You know those shirts that say, “Running sucks?” (Not with the question mark – that’s just the end of my question.) Last year, I believe Nike made shirts that said, “NOT Running Sucks,” which I believe is much more true to form. The first one is most likely meant to be funny, unless you’re an injured running and you’re all like, “NO IT DOESN’T, RUNNING IS THE BEST.”
And not running is what I did for five weeks, which was the opposite of fun. Ever since I got the flu and had to DNS the NYC Half, I put myself on a self-imposed running timeout. My groin and calf have been increasingly cranky as I increased my mileage for the half marathon, which I documented basically the day before I got the flu. I started seeing a sports medicine doctor (well, she’s a PA) and started physical therapy. Once I was out from the NYC Half, I realized I didn’t have any races coming up, so it would be a good time to take some rest. I took four weeks off after the NYC Marathon, and the pain in my groin and calf went away. I was able to start up running without pain other than my mind wondering if the pain was going to come back.
Of course, the pain did come back. The further I pushed my mileage, the more cranky my groin became. I hesitate to call it pain because it didn’t necessarily seem painful, it just felt different than my right groin. I can feel the movement and something doesn’t feel right, but it didn’t really hurt. Once my long runs got up to about 10-12 miles, I’d have more stiffness and an achy feeling down the front of my left thigh. Sometimes I’d have to go down stairs one at a time post-run, and it would sometimes hurt to walk. When the pain was really bad last spring, I had a lot of trouble with stairs and it would hurt to swing my left leg forward to walk. Time off fixed that – once in the spring and then again after the NYC Marathon – so I figured it would work again.
To be honest, I don’t remember how much discomfort I was in when I stopped running. I’ve been doing PT for about six weeks and threw in two deep tissue massages for my groin/quad and calf. Manual therapy at physical therapy involves working on my groin, hip flexors, IT band, butt, and calf. I can pinpoint the spot in my groin that hurts, and most of the time the pain stays just there – no radiation or any other spots with pain. I can feel it more (again, not pain, necessarily) when doing moves that required adduction. All of this makes me (and my PA and PT) believe it’s some sort of muscle weakness/imbalance/strain. The PT exercises don’t cause any more pain, and I’ve been doing them regularly.
Last week when I was in Boston, I noticed more discomfort when I was sitting. I also realized that I seemed to have discomfort all the time. I don’t know if that was a result of being surrounded by running and not being able to run, but I can feel my groin all the time. On the train coming back from Boston, it was really uncomfortable. I almost wanted to cry because it’s so frustrating – why is the discomfort getting worse when I’m doing what is supposed to be making it better? And I’m not even running!
On Tuesday last week, I had an MRI of my left hip with and without contrast. I’ve never received contrast before, so that made me nervous. (Also, the tech put a 24 gauge in my arm – where I work, and basically everywhere else, – you put an 18 gauge in. I asked about this and got a weird look. And you could definitely get an 18 gauge in my awesome veins, so that was confusing. Anyway.) The MRI was actually ordered by an orthopedic oncologist that I was suggested to go see, as my MRI from last year showed a small lesion on my hip. Basically every doctor thought it was nothing, but in case it WAS something, it’d be good to get it checked out. Although when I went to see the orthopedic oncologist, I felt a little sheepish saying, “No, I don’t have pain in my back. Yes, it hurts more when I move and stops when I don’t.” AKA, seems super muscular and not in the location of the lesion. But I got it checked out.
I went back to the orthopedic oncologist on Friday to get the results of my MRI. He brought in his NP with him, which made me a little nervous. (It’s like if you get a call that says, “Come in to get your results, and bring something with you,” because you’re about to get bad news.) The good news what that I don’t have cancer – not really suspected by anyone, but good news nonetheless. The lesion is the same size as last year, so that’s a plus. The bad news is that I have a tear in my labrum.
I wasn’t necessarily surprised. My pain hasn’t gotten better even with PT and rest, so if it was muscular, it should respond at least a little. All my googling said that a torn labrum was certainly an option. I just hoped it that wouldn’t be it, as I’ve read about runners having torn labrums and what the steps are to fix it. The good news of the labrum tear is that I have a “focal” tear, which means small in the medical world, so that’s a plus. The official reading was, “Focal tearing of the anterior superior labrum.” As the orthopedic oncologist said, “It could be worse,” (aka I could have cancer, which would be WAY worse) but he also referred me to an orthopedic surgeon who specializes in sports medicine and likes to work on hips. As he said, “I don’t really do this, so you should go see someone who does.” Well, obviously.
Like a smart/anxious runner, I made an appointment to see the sports medicine PA after getting my MRI results, so I headed over there. I started the appointment by saying, “Well, I don’t have cancer, so that’s good. But I do have a labral tear.” We talked about everything I said above – how I stopped running, did PT, don’t really feel better/maybe feel worse. She also recommended seeing the orthopedic surgeon, so that’s a plus to get two recommendations from two different people. (They’re all in the NYU network, so maybe that’s why, but it still seems positive.) She did a physical exam, and we both agreed that my pain seems so muscular, but it should have improved by now. Also, if you push on my groin, it’s right in the anterior position that causes the pain, so that makes sense.
We agreed to continue PT, which can’t hurt, except those copays are really starting to add up! She’s calling the radiologist to get a better read on my bone structure to get an idea of what my bones are doing and if that is related to why my labrum tore, which could also affect treatment options. (I also would like to add that I’ve been running for 19 years, so there’s some wear and tear for you.)
I’m seeing the orthopedic surgeon on May 3, so I’ve got some time to work myself up about what’s next. The one thing I appreciate most is that both doctors said, “If you weren’t a distance runner, we’d basically do nothing, but I assume you want to run for a long time.” I appreciate that they didn’t just tell me to stop running, which is what happened when I hurt my back four-ish years ago. From what I can gather, treatment for a hip labral tear includes:
- Physical therapy.
- Guided arthogram (to visualize the labrum and see extent of damage) with possible steroid injection.
- If the steroid injection doesn’t help with pain, surgery.
For some people, a steroid injection works wonders for pain management, and that is that. I had multiple steroid injections for a tear in the disc in my back (two in 2012 and two in 2013), and I haven’t had any problems since. It was magical. However, steroids don’t fix anything, so the problem is still there. If you’ve ever know anyone who has surgery for repair of their labrum, it’s quite an intense/long rehab. The surgery is generally done outpatient, but you’re on crutches for awhile, and the return to running can take about six months. Not that I’m necessarily worried about a long recovery since I haven’t run well in years, but I have a very physical job and have some life changes coming up that would complicate that. The positive of all of is that is that my tear is small, so on the scale of recovery, it wouldn’t be the worst.
But, per usual, I’m getting way ahead of myself since I haven’t even met with the orthopedic surgeon, and we haven’t discussed options and plans. However, I’ve been dealing with this for over a year, and I’ve done physical therapy and rested multiple times, so I don’t think it’s going away. We’ll see what he says and go from there.
In the meantime, in a whisper, I asked the sports medicine PA if I could run. If not running hurts more than when I was running, then I can run, right? She said running shouldn’t really make it worse, but to take it easy and not go crazy. I promised to not go out and run a marathon – not that I could anyway, since I’m crazy out of shape. Eric is doing some running, so I ran with him on Sunday – three miles at 9:35-ish pace, which was fine. My lungs felt better than my legs did! I ran by myself today – four miles on the bridle path to keep some softness under my feet, and I held an 8:38 pace. If only it felt as easy as that pace should, but I was so happy to be running I didn’t necessarily care. I can’t tell if my groin hurts more or less than a few days ago, but I can still feel it basically all the time. (I want to convince myself that it hurts less now that I’m running, but I don’t think that’s true.) I’ll run a couple more times this week, then off to the orthopedic surgeon and hope for the best!
I know a couple runners in blogland have had their labrum repaired. I’ve kept up with Grace, who had both hips done, and Elizabeth, who I was able to cheer on at Boston this year. Elizabeth has a post that outlines her entire diagnosis/surgery/recovery, which I’ve read about ten times. Both ladies are very accomplished runners, and they’ve been able to get back to running marathons, which obviously gives me hope. From other people who have had labral tears, I’ve gotten such a mix of answers. Some people had surgery and said it was the best thing they ever did (after the recovery, of course) and they were able to return to their activity. Other people didn’t have surgery and said I should do everything in my power to avoid surgery. I don’t know which is right since both had success, but I guess I’ll had to see what will work best for me. People advised that surgeons will be quick to cut, although I believe (hopefully rightfully so) that a good surgeon won’t jump to just do surgery. So we’ll see. Cross those fingers for me, I really just want to be able to run like myself again.
Has anyone had a hip labral tear? Do you have words of wisdom? Did PT work for you? Did you have surgery? Have you returned to your original activity? I want to know everything.