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pain in upper hip when running

2016/7/22 10:05:14


Question
Hi, my pain started after  a 12 km run about 5/6 weeks ago. I ran along the beach for part of the run, but it felt pretty flat and even. I was wearing an older pair of my running shoes that day.I experienced no pain during the run, only later that day. I didn't run for 4 days, and during the next run, I didn't feel pain, until after the run. I only ran 6 km and did this alternate days having the same results. I went for lynotherapy 3 times, over the next 4 wks, but my hip felt the same after a run. (a little uncomfortable during but not sore) I tried a 10 km run to see how that felt, but i was in more pain from doing that distance. I then cut it down more, and went to the chiro, she clicked me and said try a run the following day.(now that my legs were equal length again...) I ran 6 k but it was a little sore during and more after the run. That was nearly 3 weeks ago, i haven't run since then but the pain has not subsided and I can feel my hip even if i break into jog over the road with my children.  
The pain is in the iliac crest area of my right hip, feels tender to pressure from my hand, and if i stand up after sitting a bit, but subsides after moving. My physio thinks it sounds like bursitis, from talking to me, but she has been away so I am waiting to see her on this week. I am spinning at the moment to keep fit, this doesn't hurt, but im not sure if I am prolonging the problem. I really want to run again.
my lumbar spine is very tight and stiff (also within the time frame of my hip injury)I am worried that it is a stress fracture, but there is no pain in my groin area or down my leg. I had a bone density test 2 years ago and was diagnosed with osteopaenia so this is a concern for me.
I am really hoping for some more insight. I can go for an X-ray but that may not show up stress fracture, or bursitis.

Answer
Hayley,  I doubt it's bursitis since your iliac crest is tender to touch.  You are correct that an X-ray wouldn't pick up a stress fracture.  I don't recommend seeing the chiropractor more than one more time. One or two manipulations can be beneficial for pain relief, but that's about it.  Since lynotherapy didn't ease pain at all it also leads me to believe stress fracture. If the pain would've change intensity or location with lynotherapy then I would've thought possible bursitis as well.  Continue to cycle.  Don't do anything that makes it hurt for 3 months.  (I know that's a long time, but you can't work through fractures.)  When you start jogging again experiment with different foot strikes.  Here are two links.

http://barefootrunning.fas.harvard.edu/4BiomechanicsofFootStrike.html
http://www.youtube.com/watch?v=7jrnj-7YKZE

Since you have osteopenia it increases your risk for stress fracture.  You should incorporate 2 or 3 foot strikes into your running. You want the forces of running to go through your bones in different directions and different magnitudes throughout each run.  This will help prevent recurrence.  Also, once you start running again continue to spin on some days.  The days you run do it sometimes up hill and sometimes on flat ground.
 
Good luck Hayley. Please let me know if you have more questions or if any other symptoms arise.  
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