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Hip stress fracture vs bursitis
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Dr worries that I may have a stress fracture in my hip. While Im waiting for my mri appt, Ive been scanning web for the difference between pain/symptoms of fracture vs bursitis. They seem to be similar.

Love to hear tales of pain & diagnosis.

Thanks!!!



Let the crazy out.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Hip fracture or fracture of femur head will present pain near groin. Bursitis is purely on the outside of the hip. Hope that helps.

4 x Kona Qualifier
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Re: Hip stress fracture vs bursitis [bwinterroth] [ In reply to ]
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I had a stress fracture of femoral neck in 2001 while training for first marathon. Overuse injury due to improper training. Pain was more medial as noted above. Must wait for MRI to be sure. This is not a diagnosis to fool around with as you run risk of converting to a true fracture. I took off for 12 weeks and was on crutches for first 8 weeks. (Not for pain but to rest it as per docs orders) i went on to have many injury free years but have always been careful with my running volume. Good Luck
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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I had bursitis in the spring of 2011. Never knew what a bursa was until I had it and it sucked. Wasn't doing triathlon at the time but was still active. I could never get comfortable, whether I was standing, sitting or laying down. I guess bursitis is the better of the two options, but either way no fun.
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Re: Hip stress fracture vs bursitis [clarkoe] [ In reply to ]
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Thank you for the comments.

I have almost electric like pain that wakes me up at night & when I try to run, limping, pain when getting out of car & when sitting in desk chair, pain on flip turns. I took 2 weeks off from running & & 1 from swimming. It calmed down. I thought it was a pulled muscle so was optimistic that it "got better". The second I tried to run again I was in same pain. That symptom is what Dr said he was most worried about.

I ran Oct 13.1, 1 week rest, started back slow. Felt pain 2nd week running, kept running until it was no longer possible. Honestly, the night pain was scaring me.

I went to the dr thinking it was bursitis & was caught off guard with sf possibility. Now I cant get into the mri machine fast enough.

What do you think of symptoms? I am fearing the worst.



Let the crazy out.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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I'm dealing with a femoral neck stress fracture right now. I first thought it was a hip flexor strain since the pain was on the front upper part of my thigh. I was loading up on NSAIDs, icing, stretching, massage, etc., etc. for a few weeks. The pain wasn't really getting any better. It wasn't until I got an MRI 5 weeks later that I learned it was a stress fx. Doc immediately put me on crutches to take the load off the leg and let the bone heal. I was initially told 3 weeks on crutches and that I could still swim and bike as long as it wasn't causing pain. After those 3 weeks the pain was only marginally better so she sentenced me to 4 more weeks on crutches and a ban from ALL swimming, cycling, walking, strength training, stretching, etc.. I've been out of running for 11 weeks and swimming and cycling for 3 now. It's just now finally feeling almost pain free. I'm hoping to get off the crutches this week, get back in the pool and on the bike and start PT. Running is still a long way off.

My advice would be to assume it's a stress fx and get on crutches until you get the MRI results just to accelerate the healing process. I wasted 5 weeks of healing time walking around assuming it wasn't a stress fx - I wish I could have those back. I don't know much about bursitis but the crutches couldn't hurt even it that's what you're diagnosed with.

Good luck
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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I had a similar issue in the spring of 2011. Thought it was bursitis. Kep running until I could barely walk after 10 mile run. Went to the Dr and the Chiro. Both suggested an MRI. The MRI said it was a precursor to a SF so I stopped running altogether. Elliptical, spinning and swimming. Had pain on the flip turns as well. Bottom line, don't run, and dont force it. I came back slowly after 10 weeks off, and ran the first 10 mi of an IM, and walked the rest.

Rest and recover. You'll be back soon enough.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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hip pain is no fun
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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The immediate return of pain when running again is a big red flag. Doesn't sound like bursitis. Bursitis should be very clear on physical exam and doesn't need an MRI. I am assuming your doc didn't feel your exam was that impressive for bursitis. Labral tear would be another consideration if deep pain on the being of the hip, but your symptoms have me more concerned about stress fx. I would definitely do as little load bearing activity as possible until you get the MRI. If I am highly suspicious for a stress fracture, I put my patients on crutches while awaiting MRI.

Another consideration is lumbar (ie low back) and/or SI etiology if your pain is more posterior (butt or back of thigh).

Good luck.

Doug Nowak
Orthopedic Sports Medicine Specialist
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Labral tear maybe?
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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I have just been diagnosed with a stress reaction of the femoral neck. This is the precursor to a fracture, so it was an early spot. Inflammation shows up on the MRI but no fractures on the CT scan. Treatment is basically the same.

I started with a low level nagging pain in my groin. Quite deep - certainly too deep to manipulate. No stretch seemed to hit it. Everyday pain in the groin got worse and worse the more I continued running. During running itself, the first 1.5km was the worst - footfalls were really painful and I would have to start very gently and ease myself into the run carefully. After 1.5k or so it would bed down, but if I had to stop and restart, it was very painful again for a few hundred metres.

Then immediately after running I would notice a sharp pain in transition movements - eg getting up from a chair - when I came to weight bear on the bad leg. Now the pain was a shooting pain focussed in the groin but referring down the leg.

After one particular fast run it became very acute, so much so that I was having real trouble walking. I found a stretch that pinged it: lie on the floor face down and do a straight leg lift of the afflicted leg. The next morning I could not walk - literally - I needed to keep all weight off my right leg.

After 36 hour I was walking very gingerly. The acuteness would not walk off though, as a muscle or tendon pull might.

Two weeks after that I was scanned and diagnosed. During that period I noticed that I was having real problems transferring my weight smoothly onto the afflicted leg at the footfall stage of an ordinary walking stride. Transition states remained very difficult and painful. Two weeks after that (ie now) I am moving freely, can weight bear on my leg at walking speeds without inhibition, and transition states are fine. However, I can feel a very low level ache that tells me that it's not yet sorted, and that it would be unwise to try a higher impact load (running) just yet.

HTH


ETA: mine is affecting the compression (lower) side of the femoral neck, so I was able to dodge crutches (though I admit there was a time when I would have been pretty keen on having some). Even at the most acute phase of the injury, I had zero pain when non weight bearing - bed or sitting. During my 36 hours of enforced bed rest I kept lying there thinking "I feel fine. What's the problem?". Then I'd have to get up to go to the bathroom, which would take 10 minutes of sharp pain, careful balancing, deep breathing and general unpleasantness, and remember what the problem was.
Last edited by: Greg66: Dec 10, 12 2:34
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Re: Hip stress fracture vs bursitis [IronDoc947] [ In reply to ]
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Thanks for all the feedback. Really appreciate it.

MRI scheduled for Wed. Appt with Dr on Thursday.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Diagnosed with stress reaction of femoral head, compression side. Crutches for 4 weeks.
Guess Ill check out the recovery threads now.
Thanks for feedback.



Let the crazy out.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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That sucks! Sorry to hear the diagnosis. As i said in my post above, I'm healing up from the same exact injury right now. I just got off the crutches this week after having my initial 4 week crutch orders extended for a few more weeks. My advice: be diligent about using the crutches to keep the weight off the leg as much as possible. I wasn't as good about this and ended up on them for double the time the doc prescribed.

The good news: bone heals. Just give it the rest it needs!!

Feel free to PM me with any questions or if you need to vent during the process.

Best of luck!
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Had tension type and healed well on crutches only. you will be fine. good luck.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Was very, very tired one morning and went for a run anyway. Hips got achy, right more so than the left. Tired enough to cut the run short. Went home and slept. Ran more later (despite super achy hips). The next day could not run at all; took the day off. A day later, biked an hour, ran 6 miles off the bike. Kinda achy but managed it. Could not run the next day and had pain with hip flexion; lifting that foot to press the gas pedal in the car was painful.

4 months of biking and walking, thinking it was tendonitis; it was constantly achy around my groin and anterior hip, but did not have sharp pain. Had to wait 2 mo to see a specialist. Got an MRI; could not tell from that whether it was a fx, a small labral tear, or tendonitis. Doctor wanted to rule out a sfx so did a bone scan, which came back clean - meaning if there had been a fx, it was healed. They gave me a cortisone shot, which cleared it up --- so I definitely had tendonitis, and may have had a fx. Looking back on it with the type of pain I had, I suspect there was a stress reaction and tendonitis.

Like someone else said, groin pain = likely fx or tendonitis. Good luck.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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That sucks man, but 4 weeks on crutches is better than months and months of recovery down the road. Im in a similar situation myself just not with crutches.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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MI Unsalted wrote:
Diagnosed with stress reaction of femoral head, compression side. Crutches for 4 weeks.
Guess Ill check out the recovery threads now.
Thanks for feedback.

Sorry to hear that. Bad luck.

Crutches for 4 weeks, eh? Interesting. I know mine's in the neck and not the head, but over here (UK) I got the impression that even a fracture on the compression side would not result in crutches. I also got the clear impression that the higher, the worse. So head issues are much more serious than neck.
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Re: Hip stress fracture vs bursitis [Greg66] [ In reply to ]
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My bad...stress reaction of femoral neck...not head. It all is a blur when hearing bad diagnosis.

Interesting no crutches in UK. Im already tired of them, but Im hoping extra caution now will lead to quicker return. Im going to take off from swimming for solid week too.

Cheers for speedy recovery.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Ugh, that totally sucks. I had two femoral stress fractures about 5-years ago, one in each shaft.

Whatever you do, don't try to come back too fast. For the first month or so after getting my go-ahead from the doc, I ended up spending 90% of my workouts in the pool, either swimming or aqua-jogging. It's not worth it to try to bounce back too quickly and then end up back at step 1. Also, be careful pushing off walls of your flip turns—either one leg-it or just U-turn it at the end of the lane.

I was back running and lifting in less than three months without any side-effects thanks to playing it safe. Also at peak swimming fitness.

Hope you have a quick recovery!

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Re: Hip stress fracture vs bursitis [maggieru] [ In reply to ]
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After 4 weeks of complete couch sitting I hit the pool yesterday. I've got that nagging burning hip pain now today. Is this to be expected?

The Dr. said that if I didn't heal up in 6 weeks that he might consider a labral tear along with the stress reaction. Should I be concerned that a labral tear is a true possibility or is it simply the stress reaction isn't healed up yet. There was an image in the MRI that he said could be a labral tear.

I've got 1 more week of crutches and then 2 weeks off crutches before Dr. follow up appt.

I was really hoping to get back in pool on a regular basis, but now I'm concerned that isn't an option either. There wasn't really pain while swimming. I did not push off the wall with the bad leg.

My main pain indicator is when lying on my back, there is pain in the front of the hip area when I lift my let up. I used to barely be able to make it lift. Then I could lift it with shooting pain. Now I can lift it with dull ache.

Any thoughts are appreciated.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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MI Unsalted wrote:
After 4 weeks of complete couch sitting I hit the pool yesterday. I've got that nagging burning hip pain now today. Is this to be expected?
The Dr. said that if I didn't heal up in 6 weeks that he might consider a labral tear along with the stress reaction. Should I be concerned that a labral tear is a true possibility or is it simply the stress reaction isn't healed up yet. There was an image in the MRI that he said could be a labral tear.
I've got 1 more week of crutches and then 2 weeks off crutches before Dr. follow up appt.
I was really hoping to get back in pool on a regular basis, but now I'm concerned that isn't an option either. There wasn't really pain while swimming. I did not push off the wall with the bad leg.
My main pain indicator is when lying on my back, there is pain in the front of the hip area when I lift my let up. I used to barely be able to make it lift. Then I could lift it with shooting pain. Now I can lift it with dull ache.
Any thoughts are appreciated.

Labral tears often cause subtle hip instability and mechanical sensations (clicking, catching, giving way), as well as nocturnal pain. The torn flap is usually anterior and so when leaning forward the pain is worse, reducing ability to put on shoes or pants. External hip rotation becomes greater on the affected side (more "turn-out," as in dancing). Sorry to say that the flap has very limited capacity for self-repair, even with long-term unloading.
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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I am 5 weeks post op from arthroscopic labral repair along with some femur head reshaping and a bone graft on the femur head to patch a spot that had a cyst. The only way to really diagnose a tear is an MRI which is the way I found out.

My guess is that the pain you are feeling in the anterior area of the hip is related to your psoas and other hip flexors being out of shape from a month on crutches. I was on crutches for nearly that long and that is where I got the pain when I got off of them. Your doc or PT should be able to give you some exercises for them as well as your gluts which also need work. Those help a lot. I have been back to swimming for two and a half weeks either with a pull buoy or very light flutter kicking. No hard kicking until two months. You may want to try that. I can ride my bike on the trainer and today got cleared to use the elliptical. Running will have to wait until March which if that is the case will be one month earlier than expected.

Good luck with your recovery!
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Re: Hip stress fracture vs bursitis [Greg66] [ In reply to ]
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So I have been battling this hip pain since the Saturday before Thanksgiving. Long story short, I got mono, didn't run for 15 days and pain went away, ran 2x easy 30 minutes while getting back into exercises, had to stop running during second run because hip hurt so bad. Went to doctor and was told hip flexor strain and no running until pain free. I was given some stretches and strengthening exercises that seemed to really help. Basically, I went to several different doctors trying to find an answer that I liked, they all said hip flexor strain and continue to exercise as pain allowed (no biking, no running, no kicking in the pool). Pool running was extremely painful. Three and a half weeks later, I went back to doctor I initially saw and he said that I was looking great and had come very far since the first time he saw me. While at the doctor, my mom called a different doctor and was able to get the her to order an MRI. Turns out, I have no hip flexor strain, but a freaking stress fracture. It is in the femoral neck proximal to the lesser trochanter.

I have a few conflicting opinions on how to go about this injury. This is my THIRD femoral stress fracture. I had bilateral femoral shaft fractures last January and now I have this stupid one. The fracture is apparently quite small, though there is still a bit of swelling. The pain is completely gone while I walk, it just hurts when I stand up or shift my wait too fast. I also am experiencing the pain referenced about pain when turning over in bed. I have been off the bike and running for 3 weeks and 5 days. Clearly I have been counting. The doctors haven't put me on crutches and think I will be able to elliptical next weekend. I am super nervous because collegiate nationals is in 4 months, though the doctors and coach think I will be able to race. Anyone have any happy/success stories?
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Re: Hip stress fracture vs bursitis [MI Unsalted] [ In reply to ]
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Even if stress fracture is the primary diagnosis you most likely have other muscular things going on. Muscles tend to guard in reaction to pain and don't necessity relax on their own. Based on your symptoms lying on your back lifting your leg, your hip flexor or psoas muscle is still tight and may continue to cause symptoms even after the fracture is healed. Based on your profile name are you in Michigan? I know some good physical therapists that specialize in manual therapy!
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