Hip / Groin Pain - Over a year later
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01-04-2023 4:07pm#1
I guess I am here to vent, more than anything else.
About 15 months ago, I went for a jog, did some yoga and woke up the following day with an annoying ache in my groin. It hasn't stopped since then. Some days it's manageable, some days there is a burning, intense pain. But it's constantly there.
I had been going to a PT for the previous few months, working on strength training to help with some core and hamstring issues. Full body work, but a lot of focus on the hamstrings, glutes, etc. The PT said to try a bit of running so I did. My hamstrings and glutes were screaming so I decided to stop, go home, and do some yoga.
The following day, I woke up with what can only be described as a dull ache right in my groin. It was constant. Standing, sitting, lying, exercising - it was always there. Luckily, it was about a 1 or 2 out of 10 in terms of pain. I thought I might have strained my groin so I rested for a while. But no amount of rest made the ache reduce or go away. I went to a physio, and got some exercises to build up the area around the groin (adductors, hip flexors, etc). No luck. The physio did a FADIR test and I failed on internal rotation - felt a bit uncomfortable rotating my knee inward - so potential hip impingement was diagnosed.
Weird thing was, I was able to do everything. Full depth squats, lunges, stretches of any kind, jogging/sprinting. I was able to do it all. But the ache was constantly there - sometimes going up and down in intensity. I went to another physio who said it couldn't be impingement. This physio said it was coming from my back; so off I went doing exercises for my back; deadlifting, etc. Months later, still the same. The physio checked for nerve issues and this was ruled out.
There were times when symptoms changed beyond a dull ache. I had covid and was stuck in bed for a few days ... When I was in bed constantly, the pain increased to a real intense burning in the groin and reduced again when I got out of bed. A lot of times, I felt discomfort in my outer hip (if you cup your hand into a C and put it on your hip - this area). At times I would feel something in the testicle nearest the groin pain. Other times I would feel a warm sensation in my inner thigh on the same side. These symptoms would come and go, but the ever present symptom was a dull ache in my groin. I had odd tingling sensations across my abdomen and a full week where I felt sudden urges to pee while in bed and nothing came out. This would occur for a few nights, then come back again a month or so later. I went to the doctor; who did blood, ultrasound and a nerve conduction test ... all clear. I thought I was going crazy ... as did a few of the people that I went to see!
The doctor referred me for an MRI of my hip joint and to a consultant who specialises in hip problems - made sense as most of the pain is here and it originated here. The hip MRI came back with nothing. The consultant was used to doing hip replacements for the elderly and didn't really know what to do with me so he referred me to do an MRI of my back in case it was originating there. It came back with nothing either.
Most of the time it didn't effect my physically, but there was times I had to stop activity as the pain just got a bit too high. On holidays I had to stop sightseeing as the pain went too intense. Also had to stop playing football with my nephew. I stopped going on long walks/hikes and I stopped jogging as I could feel it getting slightly worse as I ran. Oddly, there were other times that I walked an entire city sightseeing and it never got worse. Mentally though it was a nightmare, every time I did anything ... I was thinking about it as it was constantly there. I walked to work every day and spent the entire 15 minutes trying to 'understand' the pain or decide if it was better or worse than the day before.
I guess at this stage I had two options. Get on with life or continue to try and fix it. I was 36 and in my opinion, I was too young to just live with it. I took these scans and all the work I had done so far, and went to a Sports Consultant. Physical and MRI examinations were clear. Only thing to work on was breadcrumbs ... the MRI had very slight indications that my back needed work. So I was sent to a PT to build up my back strength. I was told to come back when I was able to deadlift above my bodyweight.
I went to a superb PT who started on the basics; arabesques, crab walks, hip hikes... before moving onto rack pulls and deadlifts. I went 1.5 times by bodyweight on rack pulls and about 1.1 times on deadlift. Only problem is that my symptoms got slightly worse. My gait was off a bit, poor range of motion and the groin pain had increased slightly. PT believed it might be a labral hip tear. I went back to the sports consultant who looked at all the data again. He gave me some facts on labral tears and impingement which indicate a reluctance to diagnose it - that people with a labral tear or impingement have no symptoms at all. He recommends an injection into the hip joint as a diagnosis tool. If there is something in the hip, I will get relief. If not, perhaps it's originating somewhere else. I liked the approach, its methodological, trying to rule things in or out.
The injection took place 10 days ago and the pain is now worse. Intense burning sensation in my groin, slight pinching when walking just above my groin (near abdomen), my leg feels fatigued, occasional weird tingly sensation in the sole of my foot and some discomfort in the outer hip and inner thigh. I completely rested for 5 days after the injection and pretty much felt as if the injection didn't happen at all. Then, the first sign of activity, and it's gone crazy. Since it flared up I have rested for a few days but it's not calming down. I am hoping it's the steroid kicking in and that it will improve soon.
I am trying to remember if I could have damaged the area; I do remember doing hill sprints and the same leg hitting uneven ground and getting pain in the front of the hip/upper thigh. This lasted a few weeks and went away. I would assume the MRI would have picked up something on it. Surely if its in the hip joint, the injection would be kicking in by now to numb it. The tingling sensations indicate nerve issues and/or back issues. Anyway.. I am just going around in circles!!
For now, it looks like another summer of looking out instead of being out.
Not looking for medial advice ... just venting, and hoping someone had similar issues and got it resolved. Thanks for listening!
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Only getting to this now. That sounds incredibly frustrating, you seem to have done your utmost to help yourself to no avail. I don't have the same issues as you but i have had a few MRI scans done and they've never picked anything up.. I've been told to focus on core work and hip flexor stretches which i try, though it's hard stick with the hip exercises as they create more pain but by degrees it's helping, just terribly slow.. I do hope you can resolve your problem, try not to let it take over your mind though, the mental block can be just as stubborn as the physical one. Keep us updated with how your summer goes..
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Thanks for the response - much appreciated. I think you have hit the nail on the head in two of your comments - spending 15 months trying to resolve a problem and getting nowhere is deflating - and the mental block is huge. When you have an ongoing ache, your brain goes into the overdrive 24/7 thinking if the pain today is worse or better than yesterday - or trying to find patterns with it (i.e., if I turn my knee outward when lying does it reduce the pain?).
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I presume your GP has checked you for a hernia? A groin hernia might cause such symptoms .. worth checking it out at this stage.
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Yes - this was checked also. I think they called it Gilmores Groin. It was ruled out.
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This is probably a bit late to comment but I was reading your post as I have been searching online re hip impingement and labral tears (I have both on both hips), to see how people managed symptoms etc. your symptoms are very similar to mine, I would have started getting hip pain almost two years ago while hiking,was also doing a lot of yoga at the time. It's been a very frustrating journey so far and it's going to be a while more before it's resolved but I suppose having a diagnosis is a start.
Hope you're doing better now.
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Hi olivecath,
For sure - having a diagnosis is a good start. How did you get this diagnosis? Did you do an MRI with contrast?
I still don't know for sure what is causing my issues. I have an upcoming appointment with the consultant and want to push for the MRI with contrast to see if it shows something up.
What are you doing at the moment? Are you seeing a consultant?
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Hi,
I had an MRI without contrast back in November,I have an appointment with an orthopedic consultant this month out in santry sports clinic. I'm hoping he will recommend surgery as conservative measures are not getting me very far at the moment and I'm a few months at it. Yeah maybe the MRI with contrast would show more, it's a pity it's dragging on so long for you. There has to be a root cause of the pain.
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Sorry to hear about your injury, its incredibly frustrating to be in this situation where it sounds like you have done everything and more that is advised to you. I cant offer any advice or solutions as I am in a very similar situation with a gluteal tendinopathy since March last year.
By way of background, I'm M/49 years old and would be primarily a runner. Prior to injury I was holding about 40-45 miles a week including races and club sessions. I have had my fair share of injuries over the years but this has been possibly the worse physically and mentally. Symptoms emerged in March which was preceded by a back strain in January but I was on the return to running in early Feb. I got COVID in March and took the week off a basically spend the week on the sofa, by the end of the week I started feeling soreness in hip especially when turning in bed. My physio diagnosed a gluteal tendinopathy and set out out a strengthening program while maintaining some level of running ( about twice a week). His approach was that rest or inactivity is detrimental to tendinopathy's so managing pain as long as it doesn't get any worse is key. I remained relatively active over the summer with a lot of cycling and gym classes with a couple of runs a week. I say the pain levels were about a 4-5 on the days that it was bad - maybe a 2-3 on good days. I was crippled getting out of bed during the night and first thing in the morning. I was generally good with my rehab - maintaining about 2 strength sessions a week.
While the pain in the hip was still there (especially in bed) I managed to get up to about 4 days running a week with gym classes and some cycling too. I did about consecutive 10 weeks in August/September/October of an average 25 mile so was feeling more positive about things despite still feeling pain in the hip. Disaster struck over the Xmas period where I had a severe flare up following a 14 hour flight. I ended up on crutches for 7 days of a family holiday to Australia where I have never experienced pain like this. Basically had to work on getting the inflammation down and managing the pain for the entirety of the holiday - its only today that I feel i have returned to 'normal' after nearly 20 days of pain and discomfort. The severity of the pain prompted me to get an MRI yesterday - for peace of mind that I didn't tear or damage something more than the glute tendon. I'm back with my physio tomorrow and I know he will advise we stick with the process and not see this as a setback and start loading the tendon again. However it has caused me to reflect deeply on the injury and see that it is impacting my mental health, my family life and my day to day functioning. If the pain continues to persist, or if I have another flare up, I am uncertain as to the best course of action.
Sorry no advice that will help your situation - only I understand your frustration and empathize . Dealing with chronic pain takes its toll. I wish you the best in finding a solution.
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Without contrast - that is interesting. I had an MRI already which didn't show anything... but everyone keeps telling me that it shows up best with contrast.
Can you please let me know how you get on after your appointment? I have a meeting at the end of the month with my consultant - will keep you informed.
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Thanks for posting!
It's funny, I used to hear about people with chronic pain previously and thought 'thats awful' and then moved on with my life. When it actually hits you it's a different story and you quickly learn to empathise more.
I completely agree on the mental health side - it just wears away at you! It's impossible to stop thinking/talking about it, which probably drives everyone that is around me crazy!
I guess there is only one thing we can do - keep going! Keep trying, keep searching for answers. Relief will come!
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Will do, good luck in the meantime!
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Hi olivecath,
Did you have your appointment in SSC? How did it go?
I had a follow up with my consultant last week. Had fresh MRI (no contrast) scans completed also and it looks like there is a labral tear in my hip. My consultant mentioned that just because there is a tear visible, it doesn't mean that my pain is coming from this tear. He has asked for another cortisone injection to see if pain reduces. If it reduces, then I would be a candidate for surgery.
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Hey, the consultant in SCC said both my hips need replacing, so a bit more dramatic than I thought but its and answer. Need couple more tests but basically looking into my options for the surgery, the cross border scheme is looking like a good option.
Hope you get relief from the steroid injection!
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just an update on my glute tendinopathy. Three days after posting this comment, I went to my physio who diagnosed nerve compression/pinched nerve in my back. He said the intense pain I was getting in my hip over the last three weeks was my sciatic nerve. A slump test confirmed this and the symptoms I was experiencing over Christmas stacked up with the symptoms of a pinched nerve. Prior to attending the physio, I had an MRI of the hips which didn't show anything on the site of where the glute pain is. The MRI showed Osteo Pubis however my physio told me to ignore this as I am not presenting any symptoms or reporting pain in the groin. Anyway I started rehabbing the back and did three solid weeks of rehab where the symptoms and pain cleared up completely. I did some cross training and wattbike work was feeling really good about things. I had a lingering low level pain in my glute which I put down to the preexisting injury. End of week 3 I did a 1 x min run/2 min walk by 10. I wasn't comfortable and the next day I felt pins and needles in leg and over the weekend my symptoms increased to experience exactly what I had at Christmas. This was very painful, couldn't walk for the best of two weeks and was waking with pain shooting down the leg. I had another MRI on the back and this showed disc herniation at L4/L5 irritating the sciatic nerve. The pain levels have dropped from an 8 to a 4 since the weekend and I can walk again. I had an appointment with a spinal consultant this morning confirming the disc herniation however he said the prognosis is good and don't meet the threshold for surgery (thankfully) and if I need an injection in the coming weeks if the pain hasn't subsided it available to me. So back to physio rehab again. I asked if the glute pain I was experiencing last year was my back and he said its highly likely that it was a back/nerve issue rather than a glue/buttock problem. Anyway key target now is never to experience a herniation again as it is severe and very disruptive to home/work/life. I will talk to my physio about best course of action to shift the focus on strengthening the back and getting to a level of training/activity that will be safe again.
TLDR: It wasn't a glue injury rather a back problem that resulted in a disc herniation.
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Thanks for sharing an update. It's great to hear that you are finding something that works for you. Being completely symptom/pain free must have felt amazing - even if it was just a short while! I am sure you still have a bit to go but its great that you have something that you know gives you relief.
Can I ask what kind of exercises you are doing for your back?
I had a recent appointment with my consultant, who did a new set of MRIs of my hips and back. The idea was to get the MRIs done and then go upstairs to the consultant who would have the MRI images for review. The consultant pointed to a potential labral tear in my hip and said the pain might be coming from that, but insisted that I should exhaust working on my hip flexor and back to rule them out as tears can often by asymptomatic.
A while later, I am able to see the official report PDF. It states mild/minor gluteal tendinopothy on both sides. The next line said that I needed to be recalled for the MRI as there was a lack of images taken to complete the report. I actually believe there is different MRI technology that can be requested to see different angles (not MRI with contrast - just a different configuration).
I went back - completed the hip MRIs - and the new report calls out that I have labral tear and cyst in my left hip. But it does not mention the gluteal tendinopothy that was mentioned in the previous, incomplete report.
The back MRI report mentioned disc bulging, but the consultant had mentioned that this is just wear and tear.
At least now I have a document that says that I have a labral tear - its something to point to!
My next steps are to continue working on my hip flexor and back to rule them out for once and for all. I am getting another injection to my hip joint to see if it improves things in any way - if it does then that means I am good candidate for surgery. If not, then it's a tough decision on next steps. What is making it even tougher is that my good hip is starting to act up now also.
TLDR: New MRI has shown a labral tear and cyst in my left hip. I must rule out everything else before considering surgery. My right hip is starting to become troublesome now.
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Hi I also have a pain from my left hip while and after running and it reduces the rotation of the lift leg which I find the left foot stamps on the ground.This is going on 2 years.I have always been light footed while running but since this hip issue I can be heard running a mile away.I have always ran in vaporfly 2 which I love and Alphafly 3 Vaporfly 3 and have tried other runners saucony Pro 3 and now boston adizero 12 to see if they could help but no difference.I went to physio a few months back they couldn't find anything but did suggest my left leg was weaker and gave me some glutes exercises as he used the needles on my buttock and got a sharp pain from the left one.The reason I put this up is to ask if anyone had an injury similar and did they find an answer to what it was.
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Yes it was great to feel some progress but the herniated disc this time really f'd me up. Extremely painful. Physio believes that there is a branch of the sciatic nerve that is very close to glute and this was irritating me last year rather than a tendinopathy
So the physio has set out a three month plan for me to progressively
- reduce pain
- build back and core strength
- return to running
At the moment (as there is still some pain radiating in back when I stand up) I am on the following set of exercise: Each exercise * 8-10 / 3 sets
Hip Flexor stretch;
Lateral Band Pull (kneeling on one knee and using a black resistance band to pull across body and out from body);
Plank (front/each side 15 sec without pausing between)
Squat with 6kg med ball/
Overhead chop w/ 6kg med ball/
Seated position band pull (both arms)
Press-ups.
Started doing 5k walks this week and I'm alot more mobile. I want to d some cardio work on bike so i hope to pick this up next week.
The consultant must think your disc bulge is just disc degeneration (i.e. getting old/in your forties). However, as someone who originally had the same diagnosis in 2015 I would mind that as you don't want that to change from a bulge to a herniation and irritating the nerve.
Hopefully you can isolate the pain further now and attend to the labral tear - I assume physio is the conservative option here.
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Sorry mate - I am not sure if what we have is the same. Hip pain is so difficult to understand. It's a complex area - the pain could be coming from a number of different places. I would make a list of possible causes and start ruling them out one by one (with the help of a healthcare professional).
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Sorry to hear the disc is really painful. I hope the exercises can give you some relief.
I get your point on my bulge becoming herniation - I have always had some discomfort in my lower back for years. Movement helps me a lot, but with the hip pain I don't move as much.
I have a cortisone injection for my hip on Tuesday to see if I can see a change and I am continuing to do exercises religiously so will see how it goes.
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I've been having intermittent pain in my left hip for 5 or 6 years. Have had MRIs done and there is no degeneration and went to 3 or 4 different physios and none of them could get to the bottom of it. At the end of last year when I was particularly crippled with it, I went to a sports physio and he told me it was most likely weakness in my hip flexor muscle which basically connects from the small of your back, and down your leg.
He set me on a program of exercises to build up strength / muscle in my lower back, nothing too intense and only once or twice a day, program was as follows
Bird dogs x 20
Dead bugs x 20
Hip bridges (5 second hold) x 10
Heel walkouts x 10
Haven't had any issues whatsoever in the last 3 months thankfully.
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