Hi Guys-
Its me again still suffering from ITBS. I have done it all ART, Two PT’s (30 sessions each), Pilates, Cortisone shot, Massage therapy, taking 2 weeks off, only doing Pilates and yoga with swimming 1x and biking 12 miles 1x a week- I have done it all! I am strengthening all of the muscles you are suppose to strengthen and I am getting stronger but…
I still cannot run more than 2 minutes and I ache almost every day down my entire leg. So I started noticing that despite the fact that I wasn’t flaring anything up with exercise- I would get a massage and then get tight within a day- Is it possible this is a hip bursitis thing?
Its tender in and around my hip and down my leg. My SI joint gets sore. I can relieve most pain by lots of stretches but then it just comes back. Its not extreme pain and doesn’t hurt when I sleep or lie on it- but could this be a bursa impacting my ITB causing ITB symptoms.
By the way just a review- I did my first marathon in January and kept training with a coach haven’t been able to run since and am wondering if I flared up my ITB so much that now its developed into this.
I would love to race again but honestly I would just be happy to play soccer with my boys and hike. Thoughts?
It doesn’t sound like a text book case of bursitis. that would have been picked up pretty quick by the PT’s you have already seen, and would have been relieved at least marginally with cortizone (assuming they hit the right spot with it). Also the ache wouldn’t radiate down the entire leg.
Are you getting any numbness or tingling down the leg ? does it get worse with sitting, coughing, going from sitting to standing, biking in the aerobars … ? it could be coming from you back. most SI joint pain has been shown to actually be originating from the lumbar spine.
I would also be looking at your hip. might be thinking of a possible MRI or bone scan. A laboral tear or stress fracture can give that diffuse pain pattern. the tight muscles is probably more a symptom of the problem (protective mechanism) and not the underlying problem. The fact that it hasn’t eased in 10 months is a little concerning. I would definately get it looked at and get further test done and not just waiting for it to get better on its own. if it was going to do that, it would have about 7 months ago.
I’d agree with the prior poster. I thought that maybe I had psoas problems. On the bike I could ride, but started developing saddle sores on the right side, and my left leg would go numb climbing. Running was fine, except up hill. When it really got bad, I couldnt sit for more than about 10-20 minutes without having to get up and stretch. I did a lot of AIS which kept me going, but the final diagnosis was a hip labral tear. You’ll need a good hip doc to look at you, then a contrast mri to really diagnose it.
I’m doing pretty good after my surgery, def. better than pre-surgery, but results are HIGHLY variable and really depend on the doc you go to. If you want the sh** scared out of you, Runnersworld has an injury forum, and the thread on this topic is now 18 pages long.
(I was biking in 10 days, racing in 2 months, but no well. 6 months post surgery and I’m back to running 3-4 times a week 5 miles and feel better than I have in years.)
Thank you for your post. For the first few months it was just in the knee (ITB) but shortly after it ended up being back stiffness, SI pain, Hip pain and just achey. The cortison shot was done in my knee didn’t do much good at all. My range of motion in pilates is for sure limited on that same side in my hip feels like its very dense in the back part of the socket. When I cross my knee in flexion across my body it pinches in the front. I have cut back so much and I really don’t see this getting better with rest. So you think going back to the doctor is the best choice? vs all of this PT, MT, and pilates?
2 weeks? I think most IT band issues take a number of months to fully resolve themselves…as do many joint/cartilage/tendons injuries. Sorry to say, but I think you might just need more time to heal…
I don’t want to open this up to an argument (and if it does I’ll be working all day so have fun), but have you tried Chiropractic? I know I am biased (DC and LMT) but obviously the path you have taken hasn’t eased the problem.
If it was my body: MD/DO/GP and request an MRI of the area (to rule out anything underlying), ask for some good anti-inflam and pain meds (if needed), would throw in blood work for good measure just in case it’s something internal causing the pain/problem/inflammation. Then DC (chiro) and have the low back/SI joint looked at. Preferably you have a chiro that understands extremities and have the hip/knee/ankle examined too. Then would REST and get to the root of the problem so that no futher injury is done. From there adjunct therapies to help support the rehab - PT/LMT/Pilates/Yoga.
I’ve had chronic bursitis in my hip and the worst ITB that feels like ice picks just constantly being jammed no matter how I moved, it turned out to be a spondylolisthesis at 3 levels in the low back (break in my lower back) that I didn’t even know was there, because thats not where the pain was located. Once I rested, the low back is EXACTLY where the pain was located (and the problem) and the body was totally compensating for what would not function in the si joint/low back juncture. Highly doubt this is what you have, but giving an example that other things can cause that pain. Hope you can get to the route of the problem.
First it has been 10 months from the previous poster versus the 2 weeks you mentioned. Yes I have tried ART with a chiropractor it was one of the first things I did- but nothing. I will contact my Ortho to get an MRI- I have PT today so will discuss with him too. But could this be a bursitis brought on by chronic ITB?
First it has been 10 months from the previous poster versus the 2 weeks you mentioned. Yes I have tried ART with a chiropractor it was one of the first things I did- but nothing. I will contact my Ortho to get an MRI- I have PT today so will discuss with him too. But could this be a bursitis brought on by chronic ITB?
I never mentioned 2 weeks, I don’t know where you got that from. I am physically running out the door. I have seen bursitis brought on by chronic ITBS (or just coincidental - no clue), so yes that is why I hate saying to rest. I went to school with some pretty crappy Chiros (as in any field) and wouldn’t think twice about getting a second opinion. Very happy to hear you are getting an MRI.
Hope you are able to get to the root of the problem - being in pain sucks.
Hi there… I am a person who has been graced by both those ailments… but the Hip Bursitis was the worst. Basically the difference was it was not a muscle pain or a tendon pain I feel when I have my IT flare up… it was more a shock feeling similar to the one you would feel if you hit your funny bone however it was in my hip and shot down my leg.
I spent over $1,000 doing yoga, pilates, ART, chiropractors, massage therapy… you name it, it was suggested… I did it. What was most frustrating was so many day to day many activities were impacted outside of training…even driving my car as the effort to pull back to accelerate pedal to the brake pedal aggravated it.
So what changed my two months of the most annoying injury I have ever had?
I found an sports orthopedic doctor… brought in a list of ALL the things I have done to date and any key movements (like driving or walking or pushing off the wall when swimming) that made it flare up – as you know… these doctors are on a tight schedule so I wanted to summarize to get him up to speed and not have me back to square one of figuring it out… He got a kick out my approach but it worked as he said he was 90% sure it was Hip Bursitis and that it was aggravated in enough it was putting pressure on my sciatic nerve which was the culprit for the feeling of shocks I got when it was really bad (http://en.wikipedia.org/wiki/Sciatic_nerve)… He put me on a week of steroids, got me in for an MRI and I was back to see him 3 days later to hear he was now 100% sure it was the Hip Bursitis. He then came in with a big ol Horse needle with cortizone in it (YOU KNOW when they HIT the spot! - that I remember!0 and after 3 minutes… I jumped off the table and my pain was gone. I did have to go back a two weeks later for one more shot… but that horrible shock sensation was finally over…
However could do what the normal world could to – walk, drive and live without that pain… I found that my running and just overall speed I had built up prior to this was gone. I went from a 8 min mile pace to 12:30. I went from averaging 18 – 19 for a 50 mile cycle to 13 – 14. Ad the results from the two months of this, my body compensated in ways and it put a “mental cast” on my right quad…
It then took PT, core and muscle building exercises, stretching, adjustments, ART, going slow & focusing on technique… oh and Advil… a year later I would say I was 99% back to my old self…
If all of this sounds familiar, I say get to a good Sports Ortho and go from there!
Sorry your going through this… I know that frustration
See your MD to get further tests done on your back and / or hip (bone scan or MRI or both. PT, RMT, etc can’t order any tests. I have to premise this with the fact that i live in canada so everything is covered. not sure about cost where you are so may have to weigh out which will be the better choice for testing. if you are able to reproduce the symptoms in an unweighted postition it probably isn’t a stress fracture (less likely). sounds more like your hip based on the description, and like a internal derrangement in the socket or capsule. so an MRI might be most beneficial.
I would also go see a good PT (with sports specific experience) to assess your back and hip and rule out any possibility it is coming from your back. They may also be able to stretch out the capsule of the hip joint if that is the cause. Often the ball can get shifted forward or backward in socket with tight muscles and rep movements (swim, bike, run, …) or prolonged sitting at work. the pinching description makes it sound very much like a hip problem - very common with athletes. and might be too subtle to show on xray or MRI - need the expertise of a manual therapist to pick up on some things. MDs are not always tought much about the musculoskeletal system and as a result miss some of these things (not a shot at MD’s - I wouldn’t have a clue how to treat half the systemic stuff they deal with).
as for the pilates, I would continue just for the benefit of general flexability and core stability - which may not fix your hip/knee/back problem, but will put you way ahead and ready to resume training much more quickly and will reduce your risk of many RSI injuries in the future.
I have had a similar problem. Hasn’t affected my running, biking or swimming, except when it was bad I couldn’t do flip turns.
Just KILLED standing up from chair or sitting in a car at length. And hurt a ton sleeping.
My pain simply started one morning in early Sept. when I woke up with an incredibly sharp pain running from my right butt down the back of my leg down to above my knee.
I am seeing a PT and am friends with an orthopedic surgeon. Somehow my right hamstring got really tight and my right hip muscle got right and I am stretching a lot and working on my posture. Still, it is not going away quickly and hurts right now as I type this.
Powerbarjunkie-
What you mentioned with the PT is usually what happens. He is known throughout the Denver area so I think he is a good one- but you are right he often has to crack and pop a few things when it gets this bad in my hip and capsule. But it seems like I may go a week without significant pain but then it comes right back- I agree with your thought on it coming out or getting malaligned but what is your experience as to when this will stop and it can just be better? I do all of the exercises he says and stretches. I am barely biking or swimming and speed walking bothers it- trying to get a cardio workout is tough right now.
Given the above do you think an MRI is still warranted or stay with the PT? The MRI will cost me about 150- not too bad as I think I have probably easily spent 3000 since January. I appreciate your perspective.
as good as any PT, DC, RMT, MD are, their opinions are biases based on thier education and experience. and they are all just trying to make a diagnosis based on symtoms and “tests” to stress different anatomical structures. but none of the tests are 100% and are still subject to tester bias. and not all are totally reliable or validated scientifically.
the MRI is totally objective and rules out a lot of things at the same time. the fact that it is 10 months later and despite all these intervensions is no better - i personally would be running (sorry - walking briskly) to get one. it will show if it is bursitis or torn labrum or OA or necrosis or … nothing (muslce imbalance). which would indicate its something much more subtle. which would suggest continuing with PT or pilates or osteopath, and it may have something to do with HOW you walk or run (mechanics) or work related (prolonged sitting or standing or crossing your legs… ) or even the start of a “frozen hip” (adhesive casulitis). I would also explore the back as a possible source if the hip investigations come back negative. As the previous posting said, things like spondylolythesis and disc derrangements can often refer to other areas and mask the problem.
there are a lot of things that can go wrong in the body and sometimes its tough to tease out what exactly is causing the problem. its great if you can make a list of all the things that make the symptoms worse, things that make them feel better (preferably mechanical things - stretches, movements, etc. not jut pain meds), pattern of an average day (worse AM, then gets better with walking, …), all the things you have tried, previous injuries, etc. so both you and the person you see get a very clear picture of the problem. the more specific and clear about these things, the easier it is to try and diagnose the problem. (its even tougher electronically).
Hi all,
have been going through the same hip inflammation issues. I pulled back from heavy training pretty quickly, but kept trying to go fast. Knew it was time to take total time out when my hip pain flared up so bad I could hardly walk. Having worked through the treatment successfully for a severe acute multiple ruptured ligament/tendon injury, was happy to try and sort it myself(have a reasonable understanding from my veterinary training).
When I was finally in a town with our olympic Doctor I tried to get along for an appointment. Was a bit peeved as could only get to the physio and not to talk to the doc. Anyway I did the strengthening exercises and took alot of time out (2 years). Was going to cost me a lot of money and whinging to get to see the doctor in question.
Three years after i first noticed it and it is all but gone. Am doing wanaka ironman in 7 weeks or so. A very dull pain is still faintly there when i train myself excessively.
Some people are recommending chiropractors, which is not good advice for a hip injury. Stress fractures need to be diagosed accurately and treated very carefully/correctly.
For non-athletes who develop inflammation in this area there are even more serious differential diagnosis that X-rays/scans are required to diagnose.
I really believe there are some instances where chiropractors maybe able to manipulate vertebrae back into place(but so can physios). I think this because while doing a decent back stretch many years ago a vertebrae seemed to pop back into place.
Really though medicine has moved well beyond much of what chiropractors propose. People with serious hip or back injuries should get scans done early on.
The sciatic nerve runs very close to the acetabular cavity(hip joint), so any inflammation in this area can soon cause inflammation of the sciatic nerve.
If the injury to the hip is very inflamed and you have enough money to sort it you should go to a specialist doctor. Scans and X-rays will be able to show what is going on to a large degree. Corticosteroids shouldn’t be used too many times.
Actually when I think back an associate at the time was the most respected orthopaedic surgeon and I did mention it to him. He would have had enough knowledge to know it takes a bit of time and expensive testing to make a good diagnosis of such an injury.
If in doubt get an opinion from more than one medical doctor.
Have been aware of the differential diagnosis of a lower back problem resulting in pinching of the nerve for some time. This is pretty much at the top of my list of the cause of my hip troubles. Wearing new and solid running shoes for training will help a bit for such injuries, but won’t correct it.
So the two years taken out from competing were spent photographing triathlons around the world, which can be seen at my site:
Here is some more info related to hip problems; I think it is a very typical scenario.
All the access to the best diagnosis and treatment and no certainty at all of a successful outcome.
All of the below is from a news clip in N.Z today.
Olympic champion and New Zealand sporting great Sarah Ulmer has announced her retirement from cycling.
New Zealand’s first and only Olympic Games cycling gold medallist has been battling a perplexing sciatic nerve injury in her leg since it forced her out of last year’s Melbourne Commonwealth Games.
A recent visit to a surgeon convinced the 31-year-old it was time to end the most frustrating period of her glittering career.
She will be remembered for her golden year in 2004 when she set a world record in winning the women’s 3000m individual pursuit at the world championships in Australia.
Several months later she bettered the record in claiming gold at the Athens Olympics.
After a year’s break from the sport, she switched to road cycling and was consistently impressive there before injury struck.
“I’ve been toying with retirement for longer than I actually expected,” Ulmer told TV3.
"It’s been a pretty frustrating year from the cycling side of things. I’ve been in and out of doctors and medical specialist and MRI machines.
"The crunch with the actual decision was a trip to a surgeon in Christchurch who didn’t give me a greater than 50 per cent chance that he could improve me.
“I needed more than that to improve this crazy problem that I’ve had.”
I feel your pain. Could it be possible it’s piriformis syndrome? I’ve been struggling with similar symptoms, done the A.R.T. thing, had xrays,etc. I believe if the problem took months, or years to develop, it can’t be fixed overnight. I’ll give you this website,see if any, or all symptoms sound/feel familiar.http://www.spineuniverse.com/displayarticle.php/article130.html. I’m as frustrated as you. If you come up with anything let me know.
I have since found out I have a herniated disk at L5 S1- They are going to inject me on tuesday. I have asked for an mri of my hip as well but they seem to want to do this injection first- I agree that some of it could be that but geez just don’t think it can be all of it. I am thinking that my initial ITB caused such an imbalance that herniated a disk. I am seeing a accupuncturist, will start yoga, keep with pilates, and hopefully keep weeding out this issue. I am starting to think this season could be a loss too- bummed but still trying to figure it out.
I have both personal and professional experience with these problems (L4-L5/L5-S1 spondy + disc bulges AND several years working as a biomechanical engineer in a spine lab before starting medical school). Take my info with a grain of salt as I am not finished with my medical training and certainly don’t know anywhere near as much as an ortho! Keep seeing the doctors. As frustrating as it is, eventually you will figure something out.
ITB problems will not lead to a herniated disc, just not how things work biomechanically
the hernaited disc at L4-L5 COULD irritate the nerve and make the glutes sieze up. since a portion of glut max inserts into the upper end of the ITB this may be the problem. in my case i have a fair amount of hip irritation and it has been suggested that the back has something to do with the problem. when my core is strong, i have fewer problems with my hip. radiologically, my hip is completely normal (boy did i breathe a sigh of relief when i got a look at the joint space on my x-ray!)
many people have herniated discs without any symptoms at all. papers i’ve read indicate that the severity of the herniation as seen on MRI doesn’t really correlate well with the clinical symptoms produced
most back-related stuff responds well in time to aggressive PT, esp core strengthening
before you let anyone even consider surgery, conservative treatment should be adminstered for 6mo to 1 year unless there are major neurological symptoms (I asked this question of all of the spine fellows I did research with)
if you do consider surgery, don’t just look at “sucess rates.” look at what the criteria for a “success” actually consist of. in many studies i saw, improvements weren’t very big and may be far less helpful than you think.
I have successfully avoided surgery for more than 10 years now (since I was 15), but I’ve had a couple of close calls. At one point during my last flareup in 2004, my physical therapist was in tears because I wasn’t getting better and she thought that I would have to quite racing for good. i had several cortisone shots in my back which seemed to help. each year since then, i have trained very hard and performed better than i ever imagined possible. my hip is pretty tight much of the time, but i manage it well with massage, strength routines, and overnight icy hot patch treatments. i’ve also noticed that when my hip starts to tighten on the ITB (and lock my knee), that modifying my core position to a more biomechanically appropriate stance will fix the problem on the fly…
