Part One: Hip feels like it's on fire.
June 27, 2008: Started crossfitting, and soon after my right hip started to feel pain, like it was on fire.
July: Saw Dr. Bruno, an Orthopod, for my hip, and he wasn't sure what was going on but had some physical therapists work with me. This involved stretching and weight exercises as well as TEMS and ultrasound therapy. Nothing was really working though.
August: After researching the crossfit forums, I realize I need to see a DO, and I have the therapist confirm that my pelvis and hip are twisted, causing the illiopsoas to stretch unnaturally resulting in severe inflammation. This inflammation is what is causing the sensation of my hip being on fire. Dr. Craddock also tells me the twisting of the pelvic muscles is why my hip clicks when I raise and lower my knee (a problem I've had since I can remember).
August 26: I meet a DO, Dr. Craddock, for the first time, he resets my hip and the pain goes away almost immediately.
August '08 - June '09: I receive regular treatments from Dr. Craddock, but after two months of no longer experiencing the inflammation of the illiopsoas I notice there is still a lingering, deep throbbing pain. This pain doesn't feel like fire, and is much easier to ignore. I figure it's still the illiopsoas, that it just needs some time to get used to being un stretched. However, this pain doesn't really go away.
February '09: I see a massage therapist and tell her about all of my various ailments, although I find her massage relaxing I do not find it therapeutic.
Part two: Maybe it's a torn labrum?
July '09 part 1: I casually mention to Dr. Craddock that my hip still clicks when I raise and lower my right knee. For a brief moment he seems a little confused by this because all the muscles are in the right place. After a second he then says I may have a torn labrum in my hip, and this might be causing the clicking and the residual pain.
July '09 part 2: I see Dr. Bruno again and he reccomends an MRI, but without contrast. He gets the results and tells me I have a torn laburm, but he's not sure since he deals mostly with old people. He then sends me to another Orthopod, Dr. Johnson, who deals with sports medicine.
July '09 part 3: Dr. Johnson determines I have fermoral acetabular impingement (FAI), but is unsure about the labrum because the MRI does not have contrast. I believe the pain I am experiencing is in my hip joint, as it feels incredibly deep. It's around this time when I come across prolotherapy for torn labrums. Dr. Johnson says that if theses treatments don't work there is arthroscopic surgery for this condition.
August: I meet up with the prolotherapist Dr. Wagner, and he says he needs an MRI with contrast in order to do anything.
September: I see Dr. Wagner again, and after the MRI he tells me that I do not have a torn labrum, only FAI and that he can not do anything for me. So I'm back to square one. Or is it two? I'm confused now with all these doctors and procedures.
Part three: No, it's tight hip capsules.
September: I go back to Dr. Johnson, preparing myself to have surgery. He comments that there probably is a small, small tear in my hip labrum, but it is the FAI that is causing the pain. He suggests trying Euflexxa injections to lubricate the hip joint and render me asymptomatic.
November part 1: The meds finally arrive and I get my first injection of Euflexxa, where they take a needle, pierce the hip capsule, and then inject the viscous solution. During the procedure I find out that I have extremely tight hip capsules, which Dr. Johnson notes may be the cause for my FAI. After the procedure, thanks to the numbing agents I receive during the procedure I do not feel any pain in my hip, and Dr. Johnson takes this, as well as my description of the pain, as a sign that the pain is indeed in the joint and not muscular. However, as the meds wear off the pain returns. ...I have a feeling that this new piece of the puzzle is important.
November part 2: I meet up with the chiropractor Dr. Bills for back and shoulder pain, but then mention the tight hip capsules, he then works on them and they suddenly feel a whole lot better. This indicates it is muscular and not a joint problem. This gives me a lot of hope.
November part 3: second Euflexxa injection. Still have pain in the hip.
November part 4: I talk to Dr. Craddock, and he recommends Rolfing, a deep tissue massage. I find one and book three appointments.
November part 5: I mention this to Andrea and she recommends Olga, her massage therapist. I cancel my appointments with the Rolfer and make one with Olga.
Conclusion: There is hope still
So yesterday I saw Olga, and she worked me over thoroughly, and unlike the previous time I got a massage I felt like this was extremely therapeutic. She worked extensively on my hip/leg muscles, and it was an incredible sensation. I told her to go as hard as she could, and the pain was indescribable. It was like my muscles were bubble wrap, and she was a rolling pin. As she slowly dragged her elbow up and down my muscles, I had this sensation like some combination of popping or sparking in muscles I never even knew existed. She commented that my muscles were extremely tight, but they were releasing quite nicely. She worked both my right and left hip.
While she was able to get my left hip to release, she said she was unable to get my right hip to release. She also commented that because this is a chronic problem it will take a while to fix it. I've scheduled an appointment with her next week, and I really hope that next week will be the week the muscles learn to relax. Unfortunately, she told me not to workout after the massage, so I had to forgo the wod.
Today I saw Dr. Bills again, this time exclusively for the hip. As he worked on them, I asked if he noticed any difference, and he said they felt a LOT better, that he couldn't feel as much "gristle" in them as he did last time.
This makes me very happy. It has been a long, long journey, but it seems like I've finally figure it out: Tight hip capsules twisted my pelvis causing the inflammation of the illiopsoas, but the tight muscles also jam my femur into the hip socket, creating the FAI.
I know I've said this before, but I'm very excited by the thought of no longer being in pain. Hopefully there will be no more curveballs, and this will finally kill the throbbing ache that I experience everyday. I write this so that others out there who may have hip pain or any other type of ailment may have hope and learn from my experiences. If I help at least one person out there, then I am a happy man.
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5 comments:
how did you injure your hip capsule. i think i have the same problem as you but i ha hip surgery as a kid
It seems like the Hip impingement is just from how my hips are made. Also, I used to play soccer, and torn labrums are common in soccer players. The tight hip capsules are just a result of never really using my abs or getting a massage.
Hi Adam,
So glad I googled this and found your blog. I, too, am a crossfitter with FAI, which I discovered rather abruptly after an intense workout involving one too many burpee sets. The pain became so intense I had to quit Xfit for a month and get PT, after one doc misdiagnosed me with a hip flexor injury. After 2 wks of PT, the pain was worse so I found a new doc, got an FAI diagnosis, a contrast MRI, and a cortisone injection in my hip. Scan showed a slight tear in my labrum, which the doc says will feel better with the shot, but also a slight bump at the top of my femur bone, which was probably congenital. They said without laproscopic surgery, I'll always be prone to this type of injury. I've been back to my "modified" WODs for 6 wks now, but the pain is creeping back again. Other than avoiding hyperextension (i.e. high box jumps, deep squats and lunges), I wasn't given a specific list of forbidden activities that would worsen my condition. I'm trying to avoid anything that seems it might aggravate it, but we do so many different exercises in our WODs, I don't know exactly what I may be doing that's causing the pain. Seems to hurt more after lifting heavy weights, back squats, and running. But also weighted half-pikes aggravate it causing a popping sensation. Any suggestions for me? I'm 39 years old, and Crossfit has me in the best shape of my life. I can't imagine having to give it up! Thanks!
Jodi,
I'm not a doctor, but your story does sound similar to mine, so let me elaborate on it. Years and years ago I tried to deal with my hip pain by doing pilates (probably similar to your PT) and that made it worse. Pilates made it worse because it turns out the pain stemmed from too tight hip flexors, and the exercise was just making it worse. A few years later, I realise that I wasn't really engaging my abs, so when I squatted I would rely on my hip flexors, making them tighter and this in turn would increase the pain.
Based on the similarites I see in our stories, perhaps your pain, like mine, comes from too tight muscles. Have you seen a massage therapist? Not a froo-froo one but one that will push on the knot until it releases? Do you do self-massage? Do you try Kstar's hip mobility MWODs?
feel free to email me at eighty_proof@msn.com
PS when you say you have a bump on your femur do you mean you have a cam-type impingement? I'd be happy to offer you all of what I know about this, and that's a whole lot.
Hi Adam - Who was the massage therapist that helped you? I live in the N. VA area also. I have been diagnosed with FAI, have had arthroscopy done on the labrum (was rough, not torn) and steroid injection. Was doing pretty well until just recently I upped my activity riding (horsebackriding) to include jumping again. My problem manifests itself as groin pain and mild hip pain. I'd like to try the deep tissue massage to see if that can help release my very tight hips, but I don't know where to find a good one. My e-mail address is erin.isaachsen@verizon.net. BTW, thanks for this blog--it has some very good info in it and I am going to look into crossfit. I had never heard of it before!
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