Debilitating hip pain - looking for advice

[pdxharth]

Looking for any advice here, as I’m dealing with something new that isn’t going away.

I’m 52, with a 30 mile round trip commute to my teaching job that I do 3-5 times a week. About 2 months ago, I developed an aching soreness in my right hip. I ignored it, like most new pains, believing it would eventually cycle through (no pun intended). As the weather was nice towards the end of the school year, I consistently rode 5 days a week. The pain got worse. It bothered me off the bike so much that it limited my walking and kept me awake at night. But I didn’t necessarily feel less strong on the bike.

School ended and so did my daily ride. I was off the bike for three weeks due to a trip east. I ran instead of riding. The hip mostly healed, though a slight pain lingered. But I was moving in the right direction.

I could not think of anything I changed until I remembered I had moved my saddle forward about 5mm or so. I loved the new position, but I traced the hip pain back to around that time, so I felt certain it was the culprit. Problem solved?

Now I’m back home and back on the bike. I moved the saddle back to the original position and have only taken a few short rides. The pain has returned.

Any similar experiences? Any suggestions? I don’t even know what a doctor could do except tell my not to ride my bike, which is unacceptable, obviously. I made no other changes to the bike and have ridden in that position for many years. I’m at a loss and a bit worried. It’s not just the potential loss of this year’s summer riding that has me concerned, it goes past that at this point. Any info would be much appreciated.

Thanks,
Harth

[Bruce K]

I forget the full name and abreviation (FJI?) but you might want to get the hip MRI’d

If your fit is off, the repetitive motion of the shaft of your femur contacting the edge of your pelvis can cause a bone bruise, followed by calcium build up. This impinges on the joint, limiting full motion and causing lots of joint pain.

Sometimes fit adjustment can alleviate most of the discomfort. The extreme requires surgery where they chisel/grind off the build up. Followed by 6-8 week recovery/PT

Good luck

BK

[paredown]

I'm a great believer in also getting your alignment checked by a good chiropractor.

The times I have had hip pain riding or backpacking have been related to falls/car accidents, and where one side of my back has been tightening up to compensate, resulting in uneven leg length/un-level pelvis etc.

[FlashUNC]

See a sports med doc first.

[CSTRider]

The condition may be femoroacetabular impingement ... symptoms can come on suddenly and there are several possible underlying mechanisms. Here's a good explanation (https://orthoinfo.aaos.org/en/diseases--conditions/femoroacetabular-impingement/).

Bottom line: don't wait - get in to see a sports medicine orthopedic doc.

[Bruce K]

This ^^^^

Thanks CSTrider!!

BK

[pdxharth]

A quick search turned up FAI - Femoral-Acetabular impingement. That doesn’t look like fun. Damn. I need to get to a PT and get this figured out.

Thanks for the input.

I forget the full name and abreviation (FJI?) but you might want to get the hip MRI’d

If your fit is off, the repetitive motion of the shaft of your femur contacting the edge of your pelvis can cause a bone bruise, followed by calcium build up. This impinges on the joint, limiting full motion and causing lots of joint pain.

Sometimes fit adjustment can alleviate most of the discomfort. The extreme requires surgery where they chisel/grind off the build up. Followed by 6-8 week recovery/PT

Good luck

BK

[pdxharth]

Just saw this after I posted my previous response. Seems like we are on the same page.

The condition may be femoroacetabular impingement ... symptoms can come on suddenly and there are several possible underlying mechanisms. Here's a good explanation (https://orthoinfo.aaos.org/en/diseases--conditions/femoroacetabular-impingement/).

Bottom line: don't wait - get in to see a sports medicine orthopedic doc.

[bob heinatz]

I can't give you any words of wisdom but at age 65 I had pain in my left hip when I hiked with my wife. It only hurt walking uphill. No pain riding. I managed to walk thur the pain and it would become less painful the longer the hike. Today I am pain free on all hikes. It just went away, however I can't sleep on my left side w/o some pain and discomfort. PT sounds like a good place to start. Good luck.

[Marc40a]

Do you regularly foam roll, stretch or do compensatory exercises?

It could simply be a muscular imbalance.

My commute is 26 miles RT, and I went through the same thing a couple years ago.

After FAI and soft tissue issues were ruled out via XRay and MRI, I was put into physical therapy. That's done the trick. Though even now, I'll experience a little pain if I don't stay on top of my maintenance routine.

At first, it's going to seem like you've been robbed of 30+ minutes a day, but after awhile, you'll see it's an investment.

[Ralph]

Take any statin drugs? They can do that.

[BobO]

A tight IT band can cause pain in the hip.

[pdxharth]

Thanks. Let’s hope FAI is ruled out, but it does seem like I’ll need PT and a maintenance routine. I’m fine with that, especially if it keeps me on the bike.

And thankfully, no statins.

Do you regularly foam roll, stretch or do compensatory exercises?

It could simply be a muscular imbalance.

My commute is 26 miles RT, and I went through the same thing a couple years ago.

After FAI and soft tissue issues were ruled out via XRay and MRI, I was put into physical therapy. That's done the trick. Though even now, I'll experience a little pain if I don't stay on top of my maintenance routine.

At first, it's going to seem like you've been robbed of 30+ minutes a day, but after awhile, you'll see it's an investment.

[sailorboy]

I'd recommend you get your GP to refer you to a sports or ortho certified PT for starters, they will have SCS or OCS after their name and degree. I would also caution against concluding FAI or some other diagnosis until you see a professional. FAI can really only be made conclusively through imaging like xray or MR. Even then, say they find it on imaging, does that mean that is the cause of your symptoms? Could be an incidental finding, and you just have bursitis or something outside your actual hip joint that is causing pain. Medicine and in my experience especially sports medicine, is a soft science to be polite.

Bottom line, go to a professional before you make any decisions.

[Bentley]

Clearly I am no Doctor so I am not going to add to the potential causes of this "pain". I thought I had a hip problem and it turned out that it was something else. Get to a Dr. and give him the history of this "pain" when it started, what you were doing, blah blah blah. Might be its not your hip, but if it is then you will have someone competent to deal with the situation.

Best

Ray

[pdxharth]

Agreed on all counts. Thanks.

I'd recommend you get your GP to refer you to a sports or ortho certified PT for starters, they will have SCS or OCS after their name and degree. I would also caution against concluding FAI or some other diagnosis until you see a professional. FAI can really only be made conclusively through imaging like xray or MR. Even then, say they find it on imaging, does that mean that is the cause of your symptoms? Could be an incidental finding, and you just have bursitis or something outside your actual hip joint that is causing pain. Medicine and in my experience especially sports medicine, is a soft science to be polite.

Bottom line, go to a professional before you make any decisions.

[hainy]

Get a proper bike fit done before you see a doctor.

This should give you some answers on your asymmetry.

Has it been steadily getting worse?

Did your mileage increase?

Hip pain on a bike can mean you drop the left hip and the right one compensates. I had this problem with dropping my right hip and build up under my right instep fixed the problem in my left hip.

Stretch after every ride and foam roll.

[Tommasini53]

The condition may be femoroacetabular impingement ... symptoms can come on suddenly and there are several possible underlying mechanisms. Here's a good explanation (https://orthoinfo.aaos.org/en/diseases--conditions/femoroacetabular-impingement/).

Bottom line: don't wait - get in to see a sports medicine orthopedic doc.

+1 google the term, look over the symptoms and go see an ortho that specializes in hips. I had it, several physicians missed it. Got in front of an ortho at K.U. Med Center diagnoised in a couple minutes. good luck, get well.

[ahumblecycler]

My initial reaction is that the new position activated muscles in different ratios, and I recommend introducing "hip-opening" Yoga stretches. Google can return multiple suggestions.

While I am not a fan of the names, I incorporate multiple into my morning routine: half pigeon, thread the needle, happy baby pose, and bound ankle pose. The funny thing for me is that I did similar stretches as a kid in elementary gym class without the interesting names :p

[d_douglas]

I forget the full name and abreviation (FJI?) but you might want to get the hip MRI’d

If your fit is off, the repetitive motion of the shaft of your femur contacting the edge of your pelvis can cause a bone bruise, followed by calcium build up. This impinges on the joint, limiting full motion and causing lots of joint pain.

Sometimes fit adjustment can alleviate most of the discomfort. The extreme requires surgery where they chisel/grind off the build up. Followed by 6-8 week recovery/PT

Good luck

BK


I had this about 7yrs ago. My hip began aching and the ortho surgeon traced it to a number of earlier sports injuries, plus holding a baby on one side all the time :).

I had my femoral head resurfaced and torn cartilage repaired around my hip joint, then a few months of walking slowly and physiotherapy. He basically said I was doomed to have a hip replacement at some point and that this minor surgery was push this repair off for years, so I went with it.

I would see a sports doc (before a surgeon) and gather the extent of the damage. You might be able to solve this though physio rather than an invasive solution...

Good luck!

[oldpotatoe]

The condition may be femoroacetabular impingement ... symptoms can come on suddenly and there are several possible underlying mechanisms. Here's a good explanation (https://orthoinfo.aaos.org/en/diseases--conditions/femoroacetabular-impingement/).

Bottom line: don't wait - get in to see a sports medicine orthopedic doc.

Ya know, I was gonna say the same thing!!:)
But go see a sports doc..

[oldguy00]

I was diagnosed with CAM/FAI this past year. It is very frustrating and no easy fix.
With mine, it causes glute pain when riding or running, which then eventually travels down my hamstring. My glute on that side is also atrophied (sp?).

I try to manage it by doing strengthening of glutes, lower back, hams, etc.

So.....have your doc order an xray. They can diagnose CAM and/or FAI via an xray.
If the doc/radiologist suspects you could have a labral tear within the joint, they would need an MRI with contrast to confirm that.

Good luck.

[CNY rider]

To the OP:
While the inter webs have already made your diagnosis without ever seeing or examining you (imagine that!) it might be helpful to take a step back and ask you to define what you mean by “hip pain”.
Is it in your groin? Back towards your butt? On the side of your leg.

Then go see someone qualified to diagnose and treat you.
Hint: if they want an MRI without having laid their hands on and examining you, go somewhere else.

Good luck, I hope you get better.

[oldguy00]

To the OP:
While the inter webs have already made your diagnosis without ever seeing or examining you (imagine that!) it might be helpful to take a step back and ask you to define what you mean by “hip pain”.
Is it in your groin? Back towards your butt? On the side of your leg.

Then go see someone qualified to diagnose and treat you.
Hint: if they want an MRI without having laid their hands on and examining you, go somewhere else.

Good luck, I hope you get better.

Dude, I watch 'House' AND 'Greys Anatomy', so I know what I'm talking about.

:)

[merckx]

Have you purchased a new mattress recently, or slept on a bed that was not yours?

[pdxharth]

Thanks for all the advice, perspective, and words of wisdom.

I got in to see a PT yesterday. She seemed knowledgeable, more so as the exam went on.

She ruled out FAI due to the position of the pain and the results of her exam. That was a good start.

She suggest that my accident in November, with broken clavicle and ribs, followed by surgery, could also have played a role due to tightened muscles on that side.

She also noted my weakness with hip abduction, which I was aware of. That needs to be addressed. I am also quite stiff in my torso and hips, which I also knew. Running and lateral exercises have helped with this, but not enough.

So I have a regimen of strengthening and stretching exercises for a couple weeks, then a follow-up visit.

Most, maybe all, of these issues were things I already knew about, and the results of the exam and the prescribed exercises were things you people suggested would happen.

But what I still don’t understand, and maybe I don’t need to, is why this pain happened so suddenly? Other than sliding my saddle forward a few mm, there were no changes in distance or bike fit or technique, so why did it hit so hard, so suddenly? Was it just waiting to happen and the movement of the saddle triggered it? Could be.

Whatever. As long as I can get back on the bike, especially in time to begin commuting again in late August, that’s all I care about, even if it means missing out on some summer riding. Right now, I have to go run some errands...in the car.

Thanks again Paceliners. What an incredible resource!

Harth

[TomNY]

Suggest you reflect upon your pedal technique! It's very easy to fall out of good spinning and into a mash that pokes a bruise in the hip.

Try some "form" riding where you focus on spinning the right pedal / foot smoothly with little pressure.

Good luck

[ultraman6970]

OP, sure you dont have something else like kidney stones?? those things can irradiate pain in the weirdest places. That could explain why you feel weak.

[coreydoesntknow]

I had something similar happen to me this spring, out of nowhere. Any time I stacked more volume on I had an aching in my hip which seemed to come from a combination of the TFL and glute med, that would sometimes act up behind my knee sometimes to the point that I could barely walk. I got a hold of a local chiro who bridges the gap between a chiro and PT who concluded that I have an adhesion of the sciatic nerve in potentially a number of places which could be causing this. I've started a course of manual adhesion release which seems to be paying off in a number of areas other than just the hip pain, overall I just feel....fresher.

[oldguy00]

...I've started a course of manual adhesion release ....

Could you explain what you do for that? Thanks!!