How to Prevent Hip Tenderness and Pain During Running

There’s nothing hip about a hip injury from running (bad joke), but what causes running-related hip tenderness and pain anyway? The most common causes of hip injury in runners is excessive hip adduction and hip internal rotation at touchdown and during the early phases of stance, which in simple terms, means the thighs and knee point too far inward at touchdown and during the stance phase of running. It is also equally important to mention that excessive hip adduction and internal rotation are common risk factors strongly linked to upper knee pain and ITB knee injury.

How Barefoot Running Helps Prevent Hip Tenderness
Running barefoot may reduce impact burdens on the hip by triggering a long line of motor reflexes that help improve leg alignment during certain phases of running gait.

How to Prevent Hip Tenderness and Pain During Running

What does it take to prevent running-related hip injury? Apparently running barefoot! This is because running barefoot produces a wide variety of sensory stimuli that triggers patterns of mechanical modifications that may be more protective on the hip-joint as compared to running in cushioned traditional running shoes. For instance, a 2010 study published in the journal of Medicine and Science in Sports and Exercise showed:

  • Habitual shod heel strike runners who switched to running barefoot instantly adopted a forefoot strike landing pattern of the foot and showed significant reductions in hip adduction and hip internal rotation at initial contact, suggesting that running barefoot could naturally program reflexive responses that may accompany impact reduction on the hip.
  • During the stance phase of running, hip adduction and hip internal rotation remained significantly lower barefoot when compared to shod, suggesting that barefoot running may sustain concentrated engagement of key reflexes involved in mediating impact-protective movement behaviors.
  • Data in the journal PMR, also found support for the above findings in that the researchers found that barefoot runners had a 54% decrease in hip internal rotation torque, reinforcing the idea that running barefoot may have a big effect on improving mechanical effectiveness in ways that may dramatically reduce hip-joint loading, potentially helping a runner do more in their efforts in preventing hip pain problems and injury.

This trend in the research is making it clear that humans may be hardwired to reduce impact naturally in the absence of underfoot protection and that running barefoot may connect all the right mechanical dots that may help effectively dismantle high impact production AND should undoubtedly come as good news for those who experience grinding hip pain while running.

Exposure of the bare foot to the ground during running may provide a better way for the motor nerves in the feet to communicate with the motor nerves in the spinal cord and brain, which plays into the equation of promoting certain motor reflexes that guide the leg to re-align on a trajectory that may shift impact away from the hips. This automacy of reflexive activation during barefoot running is what matters in helping to prevent clumsy, inefficient strides, thereby making running without shoes potentially more ergonomically-friendly on the hips as compared with running in very cushioned running shoes.

I hope you’ve enjoyed my article! To stay more informed on the health and performance benefits of barefoot running, I also have a YouTube channel: Run Forefoot where I also discuss the latest research regarding the hot-button debate, forefoot strike vs heel strike running!

Too shy to run barefoot? The next best approach you can take is to wear shoes that are perfectly tailored to mimic the barefoot experience.  Here are my reviews on the shoes that are supremely qualified in reflecting being barefoot.

More From Run Forefoot:

Winter Running Shoe – Warm, barefoot shoes are hard to find, but not with these!

Stretching – Surprising things you should know about pre-run stretching.

Get faster – Tips on building more running endurance.

Proprioception – You want to make sure you are getting lots of this when you are running.


Kerrigan et al. The effect of running shoes on lower extremity joint works. PMR. 2009; 1(12):1058-64.

McCarthy et al. Barefoot running and hip kinematics: good news for Knee? Med Sci Sport Exerc, 2010. DOI:10.1249.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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