We runners have a love-hate relationship with pain. We seem to deal with nagging aches all the time but we keep trying to find a way to pound the pavement every day. Core strength has gotten a lot of attention for improved running, but don’t forget the hip muscles.

A study from Indiana and Purdue universities showed that runners who suffered from patello-femoral pain, or runner’s knee, were able to reduce the pain from seven to two or less, in a scale of pain from one to 10, when strengthening the hips muscles with exercises such as the single leg squat.

“The thing about running is that it’s a sport of balance. You go from one leg to another and you’re never on both legs”, says Michael Fredericson, MD, Professor and Director, PM&R Sports Medicine Team Physician Stanford Athletics.

Can You be Pain-free?

From the location of the pain to why Pilates can be the next cross-training exercise that you should try, Fredericson explains it all.

Your hip is sore: Part of hip soreness depends on the location, and if it happens before or after running. If the pain is after the run, in particular on the side of the hip, it could be due to weakness in that muscle. In his research, Fredericson sees a lot of runners have very weak outer hip muscles, the gluteus medius. It is a muscle that is very important for controlling the hips and keeping pelvic stability, but when you were running in a forward motion you don’t work that muscle very much.

If it’s more severe pain in the front of the hip, then you have to worry about arthritis, or a stress fracture.

If it’s more in the back, then that could be pain from the lower back, it could ever be from piriformis muscle, or a little bit lower, at the hamstring attachment.

Fix it: The most common one is on the outside of hip and that’s from weakness of hip muscles. There are some specific exercises you can do, but Pilates is a really a great cross-training option for runners.

Your knee is sore: The same muscles that can give you hip pain can also give you knee pain. Every time your foot lands and hits the ground it affects the entire leg. When you land on one leg, and when you have weak hips, your hips and upper leg turn in a little bit. That creates bad alignment at your knee joint. People think you need to focus on muscles around the knee, but you should also strengthen the hip area and create strong hip stability.

The other thing is that a lot of runners can have is a tight IT band - that’s the big ligament that runs along the side of your leg, above your hip to below your knee. It often gets tight for people who run a lot and that can cause a lot of hip problems.

Fix it: Use a foam roller. It can be very helpful on a regular basis. Lay the outside of your leg on the foam roller and go down from your hip to your knee. If you find a tight spot, stay there until it relaxes. The more it hurts, the more you probably need it.

Your groin is sore: You have to be very careful in sorting that out. Some groin pains are very serious and some of them aren’t. If you get a sore groin, one thing that we worry about is arthritis in your hips. Even early arthritis can give you a tear in the cartilage in your hip and that can cause groin pain. If you run through that, it can get worse. If you have persistent groin pain, you should probably see a doctor.

Some people can get what is called osteris pubis - where the pubis joints come together. You’ll see that a lot in women after pregnancy - or people in downhill running because they are over-striding. Or sometimes you can get a stress fracture in the pubic bone. I ask women to talk to their doctor when they have groin pain because it could be something else like endometriosis or a UTI or something related to internal female organs. Another thing to think about it, if you do develop a stress fracture in the pelvic region, is that you may have low bone density, especially if you are women.

Fix it: Generally, I would say, shorten your stride a little bit. People who over-stride are more prone to getting certain injuries.

You may also want to check out your step rate. One recent study from the University of Wisconsin-Madison shows that a subtle increase in step rate when running can substantially reduce the loading to the hip and knee joints which may prove beneficial in the prevention of the most common running-related injuries.

One move that covers all

As a runner myself who used to log over 30 miles a week, I’ve been able to stay away from hip and knee problems due to my emphasis on strength workouts. One exercise that tackles the most demanding muscles when running is the KB swings with frontal walks. It works the quadriceps, hamstrings and the gluteal deltoid, gluteus medius, maximus and tensor fascia lata. I also like to do this with kettlebeel swings so this way I also work the upper muscles along with the core which gets heavily involved when decelerating the swing.

Marta Montenegro inspires people to live healthy lives by giving them the tools and strength to find one’s inner athlete through her personal website MartaMontenegro.com. She created SOBeFiT, a national fitness magazine for men and women, and the Montenegro Method DVD workout series – a program she designed for getting results in just 21 days by exercising 21 minutes a day . Marta is a strength and conditioning coach and serves as an adjunct professor of exercise physiology at Florida International University.

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Marta Montenegro is an exercise physiologist, certified strength and conditioning coach and master trainer, who teaches as an adjunct professor at Florida International University. Marta has developed her own system of exercises used by professional athletes. Her personal website, martamontenegro.com, combines fitness, nutrition and health tips, exercise routines, recipes and the latest news to help you change your life but not your lifestyle. She was the founder of nationally awarded SOBeFiT magazine and the fitness DVD series Montenegro Method.

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