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Hip pain: Tensor fasciae latae

 

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npda

Feb 4, 11 12:46

Post #1 of 54 (43815 views)
Hip pain: Tensor fasciae latae Quote | Reply

I've searched through the threads on slowtwitch, there are a few entries with "hip pain," but none of them specifically talk about injuries to the tensor fasciae latae muscle, which is what I believe I have had for 16 months now. I've also heard that women get this more often.

I was curious if anyone else had been diagnosed with "tendonitis" or "inflammation" of the tensor fascia (it's technically a muscle, so I guess tendonitis isn't actually correct- but that is what my chiropractor calls it).

The pain I feel specifically is a sharp pain on (kind of behind) my illiac crest bone, which I think is from the tensor fascia being tight and pulling on the bone. This pain is always a little bit there, but it gets worse after a run. Cycling/swimming don't irritate.

My chiro gave me some strength exercises and stretches which have helped get me from Zero running to a steady ~10-15miles a week for the past three months, but with no change- no improvement nor worsening of pain. He basically set me free two months ago and said "keep doing your exercises, it takes a long time to heal." I believe him, but at this point I want to see if it's worth it to get a second opinion or additional treatment. Before I go break my piggyback getting another opinion or trying another, more expensive-insurance-doesn't cover-it approach, I thought I would post here and see if anyone else has had this and what they did to help/cure it. Or, just wait it out and suck it up.

Thanks for your help!


npda

Feb 4, 11 12:57

Post #2 of 54 (43811 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

Okay I totally missed this:

http://forum.slowtwitch.com/..._reply;so=ASC;mh=25;

The solutions in this thread were:
One legged squats
Lunges to strengthen glutes
Change running form
ART
Foam roll ITB constantly

Many of the participants in this thread said, "I tried X and the pain went away in a week!" I have tried all of these, except ART, and the pain has been around for 16 months. (Actually after reading this thread I'm even more discouraged!) Anyone else have such a nasty case of this?


tigerchik

Feb 5, 11 9:54

Post #3 of 54 (43763 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

npda,

I think I posted on the thread you cited ^ . I've had various hip troubles and the cure for me has been strengthening glute medius muscles and foam rolling. I've had that side-of-the-hip pain you've mentioned and in my case, rigorous time on the foam roller helped a lot. Foam roll glutes, IT band, quads, and calves. I also did heat before runs and ice after.

Google the "clamshell" hip exercise. That is a good one. The abduction machine at the gym has helped me too, even though my PT swears "machines are crap!" The clamshell exercise does the same thing as that machine.

Hope you can get it to clear up and

Proud member of Fishtwitch and the ST Grammar Police
send a PM for blog accesshttp://www.tigerchik2.wordpress.com


npda

Feb 5, 11 17:34

Post #4 of 54 (43733 views)
Re: Hip pain: Tensor fasciae latae [tigerchik] [In reply to] Quote | Reply

TC-

Did you see a PT, or did the advice you got from the ST community work for you?

Were you able to kick it completely, or does it flare up from time to time?

I do the clamshells, the one legged squat type exercises and lunges. I can certainly tell an imbalance in my strength, but even as I get the weak side stronger the actual pain is not going away. Did you do any professional treatment besides ice and heat for the pain, or... should I just be more patient... :)


tigerchik

Feb 6, 11 1:36

Post #5 of 54 (43712 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

At the time I had the TFL issue, I did not see a PT. (I see one now). The foam rolling + clamshell exercises were enough. So, nothing other than ice and heat.

If you haven't seen a PT it might be worth it; sometimes treatments like ultrasound or laser (this is a new one to me that my PT has) can help with pain and inflammation.

Proud member of Fishtwitch and the ST Grammar Police
send a PM for blog accesshttp://www.tigerchik2.wordpress.com


rockykito

Feb 9, 11 9:03

Post #6 of 54 (43602 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

I know it's not usually the case, but looking back, my TFL pain was an indicator of a bulging disc in my back. Now I'm in PT purgatory!


Margo Plicatus

Feb 9, 11 14:22

Post #7 of 54 (43584 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

I've been experiencing that pain, too, for a few months now. It doesn't hurt badly, but I can feel it during my runs, and it's worst when I stand up after sitting for a little while. I'm in PT for that and for back pain right now. Apparently my back pain was due to pelvic misalignment, and it's almost entirely gone now that we've strengthened my core enough to keep it aligned properly. Now we just need to clear up the TFL pain... I'm still not totally clear on what's causing it, but my PT has me doing exercises to strengthen my glutes and hip flexors, and does some ART to loosen up my psoas and piriformis. (There might be other purposes to what we're doing, too, but mostly I just shut up and do what she tells me, since I've been seeing improvement).

Sorry, I know that's not really helpful, I just got excited to see that someone else is having a similar issue. If I find a magic cure I will let you know!


npda

Feb 9, 11 16:52

Post #8 of 54 (43578 views)
Re: Hip pain: Tensor fasciae latae [Margo Plicatus] [In reply to] Quote | Reply

Margo Plicatus wrote:
it's worst when I stand up after sitting for a little while. I'm in PT for that and for back pain right now. Apparently my back pain was due to pelvic misalignment, and it's almost entirely gone now that we've strengthened my core enough to keep it aligned properly. Now we just need to clear up the TFL pain... I'm still not totally clear on what's causing it, but my PT has me doing exercises to strengthen my glutes and hip flexors, and does some ART to loosen up my psoas and piriformis.

Thanks! YES, after sitting it can be excruciating to stand up. Stretch it out a bit and it calms down.

Interesting you say that your back was part of it. I've never had back problems but recently I've had some soreness/stiffness. It never occurred to me it was related. I'll have to check that out. Thanks for your input! It is relieving to hear someone going through a similar issue. Being injured can really make you feel alone in the world. Hope you clear it up fast!


DirtGirl

Feb 9, 11 18:58

Post #9 of 54 (43569 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

In January 2007 I had hip pain while running and went to 2 ortho docs and it was diagnosed as tendonitis in my hip. It kept me from running for 2 months and didn't feel like it was getting any better. I decided to give ART a shot. I had 3 sessions over a period of a week and I was running again. I eventually picked up the trigger point kit and was then able to sit on the trigger point ball and release the tightness myself in between visits.
I have had my share of various injuries since then and have found that ART and the trigger point kit (I got the dvds and found them to be very helpful) have resolved or minimized all of them.
Tamela


bc rob

Feb 11, 11 8:42

Post #10 of 54 (43532 views)
Re: Hip pain: Tensor fasciae latae [DirtGirl] [In reply to] Quote | Reply

Two Cents Worth: as a Physical Therapist who deals with these issues all the time...

The TFL muscle attaches to the front outside rim of the pelvis (Iliac Crest) and your Ilio-Tibial Band (ITB) and functions as a hip flexor, abductor, rotator. It frequently gets shortened due to sitting postures and cycling, especially TT positions. This causes the pelvis to rotate forward (increasing Lumbar lordosis- sway back) when standing upright and especially when running which can cause excessive loading on the muscle-tendon junction and also cause lowback compression issues. Addressing this shortening of the TFL muscle can help significantly (stretching, ART, foam roll, Myofascial release, massage ball, etc...)

Additional things to consider:
as many of you have noted, addressing other hip stabilizing hip musculature for strength and/or flexibility imbalances is important. Also, have the Sacro-Iliac joint position/mobility evaluated by a PT, Osteopath or Chiro...if this is out of alignment the TFL can become symptomatic.
Also...the function of your lower Rectus Abdominus/Obliques/Transverse and pelvic floor musculature in supporting proper pelvic alignment is super important along with Lumbar-Sacral extensor flexibility...train your core to optimize your hip posture and function of your hip musculature!

Hope that helps...
Rob


(This post was edited by rkopitzke on Feb 11, 11 8:51)


tigerchik

Feb 11, 11 15:53

Post #11 of 54 (43516 views)
Re: Hip pain: Tensor fasciae latae [rkopitzke] [In reply to] Quote | Reply

I've had a PT working on my SI joint lately. Today was the first day my hips were in alignment of their very own accord :-) I was so proud.

The mini-back-massage on the SI joint has helped me with SI joint pain; not connected to TFL issues (I'm not currently having them); just saw that you had mentioned SI joint mobilitizing.

Proud member of Fishtwitch and the ST Grammar Police
send a PM for blog accesshttp://www.tigerchik2.wordpress.com


Allie

Feb 21, 11 17:17

Post #12 of 54 (43361 views)
Re: Hip pain: Tensor fasciae latae [tigerchik] [In reply to] Quote | Reply

YES!
I had this issue develop during my marathon and I thought I would DIE.
I had seen the folks at the SPEED clinic at UVA and they diagnosed a pretty severe imbalance on that hip and had prescribed the exercises that a lot of women/men already talked about but I ran the marathon slowly thinking I could do ok. wrong.

I also do hip hikes off of a step with about 5-6 risers, clam shells, 1 legged dead lifts, LOTS of balance poses throughout the day.
Slowly but surely, by reducing mileage and starting to tri train, it has lessened significantly.

Best wishes to healing up.


npda

Feb 22, 11 7:24

Post #13 of 54 (43342 views)
Re: Hip pain: Tensor fasciae latae [Allie] [In reply to] Quote | Reply

One-legged dead lift- wow. How does that work exactly? Do you use weights?


Allie

Feb 22, 11 10:33

Post #14 of 54 (43335 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

Yeah, I use a weighted body bar or the barbells that they have over in the free weight section.

I have used dumbbells before to do that, either way is fine. I tend to not fall over if I am using the bar though.

Just bend back the leg that is not bearing weight and bend forward.


johnnybefit

Feb 24, 11 8:15

Post #15 of 54 (43268 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

I have the same pain and I am headed to the Dr. today. My pain started in my hip after treadmill running. I had a lot of low back pain and it got a bit better, then my hip started to hurt - all on the same side. It is quite sore to the touch and, when I move my leg, it feels like something rubbing over the top of the iliac crest.
Hoping for some good news today or at least news to help me heal.


npda

Feb 24, 11 12:00

Post #16 of 54 (43258 views)
Re: Hip pain: Tensor fasciae latae [johnnybefit] [In reply to] Quote | Reply

I have been seeing yet another (new) doc this week, a chiro who is also trained in ART. He thinks the iliacus is also involved and has been doing some tissue work on loosing it up- with two treatments I already feel the tightness/pain going away. He also recommended stretching 3x daily, taking fish oil supplements, icing the area and taping it up with kinesio tape. He says that the studies show that consistent stretching is the key- for example, stretching daily for 30 seconds is better than every other day for 5 minutes. Not sure if I believe that, but I'm doing what he says anyway.

Also keeping with the strengthening exercises everyone on this thread suggested.

Good luck I hope you get good news.


johnnybefit

Feb 24, 11 12:51

Post #17 of 54 (43256 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

Thanks for your response. I just returned. The Dr. indicated my pain is caused by my rectis femoris being "sprained", not torn and not pulling off the bone. He did x-rays and confirmed my hips look good and the crest looks good - both sides. Recommend some PT and Celebrex for the pain but did not give any restrictions. However, my pain is acute so I am going to rest it. I start the PT next Wednesday. Can anyone recommend some stretches for this in the mean time? I do have a foam roller and the stick if that will help.

I am also going to see a spine Doc about my back as it has/is causing me pain as well but the Doc above did not think they were related.


npda

Feb 24, 11 13:32

Post #18 of 54 (43254 views)
Re: Hip pain: Tensor fasciae latae [johnnybefit] [In reply to] Quote | Reply

Since the hip area is a cluster of all those muscles and fascia, I would say it won't hurt to roll your IT band, gluteus medius and gluteus maximus. Not sure if you should roll your rectus femoris or not- strain? hmm, call your doc back and ask.

A good stretch for the region is the lunge position- affected side leg back. put non-affected side arm up in air and lean back. you can get as aggressive as you want. also just a simple quad stretch holding affected side ankle in hand. probably google the diagnosis and you'll find some more stretches. Those two are all I do.


johnnybefit

Feb 24, 11 17:39

Post #19 of 54 (43234 views)
Re: Hip pain: Tensor fasciae latae [npda] [In reply to] Quote | Reply

Thank you, I appreciate it. Is anyone using Celebrex for pain or something else?


GhiaGirl

Feb 24, 11 20:43

Post #20 of 54 (43222 views)
Re: Hip pain: Tensor fasciae latae [johnnybefit] [In reply to] Quote | Reply

This is a great site (not just the actual page I'm linking) to information about injuries etc...



Also, see the post on the main page about NSAIDs regarding Celebrex


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johnnybefit

Feb 25, 11 3:03

Post #21 of 54 (43213 views)
Re: Hip pain: Tensor fasciae latae [GhiaGirl] [In reply to] Quote | Reply

GhiaGirl wrote:
This is a great site (not just the actual page I'm linking) to information about injuries etc...



Also, see the post on the main page about NSAIDs regarding Celebrex

Thank you! I like the site! I have to keep looking for the Celebrex post but I really like the rest of it.


GhiaGirl

Feb 25, 11 9:30

Post #22 of 54 (43195 views)
Re: Hip pain: Tensor fasciae latae [johnnybefit] [In reply to] Quote | Reply

It's titled NSAIDs or something. Celebrex is a NSAID (anti-inflammatory drug)


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johnnybefit

Feb 25, 11 10:20

Post #23 of 54 (43190 views)
Re: Hip pain: Tensor fasciae latae [GhiaGirl] [In reply to] Quote | Reply

My Dr. also told me that icing that area is not very effective. Does anyone ice the iliac crest area and the surrounding muscles to good effect?


johnnybefit

Mar 4, 11 18:23

Post #24 of 54 (43087 views)
Re: Hip pain: Tensor fasciae latae [johnnybefit] [In reply to] Quote | Reply

My first PT session was a bit underwhelming. Some stretching exercises to do at home after about a 30 minute eval. I was expecting someting more intensive and hopefully helpful. I have completed the exercises for the last three days but have not run. I did walk on a treadmill for 30 mins today and my ASIS (I think) hurts. it is the fleshy part at the top of my iliac crest near the front. Of well..just frustrating to not be able to run and have this pain..


npda

Mar 4, 11 20:54

Post #25 of 54 (43083 views)
Re: Hip pain: Tensor fasciae latae [johnnybefit] [In reply to] Quote | Reply

That sounds frustrating. I had a similar experience with my first chiro- who just adjusted me and gave me strength exercises. I did these for 4 months with a little improvement, but not enough to run pain free for more than two miles.

Now, it's been one month since I started this thread and I've had seven sessions with another chiro who does ART and Graston techniques. The pain is 90% gone and I'm doing my first ~20mpw in what feels like forever. I don't know if this will work for you, but for me, finding a doctor who can do release techniques on the tissue was exactly what I needed. I think the strength stuff is still important, but the tightness has been specifically addressed with the ART and Graston. It's truly amazing.

The hardest thing for me was to call around and be pushy about what kind of treatment I wanted. Obviously, as a person with no medical degree, I felt bad asking my first doctor for a referral. But I did, and it was worth it.

Good luck! Keep shopping around!

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