Hip trouble

[burke21]

NOTE: I have posted the same thread on AirborneRanger.com, though because I'm searching for as much input as I can recieve, I'm posting here too. Many thanks in advance for any help that can be directed my way.

In a sort of debacle. Shipping on 20060706 and I think I've developed a bit of an overtraining injury in my upper hips (both legs). I've been rucking regularly with 55-60lb rucks roughly 10 miles on average two to three times a week and running considerably on roads when not lifting, doing ab work, etc. (including lower ab work that drives hip flexors considerably). For a few weeks now, I've backed off from alot of those activities due to a doctor's reccomendation, have gone through a cycle of taking anti-inflammatories for 2 weeks and icing regularly, have layed off running almost entirely, and have even had an X-ray and MRI taken of the effective area, both returned to say that absolutely nothing appeared wrong whatsoever. But that's little solace to me.

I can run, and even ruck, but I can feel something wrong within my hip and it does cause some pain (not excruciating) while walking about normally on occasion, but then sometimes it's alright. I've been visiting a physical therapist who is a friend of the family to gain his opinion on the matter, but me appears to be just as confused as the rest of us.

I'm glad that I can still train with minimal pain, but I'm obviously interested in figuring out what the hell is going on, so to prevent further injury. The reason I'm coming here instead of another doctor is just because AR has never steered me wrong, and I have a feeling that what I'm experiencing is not uncommon to those who also do substantial rucking, running, etc.

I've done quite a bit of research on the possibilities and the number one issues that come to mind include:

ITBS - which I'm doubting, since I have no pain on the outsides of my knees. The pain is primarily in the Tensor facia-latae, the out side of my upper hip, deep in the gluteal muscle, and in a semi half-circle encompassing those three elements in different areas on an episotic fashion.

Bursitis - which I'm also doubting, considering the fact that I don't have joint pain to speak of, and all the doctors I've talked to claim that my symptoms are different than that of bursitis (the PT also informed me while probing my hip with his hand that certain areas would be painful to touch if bursitis was the problem, but these areas did not cause any pain for me)

Overall, I'm stumped. I've been stretching regularly and continuing to ice and take anti-inflammatories regularly, and of course I'm not going to let this stop me or even slow me down from my goals, but I'd like to take some intelligent steps, and I could think of no better place to go for those intelligent steps than here.

Thanks again to the SF and Ranger comunity here, and I hope I didn't leave any important information out.

Thanks again.

[Baseplate]

Go to a chiropractor you might have a pinched nerve in your back

[DJB]

Need more info here bud, Hip is not specific enough. The “hipâ€

[burke21]

Ranger Bustedkidney,

Roger that. Unfortunately my ability to target the specific source of the pain is somewhat limited due to the extreme randomness and episotic nature of the injury. I will attempt to answer your questions specifically for lack of a better knowledge/ability to relay the situation due to my own lack of understanding:

It sounds more like you have anterior-lateral-proximal-thigh pain. Is this correct?

Yes, there is pain in the anterior-lateral-proximal thigh area, thought he pain is not only found in this area. The outer upper thigh is occasionally sore to the touch, but, as with the rest of the injury, this pain is not always consistent. Also, this pain-to-the-touch, when it is present, is usually only able to be felt if a downward rubbing motion is made, not just a poke/probe. The Tensor fascia-latae, from what I can feel, is extremely tense and almost in a constant state of contraction (I assume it is the TFL as it runs shortly down the upper thigh and cuts into my groin area going about half the way from the center of my upper thigh towards my central groin. The physical therapist I've been visiting informed me that my sacoriliac (my apologies for spelling errors) was out of alignment and said it could have possibly be caused by something as simple as a missed step. With a few exercises he fixed the problem and upon later examination, the bones were properly aligned. Unfortunately, that did not help the problem. It is his current guess that perhaps the offset of the sacoriliac forced my other muscles to contract awkwardly in order to prevent further injury, but much of my pain to him is unexplainable. The doctors at the local clinic seem to be of the impression that because the MRI and X-Ray are normal that there is nothing structurally wrong, but I feel that perhaps I should request a bone scan in order to ensure that there is indeed no stress fracture involved.

I can walk and run without much pain but have been, of course, laying off both activities lately and going heavily after non-impact cardio like swimming and eliptical training instead.

The pain feels occasionally like it is deep within the hip and other times feels more superficial. I can run my leg through a full range of motion without any pain 99.9% of the time, and the other 0.1% doesn't follow any specific guideline as to any specific movement that causes the pain. Walking sometimes hurts a litle, sometimes it feels completely normal. I did a land-nav exercise this weekend (without ruck) going up and down some substantial inclines over moderate distances and can't say that I had much pain at all, though if I had to pinpoint an activity that caused the most stress, I probably would identify the downhill descent.

I wish I could give more specific information than I am, my aspirations are that of LRS and an inability to relay information bothers me at a personal level. It would mean an awful lot to me to be pulled out of the dark in regards to this "injury," I just can't seem to be able to find anyone who can point me in the correct direction.

Bottom line, I feel that I can operate effectively on it, but I do not particularly want to risk a serious injury and would like to fix it effectively and as fast as possible and prevent it from happening again. Hence why I came here.

Thanks in advance for any advice.

[/quote]

[DJB]

but I feel that perhaps I should request a bone scan in order to ensure that there is indeed no stress fracture involved.

Don’t waste your money, its not indicated at this time. Unless you have some kind of underlying disease process like cancer it wont tell you anything new. If you have a stress fracture not visible on plain film, it is very minor and just requires rest which is what I recommend for the pain regardless of the cause.

You are right, the pain does sound fairly ambiguous,

I assume it is the TFL as it runs shortly down the upper thigh and cuts into my groin area going about half the way from the center of my upper thigh towards my central groin

. If it crosses over from proximal anterior lateral (ASIS) to medial knee it sounds more like sartorius muscle pain distribution. Which is possible, rectus femoris and sartorius muscles can be strained and lead to tendonitis and increased pain at the ASIS (the location of your described pain). A definitive diagnosis is impossible to make without a physical exam and better understanding of your pain. Again my advice is continue to follow it up with your doc, a PMNR consult may be appropriate. Otherwise continue flexibility training and upper body strength training, general guideline for everything else is, if it hurts, don’t do it right now. Sometimes that old cliché/joke "doc, it hurts when I do this" "then don’t do that" is very good advice. You are young and you have been training hard, let yourself heal, it wont take long and it wont ruin you. There will be plenty of time to be hard in the future. Keep in mind, it’s easy to be hard, it’s hard to be smart.

[burke21]

Many thanks for the information, Ranger bustedkidney. I will definetly keep your suggestions in mind.