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Hip pain: Tensor fasciae latae
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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!
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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?
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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

maybe she's born with it, maybe it's chlorine
Fishtwitch is chlorintined!
disclaimer: PhD not MD
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Re: Hip pain: Tensor fasciae latae [tigerchik] [ In reply to ]
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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... :)
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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.

maybe she's born with it, maybe it's chlorine
Fishtwitch is chlorintined!
disclaimer: PhD not MD
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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!
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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!
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Re: Hip pain: Tensor fasciae latae [Margo Plicatus] [ In reply to ]
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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!
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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
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Re: Hip pain: Tensor fasciae latae [DirtGirl] [ In reply to ]
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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
Last edited by: rkopitzke: Feb 11, 11 8:51
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Re: Hip pain: Tensor fasciae latae [rkopitzke] [ In reply to ]
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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.

maybe she's born with it, maybe it's chlorine
Fishtwitch is chlorintined!
disclaimer: PhD not MD
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Re: Hip pain: Tensor fasciae latae [tigerchik] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [Allie] [ In reply to ]
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One-legged dead lift- wow. How does that work exactly? Do you use weights?
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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Thank you, I appreciate it. Is anyone using Celebrex for pain or something else?
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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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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Re: Hip pain: Tensor fasciae latae [GhiaGirl] [ In reply to ]
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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.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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It's titled NSAIDs or something. Celebrex is a NSAID (anti-inflammatory drug)
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Re: Hip pain: Tensor fasciae latae [GhiaGirl] [ In reply to ]
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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?
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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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..
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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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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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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I have gone to a Chiro that a friend recommended to me twice this week. He has performed both an adjustment on my SI joint which was almost immobile and ART on my TFL. I am feeling better from both. I have not tried to run yet, will keep resting it awhile to see but I am encouraged so far.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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POsted on another thread but will update here. No running for 6 weeks, tried a 10 min and a 12 min run and the pain returned immediately. Don't know where to turn next.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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That is so frustrating! I still haven't kicked my TFL pain, but at least I've been able to run all this time. I've been discharged from PT, though, so not sure what's up next... Have a follow-up with my doctor next week, perhaps she'll have some ideas. Are you still in PT for your issue? Haven't seen your other thread, but maybe you're getting some good ideas over there.
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Re: Hip pain: Tensor fasciae latae [Margo Plicatus] [ In reply to ]
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Yes, still having the pain. The Chiro work along with ART, Foam Roller, and PT exercises does not seem to be doing that much for it. It seems that rest from running is the only thing that helps.
I did not a sprint tri yesterday that ended with a 5K and the pain at the top of my iliac crest started about 10mins into the run and it still a bit tender today.
I am going to see another Sports Med Dr. this week or next (I hope) to get a third opinion.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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Well, I saw my doctor Friday and she said I'm one of a handful of people she's seen with localized pain where the hip flexor tendons insert on the iliac crest. She said I might consider giving acupuncture a try, because she's seen it help some people, and her only other suggestions were to just give it time and continue stretching my hip flexors daily, (they're still somewhat tight on that side) and possibly try platelet rich plasma. I'm skeptical, but have an appointment for acupuncture tomorrow. PRP isn't covered by insurance, and I'm a student living on loans, so I'm not even considering that. Let me know if your third opinion has any great ideas!
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Re: Hip pain: Tensor fasciae latae [Margo Plicatus] [ In reply to ]
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I certainly will let you know. The pain is so localized it just seems that stretching is not the way to go. I will check into some other treatment methods and post here.
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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Yes, and be careful, if you ignore it, you can tear it. This is sort of important because it is how your IT band connects to your hip.

"It's not just a daydream if you decide to make it your life"
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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So happy to find this thread. I am wondering if I also have issues with the TFL.

I ran NYCM in November, ran low mileage for a couple of weeks before ramping back up for the Houston Marathon in January. The week before Christmas, I went out for an easy 3-miler and noticed that my hip was achy and tight. As the evening went on, the ache became more painful so I iced, stretched and foam rolled. Two days later, I ran 6 miles - the hip was achy the 1st couple of miles, but seemed to get better. Again, after the run, the pain got worse. I rested a few more days before doing my final long run before Houston - 18 miles. Same thing - the hip was achy at 1st, but seemed to get better as I warmed up. Two days later, I attempted a 4-miler and every step was excruciating. I had to turn around and come home. At the time, I was also biking and swimming, so I stopped running but continued with the other activities (trying to also train for a 70.3). The hip continued to hurt, so after a few more days I stopped everything and saw a Chiropractor. At this point, I was limping and daily activities like getting dressed, getting in and out of bed, in and out of the car and walking were painful.

The Chiro felt that it was a case of tendonitis and thought that with a couple of treatments that I could still run Houston (by then it was only 1 1/2 weeks away). After my initial visit with massage, electric stimulation and adjustments, I was feeling better - I could walk without wincing and almost get dressed with no pain. The Dr gave me some exercises and stretches to do at home and I did them faithfully. That weekend, I tried a 4-miler and the intense pain came back. I went in for a 2nd treatment and again, I felt better. At this time, I also saw an Orthopedic who took x-rays and confirmed the Chiro's tendonitis diagnosis. He gave me some Celebrex samples and a RX. He also felt I could run the marathon without making the injury any worse. I went back to the chiro one more time, got taped up with Kinesio tape and was prepared to at least attempt the marathon...until I attempted to run the day before. It was excruciating both to put weight on the leg and lift it. I did not do my marathon.

So I just switched to a Chiro who specializes in ART. He felt the pain was actually in my rectus femorus, but after reading more about the TFL, I think he might be wrong. After 3 ART treatments, I am still not able to run. I ran 2-miles last week and felt pain - first toward the back (glutes) and then in the front. Granted, it was not as intense as the pain before the Houston Marathon, but it was bad enough to make me want to stop running and go back home.

I guess I typed all this to say that you might want to get a 2nd opinion, but it may not help. I am beginning to think that the hip is much more complex than I realized and that doctors can only guess and make suggestions...those guesses aren't always right. I've also read a lot about various hip injuries and it seems that the hip can take a long time to heal! Not really what I wanted to hear, especially since I was trying to train for a 70.3! I hope you have better luck than I have had in getting answers and getting back to 100% soon!
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Re: Hip pain: Tensor fasciae latae [aggiegrad96] [ In reply to ]
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aggiegrad96 wrote:
I am beginning to think that the hip is much more complex than I realized and that doctors can only guess and make suggestions...those guesses aren't always right. I've also read a lot about various hip injuries and it seems that the hip can take a long time to heal! Not really what I wanted to hear, especially since I was trying to train for a 70.3! I hope you have better luck than I have had in getting answers and getting back to 100% soon!


Yes- I think you are right. It took a massage therapist, several chiropractors and several PTs to fix me. And yes, it has been eight months of pain free and I have run 2 50ks, 1 50miler, a few marathons and no pain has come back.

The description of your pain, however, sounds quite different than mine. So it might be a completely different diagnosis/cause.

Keep trying different techniques, doctors, etc.; be patient and be pushy. You will heal!
Last edited by: npda: Feb 20, 12 16:15
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Re: Hip pain: Tensor fasciae latae [aggiegrad96] [ In reply to ]
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aggiegrad96 wrote:
So I just switched to a Chiro who specializes in ART. He felt the pain was actually in my rectus femorus, but after reading more about the TFL, I think he might be wrong.
Ive had an on going hip pain that has been (apparently) misdiagnosed for months.

Although I have an ache in my hip, it also manifests itself as hamstring weakness.'
Finally been disagnosed with chronic shortening of the illiopsoas muscles on my left side and shown how to release them myself.
After 1 day of self release, the pain has halfed and I can actually walk again without limping.

Ive also been told that my problem is actually very common and many people suffer from it, especially triathletes.
Something to think about.
Hope you get it sorted ASAP. being injured sucks!
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Re: Hip pain: Tensor fasciae latae [Andrew69] [ In reply to ]
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>>Although I have an ache in my hip, it also manifests itself as hamstring weakness.'
Finally been disagnosed with chronic shortening of the illiopsoas muscles on my left side and shown how to release them myself.
After 1 day of self release, the pain has halfed and I can actually walk again without limping. <<

What do they have you doing to release it?

clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com
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Re: Hip pain: Tensor fasciae latae [trackie clm] [ In reply to ]
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trackie clm wrote:
What do they have you doing to release it?
Two things.
First is the typical iliopsoas stretch where with one knee on the ground, you step forward with the other leg and press the hips towards the ground, but you also need to reach up with the arm (same side you are stretching) and lean away. This greatly increases the stretch.

The other, and the one that really helped was to find the muscle in the abdomen (google it, its pretty easy to find once you know where to find it) and while lying on your back with your leg was bent towards your chest, apply very firm pressure with your fingers and then slowly extend the leg. Be warned, if you iliopsoas are tight this will be painful and you will feel a very deep pain, but the relief will also be instant.

You will need to do both for at least a few times per day for at least 3 weeks (or so I have been told)
Hope that helps.
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Re: Hip pain: Tensor fasciae latae [johnnybefit] [ In reply to ]
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Wow, I have all of these things. I now wear an SI belt all the time except for sleep since I need adjustment every visit (3x a week) at the PT office. Definitely helps! I hope all of you have better luck with getting these issues sorted. I have hypermobility in all joints and very lax ligaments, so my 6:05 miles were very jarring on the body. Now that I'm pregnant again it is even worse-- not just the running but the inability to stabilize the joints. =)
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Re: Hip pain: Tensor fasciae latae [Andrew69] [ In reply to ]
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Thanks! Looks like I was completely wrong (as was the doctor)! I had an MRI and I have 3 issues - stress reaction on the right proximal femur, low grade tear on the illiopsoas and partial articular tear on the anterior labrum. No running (or anything high impact for 12 weeks) and no biking or swimming for the time being. :o/
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Re: Hip pain: Tensor fasciae latae [Andrew69] [ In reply to ]
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So how was your hip hurting that was "achy"? I ask because mine seems a bit different than what others have described.

Ran a half marathon a couple of weeks ago, first half was run pretty hard & I was probably heel striking pretty hard. I tend to otherwise have a fairly soft stride that trends towards midfoot (that's what happens when you're slow). The next day we went for an easy/slow 3mi hike that had some hills & stairs (Belle Meade). Nothing too strenuous, just fun. My hip was a bit achy after the half & everything was a bit sore during the hike but was ok. Fast forward, two runs during the week - hip starts hurting about 2-2.5mi in. Both runs around 4-5. Pain doesn't really get excruciating but is a present ache, very localized & way down in there on my hip. I guess if you made my waist a clock it would be about 2-2:30. But here's the deal, I can't find it - can't push on anything & locate it, doesn't get super bad if I sit for too long or stand for too long, lay on it or stretch things too much. If it's already aggravated the only time I can find it is by kicking my hip back & out (maybe extending out the joint? Think sticking your hip/butt out really far & sideways...) I get a little twinge when I stand up but mostly it's just a dull ache that's become more noticeable during/after each run. Didn't run for a few days last week, took Aleve fairly regularly, was going to try the long run on Saturday. Made it about 3 before it showed up & progressively got a little more persistant. Had to call the run at 8 when it flared into a sharp pain on two steps. I didn't want it to continue to get worse.

Rode my bike last night for about 13mi (first time since 10/10), had some steady hills...did some in & out of saddle climbing. Today I have barely sore hamstrings but my hip wasn't sore at all after the ride, just still the slight ache that seems to come & go (depending on my aleve intake & how long I've been still, apparently). Did a 5.3 trail run today that's some fairly rugged trail. Was taking it easy both up & down the hills trying to be easy on it. Right around 2.5 the dull ache started. I slowed way down & was really conservative all the way back but still had to pound a bit & it definitely fired up more. Now it's the tired/ache that's definitely letting me know it's there. I haven't taken any aleve since mid-morning so it's time. Icing doesn't seem to make much difference either, just makes me cold.

Anyone have any ideas? I still can't pinpoint the pain...it's down in there. I wish I could push on something or stretch something or bend somehow to make this better! I really don't want to go to a doctor...I have a lot of travel coming up sprinkled with a half marathon, sprint tri, marathon, the Women's Committee seminar (in St. Pete the day after St. A's!!!) & vacation....

AW
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Re: Hip pain: Tensor fasciae latae [AWARE] [ In reply to ]
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My hip was and still is some what "achy".

Ive got slack with my stretching and my symptoms are slowly coming back. :-(
It certainly wouldnt hurt for you to do the stretches Ive mentioned.
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Re: Hip pain: Tensor fasciae latae [Andrew69] [ In reply to ]
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I battled TFL pain after IMLP last year. It was ongoing for about 8 months and still occasionally nudges me. For the most part, it's gone though. I had IMS (Intramuscular stimulation) treatments, rolled around on a tennis ball (OUCH!) and strengthened glute medius and surrounding gluteal/hip stabilizing musculature. Also added vinyasa yoga twice weekly and things are much better. Fingers crossed that things will improve for you as well.

...oh ya...and I gave up running for many months too and now run mainly trails for the lesser impact.
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Re: Hip pain: Tensor fasciae latae [Andrew69] [ In reply to ]
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I gave in & went to the doc...had the x-rays & MRI, poked & prodded. Just returned from the follow-up with a good dose of cortisone in my hip. Not thrilled but it's good to know that it wasn't all in my head & it wasn't necessarily just a muscle strain. Now I have to officially baby my hip for the rest of the month & just get through the marathon. I was doing the stretches/exercises 2-3x/day - clamshells, fire hydrants, monster walks & some balance work. Now I get to continue to ice & advil & reintroduce short runs as long as I don't push hard or run wonky.

Have another shot slated for the day before the run (I'll be out of town until then). Then I lay off running for a month or so. Not a thrilling diagnosis but hopefully it works & I'm patient enough to let it be. Then I can build slowly back into comfortable running to enjoy some late summer/fall/winter running again.

AW
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Re: Hip pain: Tensor fasciae latae [AWARE] [ In reply to ]
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Just curious to see how your hip is doing afer your cortisone injection? I hope it helped!

I am scheduled to get an injection on kenalog on Thursday. I hope I have good results!
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Re: Hip pain: Tensor fasciae latae [aggiegrad96] [ In reply to ]
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Got the first injection on 4/5/12, the second on 4/27. The first seemed to do a great deal of good, my hip wasn't really hurting when I got the second one. There was a ton of travel involved between the two, including some very long car rides & flights, much time at sales conferences on my feet (may or may not have worn heels most of the time...). There were only a couple of times that my hip would feel "tired" at the end of the day. Not really achy or hurting, but just tired..like something isn't 100% but wasn't bad. I ran and walked quite a bit between them as well. I got the second shot more as a deterrent than anything else, I ran a marathon the next day. Of course it was fine the whole time - no real pain or discomfort or even that tired feeling. Every other time I've run marathons my hips are always sore....but this time it was almost purely my feet (also "normal" for post-marathon for me).

So I'd say it's done great & I feel great. I've not run since the marathon though and will be starting back very slowly over the summer. My plan is to build consistency & endurance. I don't really intend to do much/any speedwork. The strengthening exercises are crucial, in my opinion.

What's kenalog? I asked what I was actually being injected with & have long-since forgotten the actual name. I remember that it was cortisone, maybe a bit of anti-inflam & a long-acting numbing agent. I don't guess it really matters though...

The day/night of the first one it was really achy overall. It was just that tired, uncomfortable, achy feeling. And the injection spot actually itched for about a day. But it wasn't too bad. A little advil & ice helped all of that. Good luck, hope it helps you too!!

AW
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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I hAve the same injury. It has taken 5 months to get a proper diagnosis. I was training for a half marathon last spring. After hill training and speed work I started to get pain in left hip just behind the illiac crest. I took IBP for the pain to start with. I would get a real lower back ache after each run and my hips were sore. The TFL area would be tender to the touch and eventually I couldn't put any weight on my left leg, I would have to pull myself up the stairs usin g the hand rail. I had physio and saw my chiro, but nothing worked. Took a six week break and then ran my race in August. I have been out of commission since then! I had exrays and a bone scan and finally an ultrasound of the muscle. My doctor suspected I had torn my gluteal medius, due to the weakness on my left side, so he was quite surprised to see a tear in the TFL. He gave me a shot of cortisone 5 weeks ago, I was pain free the next morning for the first time in 5 months. I was doing great, started doing short runs three times a week and lots of hip excercises with weights in the gym. The pain has returned again at the illiac crest and it pulls with every heel strike. It's been several months now, and it hasn't healed. I see my doctor again next month, so I'm hoping he will give me another shot of cortisone. I don't think there is anything else he can do for me. I'm wondering if I will ever be able to run again.
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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I had exactly the same pain last year training for a half. Once I started speed work and hills it got to the point I couldn't put much weight on that left side and way too painful to run on, even walking caused me to limp. Finally got an ultrasound of muscle and discovered a tear in the TFL. Quite rare I'm told. I would be very careful not to push it, as if it tears like mine has, it's extremely painful and you won't be able to do any weight baring excercise. I have had a shot of cortisone and that has enabled me to start short 5k runs, first time pain free in 6 months. It's been 7 weeks since the shot and it's starting to ware off. I'm getting that pain behind illiac crest. 10 months now and not healed.:(
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Re: Hip pain: Tensor fasciae latae [Underpar] [ In reply to ]
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Your injury sounds very frustrating.

I had the same pain awhile ago when I started this thread, but ART and graston techniques healed it completely for me. I did not tear mine though. I didn't have any cortisone shots. Don't give up on running! If one thing doesn't work, try something else, or another doctor. Keep trying! However, tearing will result in scar tissue, and someone good at ART can work out that scar tissue. Strength training is obviously good, but in conjunction with actual treatment of the injury in my (non-medical) opinion is critical.

It finally cleared completely for me in 2011 and since then I have run almost a dozen ultra races including a 100k and 100miler. And at my low point, I didn't think I would run again either.

Don't give up, please!
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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Do you have pain walking when the pain is bad? Do you know if the TFL is actually torn? I went for a 5k run yesterday and my pain is right back to where it was 6 months ago. I'm have trouble walking today, and constant pain sitting. I'm going to need ibuprofen. The cortisone shot has obviously worn off completely. I see my doctor in 2 weeks, I'm hoping I can get another shot. I'm going to try the one legged squats. How does one change their running form? I had been doing many strength excercises while the cortisone was working, and I had noticed a quite an improvement on the weak side, but it hasn't made any difference. :-(
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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I'm so glad to have found this post, and am encouraged to hear you have returned to some awesome racing. I have been dealing with the exact issue you described for 11 weeks now with minimal improvements. I've been going to PT and they have been doing trigger point dry needling on all the muscles that lead into the hip. I'm able to run 2 miles and feel it slightly while running and then it gets angry and sore for the rest of the day after. When cycling (even on my TT bike) and swimming do nothing to cause irritation and pain. Do you think I should take off time completely from running, biking, and swimming, or stick with what doesn't irritate it. Also anti-inflammatory drugs or no? Lastly, the my physical therapist noticed that when I try to do a small single leg squat my knee wants to go in quite a bit, and when I run for her barefooted she sees that knee dipping in slightly when on that leg. She feels that I'm still having issue because of that imbalance and I was wonder the best way to strength that leg. I plan on doing Coach Jay - Hip Myrtle Routine (Search YouTube), foam rolling, Hot Yoga, stretching, and trigger point ball work. Thank you for your responding any and all.
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Re: Hip pain: Tensor fasciae latae [jtemails] [ In reply to ]
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Just to give you an update. I ended up getting a second cortisone shot into the torn TFL muscle and that enabled me to keep training and strengthen. I was able to run two half marathons this summer! That hip seems to be fine now, however, it was a year before it felt good again. I am now starting to get the same issue with the other hip, starting the same way, achey and sore after a run and my lower back is sore all the time. I'm going to take the winter off from running and try to sort out lower back issues and hopefully correct hip pain. I would recommend not running until you get it sorted. I
Just made mine far worse by not letting it heal. It's a long slow process!
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Re: Hip pain: Tensor fasciae latae [jtemails] [ In reply to ]
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jtemails wrote:
I'm so glad to have found this post, and am encouraged to hear you have returned to some awesome racing. I have been dealing with the exact issue you described for 11 weeks now with minimal improvements. I've been going to PT and they have been doing trigger point dry needling on all the muscles that lead into the hip. I'm able to run 2 miles and feel it slightly while running and then it gets angry and sore for the rest of the day after. When cycling (even on my TT bike) and swimming do nothing to cause irritation and pain. Do you think I should take off time completely from running, biking, and swimming, or stick with what doesn't irritate it. Also anti-inflammatory drugs or no? Lastly, the my physical therapist noticed that when I try to do a small single leg squat my knee wants to go in quite a bit, and when I run for her barefooted she sees that knee dipping in slightly when on that leg. She feels that I'm still having issue because of that imbalance and I was wonder the best way to strength that leg. I plan on doing Coach Jay - Hip Myrtle Routine (Search YouTube), foam rolling, Hot Yoga, stretching, and trigger point ball work. Thank you for your responding any and all.

Hi there- i'm not sure what trigger point dry needling is- but it sounds like it's supposed to release tightness?

In theory, doing exercise that does not irritated your hip will not make it worse- in my case, the way I initially treated this injury was to just stop running and hope it would go away, and I swam and cycled a ton. It didn't make it worse, but it never got better, because I never did anything to heal the TFL, and I didn't do anything about my strength imbalances for running.

I believe the knee tracking issue you describe is most likely related to a weak glute issue (non medical opinion, for whatever its worth). I did a lot of one legged squat/dip type exercises and did it in front of a mirror to watch my knee so that it would stay straight. it's been three years now and I never got the pain back, after doing the ART to work out the TFL and illiacus tightness and work on the strengthening.

foam rolling, hot yoga, stretching, trigger point are all great, and might be enough- but they are not as aggressive as graston and ART- i'm not saying that is what you need, but it is what worked for me. I also think one legged squat and dips and anything to work on those glutes is gold.

good luck.
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Re: Hip pain: Tensor fasciae latae [npda] [ In reply to ]
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I have had pain in my TFL and gluteus medius for a couple of years. I've been to a sports meds doc, a chiropracter and physical therapy. For this type of pain it is more from an imbalance in the gluteus muscles. In running the glutes aren't really engaged much so we need to build them up. One legged squats while watching knee tracking are so important. The knee wants to track inward and we have to train our glutes to prevent that from happening. Also, clam shells and side leg lifts with a resistance band are great also. My problem is that I get to feeling better and slack on the exercises and of course the pain comes right back.

I've read some articles on dry needling and talked to a friend who is a sports med doc. The purpose theoretically is to break up the injured, contracted tissue. He hasn't had any luck with this.

Hope this help!
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Re: Hip pain: Tensor fasciae latae [wsummerhill] [ In reply to ]
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Yes, I think you are right, in my case I need to continually keep up those exercises, I stopped doing them when I felt better and now I'm having the same problem with the other hip, it's definitely an imbalance and continually running on it causes a lot of pain. I am starting sessions with my chiro again next week and then into the gym. I hope this works!
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