Last Updated on August 15, 2023 by Heather Hart, ACSM EP, CSCS
The following post, 7 Reasons Runners Should Pay Attention to Hip Alignment, was written by Dr. Brent Wells, D.C. of Better Health Chiropractic & Physical Rehab Anchorage. His expertise regarding hip alignment and the physical structure of a runner’s body far exceeds mine, so I’m happy to share this post.
Your entire body is impacted by the way you run, which is why form is so important. When you stride, your body absorbs the impact of landing. If your body is in alignment when you strike the ground, the impact moves through without pain. But, if you strike while your body is out of alignment, the pressure can impact the weaker parts of the body.
With poor hip alignment, the body can suffer from overuse injuries that can result in unwanted stiffness and stress. When the pain and discomfort becomes too much, many people who have hip misalignments often stop running. In most cases, misaligned hips can cause pain in other areas of the body which can result in typical and preventable injuries.
Hip Alignment: Why it Matters for Runners
There are several reasons why runners need to pay attention to the alignment of their hips. Here’s a breakdown – of how the body breaks down – when hips are misaligned.
The Body Favors One Side
The body comes quickly out of alignment because it tends to favor one side. The strong side continues to strengthen as the weak side grows weaker. As one side weakens, it is more likely to become injured and to continue growing weaker. Then, the favored and weak sides can cause injuries in other parts of the body.
(Heather’s note: this is why I’m such a huge proponent of strength training for runners! Fix those weaknesses!)
The Favored Side and Injuries
The favored side pulls the hips even more out of alignment. Eventually, the misaligned hips become injured, and it takes a long time for weakened hips to recover. Once hips are misaligned, strength becomes unbalanced and more problems occur.
The Body Balances on the Hips
When the hips are out of alignment, the torso becomes unbalanced. When the torso is out of alignment, runners tend to overstride as they reach their legs forward ahead of the torso. Overstriding happens because of inflexibilities and weaknesses in the hips.
(Heather’s note: a common issue related to overstriding? Shin splints.)
Legs Become Misaligned
When runners have misaligned hips, they can begin to suffer from leg-length discrepancies. In some cases, it is leg-length problems that create imbalances in the hips in the first place. But, other times the imbalance from a weakness affects the legs. This can cause issues such as from iliotibial band issues or tight hamstrings.
No matter how the leg-length issue arises, the problem often ends in injury caused by favoring one side over the other. If the pain becomes too much, many runners with leg-length problems stop running. Unfortunately, many health care providers try to treat the problem with orthotics, but all too often the problem is the hips and pelvis.
Problems Move to Around the Body
Hip misalignment can radiate into other areas of the body. These problems can be intensely painful for runners. When hip alignment moves into the hamstrings, piriformis, and IT band, they become more difficult to treat.
Problems from hip misalignment can also radiate farther into the knees and the Achilles tendon. When runners favor one side, eventually they will develop a problem called Runner’s Knee. The misalignment problems can also move into the Achilles tendon, which can rupture or become strained, which makes the leg weak and immobile.
Hip misalignment also affects the shoulders. When your hips are misaligned, one tilts away from the shoulders, so the shoulders drop to compensate. This creates problems in the front and back of the body, as well as in the neck and low back.
Poor Posture Causes Damage to Your Bones
When you are a runner and you rely on your body to move quickly through space, you need your skeleton to support you. When you have poor posture due to hip misalignment, your hip flexors tighten, causing your pelvis to react in the opposite direction. This knocks your pelvis out of alignment and can result in several problems.
Eventually, the pelvis tilts so your tailbone points back rather than toward the floor. This puts extra pressure on the lumbar spine. The tailbone tilt can create problems with the ligaments and muscles that eventually weakens the skeletal system. Imagine putting the pressure of running on these weak areas of the body, and it is easy to see why hip alignment is so important for runners.
Hip Alignment with Running Economy
When your hips are aligned and you can easily run long distances in a pain-free way, you can tell. Endurance runners need to have strong knees and aligned hips. Studies found that running economy – the way runners use energy and biomechanics – improves when the hips are aligned and body mass is low.
When the joints – from the ankles to the hips – are stable, running economy improves. The hip muscles help with generating power and with creating stride length. When hips are out of alignment, their ability to generate even power decreases and runners have to work harder to run.
Preventing Hip Alignment Issues for Runners
Rather than living with hip problems that can make running painful, runners should do what they can to avoid hip alignment problems. They should always warm up before they run. This warm up should include dynamic exercises that get muscles moving through their full range of motion.
(Heather’s note: check out this great post on hip strengthening exercises from my friend Amanda at Run to the Finish)
Runners should also take time to stretch after their runs. The stretches should include foam roller moves to take care of the knots that happen before, during, and after runs. Along with foam rolls, runners can also visit a massage therapist to keep the muscles loose and prepared for running. When muscles tighten, misalignments happen, especially in complicated joints like the hips.
Runners should also pay close attention to their posture and how they are aligned. For example, if you carry a bag with you, you should switch sides. On even days, carry your bag on your right side. On odd days, switch to the other side. If you carry a baby, do the same. It is also important that you work on your balance and posture by alternating the side of the road where you run.
Many runners try to treat their troubles with chiropractor visits where the chiropractor cracking back means that the back is out of alignment. The visits help relieve some discomfort from misaligned hips.
About Dr. Wells
Dr. Brent Wells, D.C. founded Better Health Chiropractic & Physical Rehab Anchorage and has been a chiropractor for over 20 years. His practice has treated thousands of patients in Alaska from different health problems using services designed to help give long-lasting relief.
Dr. Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe, Organic Facts, and Thrive Global. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.
Heather Hart is an ACSM certified Exercise Physiologist, NSCA Certified Strength and Conditioning Specialist (CSCS), UESCA certified Ultrarunning Coach, RRCA certified Running Coach, co-founder of Hart Strength and Endurance Coaching, and creator of this site, Relentless Forward Commotion. She is a mom of two teen boys, and has been running and racing distances of 5K to 100+ miles for over a decade. Heather has been writing and encouraging others to find a love for fitness and movement since 2009.
Krysten Tomlinson
Hi! I’ve been a runner for 10+ years and have really been struggling with hip misalignment after having my 3rd child last year. It’s been hard to run and feel stable like I used to. Your article is spot on to what I’ve dealt with and I’ve tried chiropractic care for this issue but that hasn’t helped. I was wondering if you’ve worked with others who’ve had this issue and any specific programs/exercises you know of to get them back to stability on the weak side and keeping their hips aligned.
-Krysten