Guideline Recommendations for Managing Mild Hip Pain in Adolescent Runners

Initial Assessment

• Evaluate hip range of motion and movement quality during functional tasks such as single‑leg squats to identify deficits that may contribute to pain. 1

Core Physiotherapy Components

• Implement a physiotherapist‑led program that emphasizes progressive hip‑muscle strengthening (abductors and flexors) using established strength‑training principles of adequate load, frequency, and progression. 1, 2
• Incorporate dynamic balance and single‑leg control exercises to improve neuromuscular stability of the lower limb. 1

Continuation of Physical Activity

• The British Journal of Sports Medicine consensus (9/9 expert agreement) recommends maintaining modified physical activity throughout treatment rather than prescribing complete rest, to preserve cardiovascular fitness and prevent deconditioning. Strength of evidence: expert consensus. 1, 3, 4

Graduated Return‑to‑Sport Progression

• Follow a three‑phase, graduated return‑to‑running protocol:

Monitoring and Outcome Measurement

• Use validated patient‑reported outcome measures such as the Copenhagen Hip and Groin Outcome Score (HAGOS) or the International Hip Outcome Tool (IHOT) to track functional recovery. 1, 4
• Complement PROMs with objective impairment measures including hip range of motion, hip‑muscle strength, and performance on functional tasks. 1

Shared Decision‑Making

• Engage the athlete and caregivers in shared decision‑making (9/9 expert consensus) to discuss expected magnitude and timeline of improvement and to co‑create sport‑specific goals. Strength of evidence: expert consensus. 3, 4

Guidance on Rest and Activity Restrictions

• Do not prescribe complete rest from running unless a stress fracture is suspected; instead, continue modified activity as part of the rehabilitation plan. 1, 3