For the past two years I’ve had nearly constant pain stemming from my TFL/lower back. I’ve tried many different professionals/treatments and nothing has helped. I’m getting ready to try to resolve this again and thought I’d post here to see if anyone had a similar issue and/or any suggestions as I’m really baffled and tired of almost always being in pain.
A bit about me…I’m almost 49yo, have been active my entire life. Did triathlon up until 9yrs ago as my right knee was bone on bone due to some soccer injuries in college and all the running. I still ride 3d per week (125 - 175mi), swim masters 2 - 3d per week, yoga 1d per week, lift 1d per week, stretch and foam roll/softball roll a couple of days per week, and am generally very healthy. I’m on the computer a lot, but have a standup desk I utilize often. I’m still able to do the above activities, but do so with nearly constant pain that I manage with 1 - 2 ibuprofen before/after working out.
How it all started…roughly 2yrs ago I randomly began having this pain in my left hip/lower back. I went to a chiro for several weeks with no relief, then tried acupuncture, same result. Tried a few other chiros who tried various treatments, but nothing. Also tried doing weekly massages focused on that area, same result. Year ago I went to my ortho who performed x-rays and MRIs and they all came back negative (just typical compression of L4/L5 for someone my age). Ortho suggested I give PT a shot, so I tried that for several months and again nothing improved. Pain is definitely worse in the morning after I wake-up or the day following a hard ride or swim.
One of my chiros believes it’s my TFL but despite trying multiple treatments could not get it to release. And while I have always had a chronically tight left hamstring, stretching it doesn’t seem to resolve my hip issue.
After my most recent treatment didn’t yield results, I’m looking to find a new professional who may be able to give me some relief and hopefully resolve this once and for all. I would appreciate this group’s insight on which way to turn. And I’m in Long Beach, CA if anyone has specific names of professionals to reach out to.
Did they check you labrum? They can do an injection and sometimes see a cam impingement on an X-ray. MRI needs to be with contrast to pick it up. That’s what mine ended being after it took 12+ months to figure it out.
Yes they looked at it on the MRI (no injection tho) and said it looked normal. What were your symptoms…similar? Most labrum issues I’ve read about seem to involve groin and hip rotation/mobility pain which I don’t really have.
I have been having issues with this recently. So far I’ve had an X-ray and am battling with insurance to get an MRI.
The doctor, from the X-ray, diagnosed me with narrowing disc space between L5/SI, and bone spurs. I did trigger point injections in the muscles in my low back and my piriformis and a round of steroids. Both helped. She said it’s not an acute injury but something that has been building. She sent me to a chiro to get my hip flexors released, which I have been doing. It sucks big time, but it is helping. I’m doing PT to get some rotation back in my upper spine, which seems to be locked up pretty well, as well as some really targeted hip flexor stretching.
I’m early on in this journey, but thought I’d at least throw out what I’ve experienced so far.
One poster talked about releasing the flexors. That is a very non-invasive way. Depending where you are at maybe to try and find a pysio/massage/Active Release Technique to release the psoas and iliacus muscles. Worth a shot. I have a client that had low back/hip issues. Ended up being tight flexors that were pulling on the lumbar spine and putting unpleasant pressure there.
I had something very similar or the same (if I’m understanding your description correctly). Pain in the lower back sometimes made me sick to my stomach it was so strong. Thought it was a disc that was messing with my sciatia down into my hip. Long story of doctor’s opinions, buying a new bed, etc… It was my piriformis. My hips had turned off. I’m pretty sure I know why in hindsight, BUT the solution was incredibly simple. I started doing 20 lunges after every run (10 on each leg). Took a couple weeks, but the pain completely disappeared. Just had to make sure that my weight was over my front knee so that my hips were forced to do the work instead of my quads during each lunge.
Hope this helps.
Friends of mine have dealt with back pain a lot and they each had slightly different ways to resolve it. One just needed some targeted streching over a few weeks - that didn’t work for the other. The other needed to ‘turn on’ their but. Lots of glute activations and muscle postural connections needed to be fixed up. Glad you found what worked for you. Good luck OP.
For the past two years I’ve had nearly constant pain stemming from my TFL/lower back. I’ve tried many different professionals/treatments and nothing has helped. I’m getting ready to try to resolve this again and thought I’d post here to see if anyone had a similar issue and/or any suggestions as I’m really baffled and tired of almost always being in pain.
A bit about me…I’m almost 49yo, have been active my entire life. Did triathlon up until 9yrs ago as my right knee was bone on bone due to some soccer injuries in college and all the running. I still ride 3d per week (125 - 175mi), swim masters 2 - 3d per week, yoga 1d per week, lift 1d per week, stretch and foam roll/softball roll a couple of days per week, and am generally very healthy. I’m on the computer a lot, but have a standup desk I utilize often. I’m still able to do the above activities, but do so with nearly constant pain that I manage with 1 - 2 ibuprofen before/after working out.
How it all started…roughly 2yrs ago I randomly began having this pain in my left hip/lower back. I went to a chiro for several weeks with no relief, then tried acupuncture, same result. Tried a few other chiros who tried various treatments, but nothing. Also tried doing weekly massages focused on that area, same result. Year ago I went to my ortho who performed x-rays and MRIs and they all came back negative (just typical compression of L4/L5 for someone my age). Ortho suggested I give PT a shot, so I tried that for several months and again nothing improved. Pain is definitely worse in the morning after I wake-up or the day following a hard ride or swim.
One of my chiros believes it’s my TFL but despite trying multiple treatments could not get it to release. And while I have always had a chronically tight left hamstring, stretching it doesn’t seem to resolve my hip issue.
After my most recent treatment didn’t yield results, I’m looking to find a new professional who may be able to give me some relief and hopefully resolve this once and for all. I would appreciate this group’s insight on which way to turn. And I’m in Long Beach, CA if anyone has specific names of professionals to reach out to.
Thx much!
I’ve had the best success activating my glutes and decompressing my spine. Did the PT talk about activating glutes?
TFL is a hip stabilizer so my guess is your gluteal muscles aren’t working like they should. I would also try to get someone to dig into your psoas
Good exercise for hip stability: stand on one leg, knee bent, and get up on your toes. Other leg is going to move to the side doing toe taps heel to side. Do 1 min intervals and add time. Do on both sides.
Checking in here, did you ever make any progress on getting to the bottom of this?
I can share a few thoughts. Been through a labral tear with severe OA, had a hip resurfacing done in 2013 (took me out of tri for way too long). In 2017, jacked my back and TFL doing Reach the Beach (stupid running down a ski mountain…), and am still figuring out exactly what’s up with that.
I spent all the time doing the PT things, glute activation, core strength, stretching hip flexors, etc. It would work for a bit, then unpredictably not.
This year, I have started to understand one key piece that has made a big difference, and that is extraordinarily tight adductors, which have a tendency to jack up my SI. A few things I’ve been doing that seem to help include:
self adjustment of SI joint daily (as often as I can) - plenty of YouTube videos, basically sit down, use your hands to resist pushing your knees out a couple times, then put your forearm between your knees and squeeze. I usually get a big ‘pop’ out of the side that gives me trouble. This is important to do before step 2
hip adductor stretch - when my back or SI are tightening up, I can’t seem to actually get much of a stretch here, so see #1 first. When things are really tight, I get on hands and knees, put one leg out to the side, and slowly sit back to get a stretch on the inner leg, then switch to the other side. When things are a little looser, I’ll start with the yoga Warrior 2 pose instead.
Those two things seem to loosen up the back / adductor complex, and since I’ve started doing that, I don’t seem to aggravate the TFL / Glute Med complex that was going berserk on me. A few other things that I’ve noticed along this journey:
-excessive motion control in the shoe is bad. my local running shop would say I need a stability shoe, but I can’t seem to run in one. A more neutral cushioned shoe (ie. Kinvara) seems to be the sweet spot for me.
-posture - attempting to “stand up straight” puts a lot of pressure on the low back and SI when I try to force it. my flexors are super tight, and there isn’t a “just stand up straighter” way out of it. It’s going to be a year or two of consistent work before I can stand up straight without the strain. In the meantime, my running/standing posture needs to be bent a little more forward at the waist than I have in my head
if it hurts, stop. This kind of pain is not something that can be pushed through, and if I do push through it, I’m bound for an awful few hours at least, to potentially overnight. Those times it affects me overnight, my nervous system is so shot that it usually sabotages 3-5 days of training.
Hope some of this might be helpful to you @sailinfast