Forums >Health and Nutrition>femoral neck stress reaction/ possible labral tear
Quick version: If I've got both, is it possible to tell which is causing which pain?
So I finished my first 100 miler (Pinhoti 100) Nov. 2nd. After laying in the grass for a while, admiring my new buckle I was feeling pretty good, until I tried to stand up to leave. I couldn't stand on my left leg (the muscles felt really weak) and the front of my hip/groin hurt when I put weight on my leg. Oddly, I don't recall any hip pain while running the race, increasing foot and knee pain over the last 30 miles yes... but no hip issues.
I tried running a week latter and my hip ached the whole time, got 3 miles in before giving up on the hip loosening up.
The next week I tried a 7 mile hike... hip felt ok during but the next day all the muscles around my hip were incredibly tight, and walking was very difficult.
One more week and I'm still limping, stairs suck (using the handrails to pull myself up and lower myself down). Range of motion is all pain free, there is no stretch that reproduces the pain, and it feels fine unless I put all my weight on it either walking or trying to stand on one leg to get dressed. I borrowed some crutches from a friend to see if staying off the leg would help and made an appointment with an orthopedic doctor. The doctor moved my leg around a bunch without causing any pain and sent me to get an mri to rule out a femoral neck stress fracture.
The results:
No displaced fracture or complete fractures identified. There is very mild bone marrow edema along the left lesser trochanter and along the inferomedial aspect of the left femoral neck. This could represent a mild stress reaction/small focal stress fracture. No iliopsoas bursitis or greater trochanteric bursitis is seen. There is no muscular edema or strain identified. There is a questionable tear of the anterosuperior labrum. IMPRESSION: 1. Minimal bone marrow edema of the left lesser trochanter and inferomedial aspect of the left femoral neck could represent mild stress reaction/small focal stress fracture. 2. Questionable anterosuperior labral tear.
Doesn't really sound too bad right?
The doctor didn't have much to say other than he is referring me to a specialist (I don't have the appointment yet) and to stay completely off the leg for two weeks, then try partial weight bearing.
I am hoping that what I am feeling is just from the stress reaction and that the labral tear is either not really there or asymptomatic (the mri was without contrast). I can put weight on the leg now without pain most of the time, but lately my hip has been aching when I am sitting. So my question is has anyone had both? Is there some way to differentiate between the two pain wise? Or am I just going to have to wait for the stress reaction to heal and see if I still have pain? Is it normal for a stress reaction to start aching after I have gone non-weight bearing? And how am I supposed to know that the stress reaction has healed if I still have pain from a labral tear?
Pinhoti 100: Finished :D
Chief Endurance Dork
" Is there some way to differentiate between the two pain wise? Or am I just going to have to wait for the stress reaction to heal and see if I still have pain? Is it normal for a stress reaction to start aching after I have gone non-weight bearing? And how am I supposed to know that the stress reaction has healed if I still have pain from a labral tear? "
The hip is pretty hard to differentiate pains -- it's just so deep and buried in tissue.
The aching symptom is more consistent with the stress reaction. Who knows....if you do have a labral tear, it may have pre-dated your 100 miler, and you could have just been asymptomatic. I think you're probably stuck waiting for the stress reaction to heal up, and then see what's going.
endurancenerd.com
I have had two hip issues in the past two years. The first one felt like an issue with the labrum but I never got the MRI or MRA. The pain was mostly in the groin and hip joint. There was a catching/clicking feeling in my groin when I moved my leg in a certain way. That catching/clicking is usually associated with a labral tear. The second problem I am dealing with now is a sharp pain in my glute when I get to 2-3 miles and a constant dull ache deep in the hip, down the front of the thigh, and a little in the groin. That is more indicative of a stress reaction/fracture. Again, I did not have a MRI but did have some x-rays which showed nothing obvious. Like me, you should just rest for now. Stay off it as much as possible for a month before introducing some non-impact workouts as long as there is no pain. I haven't been doing anything but upper-body strength training for 3 weeks and am just now getting to the point where I don't ache constantly.
if you do have a labral tear, it may have pre-dated your 100 miler, and you could have just been asymptomatic.
I really hope so!... the stress reaction is enough of an injury. I've been lucky so far I guess, this if the first injury I've had that I actually felt the need to see a doctor about. The hip is starting to feel better. Only minor random aching in my upper quad so far today. Wait and see is probably all I can do.
Tim - glad to hear you aren't aching constantly anymore. I seem to be healing in discrete chunks rather than getting a little better each day. At first it always hurt to put weight on my leg, then I woke up one day and found I could walk without a limp most of the time (28 days post race), but it aches sometimes now. I haven't noticed any clicking or catching which is why I was a little surprised they found a possible tear. Upperbody only sucks... especially on machines. I'm used to using free weights, but can't until I can carry them around. I have been swimming with a pool buoy and doing some pool running as of last week (so one month in) which is really helping my mental state. Going from the best shape of my life to sitting on the couch has been difficult.
Hip Redux
The labrum tear could definitely be asymptomatic and the pain coming from the stress reaction. But I think the stress reaction will require more than just two weeks to heal? Not sure, but that's what I've seen with others - 4-6 weeks or something along those lines. It's hard to get that sort of stuff differentiated because the hip can radiate pain lots of weird ways.
Yeah, definitely more than two weeks... It's been over 5 weeks since the race, ~4 weeks since I last did any kind of weight bearing workout, and I been using the crutches for 2.5 weeks now (mostly, I walk around the house some without them). And I am pretty sure the reason I only feel some minor aching is because I am mostly non-weight bearing. The aching is definitely worse when I "forget" the crutches too often. I think getting off the crutches is going to be a bit of a process.
Hi, I know this is an old thread but just curious how things turned out. I was training for a marathon (with much lower than normal miles, only 3 days/week) when I started getting hip pain that became unbearably painful. MRI showed stress reaction in femoral neck and labral tear. My orthopedic Dr thinks all my pain is from the stress reaction and isn't addressing the tear at all. I've been on crutches for 7 weeks and still have pain using 1 crutch, sitting, and even laying down. Like you, I wonder if some of the pain is from the labral tear? How can you tell? And what can be done? Ortho just wants to wait out the stress reaction but I fear after all that time off the labral tear will FINALLY be addressed and need additional time off. If it's fixed now it could heal at the same time. Did your labral tear heal on it's own? Did you wber distinguish between the 2 pains? Frustrated my dr is only focused on the stress reaction because he was quick to put me in the "marathon runners over train and get stress fractures" category.
SMART Approach
Labral tear unlikey to heal on its own, however not all tears are symptomatic. I have a labral tear in my shoulder found out when testing for something else and I have no issues with my shoulder. You need to heal your bone-this is first priority. Good nutrition, more protein, more Vitamin D and K2 and proper rest. You will bounce back.
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