Running is a wonderful form of aerobic exercise that millions of people enjoy, but it is a high impact activity, and regular runners almost invariably become injured or experience pain at some point. The knees, Achilles tendons, and soles of the feet are perhaps the most common running sites of running related aches and woes, but pain in the hip, particularly in the upper point of the pelvic bone known anatomically as the iliac crest, can be debilitating and has a variety of causes.
Iliotibial Band Syndrome
The iliotibial band, or ITB, runs along the outer thigh from the iliac crest to the outside of the knee joint and is a very frequent source of hip pain in runners. The ITB acts to stabilize the pelvis, so any source of continued imbalance between your right and left legs can lead to tightness and pain on the side that is effectively made longer. If, for example, your right hip hurts, it could be a result of doing too many clockwise laps on a tight track or running on a cambered road that tilts to the right.
Piriformis syndrome, which results from overly tight muscles beneath the gluteal muscles impinging on the large sciatic nerve as it passes through the butt muscles toward the thigh, can cause pain throughout the buttocks and hip area, and many long-time runners experience this at some point as the pelvis begins to show the wear and tear of accumulated mileage. A lack of flexibility, worn-out shoes, muscle imbalances and leg length discrepancies are contributing factors.
The pelvis, forming as it does the junction of a part of the body that is usually held stable -- the trunk -- and the parts that get it moving -- the legs -- is the site of attachment of a great many muscle pairs to areas above and below. The iliac crest includes attachments of hip flexor muscles as well as numerous abdominal and back muscles, also called core muscles. The repetitive motion of running can irritate these points of attachment.
Treatment and Prevention
How to eliminate hip and iliac-crest pain and prevent a recurrence depends on the source of the pain, but there are a number of general strategies to follow even if you haven't had a problem yet. If you have pain, apply ice nightly and rest completely for a few days. Otherwise, avoid too much uphill or downhill running or running on uneven surfaces. Stretch and strengthen the hip and core muscles. Stretch the iliotibial band, hamstrings, quadriceps and hip flexors. Replace worn-out shoes as needed.