Running: how to prevent hip stress fracture

Written by: Mr Rishi Chana
Published: | Updated: 18/04/2019
Edited by: Laura Burgess

Hip injuries are especially common in runners and triathletes. Stress fractures almost always occur when runners are trying to increase their miles before a big race because the bone simply cannot take the overuse. Expert orthopaedic surgeon Mr Rishi Chana suggests preventive measures to take to stay safe and pain-free when exercising and what potential symptoms to pay attention to.
 

What are the symptoms of a hip stress fracture?

The symptoms of a hip stress fracture include:

  • Hip pain in the front thigh region
  • Groin pain in the inner skin crease - this worsens when running or hopping
  • It hurts when lying down
  • Pain almost always gets worse with activity - do not try and run through the pain


If you this type of pain, you can ask yourself two questions:

1. Have I upped my training too fast too soon?

2. How is my bone density?
This is a significant risk factor and formal osteoporosis (very low bone density) does not have to exist for a stress fracture to occur.

If you cannot hop on the affected leg and think you have a stress fracture, please do not continue your routine. It is recommended to visit a specialist.
 

How is hip stress fracture diagnosed?

A good clinical examination is always important. X-rays are helpful but an MRI scan is the gold standard to show whether a stress fracture has occurred. A bone density scan is also recommended to check that your bones are in good health.
 

What treatment is required?

In mild cases, the fracture will heal if activity is altered and crutches may be used to protect the hip for a few weeks. Use dynamic rest and stop any activity that impacts the hip joint. Use the upper body and core workouts to maintain your fitness.

Supplement your calcium and vitamin D intake. We require 1,300 milligrams a day and vitamin D is made by your skin naturally in sunshine so make the most of this when the sun is out. It’s important to stay covered up in the sun, wearing sunscreen with sun protection factor (SPF) of at least 20, and a hat and sunglasses.

Slowly strengthen your body as the fracture heals. It may take up to three months for the bone to heal. Gradually add lower body exercises to your routine but consultation is recommended before returning to any impact activity.
 

How can hip stress fracture be prevented?

The following tips can be followed to prevent stress fracture:

  • Increase your calcium and vitamin D - have milk and yoghurt or supplements, especially if you have a family history of osteoporosis.
  • Follow the 10 per cent rule - never up your weekly running mileage by more than 10 per cent.
  • Train your hips and core - the stronger your core muscles, glutes, hips and legs are, the more support your hip joint will have against injury with regular impact.
  • If you have this type of pain or problem, it is recommended to see an orthopaedic surgeon for investigation and advice.


If a stress fracture is unrecognised and left untreated, ongoing activity can lead to a full break. This may be unstable and require urgent surgical fixation to prevent it from moving or displacing as this can jeopardise the hip joint, putting it at risk.

It is important to recognise a stress fracture early to prevent this from happening.

 

How long will it take to recover?

Rehabilitation starts with two to four weeks of protected weight-bearing. Strengthening exercises take place at six to eight weeks. The average time it takes to return to sport following recovery is 12 weeks.

 

Do not hesitate to book an appointment with a specialist for advice following a sports injury. 

By Mr Rishi Chana
Orthopaedic surgery

Mr Rishi Chana is a skilled consultant trauma and orthopaedic surgeon based in London and the surrounding area. He specialises in lower limb surgery - particularly surgery of the hip and knee. He is an expert in performing arthroscopy of both the hip and knee, joint preservation surgery, hip and knee replacements, and is a certified to perform the world's most accurate hip and knee surgery.

A graduate of the Royal Free Hospital Medical School (University of London,1999), Mr Chana is now a Fellow of the Royal College of Surgeons (Trauma and Orthopaedics) (FRCS Tr&Orth). He is fellowship-trained in hip arthroscopy and completed a world-renowned fellowship in Sydney, which trained him to deliver an exceptionally high quality joint replacement service with enhanced rehabilitation. Mr Chana served as Lower Limb Lead for Ashford & St Peters Hospital in 2017, and presently practises at a number of locations, including Spire Thames Valley HospitalSchoen Clinic, London, and a number of BMI hospitals. He is also part of the Surrey Orthopaedic Clinic.

Mr Chana has a wide range of expertise, being able to treat adult patients both young and old with hip, groin and pelvic pain. His patients include athletes suffering from conditions such as labral tears and pincer impingment, and has a track record of returning them to action. He emphasises patient care and, as a result, achieves a high level of patient satisfaction.

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