Actually...It's pretty common clinically. Critical to have a very thorough musculoskeletal exam....that, surprisingly, can be hard to get these days. If you feel comfortable with the current PT and you feel like you've received a thorough exam and clear explanation on how he/she's gonna treat it... (not just a 2 minute "bend over...oh you look stiff" exam)...stick with said PT and see if you make progress. You'll likely get a lot of treatment recommendations from the web, do this exercise, or that exercise, etc.....stick to the PT's plan for a bit...reassess in a couple weeks. With a 2 year history, it may take a bit to "peel the onion" so to speak.

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CB
Physical Therapist/Endurance Coach
http://www.cadencept.net

Yes, I also have spent an entire year on the DL due to "hip" issues that were really from my back. I dislocated my hip when I was younger, so I think Drs zeroed in on that. Went to an awesome PT, who did a full body assessment, said that I had tons of indications that my low back muscles were weak and imbalanced, which was creating tightness and limited mobility in my hips and aggravating my old hip injury. I've done 3 months of strength training to strength low back and glutes, and stretching and body work (some ART/massage/acupuncture to relieve tightness in muscles) and i'm finally to a point where I can run and ride mostly pain free. It has taken a long time. And I am now in terrible shape!

Sorry to hear this. I spent 16mo on the DL with plantar fasciitis. Saw 3 Dr's, 2 PT's, did everything they said with zero improvement. Took 6mo off running and lots of strength training, no luck. Watched a video of Gwen Jorgensen's and saw her doing arch/foot strengthening. Did the same simple exercises for 4 days and the pain was gone. I do them every other day now and I'm back up to 20+mi/week over the last 3 mo and running 12 mile long runs.

I know this doesn't help your issue but don't neglect the little things as they could be causing something big like your pain. Have you gone for trigger point massage or acupuncture?

May I ask what were the strength training to target the low back?

Yes, but I’m going to have to use lots of words to describe some of them! Sorenson holds and something where I lay over a stability ball and muscle up to a neutral position (like a hyperextension but not hyperextended). Lots of different kinds of bent over rows at an angle to target the lats (which wrap around all the way to your low back). Hamstring bridge curls. Pull across chops, both up and down. I have hyperlordosis - basically excessive curvature in my spine - so am really careful to only go to a neutral position so as to not put excessive strain on my low back for things where you can hyperextend.

Sorenson Hold - Got it... doubt I'll be able to do that w/o access to a gym or sorts.
Bent Over Rows - Yep. Doing that. When you mean angle, you're saying instead of the usual 90Degress right?

Thanks

Hip? No. Legs? Yep. Went to a bunch of specialist before a doctor did a quick interview and told me that I was in the wrong place - go across the hall to the back and spine specialist.

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"...the street finds its own uses for things"

Howdy, I'm an ex-hip issue person, in that I had surgery for labrum tear / FAI (right side) in March 2017. Thing is, I still had the right side flank pain I'd had for years. Prior to hip surgery I had seen all kinds of people trying to track down the real source, since diagnostic hip injections made it clear the labrum wasn't the problem. Never got anywhere and eventually tore labrum further and so had it fixed.

So this time around I've been trying alternate approaches. Went to pelvic floor therapy for a bit. I breathed "wrong", where pelvic floor should push out during in-breath, mine instead pulled in. Now I'm doing postural restoration stuff aiming to get me to better engage muscles on the left side that have been under recruited.

This does ease the right side issues but I'll make two points. First, I do less aggrivating stuff now: swim just twice a week, use a snorkel a bunch, threw out flip turns, b/c flip turns and normal breathing continually have me over recruiting right side. I also run much less. Second, engaging the left muscles hurts as they aren't used to the work load. So I can't say I'm fixed yet.

Anyway, if you're inclined, look up PRI. I just got my 1st balloon exercise but have previously been doing work to engage TA, left side obliques, hamstrings, inner legs, while relaxing and breathing into my upper back.

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To breathe, to feel, to know I'm alive.

I'm in the yes/no/maybe/dunno camp i'm afraid.
Still ongoing and hopefully an imminent mri scan will show the root cause.

Started with niggly glute problem that jumped to my lower back.
Sort of ignored it and carried on riding and running. It was mostly okay during these.
Physio and stretching had no effect- if anything seemed to make things worse. Everything tightening up and pains moving around.
Physio noted i did have a slight alignment issue to the RHS possibly work related.
Finally, hip practically stopped moving, getting sharp pains around pelvis, really angry glute, and down the outside of my calf. Impossible to sit, or lie down to sleep. Felt like a bone wanted to come out of my hip sideways. diagnosed at the quacks as ischeal bursitis, and given pain killers and not much else.
Wasn't improving and no exercise other than walking. Couldn't twist to get in the car or to put shoes on even. A trip to A and E, who didn't disagree with the previous diagnosis, but changed meds. Massive improvement but not right but at least manageable now.
Both Docs said needed and mri scan but only referred me to a skeletal clinic, whose only line of attack was sciatica sciatica sciatica despite not having any of the regular known problems. Said there was nothing wrong with hip or pelvis/ bursa's, it was okay, but you know where it hurts right?? Pressed around my S3 vertabra and asked does it hurt? Yes, but not where i've been getting any problems. Felt that straight down the back of my calf ala sciatic nerve issues.
She said i needed an mri scan too, but to do exercises for lordosis as i was inflexible.
Yes not flexible because my hip problem is stopping me moving everything. If that didnt hurt, then i'd be able to do this that and the other.

I have done them a few times each day, and i'm not convinced they've helped or if its just that things are recovering over time.

This is going on a couple of months now and only just getting on the bike for very steady 1 hour rides.

I'm going through this problem right now. Last January and April I had right and left hip labral reconstructions, respectively. Both labrums were completely shredded. Now, my left hip is feeling great, but the right hip is hurting again (in the last few weeks). I saw the doc, and the pain is likely due to arthritis and spinal stenosis. If the pain continues, I'll probably need another MRI and some diagnostic testing - ugh.

If the arthritis progresses I'll need a hip replacement. It it's the back, maybe spinal surgery. No fun.

In the meantime, more stretching, weights, and playing badminton. Sitting at a desk is a killer, and cycling is a wash.

Michael

This is all very interesting - I was recently diagnosed with a labral tear in my hip when I went in for an MRI. The MRI was ordered because orthop and PT suspected a stress fracture. Well, no stress fx, but the labral tear showed up. But there's no way to know if I caused the tear and therefore the pain, or if the added mileage from IM training aggravated it. I've been athletic my whole life, so I could've torn my labrum years ago. Now that the IM is over and I've stopped running altogether, the pain has mostly subsided, except some tension in my low back.

I guess my point is - just this week I've been wondering if my tight hamstrings and lower back (posterior chain) are actually what's causing the pain and not so much my labrum anymore...and now I see this thread. It's somewhat relieving to know I'm not the only one...

Yes. The cause is often hard to diagnose. For me, having had the labral surgery, I know I have some right hip arthritis, despite MRI's showing very minimal arthritis prior to the surgery. I've also had an MRI of my spine, and I have significant spinal stenosis, enough to cause bottom of the foot numbness. But I still don't know the cause of my current right hip pain? Is it the arthritis, or is it spinal stenosis?

Did my labral surgery fix the pain in my hips? To a degree - yes. I have more range of motion with my hips than before the surgeries. Also, pain in my left hip is virtually gone. But the right hip pain has made a resurgence, 8 months post surgery. I'm fairly confident my labrum is intact (manufactured from cadaver tissue), despite a 5 foot fall one week post-op, but the arthritis and/or spinal stenosis, keeps the pain present.

Yep yep. I've recently developed some strong hip pain and gradually came to the conclusion that it's quite possibly lower back related. Things get tight, tight things pull on other things, then those seemingly unrelated things (hips) start to hurt.

I do a variety of rows. Most are at 45 degrees, and my focus is sucking in stomach, feeling back muscles engage, and holding my breath/the engagement during the entire movement part. Sucking it in and holding has made me much more cognizant of my core muscles.

Also, for the sorenson, you could do that at home if you can find a bench. But I’d easier in gym for sure.

I wanted to follow up here because for years, I didn't understand this 'pulling belly button to spine' prompt that many use to describe activating core muscles. To me, it and sucking in your stomach sound like prompts to limit diaphragm movement and force breathing up into the chest. Or to not breathe, which is counter to what all my trainers have always said.

Last year, while rehab'ing after hip surgery, I heard transverse abdominis engagement described as should feel like tightening a belt low across your hips, which to me feels like bracing myself against being punched in the stomach. I would have understood this ages ago if people used it in place of the belly button prompt. Maybe other people's belly buttons are far lower than mine, or others have much more space between it and the bottom of their ribs than I do.

I offer that up in the event 'belly button to spine' is confusing to others as it was to me.

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To breathe, to feel, to know I'm alive.