Struggling to heal from hip injury

[dumpmutt]

Had a hip injury about 6 months ago and struggling to identify what happened and how to move forward.

Background:

• 37-year-old male with 5 years of weight training experience.
• For a month before the injury, experienced left hip tightness and shin pain post-back workouts. Increased stretching and used Theragun, which provided temporary relief. Continued training normally with progressive overload.

Injury Event:

• Achieved a personal record in deadlifts, felt no pain during the lift.
• Reduced intensity for accessory exercises post-PR. During the last exercise, seated cable rows, felt a crunching or pulling sensation in the left outer hip and sharp pain radiating down the leg.
• Post-workout, experienced intense sciatic pain and hip muscle pain, worsening with sitting or lying down. Initial self-care with ice, heat, and ibuprofen provided minimal relief.

Initial Management and Recovery:

• Self-Care: Engaged in hip rehab exercises, core strengthening, and used TB500 which seemed to aid in recovery.
• Recovery Progress: After about a month, the ability to sit normally returned, and most pain diminished.

Reinjury and Current Condition:

• After a 12-day break (vacation), resumed training cautiously the first few weeks. Felt similar pulling sensation and sciatic pain while picking up dumbbells, resulting in a worsened condition.
• Sciatic pain became more severe this time, with initial treatments less effective. Primary care physician diagnosed a hip strain and ruled out disc issues. Advised high-dose ibuprofen and topical capsicum along with existing rehab work and stretching.

Current Status and Concerns:

• Ongoing issues with hip hinge movements, significant weakness in squats and deadlifts. Almost all lifts are back to where they were prior to injury inluding leg accessories, other than anything with hip hinge which feel unstable and very weak. Squat and deadlift struggling to get 5 reps at a weight I could rep for 10 four years ago. Even the light warmup weight on those compounds doesn't feel right, the hip just doesn't feel the same. Wanting to slowly add back in those lifts but worried about reinjury. Aware it will take time for those lifts to come back and nerve injuries take forever to heal, just wanted to hear from anyone else who dealt with this before, what the prognosis was and what you did that helped.

 

[AlexDavis43]

Had a hip injury about 6 months ago and struggling to identify what happened and how to move forward.

Background:

• 37-year-old male with 5 years of weight training experience.
• For a month before the injury, experienced left hip tightness and shin pain post-back workouts. Increased stretching and used Theragun, which provided temporary relief. Continued training normally with progressive overload.

Injury Event:

• Achieved a personal record in deadlifts, felt no pain during the lift.
• Reduced intensity for accessory exercises post-PR. During the last exercise, seated cable rows, felt a crunching or pulling sensation in the left outer hip and sharp pain radiating down the leg.
• Post-workout, experienced intense sciatic pain and hip muscle pain, worsening with sitting or lying down. Initial self-care with ice, heat, and ibuprofen provided minimal relief.

Initial Management and Recovery:

• Self-Care: Engaged in hip rehab exercises, core strengthening, and used TB500 which seemed to aid in recovery.
• Recovery Progress: After about a month, the ability to sit normally returned, and most pain diminished.

Reinjury and Current Condition:

• After a 12-day break (vacation), resumed training cautiously the first few weeks. Felt similar pulling sensation and sciatic pain while picking up dumbbells, resulting in a worsened condition.
• Sciatic pain became more severe this time, with initial treatments less effective. Primary care physician diagnosed a hip strain and ruled out disc issues. Advised high-dose ibuprofen and topical capsicum along with existing rehab work and stretching.

Current Status and Concerns:

• Ongoing issues with hip hinge movements, significant weakness in squats and deadlifts. Almost all lifts are back to where they were prior to injury inluding leg accessories, other than anything with hip hinge which feel unstable and very weak. Squat and deadlift struggling to get 5 reps at a weight I could rep for 10 four years ago. Even the light warmup weight on those compounds doesn't feel right, the hip just doesn't feel the same. Wanting to slowly add back in those lifts but worried about reinjury. Aware it will take time for those lifts to come back and nerve injuries take forever to heal, just wanted to hear from anyone else who dealt with this before, what the prognosis was and what you did that helped.

I see you referenced your PGP (good!) but further studies were not advised. Like an MRI or EMG.

Maybe consider seeing a specialist.

 

[RekTest]

I havent had a hip injury, Ive only had a wrist/hand injury and in my instance I completely stopped the gym to let it heal the fastest

If I was in your shoes, not knowing exactly what the cause is I would jump on hgh/bpc/tb500, get an xray and MRI. Go to a sports clinic.

 

[egruberman]

Sounds like bog standard herniated disc to me. ~3g/day of ibuprofen for a week may calm it down.

 

[RandallFlagg]

Had a hip injury about 6 months ago and struggling to identify what happened and how to move forward.

Background:

• 37-year-old male with 5 years of weight training experience.
• For a month before the injury, experienced left hip tightness and shin pain post-back workouts. Increased stretching and used Theragun, which provided temporary relief. Continued training normally with progressive overload.

Injury Event:

• Achieved a personal record in deadlifts, felt no pain during the lift.
• Reduced intensity for accessory exercises post-PR. During the last exercise, seated cable rows, felt a crunching or pulling sensation in the left outer hip and sharp pain radiating down the leg.
• Post-workout, experienced intense sciatic pain and hip muscle pain, worsening with sitting or lying down. Initial self-care with ice, heat, and ibuprofen provided minimal relief.

Initial Management and Recovery:

• Self-Care: Engaged in hip rehab exercises, core strengthening, and used TB500 which seemed to aid in recovery.
• Recovery Progress: After about a month, the ability to sit normally returned, and most pain diminished.

Reinjury and Current Condition:

• After a 12-day break (vacation), resumed training cautiously the first few weeks. Felt similar pulling sensation and sciatic pain while picking up dumbbells, resulting in a worsened condition.
• Sciatic pain became more severe this time, with initial treatments less effective. Primary care physician diagnosed a hip strain and ruled out disc issues. Advised high-dose ibuprofen and topical capsicum along with existing rehab work and stretching.

Current Status and Concerns:

• Ongoing issues with hip hinge movements, significant weakness in squats and deadlifts. Almost all lifts are back to where they were prior to injury inluding leg accessories, other than anything with hip hinge which feel unstable and very weak. Squat and deadlift struggling to get 5 reps at a weight I could rep for 10 four years ago. Even the light warmup weight on those compounds doesn't feel right, the hip just doesn't feel the same. Wanting to slowly add back in those lifts but worried about reinjury. Aware it will take time for those lifts to come back and nerve injuries take forever to heal, just wanted to hear from anyone else who dealt with this before, what the prognosis was and what you did that helped.

I have had sciatic-like pain and excruciating lower right back pain for over 20 years. I had issues with everything you mentioned but mostly I spent 20 years suffering and accepted it because I had to "survive life" and just kept focusing on school, career, family (rather than fitness since nothing was comfortable to do).

I saw every specialist you could imagine. I had at least 5 MRIs (of my back only)...if you can think of the specialist, I saw them

I went to at least 6 different PT places. I tried every therapeutic intervention you can think of. They have me over 10 steroid injections in my back with zero improvement.

I finally hit a point of barely being able to function and took medical leave from my job for 1 year. During that time I self diagnosed myself with a hip labral tear. Turns out I likely had it since I was a child...and my body was just used to compensating.

No ONE had suggested that could be an issue. I got an MRI...had surgery...I would estimate 11 months out of surgery and I am 40% better and of course back at work and at least functional again. I am optimistic I will be able to continue improving for the first time in my life. I am stunned that doctors let me flail like that for most of my life and never even suggested my hip could be the problem.

Long story short, get an MRI. You're odds of a successful outcome and recovery are waaaay better with faster intervention (not saying you specifically have a hip labral tear....and opinions vary on the success of hip labral surgery but mostly fuck opinions...lol).

Thank you for attending my TED talk. Good luck!

 

[buck]

I go to Ortho sports Medicine surgeons to deal with spine/skeletal issues. I find they are more knowledgeable. When things can't fix themselves i get a surgery to do it. And am not sorry about the ones i have had.

 

[dumpmutt]

Sounds like bog standard herniated disc to me. ~3g/day of ibuprofen for a week may calm it down.

Doc had me do some tests to rule that out, spine articulation doesn't cause symptoms, just hip movements. They did imaging on spine also, everything looked good.

 

[RandallFlagg]

Doc had me do some tests to rule that out, spine articulation doesn't cause symptoms, just hip movements. They did imaging on spine also, everything looked good.

I'm glad you trust your PCP.

However, I strongly agree with the suggestion to see a sports medicine Ortho.

What kind of imaging was done? If an MRI, you will need to explicitly confirm they imaged the hip (which would almost always be a completely separate study/ separate MRI).

Not sure if you are in the USA or not ...but you would be stunned at the level of misdirection and lack of actual investigative "doctoring" performed. Sadly, I have found you have to narrow down your own diagnosis...and figure out which specifics tests to ask your physician to order in order to rule in or out a problem.

I have a medical background. This still turned out to be an onerous task for me because I spent my life caring about other people's problems and not focusing on my own...until I couldn't function anymore to perform my profession..and then had the time to expend that effort on myself.

As already suggested, an EMG would also be a great idea....but you would probably need to go to a neurologist to have this done thoroughly and competently (assuming you find a neurologist who will care enough to not blow you off for another 6-12 months).

 

[RandallFlagg]

I will also say that I am not trying to push an agenda or be so insistent on pushing a diagnosis on you. You sound waaaay ahead of me functionally so you have a much sounder base and knowledge of your body and how to push forward.

If additional testing is not your desire, I will share things that have helped me the most and maybe a little 'outside the box'.

- Pilates (don't judge...lol) yeah, I'm literally my instructor's only male participant but it has been amazing at identifying areas of weakness and addressing in a low impact (but not easy way).

- Postural restoration: you can look up Connor Harris on YouTube for some ideas (though he is controversial in that he sorta re-packages the concept as his own ideas even though there is a legit postural restoration institute...just hard to find instructors everywhere).

- Ketamine infusions; they were extremely expensive but worth every penny (hated them...but they are least helped my mental health and if I could have afforded more sessions eventually I would have gotten to a dose high enough to have major analgesic effects.

- Acupuncture: (this is obviously very controversial...but I'm not some quack...it helps...if nothing else it may help reveal some.trigger points that you didn't realize existed.

- MELT method (check YouTube)....this will also make you think I'm a chick or gay (or both...which is fine with me) but I can tell you it helps me.

- Neubie Neufit (game changer...but hard to find someone skilled in this with a machine).

- HGH at 2 IU q 12 h has helped...but I think it mainly help with fat loss. I couldn't tolerate BPC (anhedonia). NPP and Deca were given brief runs as I was desperate for joint pain relief but I couldn't tolerate the apathy and side effects (probably because I'm too fat still to dabble in these compounds effectively)

Thinks I'm still considering trying: Pentosan...but I'm short on $$ right now.

 

[egruberman]

What kind of imaging was done? If an MRI, you will need to explicitly confirm they imaged the hip (which would almost always be a completely separate study/ separate MRI).

I've had hip pain for over a decade and once went to one of the top Sports Ortho clinics in the country. Saw a hip person, happened to mention that I'd had a problem with sciatica, so she ordered an MRI. Roughly $10k later, 10% of which I was on the hook for, I was sitting in front of the spine guy telling me about the bulging disc I knew I had and nothing about the hip pain. I was furious.

Doc had me do some tests to rule that out, spine articulation doesn't cause symptoms, just hip movements. They did imaging on spine also, everything looked good.

I wouldn't say that sciatica is linked to spine articulation and not hip movements. Any pelvic tilt, posterior or anterior might trigger an impingement on the sciatic nerve. Tightness in any number of muscles, hamstrings, glutes, adductor, iliopsoas might cause pelvic tilt during hip movements.

Not that I disagree, necessarily, just that it's possible, but the imaging should rule out a bulging disc. Who interpreted it?

You mentioned "sciatic pain" but I'm curious if the pain radiates down your leg or is localized in your glute?

I had a similar problem a couple years back, well after the aforementioned spine MRI debacle. During a deadlift I felt something go and had some incredible hip pain. I couldn't walk correctly for quite some time and reinjured it several times. Got an MRI of the hip this time, discovered a torn labrum, set up an appointment with the best person I could find that does labral reconstruction.

An amusing tangent was that where I live near SF, it's hard to get an appointment with any kind of medical professional in a reasonable period of time. I was expecting something at least six months out. When I called they offered me the date of the following Tuesday to which I responded, "this year?"

So I booked the appointment, met with the surgeon who confirmed that I had a labral tear, just like everybody else my age and that the pain I was presenting didn't suggest surgical intervention.

I was astounded, here was a surgeon that didn't want to cut me open, and moreover, very explicitly took the time to patiently sit and answer all my questions thoroughly before zipping out of there.

And now for the reason I'm typing this wall of text and hopeful that this might be helpful: They gave me a corticosteroid shot guided by ultrasound to do a differential diagnosis. If done correctly, the shot would temporarily relieve the symptoms and indicate the problem was in fact, in the hip joint. They did and it wasn't.

My best guess at this point is gluteal tendinopathy which also showed up on the MRI and is probably the thing that's been causing me hip issues for a decade.

 

[dumpmutt]

I wouldn't say that sciatica is linked to spine articulation and not hip movements. Any pelvic tilt, posterior or anterior might trigger an impingement on the sciatic nerve. Tightness in any number of muscles, hamstrings, glutes, adductor, iliopsoas might cause pelvic tilt during hip movements.

Not that I disagree, necessarily, just that it's possible, but the imaging should rule out a bulging disc. Who interpreted it?

You mentioned "sciatic pain" but I'm curious if the pain radiates down your leg or is localized in your glute?

So the pelvic tilt is interesting to bring up. I definitely have anterior pelvic tilt, it's gotten better in the last few years with exercise and posture correction, used to be a lot worse. It does seem like an impinged nerve. And tightness in the muscles you named is a certainty for sure.

PGP interpreted the x-ray and said there was no issue with spine or discs.

The sciatic pain does radiate down my leg. It is mostly from the knee down to ankle. No foot pain or numbness. The first month and a half after each injury I was unable to sit or lay down at all without serious pain. Standing or walking there was no pain, but I was unable to run or even jog at all. I don't have nerve pain in my glute/hip. The pain there is muscular, almost feels like a big welt or bruise. I typically pin oils in VG and the injured side feels very much like a bad injection or a large volume injection that hasn't fully absorbed. It's an odd sensation. No real visible swelling though, it's just a feeling.

 

[egruberman]

PGP interpreted the x-ray and said there was no issue with spine or discs.

I don't want to come off as being contentious, there's a lot here that I don't know, but I'm dubious that a PCP could rule out a bulging disc with an x-ray. Typically, that takes an MRI and a spine specialist.

The sciatic pain does radiate down my leg. It is mostly from the knee down to ankle.

This has me again thinking that a bulging disc is more likely. My money is on L5/S1. At the very least, something is irritating the sciatic nerve.

Other than a bulging disc, there's a couple of things that could irritate the sciatic nerve. Here's an anterior view of the left sciatic nerve:



This image is the view under the gluteus maximus. The piriformis runs horizontally there over the sciatic nerve and the hamstring does as well near its insertion point on the hip. Inflammation in those tendons can cause sciatic pain. Piriformis syndrome is fairly common and with the resultant nerve pain can cause the hamstring to tighten up and join the party.

Regardless, I think a orthopedic specialist is probably the next step.

 

[dumpmutt]

I don't want to come off as being contentious, there's a lot here that I don't know, but I'm dubious that a PCP could rule out a bulging disc with an x-ray. Typically, that takes an MRI and a spine specialist.



This has me again thinking that a bulging disc is more likely. My money is on L5/S1. At the very least, something is irritating the sciatic nerve.

Other than a bulging disc, there's a couple of things that could irritate the sciatic nerve. Here's an anterior view of the left sciatic nerve:

View attachment 295675

This image is the view under the gluteus maximus. The piriformis runs horizontally there over the sciatic nerve and the hamstring does as well near its insertion point on the hip. Inflammation in those tendons can cause sciatic pain. Piriformis syndrome is fairly common and with the resultant nerve pain can cause the hamstring to tighten up and join the party.

Regardless, I think a orthopedic specialist is probably the next step.

Thanks, this is great info. Will find and schudule a visit with an orthopedic.

 

[RandallFlagg]

I don't want to come off as being contentious, there's a lot here that I don't know, but I'm dubious that a PCP could rule out a bulging disc with an x-ray. Typically, that takes an MRI and a spine specialist.



This has me again thinking that a bulging disc is more likely. My money is on L5/S1. At the very least, something is irritating the sciatic nerve.

Other than a bulging disc, there's a couple of things that could irritate the sciatic nerve. Here's an anterior view of the left sciatic nerve:

View attachment 295675

This image is the view under the gluteus maximus. The piriformis runs horizontally there over the sciatic nerve and the hamstring does as well near its insertion point on the hip. Inflammation in those tendons can cause sciatic pain. Piriformis syndrome is fairly common and with the resultant nerve pain can cause the hamstring to tighten up and join the party.

Regardless, I think a orthopedic specialist is probably the next step.

Totally agree with your skepticism. I had 2 orthopedic surgeons, 3 different PT locations, an exercise physiologist, a neurologist, and 2 different pain management groups all tell me it was 100% sciatic nerve pain from a lumbar disc.

I finally found a neurologist (totally private practice) spend 90 minutes evaluating me and sharing my EMG results and Nerve conduction velocity tests...which all proved my sciatic nerve was functioning perfectly and not likely the actual source of pain,

I then politely argued with a neurology, traced out my pain which went all the way down to my OUTER toes....and unsaid 'this isn't the pathway of the sciatic nerve...it should cross over to the inside toes." He said "huh, you're right.... let's try some more nerve blocks that have done nothing to help you." Lol

 

[egruberman]

I then politely argued with a neurology, traced out my pain which went all the way down to my OUTER toes....and unsaid 'this isn't the pathway of the sciatic nerve...it should cross over to the inside toes." He said "huh, you're right.... let's try some more nerve blocks that have done nothing to help you." Lol

That's incredibly frustrating and disturbing. It's basic fucking anatomy that your doctor should know, clear evidence that he's checked out.

The state of medical care in this country is rough.

 

[dumpmutt]

This has me again thinking that a bulging disc is more likely. My money is on L5/S1. At the very least, something is irritating the sciatic nerve.

Regardless, I think a orthopedic specialist is probably the next step.

Saw orthopedist today and he agreed with your view, this is a lumbar spine issue and not hip. He ordered an MRI but my insurance won't approve until they get new x-rays so got those done today. Just wanted to share the radiology findings because they pointed out L5/S1 as you said. Thank you again.

 

[dumpmutt]

Got MRI results back today but waiting to hear back from orthopedic doc. Looks like 3 herniated discs and a compressed L4 nerve root. You guys were right.

L3-L4: Left central disc extrusion with inferior migration that contacts the traversing left L4 nerve roots. Prominence of dorsal epidural fat. Ligamentum flavum infolding. Left subarticular zone narrowing. Moderate spinal canal narrowing. Mild bilateral neural foraminal narrowing.

L4-L5: Disc bulge. Mild bilateral, left more than right facet arthrosis with trace facet joint effusions. Prominence of dorsal epidural fat. Ligamentum flavum infolding. Moderate spinal canal narrowing. Mild bilateral neural foraminal narrowing.

L5-S1: Central disc protrusion. Mild bilateral facet arthrosis with trace facet joint effusions. No spinal canal or foraminal narrowing.

 

[Laxman3221]

Epidural Cortizone injection will help, but you need to stop dead lifting and squatting.

I go get a 50 minute stretch a week and that stopped my back pain after last injection. I had very tight hip that caused my hip to rotate forward compressing the disk.

 

[dumpmutt]

Epidural Cortizone injection will help, but you need to stop dead lifting and squatting.

I go get a 50 minute stretch a week and that stopped my back pain after last injection. I had very tight hip that caused my hip to rotate forward compressing the disk.

I don’t have much pain from this anymore so I am surprised there’s so much going on in the MRI 7 months after the injury occurred. But the sciatic pain I had initially and for the first few months was the worst I’ve ever had from any injury.

Sucks to hear about deads and squats because those were my best lifts but I suspected this would be the case.

I had some anterior pelvic tilt and I think hip rotation during compounds may have caused this too. I never used a belt and was deadlifting 475 for 8 reps, squatting 375 for 8. The day the injury occurred I pulled 405 for 14 reps.

 

[dumpmutt]