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Left Hip Pain in the 38 year-old-marathoner
Susan, a 38 year old marathoner from Iowa came in for an initial consultation
and possible treatment to left hip. The patient was referred to Caring Medical
and Dr. Hauser by a local physical therapist in Iowa, and also from another
runner patient from University of Iowa track team.
She started noticing
discomfort in her hip when running around 10 miles. She did a 13 mile run and stated her hip was extremely tight the next day. The few times she
has tried to run, she has not been able to run more than 3 miles due to pain.
Susan reported that she could not even run a mile when she tried.
Susan’s pain radiates into left quadriceps and down the lateral aspect of thigh
and knee on physical examination by Dr. Hauser. She also reports pain when she
pushes her left foot off the ground but says there is no crunching.
After a thorough physical examination, Dr. Hauser recommended that Susan have
her left hip and
left sacroiliac joint treated
because there is instability in both areas. She said she did not have pain in
her low back area, but reports stiffness in her low back in the mornings.
Dr. Hauser told the patient that she has some hip and sacroiliac instability, as
well as benign congenital
hypermobility syndrome, which means that her
ligaments
and joints are looser than most people’s. This is a great mechanical advantage
for athletics and good for aging, but this means that she is more likely to get
an injury (because her ligaments are already stretched out). Ligaments have a
very poor blood supply, so when they are injured, it’s difficult for your body
to adequately heal the injured ligaments. Because her hip and sacroiliac joint
are unstable, her piriformis muscle is trying to stabilize her hip and when the
piriformis muscle tightens up, it can compress the
sciatic
nerve, which can cause the flat footed feeling she is experiencing
when she tries to run.
Dr. Hauser felt Susan was a good
candidate for Prolotherapy. He
felt that she needed her hip and sacroiliac joint treated. He recommended that
she do the elliptical for 3-4 days post Prolotherapy. He reminded the patient to
remember to keep her chest up when on the elliptical and when running to protect
her pelvis. If she can do the elliptical hard (with intervals), then she can
start running. Dr. Hauser recommended she start a 3 mile run in zone 1. Then jog
for 2-3 minutes and walk for 1-2 minutes during the run. He also instructed her
to not do any speed work until she can run 10 miles in zone 1 (heart rate 125).
If her hip is bothering hurting, she can try shortening her gait. Dr. Hauser
thinks there is a good chance that she will still be able to do the Nashville
Marathon, but she might not be able to do the speed work she wanted to do. After
the marathon, she should do strength training 3 days per week for an hour at a
time. This will help you to tighten up your joints/ligaments and will help to
prevent future injury.
To strengthen your hip, Dr. Hauser recommended she do the one legged balance
exercises on the Bosu ball. He also recommended that she learn to swim, because
swimming will strengthen muscles that she doesn’t normally strengthen with
running. Running does not cause arthritis. Non-healed injuries cause arthritis.
Dr. Hauser felt that her treatment today should cause her hip/back to improve
right away. But if it does not, then he recommended that Susan come back again
in two weeks. If you see some improvement, then come back in 4 weeks for a
second treatment.
See our
research study
Chronic Hip Pain at
prolotherapyresearch.com
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