11-13-11, 11:39 PM | |
Join Date: May 2011
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First of all, I'm really sorry you have to deal with this. As a fellow enthusiast of all things movement, I feel deeply when I hear about pain limiting someone's activity. I'm not sure if my post will be useful but I'll offer up a few ideas.
Without more detailed information, my first suggestion out of the gate (based on your report) would be to investigate snapping hip syndrome or possibly a Hip Labral Tear. Here's some info that might help you: There are 2 major types of snapping hip syndrome Lateral snapping hip is felt at the outside of the hip and is caused by the Tensor Fascia Lata (TFL) or Gluteus Maximus flicking across the greater trochanter (bony protrusion on the upper part of the femur/thigh bone). The clicking feeling is often not painful. Internal snapping hip (more closely matches your report of symptoms) is most often caused by the Iliopsoas muscle as it flips across the Iliopectineal eminence (front part of the pelvis). Internal snapping hip syndrome can also occur by other mechanisms: * The iliopsoas tendon also may produce snapping with sudden movement over the anterior inferior iliac spine or possibly the bony ridge on the lesser trochanter. * Less common causes of internal snapping hip syndrome include movement of the iliofemoral ligaments over the femoral head or anterior capsule of the hip. Though this is less common in general, your history of dislocation would put you at a higher risk for this form. Though the name implies that a snapping sound might be present, the internal form often produces no audible snapping sound. Patients will more often report a sense of "movement" (they sense the sudden displacement of the tendon) and associated pain. Targeted stretching/strengthening is the typical treatment. On an interesting note, core strengthening is important because it keeps the hip flexors (psoas) from over-working. An over-worked hip flexor is tight and more likely to contribute to "snapping". Labral Tear Capsular laxity or hypermobility of the hip (in relation to your injury as a teen) can result in injury to the labrum down the road. When ligaments are stretched beyond normal ROM (as with trauma), they may not regain the same degree of "tightness" after healing. That means less joint stability (laxity). The laxity allows more play in the joint during repetitive motion (running etc) and can cause wear/tears to the labrum. PT (to strengthen the hip) and/or arthroscopy (similar to the knee version) are common treatments. Your past injury does leave you more vulnerable to certain types of injury but it's also possible that you have simple soft tissue injuries related to activity. If you are not intimately familiar with foam rolling and trigger point work, I cannot suggest that strongly enough. People are often shocked when they start mapping out trigger points and pain patterns. You will undoubtedly find pain in surprising areas. Body awareness and recognizing your own patterns can really lead to more complete healing. Your doctor may or may not be able to enlighten you about what is going on in your hip. IMHO, in order to get truly comprehensive treatment, you'll need to do some exploring/mapping on your own. I really HTH. |
11-14-11, 01:59 AM | ||
Join Date: May 2011
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Quote:
You really don't have to worry about pinpointing the problem. With the type of past injury you describe, it's likely that the entire hip region would benefit from foam/trigger point rolling. Once you get started, it will probably fall into place fairly quickly. Describing it can make it sound more confusing---- feeling the patterns and connecting the sensations will turn on the light bulb for you. Once you learn to roll the region (the workbook will give you the basic guidelines), you'll probably just know what you need. There are different qualities and depth of pain that can help guide you to understand the connections. Soft tissue injuries are still largely ignored in modern medicine. Back when you had your injury, they wouldn't have even been a consideration. Orthopedists like to treat broken bones and torn ligaments. Trigger points don't show up on an x-ray or MRI so they get little attention. But as you witnessed with your husband's shoulder, they can make a big difference when it comes to treatment. I would start with home exploration because you are the best potential expert when it comes to your body. But if you would like a consult, there are trigger point specialists. In a clinical setting, a doctor will often treat/inject trigger points with local anesthetic rather than use manual pressure or rolling techniques. These physicians tend to work in pain clinics or sport's medicine settings. You have to be specific in asking about these techniques as they are the exception rather than the rule. There are also massage therapists that specialize in trigger point therapy. I don't have time to collect the links right now, but youtube has some excellent videos related to general and massage therapy techniques for trigger points. I would like to point out that many of the "issues" related to past injuries can be directly or indirectly tied to trigger points/ myofascial contractures that were never addressed during the original injury. It's not unusual for patients to incorrectly assume that certain pains are just permanent leftovers from the injury. I don't know the extent of your injuries but I hope you will be pleasantly surprised as you explore these new techniques. ETA: Pinky balls are great trigger point tools -inexpensive and effective. These are essentially the same balls that Jill Miller uses in her program. I get them for about $1 at the local toystore. |
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11-14-11, 10:46 AM | |
Join Date: Apr 2007
Location: Ellicott City, MD
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It sounds like you are on the right track with being aware of ROM and seeing your doc. Dr. Louis Pack is a podiatrist who sits on a Rheumatology board and works with a lot of athletes and patients with similar issues (diff in limb length). He wrote a book called The Athritis Revolution which I am currently reading for my SO who has lots of joint and Athritis issues.
Sorry to hear you going through all this but I also have to commend you on your strength and courage to keep working through and recovering from a tough accident. You are very inspiring and a wonderful role model . I hope the doctor has some good news for you. Keep us posted. |
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