Back to Running This Fall: Hip, Knee and Low Back Aches to Watch For

Every year when the weather cools in October, the trails and neighborhood loops around North Austin fill back up. Some runners are returning after a summer off, others are picking up the pace, and some are training for the Austin Marathon in February.

Whatever their starting point, they're asking their bodies to do more than last month, which can lead to aches in the hips, knees, and lower back. Increasing mileage, intensity, or frequency too quickly can raise the risk of sports injuries. Whether you're adding longer runs, tackling more hills, or picking up the pace, your body needs time to adapt.

Why Fall Is When the Aches Start

A jump in mileage, load, or frequency can often be the piece that explains the rest. Fall running season is that jump for a lot of people.

It rarely looks like one bad run. The weather turns, you go from two short runs a week to four longer ones, you add a hill route because it is finally pleasant out, and three weeks later the outside of your knee hurts on every downhill.

The Complaints We Hear Most

These are descriptions, not diagnoses. Several of them can look alike, and some can come from more than one source.

• Pain around or behind the kneecap. Often a dull ache at the front of the knee that is worse going down stairs, running downhill, or after sitting for a while with the knee bent. Runners often call this "runner's knee."
• Pain on the outside of the knee. Often starts at a predictable point in a run and builds until it is hard to continue, with downhills usually worse than flats. This is commonly linked to the band of tissue that runs down the outside of the thigh, and to how the hip is controlling the leg.
• Outer hip or buttock ache. A deep ache on the side of the hip or in the buttock, sometimes worse lying on that side at night or climbing stairs.
• Front of the hip or groin tightness. Common in people who sit a lot during the week and then run on the weekend. We covered how to tell hip pain from a nerve pattern in Sciatica or Just a Tight Hip? How to Tell the Difference.
• Low back stiffness after a run. Often a tight, achy lower back that shows up after longer runs or the next morning, especially after a jump in distance.

The Sore Spot Is Not Always the Source

This is the most useful idea in this article, and it comes straight from how we look at running injuries. A knee that hurts can come from a hip that is not doing its share of the work. A recurring ankle problem can come from strength and control that never fully came back after the first sprain. And a lot of foot and arch problems change how the knee and hip are loaded on every step.

That is why an exam for a runner's knee here looks above and below the knee: how the hips, the lower back, and the feet are moving, and where strength or control drops off. Treating only the spot that hurts is how people end up with the same problem next season.

Warm-Up Basics

A few minutes of movement can help you ease into a run.

• Start with a walk or an easy jog. The first several minutes of any run should feel almost too easy.
• Move through your hips. Leg swings front to back and side to side, holding a fence or a tree.
• A few bodyweight squats and lunges. Slow and controlled, just enough to get the hips and knees moving through their range.
• Save the long held stretches for afterward. A few relaxed stretches after the run, when you are warm, are more comfortable and beneficial than forcing them cold.

Building Back Up Without Paying for It

• Increase one thing at a time. Add distance, frequency, inclines and speed gradually rather than all at once.
• Build in easy weeks. Every few weeks, back off for a week before building again.
• Check your shoes. Shoes wear out, and a lopsided wear pattern on the soles is worth pointing out at an exam. Some runners with recurring foot, knee, or hip complaints are candidates for custom orthotics, which we fit only after an exam.
• Strengthen hips and glutes. Simple exercises a few times a week support the knees and lower back. We can give patients a customized short routine depending on what we find.
• Make recovery part of training. Walk for a few minutes after your run and pay attention to how soreness feels the next morning. Pain that persists or worsens deserves attention.

When to Get Running Pain Checked

Consider a chiropractic evaluation if you experience:

• Pain that persists, returns with each run, worsens over time, or changes your stride
• Pain that radiates down the leg or comes with numbness or tingling
• Recurring knee, hip, groin, or lower back pain that limits your activity

A visit to the chiropractor doesn't automatically mean you have to stop all running. Depending on the cause, modifying incline, speed, or other aggravating activities may allow you to keep training. Some injuries require rest or further medical assessment.

Get Medical Help Right Away If You Experience

• A knee that swells quickly, locks, or gives way
• You cannot put weight on the leg
• Sharp pain at one specific spot on a bone that gets worse with every step, which can point to a stress injury that needs imaging
• Hip or groin pain that is present even at rest or wakes you at night
• A hot, red, swollen joint, or joint pain with fever

The Short Version

Enjoy the cooler mornings, but add one thing at a time. Warm up before you run. Strengthen your hips. Pay attention to aches that come back on every run or change how you move. And if your knee hurts, expect us to look at your hip and your feet too.

We are on Wells Branch Parkway in North Austin and the Chicoine family has been caring for people here since 1989. Call (512) 255-1777 or book online. Se habla español.

General wellness information, not medical advice. A joint that swells, locks, or gives way, or pain that keeps you from bearing weight, needs prompt medical evaluation. For an individual diagnosis, see a provider.