Q: Do you feel a dull ache on the outside of your hip? Does it hurt during or after a run? Do your leg muscles feel tight?
If the answer is yes, you could have bursitis, see [A] below. If not, read on.
Q: Is the pain more on the inside of your hip? Is most of your training on concrete or asphalt? Do you run all season and rarely take a break?
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If the answer is yes, you could have a stress fracture, see [B] below. If not, read on.
Q: Do you have a "clicking" or "catching" feeling? Is the pain intermittent? Did you fall or twist your hip recently?
If the answer is yes, you could have a cartilage tear, see [C] below. If not, read on.
Q: Does the outside of your knee hurt? Is most of your running done on the roads or the track, and do you stick to the same route?
If the answer is yes, you could have iliotibial band syndrome, see [D] below. Otherwise, consult your physician.
[A] Bursitis is inflammation of the fluid-filled sacs that lubricate your joints. It's caused by overuse or a tight hamstring or iliotibial band (the ligament that runs along the outside of the thigh). You may feel a dull ache, burning, rubbing, or popping sensation on the outside of your hip. Initially pain appears during or after a run. Reduce your mileage, stretch your hamstrings and ITB after a run, apply ice, and take anti-inflammatories. You should be better in about a week.
[B] Stress fractures occur when your bones are broken down faster than they can repair themselves. You'll feel a throbbing pain in the groin area that gets worse the longer you run until you're limping through your daily activities, says Sherwin Ho, M.D., associate professor at the University of Chicago. See a sports medicine specialist, who will prescribe imaging tests to rule out a complete fracture (which means surgery). Treatment is six to eight weeks of rest. You may be able to do some low-impact cross-training (walking, low-resistance stationary bike, swimming). When you've been cleared, ease into your running, and switch to softer training surfaces.
[C] Cartilage tears usually occur where the ball and socket joint insert. Most are caused by trauma (sudden twisting or a fall). You'll probably notice a clicking feeling in the hip and an intermittent, sharp pain in the groin that will feel fine until you "catch" it in just the right position, says Dr. Ho. Stop running and see a sports medicine specialist if you notice a loss of range of motion.
[D] Iliotibial band syndrome is irritation of the ligament that runs down the outside of the thigh from the hip to the shin. You can get it by always running on the same side of the road or the same direction on the track, running too much too soon, having tight hamstrings, or wearing old shoes. Change your route or alternate directions on the track, stretch your hamstrings and ITB, and replace your shoes. Sometimes warmth brings relief, says Robert Bronstein, M.D., sports orthopedist at the University of Rochester. Apply a heating pad on a low setting for 10 to 15 minutes. If you catch it early, you can reverse it in a week or so.
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