On the Mend

The new year is here and with it a lot of changes. As I briefly stated in my last entry, for the past few months I've been dealing with a hip injury. It started after my last triathlon. I was running more on the treadmill, trying to squeeze in workouts as best as I could. Hip pain would flare up soon after a run. I would stretch all sorts of ways, but nothing could stop the pain or burning. An hour or so after running on the treadmill 4mi I was limping so badly I could hardly walk. The next day I called up my physical therapist.

After a month of seeing no improvement I went to an orthopedic. At first the doctor told me to go to a gynecologist because he thought I had a hernia. He seemed to be taking guesses for a diagnosis. (BTW - he's a horrible doctor and I wouldn't recommend him to anyone.) He was about to leave when I asked, exasperated that I was losing my one chance at getting a physical therapy prescription, "WHAT ABOUT THE SNAPPING?!" He came over and said he didn't feel any snapping. So I rotated my leg the way I had learned that makes it snap, and it did, painfully. My eyes shut and my face tightened in pain. He looked down at me, unamused. "Ok. You have "Snapping Psoas Syndrome". Uh. What?

Well he was no help really explaining it so I did a ton of Google searching after I left his office. The smart explanation via http://emedicine.medscape.com:

(photo from : www.arthroscopichipsurgeon.com)

"The most common cause of a snapping hip is the iliotibial band snapping over the greater trochanter. This may be associated with trochanteric bursitis or with increased varus of the hip. The finding of a tight iliotibial band is common. Sudden loading of the hip (eg, landing after a jump) may reproduce this sensation of the iliotibial band subluxing over the greater trochanter. With sudden loading, the hip typically is flexed, causing the iliotibial band to move anteriorly followed by the tendon snapping backward as the individual recovers and extends the hip."

Basically, there's a muscle in my hip snapping over another muscle. The causes of SPS (BTW - Snapping Psoas Syndrome is also known as Snapping Hip Syndrome) are varied. My amazing physical therapist over at Excel Physical Therapy in Hamden, CT had the same injury from running and training for half marathons. Mine is an overuse injury as well. It's a bitch, but with a lot of work, is treatable. The added bonuses I had to make this ordeal more painful was 1. Hardly any hip flexor strength, and 2. Scar tissue developed in my groin to make up for the lack of hip flexor strength. I can think back over the years and remember all the times I stopped or skipped an exercise that dealt with hip flexor strengthening. Every time I tried these particular exercises my hip felt like it was grinding and snapping, the feeling made me nauseous as it was so strange.

It seems logical when you feel pain or grinding/snapping you would respond by stopping. Stopping turned out to be the exact wrong thing to do in this situation. I should have pushed forward, built up some hip flexor strength and I wouldn't be in this mess. Hindsight = 20/20. So I've been building up strength, little by little, and the snapping is less persistent. The constant burning feeling (which was bursitis) has lessened a great deal. My PT has broken up the scar tissue over the past few weeks with ultrasound and scraping (yes, scraping) at my groin with an object that looks like a wrist bone. As much progress as I've made, I still have to keep working at strengthening and stretching my hips before I can run. I have been going on the elliptical and today started a month trial of Bikram yoga.

Other than all that, this week is my first week of grad school. I'm going to the New School in New York City to obtain an MA in Media Studies. For now I will be staying in New Haven and commuting once a week into the city. My job has kept me on part-time, and I can't say enough how thankful I am that my company has been supportive of this decision.

Great blog post on helpful tight psoas exercises:
Low back pain while running... a real pain in the butt

Yoga Journal article 'Get Hip' which goes over some hip stretching poses, such as pigeon (shown above).