Most runners experience significant pain in one or both hips at some point. Because of the large number of muscles, tendons and other connective tissues in the area, the causes and exact location of hip pain vary. Acute or chronic hip pain that you feel closer to your midline, along the waist, can stem from a number of anatomical and functional sources.
Iliotibial Band Syndrome
Your iliotibial band or ITB runs from your iliac crest at the top of your hip bone to the outside of your knee and is a very common site of pain among runners. Sometimes the pain can shoot down along the outside of the thigh, but it's typically closer to your waist. Running uphill or on uneven surfaces such as a cambered road and increasing your training mileage suddenly often bring on ITB pain. According to Dr. Mark Steckel, treatment involves rest, icing, stretching and self-massage.
Osteitis Pubis
Osteitis pubis is the inflammation of the pubic symphysis, the point at which the pubic bones running along your waist meet. The condition is marked by sharp pain and tenderness that you usually feel most strongly in the front and center of the pubic bone, but radiates upward into your lower abdomen, down toward the groin and outward toward either hip. Overtraining, especially in conjunction with a biomechanical imbalance such as a leg-length discrepancy, is the most common cause. Rest, icing and strengthening and stretching exercises can provide relief and help prevent the problem from returning.
Tendinitis
According to Dr. Cathy Fieseler, the pain you feel in your waist and hip area may be attributable to any one of a great many muscles that have attachments on the pelvis. These include your hip flexors, abdominal muscles, the tensor fascia lata, and other muscles of the back and trunk. The root cause is often weakness in one or more of these muscle groups that predisposes the tendons to inflammation, especially when the muscles on one side are preferentially called into play because of an imbalance. As a result, strengthening your so-called core muscles is the surest route to recovery and preventing a recurrence.
Athletic Pubalgia
Also known as Gilmore's groin or a sports hernia, athletic pubalgia is pain on one or both sides of your waist medial to your hip as a result of muscle weakness. It is distinct from a traditional hernia in that there is no protruding loop of bowel into the inguinal canal. Instead, the pain results from inflammation of the attachments of the adductor muscles inside your leg to the hip. You are susceptible to this condition when your running involves lots of accelerating from rest or side-to-side movements. Rest and physical therapy can sometimes help, but advanced sports hernias usually require surgical repair.
