In runners, symptoms around the front, side, groin, or back of the hip can come from different tissues and may be influenced by training load, strength, mobility, previous injury, and how quickly running has been progressed. Rehabilitation should therefore be built around the individual problem rather than a generic list of hip exercises.
Align Health is a DOH-certified physiotherapy clinic in Abu Dhabi. The information in this blog is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider regarding your specific condition.
Why Hip Pain Can Appear During or After Running
Running repeatedly loads the hip and the muscles that control the pelvis and leg. Most runners tolerate this well when training demand and physical capacity are reasonably matched. Pain can develop when the load changes faster than the body has adapted, when an irritated tissue is repeatedly stressed, or when an existing hip problem becomes more sensitive under running demands.
Possible causes range from muscle or tendon overload to joint-related hip pain, referred symptoms from the lower back, or less common problems that require medical investigation. The location of pain alone is not enough to diagnose the cause, which is why persistent or recurring symptoms are better assessed than guessed.
Step 1: Work Out What Is Actually Driving the Pain
A useful rehabilitation plan starts with assessment. A physiotherapist will usually ask when the pain started, where it is felt, what type of running brings it on, what changed in training, and which daily activities are affected. The physical assessment can then look at hip movement, strength, control, functional tasks, and other areas such as the lower back, knee, or ankle when relevant.
For runners, the training history matters just as much as the examination. A sudden increase in distance, speed work, hills, races, gym training, or a return after time off may all change the demands placed on the hip. The goal is not to find a single fault. It is to identify the factors that are most relevant to your presentation and recovery.
If hip pain is limiting your training, an assessment through physiotherapy for hip pain can help clarify the likely source of symptoms and the appropriate next steps.
Step 2: Settle Irritation Without Losing All Activity
When running is repeatedly aggravating the hip, a temporary reduction in the activity that provokes symptoms can be useful. This does not automatically mean complete rest. Depending on the condition, some people may be able to continue with shorter or easier runs, walking, cycling, strength training, or another form of exercise while the irritated area settles.
The right level of activity is individual. The key is to avoid repeatedly pushing symptoms up while also preventing an unnecessary period of total inactivity. Your physiotherapist may use symptom response during activity and over the following day to help decide whether the current load is appropriate.
Step 3: Rebuild Strength and Load Tolerance
Pain relief is only one part of rehabilitation. To return to running with confidence, the hip and surrounding muscles need to tolerate the forces involved in repeated single-leg loading.
A progressive programme may include hip abductor and extensor strengthening, calf and lower-limb work, trunk control, and functional single-leg exercises. The exact exercises depend on the diagnosis and the deficits found during assessment. As capacity improves, rehabilitation should become more specific to running rather than staying at a basic exercise level.
For some hip conditions, education about load management combined with exercise is an important part of treatment. Research in conditions such as gluteal tendinopathy supports an active approach that helps people understand aggravating load while progressively rebuilding strength.
Step 4: Look at the Running Load, Not Just the Hip
A runner can complete every rehabilitation exercise well and still flare the hip if the return to training is too aggressive. Rehabilitation therefore needs to connect clinic progress with real running demands.
That may mean reviewing weekly distance, frequency, pace, hills, intervals, long runs, surfaces, and other training such as strength or group fitness. There is no universal percentage increase that is safe for every runner. A sensible progression is based on your recent training history, symptoms, goals, and how well you recover between sessions.
This is where physiotherapy for sports and exercise becomes more useful than simply treating the painful area. The plan should prepare you for the activity you actually want to return to.
Step 5: Gradually Return to Running
Returning to running should usually be progressive rather than an immediate jump back to your previous distance and pace. Depending on the injury, a runner may begin with comfortable walking, short run-walk intervals, or reduced-volume running before increasing continuous distance.
As tolerance improves, distance can be built before harder elements such as faster pace, hills, or longer efforts are reintroduced. Progression is guided by symptoms, function, strength, and the demands of the runner rather than by time alone.
When Hip Pain Needs Medical Assessment
Not every episode of hip pain is suitable for routine self-management. Seek prompt medical assessment after significant trauma, if you cannot comfortably bear weight, if pain is severe or rapidly worsening, or if symptoms are accompanied by fever, unexplained illness, marked weakness, numbness, or other concerning changes. Runners with persistent deep groin pain or pain at rest should also be assessed rather than repeatedly trying to run through it.
Hip Rehabilitation at Align Health
At Align Health, hip rehabilitation is based on the cause of the problem, your physical assessment, and the activity you want to return to. For a runner, that means connecting symptom management with strength, movement, training load, and a gradual return to running.
If hip pain after running keeps returning or is stopping you from training normally, our physiotherapy team can assess it and build a rehabilitation plan around your goals. Book your appointment at alignhealth.ae or call 02 585 8322 (Al Zeina) or 02 671 9103 (Saadiyat).
Frequently Asked Questions
Should I stop running completely if my hip hurts?
Not necessarily. Some hip conditions can be managed with a temporary change in distance, pace, frequency, or terrain rather than complete rest. The right decision depends on the cause of the pain, its severity, and how symptoms respond to load.
Why does my hip only hurt after I run?
Symptoms that appear later can still be related to running load. Fatigue, repeated loading, tendon or joint sensitivity, and the total amount of training can influence when pain becomes noticeable. The timing of symptoms is useful information during assessment.
Can weak glutes cause hip pain when running?
Hip strength may be relevant in some runners, but pain is rarely explained by one weak muscle. Assessment should consider strength together with training history, movement, the location of symptoms, and the likely tissue involved.
How do I know when I am ready to run again?
Readiness is usually based on a combination of symptom response, walking and daily function, strength, functional testing, and tolerance of gradually increased running load. There is no single test or fixed timeline that applies to everyone.
Do I need a scan for hip pain after running?
Not always. Many hip problems can be assessed clinically first. Imaging may be appropriate when the diagnosis is uncertain, symptoms suggest a condition that needs investigation, or the result would change management. Your physiotherapist or doctor can advise when imaging is warranted.
Blog written by Fernando Tassi Salati, Physiotherapist.
References
Enseki KR, Bloom NJ, Harris-Hayes M, et al. Hip Pain and Movement Dysfunction Associated With Nonarthritic Hip Joint Pain: A Revision. Journal of Orthopaedic & Sports Physical Therapy. 2023;53(7):CPG1-CPG70. doi:10.2519/jospt.2023.0302.
Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection versus a wait and see approach on global outcome and pain from gluteal tendinopathy: randomised clinical trial. BMJ. 2018;361:k1662. doi:10.1136/bmj.k1662.
Fredette A, Roy JS, Perreault K, et al. The Association Between Running Injuries and Training Parameters: A Systematic Review. Journal of Athletic Training. 2022;57(7):650-671. doi:10.4085/1062-6050-0195.21.