Hip Pain II

[indysteel]

Oakleaf's thread and Knotted's very helpful answer have inspired me to post my own hip pain question. Knotted, sorry to take advantage of your expertise, but I'm just looking for some general guidance. I have a tendency to just suffer through injury.

Late last winter (December maybe), I started having low back and hip pain on my right side. The pain wasn't consistent. I didn't feel it all the time and it wasn't always in the exact same spot. A lot had changed in my routine this past fall. I was spending a lot more time driving, we had otten a new mattress, and I'd gone back to yoga after a short hiatus. I couldn't pin down exactly what was causing it, but because it hurt quite a bit when I stood up from a chair, I assumed that my psoas muscle was involved, and I started doing some stretches/releases with some success. I was also watching how I sat in my office chair, making a better effort to uncross my legs/keep my feet on the floor.

Then I went to a "core conditioning" class for the first time. It was a pilates mat class more or less. From there, things got ugly. Within a day of the class, I felt like I'd pulled something in my groin, and my ROM went from extremely limber to extremly tight. I can still barely open up that hip. For instance, I can't really do Baddha Kanasana or Janu Sirsasana anymore. My left hip opens up just fine. When the injury first happened, my other (seemingly unrelated) hip pain started up again with a vengeance. I could barely stand up straight at times, and my hip would almost lock up--deep in my glute--while I was walking. This happened a week before my honeymoon in Europe, so parts of my trip were rather painful.

Once I returned from Europe, the worst of the psoas (I think) muscle issues were better, but my groin continues to hurt. I get some relief from yoga. I stretch it a bit during class, but mostly avoid certain poses. Cycling does not hurt at all; walking does a bit. It doesn't really respond to ice or pain relievers. Oddly enough, the one stretch that seems to feel good to me is an IT band stretch I used to do for my knee. I'm so confused!

Anyway, I keep putting off seeing a doctor, because I find her to be less than helpful when it comes to sports or soft tissue injuries. That, and I'm not sure when I could do physical therapy.

If anybody has any insight, I'd love to hear it. And if the advice is to see a doctor, I'll bite the bullet and do so.

[KnottedYet]

Wanna try doing the same thing I told Oak?

[indysteel]

I will. Thanks!

Is it bad to gently stretch the groin? I originally assumed I just pulled something, but this has been going on since April with on modest improvement.

[KnottedYet]

It might just be pointless to stretch the groin, but probably won't hurt anything.

Muscles don't get tight just because they get a wild hair and spontaneously decide to tighten.

They tighten for a reason. Until you clear up the reason, they will just keep tightening up.

Stretching a chronically tight muscle can be a nice hobby. You can do it for years and years and years...

You did something to your back or hip. No biggie. Normally they fix themselves, maybe yours just needs a little extra push.

Try the one-step-at-a-time thing I wrote up for Oak. (remember, STOP the steps when you find something that makes you better) Again, if none of the 3 basic moves do diddley-squat, go to your doctor.

[KnottedYet]

It might just be pointless to stretch the groin, but probably won't hurt anything.

Muscles don't get tight just because they get a wild hair and spontaneously decide to tighten.

They tighten for a reason. Until you clear up the reason, they will just keep tightening up.

Stretching a chronically tight muscle can be a nice hobby. You can do it for years and years and years...

You did something to your back or hip. No biggie. Normally they fix themselves, maybe yours just needs a little extra push.

Try the one-step-at-a-time thing I wrote up for Oak. (remember, STOP the steps when you find something that makes you better) Again, if none of the 3 basic moves do diddley-squat, go to your doctor.

I need to add: the sideways banananana hip push thing is "sore hand on sore hip, push!" So if your pain is on the right, it is right hand on right hip, push everything leftwards. If your pain is on the left, it is left hand on left hip and push everything rightwards.

[Trek420]

This is making me wonder: what if the hokey pokey is what it's all about? ;)

[kjay]

Maybe I shouldn't post this because I'm in my mid-60s and you're probably much younger, but I started getting intermittent pain in my groin and was going to a physical therapist for pain in my back. He suggested I get an MRI to know exactly what was going on. Turns out that there's a labral tear (cartilage) in my hip and I'll eventually need a hip replacement. I thought for certain I had pulled a groin muscle but unfortunately that's not the case.

[BikeDutchess]

Labral tears can happen at any age. My teenage daughter dealt with hip pain for years before we finally found out she had femoroacetabular impingement (http://www.hipfai.com/) which, in combination with her intensive physical activities, had caused labral tears. But labral tears can also be due to an acute injury/trauma. Disclaimer: I am not a medical professional, just someone who has learned a lot about FAI/labral tears during the course of my daughter's diagnosis and treatment.

As Knot advised,
if none of the 3 basic moves do diddley-squat, go to your doctor.

[indysteel]

Thanks for the additional information. I'm happy to try what Knotted suggested, but I think I better just get myself to the doctor some point soon.

[lo123]

Yes. I have that in both hips from ballet. I need to look into arthroscopic surgery though. That is the first step.

Unfortunately, this originally happened when I was a teenager. I assume there is too much degeneration for your doctor to consider the less invasive approach?

Well, I've been doing a LOT of research on this... I have hip issues due to something similar to rheumatoid arthritis, and I'm getting tired of getting steroid injections every 6-12 months so that I can ride and walk. =/

Hip arthroscopy is still pretty darn new. Not many docs do it. It seems the main indications for arthroscopy are labral tears and loose bodies. Some doctors are doing some FAI repairs through arthroscopy as well, but I haven't seen a ton of follow up studies on that.

From what I can tell, the general thinking is that if you can get the tear repaired early on, great--but you may still need more surgery down the line. But even after the fact, arthroscopy could help preserve the joint a little longer.

I know I'll eventually need a new hip, that's just the nature of my situation. But I'd prefer that to be in my 50s, not my 20s. My main problem now is that all symptoms point to some sort of loose bodies or labral tear, but nothing shows up on MRI. lucky me.

Edited to add:
Hmmm.... just noticed you said ballet.. I danced ballet for 13 years--until the arthritis dx. Wonder if some of the hip issues started there. Seeing ortho on Wed to get a non-rheumatologist opinion, will mention then. Can't hurt!

[indysteel]

Well, after months of procrastinating, I finally saw a doc today. I wasn't expecting a definitive answer--and I didn't get one--but I did walk out with orders to get an x-ray done of my hip and to start PT. I'm hopefully we'll eventually figure out what's wrong. I have my PT eval on Wednesday.

[Catrin]

Well, after months of procrastinating, I finally saw a doc today.

Glad to hear that you made it to the doctor! I see mine tomorrow morning... I do hope the PT is able to take care of things for you!

[OakLeaf]

Good luck Indy (and Catrin too). Hope you get it all sorted sooner than later.

[indysteel]

Thanks, Oakleaf. I hope your hip is still feeling better.

One thing worth mentioning came out of my dr. visit today. Last year, I had a fitting with a guy who runs a biomechanical program at a nearby university. He noted a leg length discrepancy, which he corrected with a shim under my right cleat. The doc today didn't see the discrepancy.

Now, my hip issue didn't arise until a few months after I had that fitting, but it still could provide some explanation. If nothing else, I'll have the PT doublecheck and I'll remove the shim if necessary.