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Hip Injury from Running?
#10235 01/23/11 10:42 PM
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Over the last two weeks, a sharp pain has developed on the back side of my hip. I run easy 2-3 mile run/walks 5 days a week, with a 6 miler on the 6th day. Twice a week I do lunges. I emphasize that these runs are very slow and easy (I have been running for decades with no problem). At first, I was able to "warm up" enough during the first mile, so that I was able to extend my right leg and complete a normal "gait", however, it became more intense to the point that my right foot now "scrapes" the ground, and I do a running "limp". This only occurs when I run, otherwise, there is no pain when I walk or when I am at rest. Also, the hip has sort of a stiff feel about it, like something needs to be loosened up. I would say that most of this became more evident when I added the lunges into the workout. I have not gone to the doctor, because there is no pain outside of running, so that lately, I have been doing other aerobic exercise and experiencing no pain.

I would sure like to know if anyone else has experienced this situation.

B


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running?
Bee #10237 01/24/11 04:50 AM
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Ouch! Sounds like an orthopedic consult is in your future.

Re: Hip Injury from Running?
Bee #10238 01/24/11 05:09 AM
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Bee, that sounds like no fun. If you're at the point that your gait is affected - especially if you're dragging a foot - you should probably back off the running till you've had a chance to get it looked at. There's always the danger that you may be exacerbating the problem by continuing to run, and the other risk that you may throw something else out of whack by continuing to run with an unbalanced gait, compounding the problem.

Hope you get it corrected - soon!

Re: Hip Injury from Running?
Bee #10241 01/24/11 08:18 AM
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Bee, this is obviously because you are so lazy on day 7! smile

Seriously, many things ruled out. Not bone, not nerve, not bursitis, joint itself, which would be affected in many more activities/positions. Position (posterior), and nature is suggestive of piriformis syndrome.

Piriformis syndrome is a common cause of posterior hip pain in runners. This is deep buttock pain that occurs with running and can be accompanied by pain radiating down the back of the leg. The muscle is tender to deep palpation and stretching (hip flexion adduction and internal rotation). Treatment consists of deep tissue massage of the area, stretching the piriformis muscle, and strengthening the hip abductors/external rotators. This is a problem that usually takes weeks or months to get better with physical therapy.

Oftimes, if there is a specific action that triggers the pain, simply stopping that action will eventually eliminate the problem.

Anti inflammatory medications (NSAIDs) for a few weeks (at full anti inflammatory dosages) usually help a lot, some people feel.

Needless to say, progression of the problem, lack of improvement over time, REQUIRES a formal evaluation.

Some might feel that your lack of symptoms in doing normal activities and walking would merit a period of conservative treatment(stopping what hurts, massage, perhaps heat, stretching, perhaps an NSAID) on your own, so long as you don't get worse, and you seemed to get better on that approach.

Re: Hip Injury from Running?
Ken #10242 01/24/11 08:33 AM
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Hmmmm... If Ken's hunch is right about the piriformis:

Several years ago, I had a hip/butt problem, but it was pain while driving long distances ...right leg, aching hip/butt area. I asked my doctor, and he was sure it was arthritis. I told my physical therapist, and he thought I should try a piriformis stretch.

I started doing the stretches -- 60 seconds on each leg -- after each workout, and the problem has completely disappeared.

Here's a picture, from this website:


And a picture from this website:


When I do the stretch, my knee is centered left-to-right between my elbows.

Re: Hip Injury from Running?
Ken #10243 01/24/11 09:36 AM
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Bee, Piriform means pear-shaped (from Latin pirum "pear" and forma "shape").

I hope this doesn't mean that your fitness plans and aspirations have gone pear-shaped.




Verum audaces non gerunt indusia alba. - Ipsi dixit MCMLXXII
Re: Hip Injury from Running?
wagga #10244 01/24/11 10:02 AM
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Hi Bee, The periformis muscle is pretty thin, especially as it gets closer to your hip, and can be overused and start to tighten up. It actually causes several problems in the mid to upper rear and lower back problems. The stretch is really good to do. What you can also do is get someone to push on it. I used to massage at a chiropractors office (my buddy DJ) and many times, the perifomis caused problems. You don't have to be an expert to find the muscle. It's right in the middle of the indentation of your rear end. It's behind the gluteus maximus, attaches to the sacrum and extends to the femur. If you can get someone to push with their elbow, right into the indentation, that will help. You WILL KNOW when your periformis is being pushed on, especially if it is tight. Have the person start softly and increase pressure until it hurts a bit. That should make it feel much better.
Also, I'm sure you could PM Rod. I know he can help.


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Re: Hip Injury from Running?
quillansculpture #10251 01/24/11 01:38 PM
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without knowing Bee's dx:

I had severely painful bilateral piriformis syndrome, unresponsive to stretching, etc. The ER visit resulted in Percocet and Valium. One pill for pain, one for muscle spasm. Woke up a new man. Wow. Took it easy for a while after that.

I know several runners who have had weird pelvic/hip pain eventually dx as stress fracture.

Story:
I had a pulmonary professor who said, not trusting his stethoscope, that the best chest exam is a chest xray

Modernize version: the best examination of a orthopedic problem might be an MRI. (disclaimer: multiple sports injury misdiagnoses by orthopedists on me and my 2 sons). Harvey

Re: Hip Injury from Running?
Ken #10253 01/24/11 03:36 PM
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Ken -- you nailed the description to a T!! I forgot to mention how the pain continues down my leg and almost seems to spiral around at the end. Absolutely no pain during any other activities, however, I can feel this strange, almost "tired muscle" feeling very deep inside the glut. It is not quite pain, rather, just that "humming" that you get when a muscle is tired.

I have immediately cut out running and today I am switching to the rowing machine (Concept 2) After 3 days of no running, what I feel is like the glut on the right side needs to be stretched, so I am going back to my dance roots and will begin with a long stretch routine.

I should mention that I had completely fallen off of stretching & doing any abdominals, as I had gotten "lazy" and just wanted to shed the 20lbs (worked) by doing a whole lot of running. It seems that too much focus on one type of exercise may have over done it. I am not sorry to be switching to rowing (machine just arrived on Friday) because the stretching movement seems to relieve that "inner pressure" that I can feel.

I will be speaking with an ortho on Friday, so I will see what he suggests.

Thank you very much for the imput; these forums really are a well of very quick info.

B


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running?
Steve C #10254 01/24/11 03:38 PM
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Steve,

This stretch seems to "relieve" that inner tension that I feel deep in the muscle.

B


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running?
Bee #10256 01/24/11 04:55 PM
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Hi Bee,

I've seen photos of you so I know you're in good physical condition, much, much better than I am; however, I recently experienced the same pain in the hip/glut area. The first time I noticed the pain was in Step Class when I was doing backward lunges off the step. I continue to take Step Classes; however, I have modified my backward lunges to reduce the pain, but the pain has not subsided completely. My aerobic instructor suggested that I engage in doing more abs to strengthen my back which should alleviate some if not all my pain. Abs are so important....I've never had good abs and the older I get well,,,,,,, you know the story.

I'm no expert - FAR FROM IT - but if I were to give you advice I'd tell you to cut out the lunges, increase ab work and maintain your running to see if the pain vanishes, if not, you'll know not to take my advice ever again.

Best of luck to you. Now go fill out your Mt. Whitney Lottery application and submit it on Feb. 1. Hope to see you on the mountain.

All the best to you,
Lynn


Lynnaroo
Re: Hip Injury from Running?
lynn-a-roo #10259 01/24/11 05:31 PM
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Lynn (& Mike): Yup, I have cut the lunges and now I do about 15min of ab work before I do anything. As I mentioned above, I got "lazy" and cut out a lot of the preliminaries and would just shoot out the door for a run after work.

Mike: You were right, also, that 600mg Ibuprofin took away that deep "pressure" that I was feeling in the glute.

Steve: On top of the above, I did about 30min of stretches according to those illustrations. Amazing that I could feel the exact spot where the pain emminates from changing from sharp pain to more of a dull "used" feeling.

Ken: After Ibuprofin & stretching, I went for a moderate walk. During the walk, I realized that my stride had been shortening over a long period of time, because when I started to take longer steps, there was this "pain memory" that made me hesitate (no pain while walking, but my running stride had been shorting to the point where my foot started grazing the ground.)

Everyone: Do not let anyone kid you that rowing is "easy" ; after 10 minutes, everything was burning from (ab)use!

If all else fails, I CAN ALWAYS MENTALLY OVER RIDE THIS WHOLE SITUATION crazy crazy crazy


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running?
Bee #10261 01/24/11 08:47 PM
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Along with a bill from Dr. Ken, watch for the request from the Mt Whitney Hikers Association for our customary fee. grin grin

Re: Hip Injury from Running?
Steve C #10332 01/25/11 08:25 PM
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Also to consider is sciatica. If the pain radiates down the leg then the sciatic nerve is definately involved. The Piriformis exits the obterator foramen with the sciatic nerve but true piriformis pain is only in the butt.Now an inflamed priformis can swell and irritate the sciatic nerve but a piriformis muscle strain condition itself does not radiate past the buttock Only the sciatic nerve can radiate down the leg to the foot.Running is a pounding activity and the butt/leg pain may originate in the lumbar spine.A diffential diagnosis is sometimes difficult as the conditions can co-exist but a trained doctor can make the correct diagnosis.Does it hurt to cough or sneeze or bear down to have a bowel movement? Do you have pain in your lowback across the beltline? Does your low back or leg pain hurt to bend forward(flexion) ,backwards(extension) or hurt on entension and simultaneous rotation?

Last edited by Rod; 01/25/11 08:27 PM.
Re: Hip Injury from Running?
Rod #10333 01/25/11 08:40 PM
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Hi Rod,

Great questions; they force me to really pay attention to the characteristics of the pain, rather than viewing it as a general discomfort.

The pain has mostly centered deep deep in the glute (which I mistook for the back of the hip, but realizing that the two areas come together) It is a deep deep pent-up pressure feeling that reminds me of needing a massage. Outside of running, the only other time that I am aware of the pain is if I sit too long or stand in one place a really long time (washing dishes after a big meal) other than that, there is no amount of movement or stretching that can render the pain that running does. In the beginning of a run, only the deep glute hurts, but when I was "Over Riding"(inside joke) the pain would reach down to my lower leg, and that even felt more like an ache at first. If I pushed past the "ache" then it became a sharp cramp-like pain that would shoot down the leg. Also, it almost feels like something needs to "pop" to relieve the pressure in the hip (I can only explain it as the way it feels when you "crack" your back and the pressure suddenly feels relieved) It is an annoying "loaded" feeling deep inside.

I hope that this description helps.

(I am going to be a very informed individual when I chat with the doc!)

B


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running?
Rod #10352 01/26/11 12:49 PM
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Rod,

I have no idea what you do for a living, but after reading your PM yesterday, and now the advice you're giving Bee in such explicit detail, I'd put my money on you being a doctor, MD that is. Sounds like you know the anatomy of a human being well.

Bee, sounds like you're in good hands with Rod's diagnosis......you should be running marathons soon.

Last edited by lynn-a-roo; 01/26/11 12:52 PM.

Lynnaroo
Re: Hip Injury from Running?
lynn-a-roo #10365 01/26/11 09:52 PM
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Actually Lynn-a roo I am a Doctor of Chiropractic (D.C.). Neuro-musculo- skeletal is our speciality.
Bee it really sounds like sciatic. The most common and likey origin of sciatic pain is the lumbar spine.The deep pain in the glut is usualy the sciatic nerve irritation.The pain radiating down the leg is definately sciatic nerve. There is no other choice. Again we look to the most common site of irritaion and that is usualy the spine. Piriformis Sydrome can mimic lumbogenic or discogenic sciatica.I personally think the piriformis is commonly over diagnosed as a cause of sciatica.
We have a common saying if the pain is hard to describe it is almost always nerve pain. If it is nerve pain it most likely starts at its origin,the spine.
The pounding of running causes a shock wave of energy that pounds the lumbar spine.
The "feeling of needing to crack your back" is another indication that the lumbar spine is the source.Since the nerve pain travels through the butt and glut area many blame the pain on muscular strain of the gluteals or piriformis when it is actually the sciatic nerve radiating through that area.

Last edited by Rod; 01/26/11 09:56 PM.
Re: Hip Injury from Running?
Rod #10393 01/27/11 02:59 PM
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Sounds like sciatic pain to me. Lots of active people suffer from it, and it's often the topic on hiking BB's.

I use stretching and yoga to help with mine.

Re: Hip Injury from Running?
Rod #10403 01/27/11 05:25 PM
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Rod, thanks for letting me know my womens intuition is still up and running correctly. You knew words and symptoms I've never heard of before and never in a million years would be able to spell, so I knew you had to be a doctor.

Tell me Rod, do you have a doctor's signature too?


Lynnaroo
Re: Hip Injury from Running?
KevinR #10420 01/28/11 03:11 AM
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Originally Posted By: KevinR
Sounds like sciatic pain to me.

Mine was bilateral pseudo-sciatica. It was horrible sciatic-like pain caused by the piriformis swelling or trapping the sciatic nerve (after overused, repetitive motion)

apparently it is rare, Rod probably know more about this.

Last edited by Harvey Lankford; 01/28/11 03:15 AM.
Re: Hip Injury from Running?
Harvey Lankford #10426 01/28/11 07:32 AM
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Originally Posted By: Harvey Lankford
Originally Posted By: KevinR
Sounds like sciatic pain to me.

Mine was bilateral pseudo-sciatica. It was horrible sciatic-like pain caused by the piriformis swelling or trapping the sciatic nerve (after overused, repetitive motion)

apparently it is rare, Rod probably know more about this.


Agreed - would like to hear more from Rod on pseudo-sciatica. I've been bothered by it on and off for years - sometimes just on one side, then both, then it alternates ... If I do specific yoga postures and stretching faithfully, it's much better, but -

For me, the pain/discomfort rarely lasts past 10AM.

Re: Hip Injury from Running: Follow Up
Harvey Lankford #10519 01/31/11 11:28 PM
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I saw the Orthopedist on Friday, and he said that his impression is that the Piriformis is irritated and causing the secondary pain with the Sciatic nerve. He asked many questions & I did maneuvers that would eliminate this or that. I am on a strict stretching program + muscle relaxers, and I am off running for 30 days (My doc is not a fan of running; he says that there are better ways to stay in shape) He is a HUGE fan of yoga, so that I might seek out a class and start up. He saw no need for an MRI or any advanced testing at this time, because the pain had disappeared once I stopped running and started stretching (and taking the muscle relaxers). If the pain persists outside of running, or returns after a 30 day rest from activity, we will take the next step in diagnosis. For the time being, there has been no pain AND I realize how restricted my stride had become now that I am stretching & walking instead of running.

I have also replaced my nighttime snacks with......popcorn, since I am not as active at this time.

I really appreciate the input from all.


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running: Follow Up
Bee #10520 01/31/11 11:33 PM
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> (My doc is not a fan of running; he says that there are better ways to stay in shape) He is a HUGE fan of yoga...

But... What about staying in aerobic shape? Can't get that from Yoga!


Regarding stretching: The older I get, the more stretching I have (been forced) to do. I've increased from zero to about 15 minutes per workout over the years. mad

Re: Hip Injury from Running: Follow Up
Steve C #10521 01/31/11 11:36 PM
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Oh, sorry -- I left out part of the conversation. He suggested a more diversified aerobic program such as bicycling, rowing (I have a machine) worked in with only a couple of days of running. It is driving me batty, beecause I cannot get that instant aerobic fix that I am so addicted to. Running really IS the quick and lazy way to get an aerobic fix (I know, explain THAT one!)


The body betrays and the weather conspires, hopefully, not on the same day.
Re: Hip Injury from Running: Follow Up
Bee #10522 01/31/11 11:38 PM
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I can relate to the "fix". But I think rowing may get the aerobic factor up there just about as fast.

I have to agree that bicycling is way gentler on the bones.

Re: Hip Injury from Running: Follow Up
Steve C #10523 01/31/11 11:42 PM
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I am allowed to row for about 5 minutes a day and I thought that my arms were going to burn off -- rowing is a killer exercise!


The body betrays and the weather conspires, hopefully, not on the same day.
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