A perpetual lurker here…in need of advice and would also like to hear your stories of how you dealt with this injury.
I started to experience pain in my tailbone (or that region) about a year ago while sitting down. Upon standing the pain would increase and then dissipate after 30 seconds or so. This has been a constant throughout my injury, sometimes taking a break for a few days, but always coming back. I can’t ride a bike for more than 20 minutes because of the pain.
Running, the pains I have are all in my hip/groin area. At first, I was experiencing severe tightness in my groin that would go through to my knee. My groin was so tight I wouldn’t be able to stop running and restart without pain. So being the smart person I am I just didn’t stop during my runs. Then along with the tightness I began having sharp/shooting pains in my groin/tip top of quad. Mostly running down hill at first, but then it would be any time during a run or while just standing around.
I’ve had my tailbone x-rayed and a mri on my hip. Both were clear. I’ve had countless hours of ART to no avail. I switched to another chiropractor/sports medicine guy and have seen some improvement, but not enough. I’ve been icing my SI joint and doing exercises to loosen up the ligaments which has helped some. My groin muscles are no longer abnormally tight, but I still have hip tightness on all of my runs and the sharp pains are still randomly happening.
Does anyone have experience with this or any helpful advice? If you need more information I can provide it, but this is a general overview. And yes, I am still seeing a chiropractor and have an appointment with a PT, but figured this was a good place to ask the masses.
You know how long I’ve been dealing with this? Long enough that I use words like anterior and posterior instead of front and back and know exactly which area they refer to without thinking twice about their Latin origins. Which for me is 3 years and for a smarter man, 3 minutes. Moving on…
Your MRI-was this an MR Arthogram with contrast injection to check for/rule out a torn labrum? Also, have you considered an ultrasound to take a more comprehensive look… “down there”?
I just had an US-Guided SI Joint injection on Monday. Many of my posterior symptoms were similar to yours but they were not prohibitive, I just lived with it. I was able to run and bike in pain. Your anterior symptoms are what would scare me.
The injection has relieved my pain. But I won’t know how well until I get after it again, starting Monday.
http://thelowback.com/how.htm.....i am just starting the program of corrective exercises, but this website explains the issues and offers possible solutions or corrective exercises. also sam visnic has some stuff on the web and or youtube. good luck
You know how long I’ve been dealing with this? Long enough that I use words like anterior and posterior instead of front and back and know exactly which area they refer to without thinking twice about their Latin origins. Which for me is 3 years and for a smarter man, 3 minutes. Moving on…
Your MRI-was this an MR Arthogram with contrast injection to check for/rule out a torn labrum? Also, have you considered an ultrasound to take a more comprehensive look… “down there”?
I just had an US-Guided SI Joint injection on Monday. Many of my posterior symptoms were similar to yours but they were not prohibitive, I just lived with it. I was able to run and bike in pain. Your anterior symptoms are what would scare me.
The injection has relieved my pain. But I won’t know how well until I get after it again, starting Monday.
My MRI was not with contrast and I’m not sure about the MR Arthogram part. I haven’t considered an ultrasound only because no one has suggested one, until you. I have an appointment with a new PT guy so I will see what he thinks. I am hopeful he will have a better understanding of what’s going on and a better way to fix me. Would you mind telling me which symptoms are anterior, as I am not as learned yet in the lingo Good luck with yours! 3 years is awfully long to be in pain.
Im not sports doc, but that doesnt sound like SIJ disfunction to me.
Ive had it in the past and my symptoms were vastly different and text book common.
I had pain on one side only (had it on both sides at various times). Pain on sitting , no real pain while running, but was very very painful on stopping my run.
Pain would extend down the back of my leg and especially radiate around the front down in my groin like Id been kicked by a mule.
Got over it with rest, NSAID’s and religiously stretching the psaos many times per day, every day.
Hope you get it sorted fast as I know how painful it can be.
The anterior (front) pain is the pain you are your referring to in your groin (at this point I’m required to make a groin joke, but since you’re a woman I’ll be respectful).
What type of physical examination have you had, if any? Do you feel any popping sensation in your hip/groin?
It sounds like you haven’t even had a diagnosis, which puts you on a dangerous path here on the interwebs-it’s one thing to commiserate with others with the same problem, it’s another to have idiots like me trying to diagnosis and treat you.
Are you diagnosed with SI joint problems? Did someone ever look for back problems?
I think SI joint problems do not radiate into the tip top of quad. So you might want to have the lumbar spine checked for problems that can radiate into your groin and quads (L2-L4 I think). It could also be a problem of SI and the lumbar spine at the same time.
I am a woman but I do have a sense of humor…so feel free
My first step was an Ortho. He was not worth the copay. He did an x-ray of my tailbone and told me I had an old stress fracture but he didn’t see anything that would be causing the pain now. He ordered an MRI. Told me if that came back clear it was probably just chronic. He told me to sit on a donut and take some anti-inflammatory drugs, which I didn’t take.
While waiting for the MRI appointment I decided to try a chiropractor/sports medicine guy I know. At the time, I didn’t know the pain in my tailbone (what I know now to be my SI joint) was related to the pain and tightness I was having in my hip/groin. So this guy looked at my x-ray and said I didn’t have an old stress fracture…that everything structurally looked sound. So I cancelled my MRI and never went back to the Ortho. For weeks we did ART on my glutes/hamstrings and he did nerve work…whatever that means. He thought my sciatic nerve was “stuck” and that was causing the pain. It wasn’t until weeks after we started working together that he even began to think the pain in my backside was related. He ordered an MRI (no contrast) to rule out stress fracture. That came back clear. I stopped seeing him at this time because we weren’t getting anywhere and I didn’t feel like he really knew what was going on with me.
So, I went to another chiropractor/sports medicine guy on a referral. He immediately knew all of the pains I had were related and he is the one who “officially” diagnosed me with SIJ dysfunction. We do very little ART and mostly he adjusts my ligaments and tells me to ice and keep the joint in motion. I have exercises and stretches that I am supposed to do every day. I do feel better and have seen improvements but they all occurred after my first visit with him and now they have plateaued. My hips still get really tight while running and I have to run a lot slower than what is normal for me. The shocks of pain happen less often but they have not gone away. I still have pain in my ass (I will just get that joke out of the way ) while sitting whether that be on a chair, in my car or on a bike.
So…I now have an appointment with another Ortho. We’ll see how this goes…
It doesn’t sound like the usual SI pain to me, and I treat that all the time, not that it couldn’t be SI pain, but that it’s not typically a pain the groin. Ask your ortho about a labral tear and maybe get an MR arthrogram (a good thought from a posting above). Also there is a bursa anterior to the hip joint that could be inflammed. Otherwise there are reports of isolated muscle/tendon pains from the hip girdle muscles, like the piriformis and obturator internus. Those are not mentioned much. I’m not sure if they are rare, or if they just go away with non-specific treatments like ice and rest. Rest is not all bad, maybe your body is suggesting that you need a swim focus for 2-3 weeks… If you really have to run in January then aqua jogging is a really good option to replace some of your time on the road. It is BORING as hell, but gets the job done. I survived with plantar fasciitis that way. When you do look for a good sport med/ortho person try the local sports teams or ask at the local running store. I found my podiatrist that way and it turned out well.
My advice would be to find a good ortho PT/chiro/MD in your area that sees endurance athletes regularly… cliche I know. Your pain location does sound hip joint related and I would highly recommend discussing labral integrity at your upcoming MD appointment. It is possible to have pain in the same area referred from the SI joint and/or lumbar spine, but a good physical exam should be able to help with differential diagnosis.
Did the last specialist provide significant relief? Or did you take time off from training and the pain decreased?
A SIJ manipulation may provide temporary relief from a labral issue, but if your symptoms persist I would suspect something else is causing some of the pain (i.e. your pain return with running, diffuse pain in buttock/outside of hip/front of hip/groin).
Does your hip ever ‘catch’ with bending or twisting? Does if feel as if there is grinding in joint or something blocking movement?
Good Luck and please let us know how things are going
I did take some time off, about a week completely from any exercise, but I took weeks off from running and just swam. Even swimming though I would get some tightness in my hip…this was 2 months ago though and (sadly) I haven’t been in the pool to know if it still happens. (Yea-I should probably get back in) I don’t have to be exercising to feel tightness or the flashes of pain in my groin. Those sometimes just happen while standing in my kitchen or wherever. Also, the “tailbone” pain has been a constant although it has gotten better and less frequent. The pain up front is either a throbbing/aching feeling or a popping sensation, like my bone shifts or something. It’s weird and kinda hard to explain over the internet.
Thank you all for your reply’s! I will hopefully have a definitive diagnosis (even though I thought I already did) next Friday.
if we were betting on this, after having both hips scoped for the same symptoms, I’d also put my money on torn labrum. Hope not for the OP though. Anthony
You are describing some of the same symptoms I have…tight groin, traveling pain, butt pain, etc… i would look into an arthrogram. They inject dye in your hip socket and run an mri. I was told labral tear. Also, they often will do an injection there, which if it relieves the pain, you know your source. Your catching feeling is also a labral tear flag. Hopefully its something else.
This problem, whether it be a labral tear or an impingement, is often caused by a posture of anterior pelvic tilt. Cycling leads to tight hip flexors and weak glutes then running causes excessive force into a tilted hip socket. Go to a PT who will evaluate your pelvic stability and low back mobility, you don’t need ART you probably need functional training of your posture. Don’t run until you are pain-free. Consider surgery only if you are not better after 2-3 months of this type of PT.
I suffered from SI joint / low back pain/ sciatic nerve pain for many years. worked in physical therapy as an athletic trainer. did all the stretches, massage etc. ART can be helpful for some people and some injuries. all of the treatment you have had is focused on one common denominator, the belief that you are “tight” and that is the problem. What if the problems is not that you are tight but that you are tight because you are weak (in specific muscles and positions)?
I never stretch anymore (statically that is… just active range of motion exercises and isometrics in the “tight” / weak positions). Have tons more mobility than ever had and have rarely felt “tight” in the last 3 years since I have stopped all static stretching. I strengthened the weak muscles that were causing other muscles to tighten up and protect. Have not had anything more than mild soreness ever since then and can run again pain free! stop trying to “release” the tightness. Your muscles are just doing their job and protecting you. Listen to them:) help them by strengthening the cause of the tightness and the tightness will go away… much more efficient than having to stretch all the time anyway:)
btw, my wife now follow same advice… she is 35 and is running almost as fast (5k / and 1/2 marathons) as when she was in college (D1)… she has not stretched in several years with FAR less pain/injury.
Contact Dr. Mike Hatrak in Alpharetta at Synergy Release Sports http://www.synergyreleasesports.com/ He a great friend and has 36 years experience helping thousands of athletes. He and his staff have worked on over 400 NFL players as well as top level and pro athletes in every field including triathlon and endurance athletes. He also has a great referral network to docs at Emory if necessary.
Unfortunately it is very hard to strengthen a muscle that has a limited range of motion opposing it. I say limited range of motion rather than tight muscles because there are a lot of structures in addition to muscle that cause the limitation, muscle is the easiest to address.
For most people stretching and strengthening are both indicated.
Unfortunately it is very hard to strengthen a muscle that has a limited range of motion opposing
Trying to be clear on what you are referring to here. Let’s take an example such as straight leg hip flexion to keep it simple. And let’s say your left leg flexes to 90 degrees and your right leg is only able to flex to 70 degrees. so we could say there is a limitation in RIGHT leg hip flexion. Now the goal is to improve range of motion AND improve stability. My argument is that if you can improve stability in the end range and specifically target strengthening these weak positions (using light isometrics and then slowly increasing intensity). the body will allow for more range of motion. The tightness (if it is a muscular related issue) is the body’s way of protecting for this weakness.
I say limited range of motion rather than tight muscles because there are a lot of structures in addition to muscle that cause the limitation, muscle is the easiest to address.
Without a doubt. And also the most important b/c it is the only one that has significant contractile component to it. Increasing tension in muscle is the body’s only way to improve stability, would you agree? Fascia helps hold everything together and ligaments are extremely important too but not much we can modify in them (at least in a positive way:) If it is a joint structure issue (bone shape) there is not much you can do to change that in the short term anyway.
For most people stretching and strengthening are both indicated.
Ok, this is where it gets interesting and you need to think a bit outside of traditional thought process. We already talked about how important strengthening the weak positions are. Let’s look at that Right leg limitation in hip flexion. To keep it simple let’s just look at hamstrings and hip flexors (although there is a lot more too it than that!). Let’s also assume the limitation is not caused by a structural change of any significance and it is primarily muscle.
Without going into all the neurophysiology, if the reason for the limitation is weakness in the hip flexors and the muscles are just doing their job to protect for that weakness, then why stretch the hamstrings? Think about that. Muscle just does whatever the brain tells it too, correct? What if that tightness was an orchestrated solution to the problem. Couldn’t it be that the stretching many people are doing is counteracting the strengthening we did of the hip flexors? Why not only strengthen and do it very low intensity.
Take the traditional hamstring stretch lying on your back. Instead of pulling your leg to your chest, why put your hand on the other side (quad) and use the hand to “be a wall” for isometrics. Get the nerves firing in the hip flexors gradually in this “tight” position. Take away the instability and the body will start firing inhibitory neurons back to the hamstrings (i.e. contract less) You can improve motion and strength at the same time! They don’t have to be too separate exercises.
Just some food for thought. We really need to THINK about what we are doing when we are stretching (statically) and why we are doing it.
You have a condescending explanation for your opinions, try not to worry so much about keeping it simple for me.
Doing an isometric hip flexion contraction will not lead to a lengthening of the hamstrings only passively or actively lengthening the hamstrings will do that. The key translation in the term isometric is “no change in length”. Isometrics as you describe would be exactly opposite of what the OP needs if, as I suggested, she has tight hip flexors and an anterior pelvic tilt.
Good luck with yours! 3 years is awfully long to be in pain.