Tensor fascia latae/IT? pain
I have never had this pain before and am trying to figure out what caused it/how to fix/how to avoid in the future...
I haven't been running as much as I used to, and have been riding a lot--riding a lot of hills.
Tuesday I went for a ~12 mile run, in relatively new shoes, on pavement, and at the end my left hip area felt a little tight, but not painful. Later that evening started to get a little painful feeling. Worked all night on my feet, got home in the morning, took a nap then went for a SLOW run. By the time I was 2 miles in it was excruciatingly painful, but I had to get myself home, so ran 2 miles back with it hurting. Now I can barely walk.
I busted out my anatomy atlas and the pain, as far as I can tell, is right where the tensor facia latae inserts onto the ASIS, or maybe even the anterior portion of the IT fascia. It's pretty limited to right on the bone, no pain further down.
I know the immediate answer is no running (let's hope it doesn't hurt to ride--I haven't tried yet) but is there anything else you PT/sports med brilliant people can tell me? And any ideas as to what caused this, other than the fact that I've been running very little, then running long--repeat pattern---?
Thanks,
Shannon
Comments
Is the involved side in slight flexion or worse in hip extension?
It can be a number of tissues and I do marvel at Leigh's ability to perform Internet diagnosis. It's hard to know where the issue is from my perspective when I can't see it or see you function.
Hill climbing usually means you move back on the seat, unless you climb standing, which shortens psoas, loads sartorius....
Vince
It's worst in slight flexion, i.e. pain from the time my foot hits the ground walking or running, through to almost the end of the stride. Without running, it's really hard to reproduce the pain unless I push on it--- or lean to the side to get a good stretch on it. I rode tonight and it doesn't hurt to ride or to climb *unless* I climb standing, which even then doesn't hurt nearly as much as walking/running.
Two ways to go after it: 1) you have to loosen it up. break out your foam roller and check out athletestreatingathletes.com (on the side menu, click on self muscle massage series and look for the posts on the lateral and anterior hip). You're going to want to work on both areas and really loosen up that area. There's plenty of tips and tricks for what to do there. If this isn't an option, you need to snag some time with a sports massage person- specifically work on the TFL, ITB, hip flexors and glutes/hamstrings. 2) gentle stretching- also on that website, click on the IT Band stuff and go to the treatment post for specifics. goal isn't to go till it hurts, just till you feel an easy pull and repeat often. 3) lots of ice to prevent the inflammation from getting worse. 4) because it's a weird area to injure, you're going to want to be careful with your return to running. Something in your stride was off for you to pull up with the hip (meaning you were pulling up instead of pushing off your back foot). Could just be tight calves/hamstrings, tired quads, etc. That part is hard to say without seeing your stride. I take it this is the first time you've ever had anything like this or is hip stuff common for you???
Sounds good. I was thinking also TFL/Sartorius adhesion...? These things are hard to treat without seeing the patient aren't they?
Shannon...if you lay on your back and use your hands to draw your good knee towards your chest (with your other leg laying flat on the ground/surface)...do you have the same range of motion on the involved side? Is there any pinch or pain in the anterior hip area on the involved side as you draw that knee in towards the chest?
Vince
Leigh- I have never had hip problems but this is on the same side that I have had a groin strain last year, and continual low back pain on the same side so I would tend to think that it's all related. The pain is weird in that it doesn't ever seem to "snap" like my very distant experience with IT problems; it's literally RIGHT on the bone, so maybe the top of the TFL tendon or the top of the IT where it splays on the bone? Seems to be right at the border.
Vince--There doesn't seem to be any difference between the 2 at all--- same ROM.
Thanks guys,
Shannon
time to get to work loosening that up. what's your game plan now that your home??
OK...well can you post a good picture (couple angles) and point to where you feel it? If it is lateral to the ASIS then we can rule out some things but if it's more medial then it may be part of the lowback/groin issue. As I stated earlier, Leigh is better at this internet dx stuff. I like to feel the tissues and look at biomechanics moreso.
Vince
Vince--will try to get one up tonight if I can get a decent one... and I really do mean decent, since I'll be pretty much posting a picture of my butt.....
S
Vince
But now, it's back and I'm trying to figure this out. I took the entire month of August off running. Drove me crazy. I then came back VERY slowly, but anytime I run over about 10 miles or so, it acts up again and I'm back to square one; have to take a few days off. I haven't run in 4 days and it's still bugging me. I have a half IM in 3 weeks and at the moment can't run pain-free. Riding still doesn't hurt it.
I can't seem to get a picture that does it justice at all, but the pain is just lateral to the ASIS, almost on the iliac crest, but a little lower. I've been foam-rolling my IT band and my glutes hoping that would help. I wasn't thrilled with the sports med guy I was seeing, so I'm shopping around, but wanted to see what you guys thought first. Thanks.
As you can see..you need to get in to see someone quickly to make your race happen.
Vince
I will also bust out the tennis ball, but I agree that my self-treatment at this point has.... failed.
Shannon