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3667 Views 9 Replies Latest reply: Oct 25, 2010 9:56 AM by hlwilliams17
runninginBeijing Amateur 15 posts since
Oct 15, 2010
Currently Being Moderated

Oct 15, 2010 4:09 AM

8 days before the Beijing marathon -- my mystery upper thigh/hip (anterior) pain

Given that I'm 8 days from the Beijing marathon, I'm anxious for feedback from runners with more injury experience/knowledge. After a 17km run on October 6 I noticed the onset of a sharp ache in the high on the front of my thigh. It's hard to pinpoint the precise location, but it seems to be a small cluster of sharp twinges in various places across my upper left thigh from my hip. The pain is associated with impact only. No impact, no pain. Impact is not limited to running, but also includes standing up and walking (the first step on my left leg), getting off my bicycle and landing on my left leg (since I dismount on the left side), hopping on my left leg, etc. Here's the weird part: The pain actually diminishes as I run. The pain is noticeable and bothersome in the first few km, but by kilometer 10 or so I more or less forget about the pain. Since the onset of this pain almost 10 days ago, I've run four 7+ km runs and a 21.1 km (half marathon) run without any problems (and in fast times by my usual standards). Can't I rule out a stress fracture for this reason? Isn't the pain from a stress fracture supposed to increase with distance to the point of agony? I've done virtually every test I can think of: resistance tests (flexion strength), range of motion tests, abduction strength, adduction strength, Ober's Test for ITB syndrome, the Trendelenberg Test (standing on one leg), Patrick's Test (or the faber test), the Thomas Test, Ely's Test, the Log Roll Test, the femur bend/pressure test for femur stress fractures, the hang-a-leg-off-the-side-of-a-bed test, etc. My muscle strength is fine and there's no pain whatsoever in any of the tests on this long list. The only symptom I have is what I described above: impact. In fact, impact is pretty painful, causing me to wince. But again, I can run through it pretty easily to the point that I forget about it after I'm sufficiently warmed up. I'm treating it with ice, forward lunge stretches, IT band stretches, groin stretches, and self-massage with a rolling pin and tennis ball on the thigh muscles. I think it's getting a little better. For sure it's not getting worse. Since I'm in China, I'm not planning to see a doctor about this. My plan is to proceed with the full marathon in 8 days and hope for the best. Any thoughts you have would be GREATLY appreciated. Thank you!

  • Damien Howell Legend 312 posts since
    Feb 27, 2008

    The worse case scenario is the problem you are experiencing is a stress fracture of the femur.  If you try to run through a stress fracture the worse case scenario is the stress fracture could become an overt traumatic fracture.  A fracture of the femur is serious injury, but a fracture of the neck of the femur is a very serious injury.  If a fracture occurs in the neck of the femoral bone is can lead to death of the femoral head.

    Damien Howell PT, DPT, OCS - www.damienhowellpt.com  

  • hlwilliams17 Expert 40 posts since
    Oct 10, 2007

    Actually, many of your symptoms DO indicate stress fracture, just because a few don't does not mean you can "rule out" a stress fracture.  I was a case in which I had very few symptoms of a femoral neck stress fracture - my only thing was pain and soreness in my hip that didn't go away and an affected gait.  I had great range of motion, my pain lessened as I ran, I didn't even have impact pain as you describe but yet I was diagnosed with a stress fracture.  They were pretty positive I didn't have one based on my symptoms thinking it was a muscle tear, but yet they wanted me to get the MRI to 1) confirm a muscle tear and 2) rule out that 10% chance they thought it COULD be a stress fracture.  It was that 10% freak chance.

     

    The point being, you can't look at the symptoms and hope on hope that you DON'T have something because a few of the symptoms don't match up.  Hip injuries are tricky and difficult to diagnose because often you will have symptoms of one injury but not all but have symptoms of yet 5 other injuries.  You really should get a proper diagnosis from a doctor - hopefully it isn't a stress fracture, but maybe it is.  And there are other hip injuries that can be quite serious as well but others are OK to run on or can be taken care of with a little therapy or a cortizone shot to get you through the worst part.  Proceeding with the marathon and hoping for the best could be really dangerous - IF it is a stress fracture and you were to run on it, it could complete the fracture.  That would put you out for months requiring surgery to put a pin in your hip and being on crutches for months.  I know this is an important race to you, but you need to get a diagnosis and find out if it's an injury that you CAN and should run on.  When I had my injury, I was gearing up for my big goal race and I was not allowed to run it.  It was devastating.  But I had to keep asking myself, "Do you want to run THIS race or do you want to run the rest of your life?" and the choice was easy.  You need to find some way to get into a doctor if you can because it MIGHT be nothing but it MIGHT be really serious.  Are you willing to take that risk?

  • hlwilliams17 Expert 40 posts since
    Oct 10, 2007

    GREAT!  I'm really glad to hear that it wasn't anything too serious and that you are cleared to run the marathon.  It can be devastating to get injure so close to your goal race.  And I'm also glad it seems the doctors there were so thorough.  That's amazing. Over in the states you probably wouldn't have gotten such great medical care.  And that's great that a few days off have helped it a lot.  Good luck in your race - come back and let us know how it goes.

  • hlwilliams17 Expert 40 posts since
    Oct 10, 2007

    Glad you made it through and the hip is no worse for the wear.  Rest up and congratulations!

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