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Sore right hip/groin (Read 254 times)

camille2


    Mendeldave, thanks for the info on the sports chiro.  If I have a worsening, I may try that.  PT can only do so much, even though I think mine is a really good one. The manager of the LRS who has a large labral tear uses him too and  agrees.  Also, please keep us posted on your progress/decisions.

     

    I finished PT yesterday. I've been religious about doing the exercises so he thinks I'll be OK to continue on my own if I stop by or call if I hit a plateau/worsen.  About half our discharge session was spent with PT doing a reality check with me.  He expects progress to be quite slow with some forward/some back. He said I shouldn't be registering/paying for a half or full, even for next fall, though he said I might be able to try one one again someday.  Since he said I couldn't do distance, I asked if I could work on speed instead. "No, distance needs to come first, but slowly. Speed really increases the pounding."  He said it's OK to do a 5k when I build to 3 miles, but not to compare times to last year or to even attempt  to race.. He's fine with me hiking, but wants me to proceed very cautiously with running and only increase 1/2 to 1 mi/wk  if the previous wk goes OK.  I'd  tried 2 miles a couple times and while I didn't have pain during, I had aching in the groin afterwards. Not severe, but annoying.

     

    I had been a marathoner and could generally whip out a half, though had to train for a full.  I'm feeling very disappointed after the talk and am trying (only partly succeeding) to put things in perspective. I know many people have it much worse than not being able to run marathons.  Still...I'm just so bummed out. I didn't think it would take so long. Sorry to have my pity party here, but I figured this group might get it.

     

    My hip/groin would have to be quite a bit worse and last much longer before I would consider surgery, even if we did the MRA and confirmed the tear.  I was in health care for a long time and as a result, I'm really cautious.

     

    BTW... I've had Hokas  for a while, but hadn't warmed to them/used them much, but tried them for my second attempt at 2 mi and that worked better. My PT said the cushioning should help, so I'll keep wearing the clown shoes.

    Good luck to everyone.

    jmctav23


    2/3rds training

      just as a bit of hope for those of us dealing with various hip issues...

       

      A colleague of mine is a pretty speedy marathoner in his late 20s who struggled through a long layoff (6+ months) due to hip bursitis.  Don't really know the whole story/details but he was out for a while and is back now.  Has run 4 marathons in the last 2 months and won two of them outright; has a nice sponsorship with Altra and the whole bit.  To say that I'm not a bit jealous would be a lie but it just goes to show that injuries don't have to be forever and it certainly does not have to mean "the end" of a running "career"


      Girl Parts

        Camille, sorry to hear that Sad    Fingers crossed that you can continue on running without issues!

         

        camille2


          Thanks to both of you.  I'm feeling a bit better about it now and did a short run today...so far it's ok.


          Prince of Fatness

            *If* you have a torn labrum, it won't heal on its own.  If you have femoroacetabular impingement (FAI), which is the most common cause of tears, it's not going to heal on its own.  Many, many people have small labral tears that are asymptomatic.  Maybe through PT and chiro visits, you can become asymptomatic.  That didn't work for me.  I've been dealing with mine for almost 2 years now.  I am having surgery in less than 2 weeks.

             

            I hope that your surgery went well.

             

            I have FAI as well and am totally convinced that if I do not have surgery done things will only get worse.  So, surgery is scheduled for early April.

            Semi-retired.


            Refurbished Hip

               

              I hope that your surgery went well.

               

              I have FAI as well and am totally convinced that if I do not have surgery done things will only get worse.  So, surgery is scheduled for early April.

               

              Thank you, Finn!  I meant to check in here as well with some of my details.  My surgery was Monday, so I am currently 3 days post-op.  So far I am happy with my decision to get cut up.  Who is your surgeon going to be?

               

              I am feeling fairly well.  I am on drugs and am staying at my parent's house for a while, so there is always someone to help me out!  Not in a lot of pain and I am going to attempt to get on the trainer again here shortly (no resistance and very slowly is supposed to help with range of motion.)  The first time yesterday was a bit scary, but I got some advice from others and am going to try raising my seat and maybe not going all the way around if it feels weird.

               

              My labrum was torn from 12 o'clock - 2.  He said that he put in one stitch at one part and had to cut away a flap as well, so I am left with the majority of my labrum, which is good.  He said having that flap gone and cut off shouldn't be a big deal.  For the impinging bone, he shaved down both some femur and some socket.  He said there was a spot of cartilage that was bubbled and irritated from the femur rubbing against it, but otherwise it looked good and no arthritis!  He told me he was optimistic about my recovery.  On the whole, I think it went really well.  I know I shouldn't jump to conclusions yet because it's still early and I am on drugs, but I don't think I can feel the impingement anymore.

               

              Recovery in the hospital afterward was a little interesting with this being outpatient.  It's not like they're shoving you out the door, but they did push me a little too early to get up and use the bathroom.  I got extremely dizzy the first time and had to sit on the toilet with about 3 nurses putting cold compresses on my head and neck while I rested there.  Then they wheeled me back to my room (about 20 feet away...ha!)  Then when they took my blood pressure it was 90/55.    Wayyyyy too early to be getting up.  But then I had some animal crackers and juice and laid for a couple more hours and then I was fine.

               

              The easy part is over and recovery will be the hard part.  I start PT in less than a week.


              ultramarathon/triathlete

                Had my MRA just now (just got back to my office, in fact).  THAT was not fun.  The needle hurt more than I expected (dr. teased me that I must be "the sensitive type."  I flinched after he had done the shots and he said he guesses I just need MORE so he shot me up more.  Ouch.  I feel like I've been slugged in the groin/hip with a baseball bat!

                 

                At least now the MRA is done.  Now I wait to hear what they see when they get around to reading it.

                 

                I will say my pain has been down to a 1 lately.  I feel mostly stiff but have had some decent runs and a lot of time on the bike.  If the pain stays where it is, I can live with that (though it's a bummer).  But the sad fact is my mileage is so far down from where it was...

                 

                For me, the MRA is really just to make sure I'm not going to do more damage if I continue to run, and also, to get a baseline to see where I am now.

                 

                I totally hear you, Camille, regarding  the bummed out feeling and trying to put things into perspective.  Frustrating!  I was at the point where I could pick up and run a marathon any given day, and in an ok time, no additional training needed.   In 2012 I ran 12 of them just for the hell of it.  Hopefully one day I'll be back to doing that again (of course, then I'll just have to worry about heart-scar-tissue on the right ventricle, or whatever it is they now say will kill us long distance runners).

                HTFU?  Why not!

                Coach: Empire Tri Club 

                Speed Coach: Brooklyn Tri Club
                USATF Coach


                ultramarathon/triathlete

                  Ug.

                   

                  Chiro called last night. Sounds like I have a few things going on down there.  Next step is to talk to a surgeon about what I need to do, if anything.  And no running for 6-8 weeks.  Sucks.

                   

                  For anyone who's curious:

                   

                  FINDINGS: There is fusiform cortical thickening along the medial cortex of the femoral

                  neck, just above the lesser trochanter, in the typical location for hip stress fracture. A

                  subtle transverse linear focus is present in the cortex at the site, consistent with

                  cortical stress fracture. There is a small amount of periosteal edema at the site. In

                  addition, there is a small amount of marrow edema lining the adjacent endosteal cortical

                  surface, seen on both the T1 and T2-weighted scans. The appearance is thus consistent with

                  cortical stress fracture. There is no fracture line extending into the marrow cavity of

                  the bone, however. The remaining included osseous structures demonstrate normal marrow

                  signal characteristics. There is no avascular necrosis within the femoral head. There is

                  mild retroversion of the upper acetabulum, predisposing to "pincer -type" femoroacetabular

                  impingement. There is also a small cam lesion on the superior surface of the subcapital

                  femur. The bony articular cortices of the hip are smooth. There appears to be slight

                  thinning and subtle irregularity of articular cartilage in the superior joint space,

                  especially anteriorly. There appears to be a moderate-sized os acetabula versus prominent

                  spur embedded within the superior to posterior acetabular labrum. This causes overall

                  enlargement of this labral segment. Also, there appears to be some subtle tearing of the

                  anterior acetabular labrum. The corrected right femoral angle of anteversion is 0 degrees.

                  There is no inflammatory change or fluid in the greater trochanteric bursa. The gluteus

                  minimus and medius tendons are well attached onto the femoral greater trochanter, without

                  sign of tendinosis or partial tear. The proximal right hamstring attachment onto the

                  ischium tuberosity appears normal. The remaining soft tissues surrounding the hip are

                  unremarkable.

                   

                  IMPRESSION:

                   

                  1. Cortical stress fracture along the medial surface of the right femoral neck. There is

                  no extension of the fracture line into the marrow cavity at this time.

                  2. Subtle developing chondromalacia in the superior joint space, especially anteriorly.

                  3. Tear of the anterior labrum. There also appears to be a prominent spur or os acetabula

                  embedded within the labrum at the junction of its superior and posterior segments.

                  4. Possible underlying mild "mixed" femoroacetabular impingement.

                  HTFU?  Why not!

                  Coach: Empire Tri Club 

                  Speed Coach: Brooklyn Tri Club
                  USATF Coach


                  Girl Parts

                    DAMN!  You hit the hip jackpot.

                     

                    The good thing is now you know - but holy toledo. Sad

                     


                    Refurbished Hip

                      Sorry to hear the news, Dave.   If you have a femoral neck stress fracture, you need to be on crutches and non weight bearing immediately.  They didn't tell you that?  The first doctor I saw thought I might have that particular stress fracture and made me walk out of the clinic on crutches when it was even just a guess at that (MRI later confirmed I did not have a stress fracture.)  You need to get your fracture healed and then worry about the FAI/labral tear.


                      Girl Parts

                        Mandy has a good point, I'd also heard about pelvic stress fractures being pretty strict in terms of weight bearing.   Do you have an ortho you can see?

                         


                        Girl Parts

                          BTW - how the hell were you running through all that??  Are you superman?

                           


                          Prince of Fatness

                            Sorry to hear the news, Dave.

                             

                            +1.  Focus on getting yourself fixed up and recovered.  All is not lost.

                            Semi-retired.


                            ultramarathon/triathlete

                              Sorry to hear the news, Dave.   If you have a femoral neck stress fracture, you need to be on crutches and non weight bearing immediately.  They didn't tell you that?  The first doctor I saw thought I might have that particular stress fracture and made me walk out of the clinic on crutches when it was even just a guess at that (MRI later confirmed I did not have a stress fracture.)  You need to get your fracture healed and then worry about the FAI/labral tear.

                               

                              Luckily it's a healing fracture.  They said there is no damage and it was likely much worse back in Dec, and just got better because I have strong muscles supporting it, and I decreased my mileage (but hey, I did race a trail marathon and pace a major half marathon, so I guess I'm a rockstar lol).  I should also add that, now that the MRI injection pain is gone, I'm in ZERO pain.  It's hard to believe I even have anything going on in there!!  But, I guess I do.

                               

                              Another guy (not my doc but a radiologist none the less) reviewed the notes for me and he says it's actually all minor stuff.  He spelled it out it more plain english.

                               

                              He said:

                              "This is a quality , complete report on your MR arthrogram. 
                              The issues seem relatively minor. 
                              1. Cortical stress #. This is undisplaced,small, healing, with no current marrow edema ( who knows what it looked like in December- almost certainly worse). 
                              2. Subtle chondromalacia= minimal softening of cartilage. Common in a high % of athletes. 
                              3. Labral tear. The report says " possible, subtle"- maybe yes, maybe no. 
                              4. Possible mixed FAI. Again "possible"...This is minor , and not uncommon. 
                              No running for a month. Swimming, water running, and Z2 biking should be fine. 
                              Treat the patient, not the imaging study. Let honest self-assessment/pain be your guide. 
                              By all means , get an ortho opinion. 
                              That's what I would do- radiologist for 30 years, triathlon for 10."

                               

                              Also, a few fellow runner/triathletes recommended an ortho surgeon who specializes in this and is in NYC.  They claimed he is the "best in the field."  I called my Chiro, who was going to get me a recommendation too and I mentioned the dr I was told about.  My chiro laughed and said that's exactly who he was going to send me to and that the guy is, indeed, the top in the field.  So, that's good news.  It'll be a week before I can get in.  I sent them all my info, he will review it (for free) and determine if I need to see him or another person at his practice.  Until then, I'm not running or biking (despite the zone 2 info the radiologist suggested above).  I'm hitting the weights, upper body.  That's been neglected way too long so that will keep me busy until I hear what I can do cardio wise again.    Still trying to be optimistic.

                              HTFU?  Why not!

                              Coach: Empire Tri Club 

                              Speed Coach: Brooklyn Tri Club
                              USATF Coach


                              Prince of Fatness

                                 I'm in ZERO pain.  It's hard to believe I even have anything going on in there!!  But, I guess I do.

                                 

                                Not that this helps, but I had an emergency appendectomy in late November.  Needless to say I was not very active at all for several weeks after that.  The pain in my hip almost went away completely.  As soon as I started exercising again it came back.  So at least in my case the level of pain coincides with the level of activity.

                                Semi-retired.

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