hip/groin/glut pain

I really really think you have a labral tear. An MRI Arthrogram will suffice.

I agree. This could be a bad injury (labral tear). Would most likely require surgery. I've been trying to answer the same Q for 3 years now. I've narrowed mine down to labral tear vs. SI joint laxity. Good luck.

Do you have pain in your lower abdominals?

This isn't a particularly easy injury to diagnose via LetsRun (not to criticize). But you have to give literally every detail possible to even come close to getting a HELPFUL suggestion as to what could be wrong.

You say that you developed pain AFTER an easy "run" and strides approximately "2 weeks ago". I put those two parts in quotes because if you developed it after one single training session, I would consider it to be a more acute injury vs. a chronic injury. Unless you had been having pain or discomfort (i.e. tightness, crampy, pinchy, achey) feeling in your hip/groin area for a few weeks or even months prior to this "adductor strain", then it's not likely you have a labral tear. I say this because to tear your labrum takes a good amount of force or repetitive stress ALONG with biomechanical issues (i.e. bone problem such as impingement and/or poor stride mechanics). You should have a much more gradual onset of discomfort (tightness/aching) that would progress into more painful symptoms (stabbing/pinching) as the injury progressed.

Did you feel any discomfort before you did the strides? Did you notice it while you were running or only after? And describe your hip and glute pain and groin pain in DETAIL. What part starts to hurt first? What exactly does it feel like? Have you tried to run on it? What does it feel like when you are running. What does it feel like when you are not running? And does it hurt during any other daily movements (i.e. sitting, standing, laying down, walking, lifting/carrying things, going up/down stairs). And if so, what does it feel like during those movements? Giving information like that will help a lot more than simply saying your groin and hip hurt.

Hi thanks for your replies. I realise that letsrun is not the ideal place to diagnose running injuries but just wanted to know whether it could be something serious as I suspected it was more than the adductor strain the physio first diagnosed. Also wanted to be armed withsome more information of what it could be if I go see someone else. So here the whole saga with all the details!

I noticed the pain while doing the strides after my easy run (Mon 2 weeks ago). I didn't feel it suddenly develop (i.e. it didn't feel like an acute injury) just at some point I just noticed my groin hurt although it was only mild. I could feel it walking, although only mildly and when I ran it felt like a sharpish pain in the groin/adductor area. I found that it hurt with knee life or if I lay on my back lifted my knee and brough it to the opposite side of my body (like you do when stretching back).

Prior to this I hadn't noticed any pain but had done quite a few runs that involved sand dunes which I am not used too which maybe could have contributed? Also I don't know if this is relevant but the injury is on my left side where I have had multiple ankle strains and recurrent achilles problems.

Tues I did an easy run on it the following morning and although I could feel it at first, once I was warmed up I didn't really notice it. That evening I raced on it and same thing I could feel it in my warmup but didn't notice it in my race at all.

I did a session of fast 200s on Thursday and did start to notice it during this session although the pain still wasn't bad. I did another short 30min easy run that afternoon and was now definately aware of it the whole run, whenever I took a step I felt that sharp pain right in my groin adductor area. It was also sore rolling over at night. Btw I iced it after both these runs and started antiflams 3x per day

The next day I went to see the physio who wasn't sure but thought it could be an adductor strain. She said that my quads on my left side (side of injury) were ridiculously tight and this was contributing so she did some massage to loosen them up. I took this day off. The next day I couldn't really feel the pain walking so I did a session of 600's(I know, silly me). By the end of this session I could feel it a bit again. But that still didn't stop me and I did a 30min easy run in afternoon.

I did a long run the next day and a 45min jog the next. and Tues went to physio again. By this point was feeling some soreness in my lower hip area, kinda where it meets my glut. It was quite non-specific and hard to localize. She discovered my gluts were really tight too and did some trigger point stuff on them which was v painful. I haven't run since then and the pain in my glut/hip has got progressively worse and is radiating down my leg into my quad. It almost feels like these is two pains now - the one in my groin and the one in my hip, although they also feel kind of connected. I tried biking but could feel that in the adductor muscle and aquajogging I could feel in both. The hip and glut area really hurts (with the pain going down my leg toward my glut) with each step walking and I have found that it really hurts when I try to put on my pants i.e. stand on the sore side and bend over to put my other leg in. So now am just doing nothing and worrying about my injury!

Sorry for the ridiculously long post but hopefully that is enough detail:)

oh and no lower abdominal pain. Doesn't hurt sneezing, coughing either if you are thinking sports hernia

I'm absolutely sure that you have a labral tear. Seriously, man. Get it checked out. MRI Arthrogram. Get 'er done.

inpain wrote:

oh and no lower abdominal pain. Doesn't hurt sneezing, coughing either if you are thinking sports hernia

A labral is most likely what you have then. That is actually probably better than a sports hernia. Good luck!

Hmmmm...

This is a messy situation because you have kept running on it! I feel like you have more than one problem at this point, although I am sure only one of the problems is really that significant. One more question:

WHERE does it hurt in your hip and what exactly does the pain feel like?

Does it hurt anteriorly/posteriorly or laterally? Is it on the front of your hip where your hip/quad meet? Does it hurt on the side near your hip socket? Is it more than one type of pain?

When you mention that you can it hurts to lay on your back and pull your knee towards your chest and try to pull it towards the opposite side of your body...

Does that create a pinchy/stabbing sensation in your hip joint?

What you are describing to me sounds like you MAY have a labral tear and hip impingment. BUT, the strain in your quad is a secondary problem from your body compensating. I would have to agree with the previous posters.

Here is the problem you may or may not run into...

There are many cases where labral tears DO show up on an MR Arthtrogram (with the dye injected); however, there are many cases where it does NOT show up and is still there. I had a significant tear in my left hip and it failed to show up twice. Also, if it does show up, impingment may not show up on the x-ray. Chances are if you have a labral tear there is SOME form of impingement. I would get more than one opinion. What state do you live in?

Also, in response to having numerous lower-leg issues (i.e. achilles/sprains), that is somewhat significant. It clues me in that there is a greater chance for impingement. Impingement in the hip socket would mess up your stride and biomechanics (enough that you wouldn't physically notice it but it would show up through multipe/overuse syndrome injuries).

I'm certainly not an expert, but I had many of the same symptoms as you, and I was diagnosed with a labral tear. A regular MRI didn't show it, but the MRI arthrogram (with dye injection) did. Good luck with your problem...I hope you get it figured out.

Thanks so much for your replies, I will definatey get onto getting an MRI asap and get a second opinion.

Does anyone know how long these types of injuries take to heal? I was in the best shape of my life prior to this injury (probably why I kept running on it so long) and don't want to lose fitness but it appears cross-training options are fairly limited as they all seem to irritate the injury.

Without knowing for sure, I can only give you advice based off my personal experience and also extensive research..

But it will be different for everyone. It's not necessarily the labral TEAR that is hurting you. I ran for months on a labral tear and had little to no symptoms. The impingement is what started to hurt me. It's complicated to explain but I'll try to simplify it. You glute pain and hip pain and groin pain are all secondary/radicular to the labral tear and possible bone impingement. The impingement is clinically known as Femoral Acetabular Impingement (FAI, if you want to Google it). You can have two different types (or both, I have both). CAM impingement or Pincer impingement. Basically both involve abnormal bonegrowth and/or adhesions on either the femur, the hip bone, or both bones. When you hip flex (during running, sitting, walking, etc) your bones hit each other and it produces abnormal rotation inside of the hip socket - hence "impingement." This impingement causes bad contact in the hip capsule and surrounding it which tears away at your labrum. That is how MOST tears occur.

SO, if you do have a form of impingement, which is highly likely, anything involving a decent amount of hip flexion is going to produce symptoms or radicular pain (groin, glute, IT band, etc). What happens is your pelvic muscles become dysfunctional; because you cannot feel the extent of damage that is inside of the hip capsule, muscle such as your hamstring, glute, quads, TFL, etc become chronically tight. Muscles that seem to be the worst for this condition are hip flexors, glute, and psoas and groin.

Bike does not work well. A lot of hip flexion and then add in resistance.

Elliptical is ok for some and not for others.

Running = no

Walking = ok for some not for others

Lower Body lifting = BIG NO, this will cause more damage, esp. a squatting position/motion

Swimming is usually ok, pushing off the wall may or may not agrivate it. I was usually ok. Pool running was ok until about 2 months then I was forced to stop.

In the end, just listen to your body. Bike might not work for me but for someone else it might be ok. It depends where the impingement is and during what part of hip flexion/extension it bothers you. If it causes pain or tightness, stop. If you feel ok and the pain does not increase during or AFTER exercise, then you are ok.

Labral tears are an active recovery, but minimum of 3 months post-surgery before you run again. I just had an operation. I am on day 19 of recovery. Much less pain. Great ROM. But I'm not running.

I asked what state you are in because If you are near NY I would suggest a few Dr's to see. I REALLY would recommend doing research before spending money on imaging. If you are having just any old ortho guy look at you or prescribe imaging, you may not get treated thoroughly, I'm just warning.

Wouldn't there be more pain with a tear?

I think it's just bursitis related to medial glute weakness. Two weeks of glute activation 2x a day and no workouts/longruns.

thanks for such a comprehensive reply. The stabbing, pinching sensation, you mentioned is definitely what I feel with any any hip flexion and the rest of what you have written seems to fit as well. I will give the elliptical a go because I've tried swimming, aquajogging and biking and they all cause pain. Even walking around causes pain. I'm not from the states, so unfortunately can't make use of any of your recommendations for Dr's.

It's no problem. If you are in Europe/GB or Australia I would suggest scouring some forums/blogs. There are a good amount of runners (especially Aussies/Kiwis) who have documented going through the surgery and how helpful their surgeon was in the process. I've read at least a dozen blogs from that area. If I can go back and find a few links I will post them.

For some more general info:

http://bryankellymd.com/hip_kelly_new.html

(^^ This link explains FAI and Labral tears in the hip and also gives a comprehensive explanation of the anatomy and different types of problems you may be facing - much better than I can do haha).

http://bryankellymd.com/fai-movie.html

(^^ This link is a great video that shows exactly what is happening and should leave you less confused. Not assuming you don't understand the injury, but I didn't understand the complexity of it or how chronic it actually was until I did more reading).

I would also suggest going and looking at the credentials this surgeon has. Although he's located in the US, it will give you something good to base your decision off. I went to about 6 HIGHLY recommended Orthos who just couldn't come close to diagnosing me. When one finally suggested "labral tear" he argued with me that I didn't have impingement. If he had done my surgery, I would have re-torn the labrum within weeks or months. Don't be scared to do the research, it will be worth it in the end.

Good luck!! :)

I was diagnosed with a tear and didn't have much pain. Also the beginning of my pain sounded similar to yours--slight mild pain in glutes during run about 3 years ago, which has progressed to all sorts of other pains. I'm still not sure whether I have a tear. Most regular ortho surgeons honestly don't have a clue and I have talked to several. Ditto with PTs, even those who are very highly recommended. You need one of the best in the country I think to get a real answer when it comes to hips.

My diagnosis was a "maybe" b/c a regular MRI arthrogram doesn't show the labrum clearly.

I would just say don't run through it. If you have pain, keep searching until you do not have pain before you continue ramping up or continuing a high level of training.

Anyway I'd follow the advice and the links given to you by Neliah. :)

strengthen your glutes!

I won't bore you with the details of my experience with these types of injuries, but my advice is to get yourself to a sports medicine doc (preferably one who deals with runners) to get this checked out ASAP. Search "Sports Hernia" as well as "Osteitis Pubis." I don't want to scare you, but you may have one or both of these two conditions. The longer you avoid treatment, and the more physical activity you try to do on the injury, the longer the recovery time. Suck it up and get this checked out now to avoid months of pain (and no running) later.

Best of luck.