The Most Common Causes of Hip Pain in Athletes

Proper Treatment of Hip Pain Can Speed Your Return to Sports

The most common causes of hip pain in the general population include arthritis, bursitis, muscle strain, and nerve irritation. Athletes, however, often have hip pain caused by direct impacts and overuse syndromes. It's important for an athlete to pay attention to hip pain when it begins in order to prevent a chronic condition from developing. Here are some of the more common causes of hip pain in athletes.

Photo of a woman running with hip pain.
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Pain in the front of the hip and inner thigh (groin) is often the result of an adductor muscle pull or strain. This acute muscle injury is similar to any other type of pulled or strained muscle but it occurs when the muscles of the front and inner thigh (the adductors) are stressed beyond their limits. 

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Iliotibial band syndrome, also called IT band friction syndrome, is a common cause of both knee and hip pain in athletes. A nagging or acute pain on the outside of the hip that increases during running, when descending stairs, or getting up from a seated position. The IT band acts primarily as a stabilizer during running and may become irritated from overuse.

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Osteoarthritis is one of the most common causes of chronic hip pain for both athletes and non-athletes alike. Osteoarthritis is ​a type of arthritis caused by wear-and-tear or degeneration of the hip joint. Over time, the smooth, protective cartilage of the hip socket wears down and bare bone is exposed, making movement painful. There are many treatments available, including appropriate strengthening exercises, but when conservative treatments fail, hip replacement surgery may be an option.

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A hip pointer injury is a painful, acute injury caused by a direct impact on​ the iliac crest of the pelvis. The injury may cause bleeding into the abdominal or hip abductor muscles, which attach to the iliac crest. The bone and overlying muscle are often bruised, and the pain can be intense. Proper protective equipment can help prevent hip pointers, and immediate first aid and rest can speed recovery.

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Hamstring injuries are common among athletes who play sports that require powerful accelerations, decelerations or lots of running. A hamstring pull can be mild or severe and typically causes sudden, sharp pain in the back of the thigh. Treatment of a pulled hamstring will depend on the severity of the injury, but quick first aid (rest, ice, compression, and elevation) can speed recovery.

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Pain in the groin and upper thigh, hip stiffness and a clicking or snapping feeling in the hip are common signs of iliopsoas injuries. This type of hip pain may be related to iliopsoas bursitis (irritation and inflammation of the iliopsoas bursa) or iliopsoas tendinitis (irritation and inflammation of the iliopsoas tendon). The condition occurs more often in gymnasts, dancers and track and field athletes who perform repeated hip flexion movements.

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Hip bursitis (trochanteric bursitis) is commonly seen in runners due to overuse, but can also be caused by a fall or impact which results in inflammation of the hip bursa (a fluid-filled sac located around joints of the body that reduce friction between tendons, muscles, and bones). If the bursa in the hip is irritated or inflamed, the athlete will have pain during almost all movement in the hip.

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Piriformis syndrome can cause gluteal (buttock) pain and sciatica in some athletes. The small piriformis muscle runs posteriorly from the sacrum to the outer hip. If this muscle becomes tight, shortened or if it cramps, it can put pressure on the sciatic nerve which passes underneath. The pain often radiates down the back of the thigh or up to the lower back.

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A less common injury in long-distance runners includes a stress fracture of the hip caused by repetitive micro-trauma to the bone over time. Like stress fractures in other bones, the best treatment is to avoid the impact of running and allow the bone to heal.

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Most tailbone injuries are due to a direct fall onto the coccyx (the bones that make up the very end of the spinal column). The severity of tailbone injuries can range from a bruise to a fracture. Most tailbone injuries heal on their own given time and conservative treatment.

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