(Disclaimer: Yes, I’ve seen a doc and even gotten an MRI, but doc can’t squeeze me back in for a followup to give results & treatment for 2 more weeks. Which is unacceptable, but that’s a different thread)
4 weeks ago went out for a short run. Later that night, my left glute, felt like the piriformis, was really tight which I attributed to not stretching well afterwards, so I stretched it out. The next morning, discomfort/pain in hip and glute during run that went away after warmup, only to come back later that day. For the next 2 weeks, same thing - tightness and discomfort that didn’t respond to stretching or NSAIDS and would be on the verge of painful when getting up from sitting to walking or standing to running for 30-60 seconds and then go away once I was warmed up. Figured it was muscular and continued rolling it and stretching. Was able to complete all my scheduled runs (marathon training, no crazy rampup in mileage) for these 2 weeks.
2 weeks ago, had a couple sessions of dry needling, both which addressed the tightness and the discomfort when going from sitting to walking - that’s gone. But during that time, could no longer run without pain or discomfort for most of or the entire run, which had now spread to my hip crease and groin and would sometimes shoot down the front of my quad. Sometimes running felt like my leg was being pulled out of my leg socket. Needless to say, test runs didn’t last long.
1 week ago, developed major lower back pain which over the last week has spread up to my neck; because of this, have completely rested for 1 week. Hip and glute feel a little better, perhaps because of the rest or maybe in comparison to the back pain which is so bad I’m having trouble sleeping; however, occasionally some of the pain I am having in the hip and glute area is on the other (right) side now. Got an intense massage on Saturday and there are 2 really big knots in my lower back, one on each side; probably what is causing the back pain. Back pain decreased after the massage but has ramped back up.
PT I saw for dry needling didn’t think I tore or fractured anything and doc was leaning the same way based on his initial exam.
SI joint issues?often hard to diagnose and can present in multiple spots(hip,sacrum,lower back etc.Don’t think it would show up on an MRI but you can work on it with a chiro/pt and also work on strengthening the area to prevent recurring pain.
If you are now having back pain sounds like Psoas (hip flexor) is the culprit too. It took me many weeks to see a top specialist ortho so not unusual. I had FAI and Labral tear fixed 4 months back now.
I also still have Osteisis Pubis in groin and maybe a sports hernia of some unknown degree. Been dealing with it for 3+ years now so it really sucks the life out of you even though i trained and raced thru it the whole time.
I’ll just say that One thing that NEVER worked for me and they all say to do it is STRETCHING. No matter who told me and how to do it i always got worse when stretching.
If i was to go back in time i would have totally stopped everything for 4+ weeks and only got treatment.
Torn labrum. Tore mine almost a year ago. Spent 2 months trying to fix all the issues, didn’t know we were failing to address the route problem. Quad, IT, hip flexer, glute, groin, all of them pretty much blew up at one time, so worked to fix them for 8 weeks. Initial MRI was without contrast so it didn’t show anything, was only able to confirm there wasn’t a stress factor – that was the initial fear. Didn’t respond positively to any of the standard labrum tear ‘tests’ so it wasn’t totally clear what was going on during the months of rehab. Couldn’t run at all due to discomfort, could kind of limp along. Missed Boston, LA and a few shorter events. Finally, after 8 weeks of attempting to fix the unfixable, had an MRI with contrast that clearly showed the damage. Had surgery in late April, was running by early summer and faster than ever by November. Be careful with continuing to run on it if you have a tear. You’d much rather have labrum surgery then a hip replacement. I was weeks away from having to have a replacement.
You have a MRI.
(speaking from experience) Instead of playing internet doctor, figure out what the MRI says and treat the cause, not the symptoms. The problem with the symptoms you are describing is it could be a whole host of causes, all of which require different treatment.
You’ve taken the often most difficult step to get the imaging, which at least should give some definitive answers as to what it is (or isn’t). Utilize that, or else you’re gonna waste a lot of time and money chasing symptoms, all of the time you’re not really treating the issue and improving.
Tight lower back muscles with muscle knots my be a result of a painful condition in the spine or pelvis (herniated disc, SI joint dysfunction, labral tear…). So, I wouldn’t recommend some wild stretching exercises until you don’t know the MRI results.
The doc squeezed me in last night and said the MRI (without contrast) looked fine. He believes it is a groin strain and gave me injections in 2 spots on my lower back and a prescription for Mobic. I’m supposed to see him back in 2 weeks.
Googling around I’m not seeing that groin strains usually manifest in pain in the hip, glute, and lower back, but he said he had someone in a few weeks ago with the same symptoms. So I guess we’ll see.
I’m thinking that if I don’t get better in 2 weeks I should insist on an MRI with contrast?
Per my earlier comment, I also had an MRI w/o contrast that looked clear. You will not be able to see a labrum tear without the contrast. I wasted about 8 weeks (and a lot of rehab money/time/insurance visits) between my 2 MRIs trying to fix something that couldn’t be fixed. If it doesn’t get better, definitely go back and get one with contrast. I think if you google how a labrum tear manifests, you’ll see things you recognize…not that google is very good at diagnosing things…you might also conclude you have cancer, shingles and leprosy.
Try looking into SI joint dysfunction. It is often overlooked because it doesn’t show up on x-ray or MRI. But it appears very common and can be caused by a number of things, including running on uneven surface or stepping off the sidewalk wrong. A good PT, chiro or pain management doctor will be able to diagnose it properly. If the joint is not functioning properly it has a cascading effect: local pain, sciatic nerve irritation, low back muscles knotting up to stabilize the joint, peripheral muscles trying to compensate, limited hip function, etc.
After 3 diagnostic injections of pain medication into the hip joint, I can tell you my symptoms were not directly resulting from referred pain from a torn hip labrum. The cycle of treatment experiments was time consuming, frustrating, and expensive.
Aside from a leg length discrepancy (based on bone length, not simply functional), I seem to favor usage of muscles on the right side of my body (long leg side). When they hit a certain amount of fatigue, they start complaining, extending generally from knee to neck but usually focused more from flank to shoulder.
By and large, pain was reduced by shimming my shorter leg in all shoes. Cycling is actually the easiest since the shims go outside the shoe vs other footwear where the full bed shims take up enough space inside to alter the fit. I also continue with core exercises and yoga, aiming for symmetry but I’m not there yet. Occasionally I really beat myself up, and the discomforts return, but not as bad as it was before the LLD discovery. Currently, when I pay particular attention to tensing muscles on the left, pain on the right subsides.
A friend recommended Red Cord Therapy, but I haven’t looked into it yet. I guess I’m still reeling from all the time/money/frustration spent chasing the possible piriformis issue, possible stress fracture, actual torn labrum, possible (sports) hernia, possible SI joint dysfuntion, chiropractic adjustments, ART, acupuncture…
Per my earlier comment, I also had an MRI w/o contrast that looked clear. You will not be able to see a labrum tear without the contrast. I wasted about 8 weeks (and a lot of rehab money/time/insurance visits) between my 2 MRIs trying to fix something that couldn’t be fixed. If it doesn’t get better, definitely go back and get one with contrast. I think if you google how a labrum tear manifests, you’ll see things you recognize…not that google is very good at diagnosing things…you might also conclude you have cancer, shingles and leprosy.
Taking your advice and getting a MRI with contrast. Tried to run on the alterG yesterday at 75% weight and didn’t last 5 minutes without pain… and that was with 1.5 weeks of no running and mostly rest.
Googling seems to indicate (and my PT thinks so as well) that cycling should be OK if it turns out it is a labrum tear. Was that your experience?
Per my earlier comment, I also had an MRI w/o contrast that looked clear. You will not be able to see a labrum tear without the contrast. I wasted about 8 weeks (and a lot of rehab money/time/insurance visits) between my 2 MRIs trying to fix something that couldn’t be fixed. If it doesn’t get better, definitely go back and get one with contrast. I think if you google how a labrum tear manifests, you’ll see things you recognize…not that google is very good at diagnosing things…you might also conclude you have cancer, shingles and leprosy.
Not necessarily true. It depends on the MRI machine. Most MRI machines are 1.5T which is like 720p TV. There are 3T MRI machines which is more like 1080p tv. My doctor insisted on using a 3T machine for my MRI… he called around to like 10 MRI places until he found one. I asked about contrast but I was told that you don’t need contrast with a 3T machine. We were able to see my tears just fine on the MRI.
My advice: Learn to love the one legged squat. If you cant do any check on youtube for instructions on how to start and progress. Do them several times a week to keep everything firing.
Learn to love the couch stretch. I hang out in the couch stretch when I ever I get the chance/ think of about it. It helps counter all the sitting we do.
All of you that said labral tear, you were right!!!
He said it was a small tear, but has recommended surgery. In doing research, and talking to my group of doc friends who have reached out to their ortho contacts, they also believe I should get surgery. I have been given the names of 2 surgeons that are highly recommended to make appointments to see.
Those of you that went this route, what was your recovery time?
Was able to start running and get in aero on the bike at 4 months post op. Could swim with a pull buoy right after stitches came out but no flip turns. Took me until 6 months to start feeling back to normal. I’m at 7 months now and have slowly built my running up to 8 miles as my longest run.
Best advice: be extremely patient. Follow your docs guidelines. Don’t ignore them and try to push it. You will pay for it if you don’t. Stay non-weight bearing for your prescribed time… You can get a stress fracture if you start weight bearing too early. Learn to be comfortable with being uncomfortable. I averaged 3-4 hours of sleep for about 2 weeks post op.
All of you that said labral tear, you were right!!!
He said it was a small tear, but has recommended surgery. In doing research, and talking to my group of doc friends who have reached out to their ortho contacts, they also believe I should get surgery. I have been given the names of 2 surgeons that are highly recommended to make appointments to see.
Those of you that went this route, what was your recovery time?
My advice: do not get surgery until you give it time to heal. Do lots of PT, strengthen, and all that. There are MAJOR horror stories associated with this surgery (along with success stories). But it is possible for the labral tear to go asymptomatic on its own–a shockingly large portion of the population has them and never knows. Some docs think this surgery is extremely over-prescribed.
I have a labral tear that is so bad that it was diagnosed without contrast on MRI by a doctor that had never seen one before. A couple months later, I was back to running without surgery, and that summer I qualified for the U.S. Mountain Running Team.
Summary: surgery may very well be necessary. But pursue all other avenues for healing before going under the knife.