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Help understanding injury (Read 67 times)

cfieser



    So much confusing information out there and since I began running 8 years ago this is my first big injury and I am trying to make sense of it.

     

    My injury came about in May from kickball (new to the sport)

    I thought it would heal on it's own. I cut back on my running until I wasn't able to run at all.

    I went to the sports doctor who did an x-ray and diagnosed me with bursitis. He did the steroid injection and prescribed anti-inflammatory meds with a follow-up 2 weeks later.


    After the 1st appt. I tried running 1 day - 3 miles and could not sleep that night.
    I told him this during my next appt. He ordered an MRI and said to take things slow, walk, run etc.
    So again I tried running - slow. Same thing, could not sleep.
    Had the MRI that Monday and results were, hamstring tear close to the bone causing inflammation.

     

    Medical Terms:
    Right conjoined hamstring tendon strain and stress reaction of the ischial tuberosity.
    Bilateral acetabular labra tears
    mild degenerative arthrosis of both hip joints.

     

    He told me no yoga, running, lower body weights for 8 weeks. Basically anything that can stretch it was a no go. He also upped my anti-inflammatory dosage.

     

    I am sure you can imagine hearing no movement for 8 weeks is horrible.
    I keep thinking if I had gone in early I would be healed or wouldn't have made it worse.

    Any advice or anyone else suffer from this and how was recovery? Am I over thinking this injury?


    runktrun

      You have a couple distinct but likely related issues going on at once.  I'll start with the hamstring because that is something that should heal with both rest and strategic PT and strengthening.  It probably won't heal well without some PT, so first order of business is finding a PT who understands runners and labral tears (more on that in a moment).

       

      You said your injury occurred during kickball.  I'm assuming it was a traumatic/sudden injury rather than some discomfort slowly escalating over months.  The MRI reading describes a partial tear or lots of micro tears (strain) in the tendon and musculotendinous junction high up the hammy where it attaches to your butt bone.  The bone here is the ischial tuberosity.  The description of the "stress reaction" of the ischial tuberosity indicates that there is a bone stress injury.  In your case, sudden pulling of the hammy possibly detached a bit of the tendon from the bone or at least really irritated the bone and periosteum (outermost layer of the bone).  This requires rest.  Do not run if you feel any discomfort during or after the run.  Do not stretch the hammy, as you will just stress the damaged tendon and insertion point on the bone.  Fine a PT and work on things like core and glute strength and stability to take the load off the quads and hammies.  Massage may help minimize scar tissue, but again, work with a PT.  I personally would avoid taking too many pain killers, especially if they are NSAIDS, as there is some evidence (and conflicting studies!) that indicates NSAIDS can inhibit soft tissue (collagen) repair.  So maybe only take them if you really need the pain relief to sleep or to regain your normal range of motion.

       

      Now, the labral tears.  These may be totally unrelated or could have lead to your traumatic injury because the hips joints were unstable.  You may never know for sure.  The labrum is a ring of cartilage around the acetabulum of the pelvis, which is the "socket" in the hip's ball and socket structure.  The labrum adds a bit of stability by holding the head of the femur (ball) in the joint.  Labral tears are often asymptomatic and only incidentally show up on imaging.  MRAs are the gold standard to visualize labral tears, not MRIs, so the reading of "labral tears" may not be very detailed.  Labral tears can be caused by impingement, where the head of the femur or the acetabulum or both are not shaped right and grind against each other during some point in the hip's range of motion.  They can also be caused by traumatic injury to the joint or just due to regular wear and tear as we age.  If you have a tear from impingement, the impingement is the primary issue.  Impingement is usually diagnosed using a combination of measurements from MRIs and x-rays.  If you don't have impingement, then the tear is usually only of concern if the cartilage is severely shredded or starts pinching in the joint or is so deteriorated that the joint because unstable.  The instability in the hip joint can then put extra stress on the surrounding musculature.  SOooo, if you don't feel any clicking, popping or resistance deep in your hip joint, your labral may actually be asymptomatic and not related to your hammy strain.  Avoid activities and specific movements that irritate the hip joint and, again, work on basic core, glute, and hip strength and stability.  Learn to do a proper squat by hinging at the hips.  Lay off the running and work with a good PT NOW and 8 weeks may be all it takes to get you back to running.  The PT should be able to explain not just HOW to do the exercises, but WHY they are important.  Ask questions and you will learn about anatomy and running mechanics.  If you don't put in the work for rehab NOW, a hammy and hip issue like this could turn into years of sub-par running...which is way worse than only 8 weeks off.

       

      *not a doctor, just a runner with an intense interest in anatomy and sports med

      Not running for my health, but in spite of it.

      cfieser


        runktrun Thank you so much for taking the time to reply! Not only did you reply, you replied in great detail which is something I was looking for vs "ouch, rest". You have put my mind at ease that with proper rest, PT and listening to my body this injury will not end my running permanently. I will put in the work to find a PT who understands runners. I like the Ortho I have seen, but I find it hard to get information out of him on what I am looking at. While he spends a decent amount of time with me during the appointments he almost seems held back and I just want it all on the table so I can be as proactive as possible. Thank you so much!


        runktrun

          You're welcome!  Ask questions, advocate for yourself and if something with your PT or recovery doesn't feel right, speak up and trust your gut.  You have some down time ahead of you, but it's definitely not the end of your running.

          Not running for my health, but in spite of it.

            you replied in great detail ... Thank you so much!

             

            Ain't she amazing?

            Well at least someone here is making relevance to the subject. - S.J.


            runktrun

              Aww shucks, gee thanks 

              Not running for my health, but in spite of it.