Presentation
The patient presented with hip pain and tightness that had been coming and going for approximately two to three months.
Running would sometimes aggravate the hip, and symptoms were also noticed with lateral bending. Despite the discomfort, the patient remained active and wanted to run more comfortably and consistently.
Examination
Palpation found significant muscular tension through the hip and surrounding structures.
The tensor fasciae latae (TFL), gluteus medius, and piriformis were among the primary areas of tension identified around the hip. Significant tension was also found through the quadratus lumborum and lumbar erectors.
The quadriceps also showed areas of tension during the course of care.
Assessment
The clinical picture suggested that muscular tension through the hip and surrounding structures was contributing to the recurring symptoms.
The gluteus medius is particularly important during running. Each stride requires a period of single-leg support, during which the gluteal muscles help stabilize the pelvis and control the position of the hip. Because of this repeated demand, we pay particular attention to the lateral hip and gluteal muscles when evaluating running-related hip complaints.
Running also depends on coordinated movement through the pelvis, low back, thighs, and lower legs. For this reason, our assessment includes connected structures as well as other muscles heavily involved in the activity, including the quadriceps, hamstrings, and calves.
Finding excessive tension or restriction in one region can prompt us to look for other factors that may be affecting movement, such as compensation from a previous injury, weakness, limited mobility, or the repetitive demands of the activity itself.
In this case, the most significant findings centered around the lateral and posterior hip, with additional muscular tension through the low back and thigh.
Treatment
Treatment focused primarily on the hip while also addressing surrounding structures that could influence hip movement and loading during running.
Acupuncture and electroacupuncture were used through the TFL, gluteus medius, piriformis, and quadratus lumborum.
Manual therapy was also applied to the hip and surrounding musculature to reduce tension and improve comfortable movement.
The quadriceps had also demonstrated tension on examination. As the primary hip findings improved, treatment began incorporating more of these adjacent structures because they also contribute to hip mechanics and the demands of running.
Treatment was adjusted according to the findings at each visit rather than following the same fixed approach each time.
Response
At the beginning of care, running would sometimes aggravate the hip. At that stage, the patient was running approximately two to three times per week for a total of around five miles per week.
As treatment progressed, the hip became less symptomatic despite continued running.
Later in the course of care, the patient completed a four-mile run without hip pain. This was a clear functional improvement from earlier visits, when running could aggravate the hip.
Ongoing Plan
A short additional course of treatment was recommended to continue addressing residual muscular tension while monitoring how the hip responded to increased running.
Regular stretching and foam rolling were also encouraged as part of the recovery routine. Used consistently, these strategies can help maintain mobility, manage muscular tension that can accumulate with repeated training, and support comfortable running between treatments.
As symptoms remain controlled, the emphasis can shift toward maintaining mobility and addressing any strength, movement, or training factors that may contribute to recurrence.
The longer-term goal is to continue running regularly without hip pain interfering with training or activity.
Some clinical details have been generalized to protect patient privacy. Individual results vary.