Tuesday, February 2, 2016

My Hips Are OK. My Glutes ... Not So Much.

Welcome to another episode of “The Continuing Saga of David’s Legs.”  In our last episode, David went to the doctor with two problems and came home with three or four problems.

To recap, last week we discussed the stiffness and cramps in both of my legs and the groin injury in my right leg.  I didn’t learn anything new about the stiffness and cramps.  I had several blood tests, but they all came back normal.  The doctor agreed that it might be a worsening of my Raynaud’s Syndrome, but we didn’t know for sure.

As for the groin injury, my X-rays suggested that I might have arthritis in my pelvis. The X-rays also revealed an abnormality in the shape of my femur.  That raised the possibility of problems with my hip joint as well.

It’s funny how the power of suggestion can work.   Before that visit, I felt discomfort in both legs, but it all seemed related to stiff, weak muscles and poor flexibility.  After that visit, I was suddenly conscious of discomfort in my hips.  I had to wonder.  I had been running with an abnormal stride for several months.  Did I damage my hips?

On Monday, I had an MR arthrogram on my right hip.  I originally wanted to know if tore something in my right groin, but this test would also show any soft tissue damage in my hip.  I got the impression from the doctor and technicians who prepped me that they all expected to discover a torn labrum.  The labrum is a thin layer of cartilage that lines the inside of the hip joint.  It helps maintain an appropriate spacing between the bones.
An MR arthrogram is a series of MRIs of the area around the hip.  First they injected a contrast medium into my hip.  The injection also included pain killers and a saline solution.  Before they started, I was told to notice how my hip felt after the procedure.  Simply injecting the fluids can reduce hip pain temporarily.

After that, it took about 40 minutes to take the images.  During that time, I had to lie perfectly still inside a cramped imaging chamber.  It took several minutes for each image, and if you move, they come out blurry.  I don’t recommend this procedure if you’re claustrophobic or have trouble sitting still.

For what it’s worth, my right hip did feel better after the procedure.

Today, I had a consultation with an orthopedist.  We discussed the history of my groin injury, and she put me through several tests of the muscles in my right leg.  Then we went over the results of the MR arthrogram.  There was good news and bad news.

I’ll start the good news.  The arthrogram didn’t show any major tearing.  In particular, my hip is OK.  One of the images showed a small partial tear in my labrum, but apparently that’s normal for someone my age.  The orthopedist seemed surprised that I ran as many races as I did without having more damage.  My hip isn’t perfect, but it's not a problem.

Now for the bad news.  In addition to pain and weakness in my right adductor and tightness in my hamstrings, I also have almost no strength in my glutes.  I have a condition called tendinopathy, which renders my tendons almost ineffective.  I’m not sure if the muscles are weak, but they aren’t able to do me much good.  Your glutes are among the strongest muscles in your body, but the orthopedist could move my leg using only two fingers, and I was completely unable to resist the movement.  Trying to resist was painful.

It made me nervous when she asked me to hop a few times on only my right leg.  I was afraid that would really aggravate the pain in my adductor.  She didn’t seem concerned.  Since the appointment, I’ve been feeling soreness there, but maybe it’s just the soreness that comes from overusing a weak muscle.

I’m going to begin physical therapy again.  The earliest appointment I could get was February 16th.  After that, I’ll go once a week.  I’ll have a therapist who works with runners.  I’ll also have a running evaluation.

For now, I’ve been cleared for swimming, biking or elliptical.  I’m supposed to hold off on running until I get the OK from my therapist.  I’ve already been doing short bike workouts with light resistance.  I’ll continue those.  I don’t belong to a gym, so swimming and elliptical training aren’t as accessible for me.

I’ve already cancelled plans for two marathons in February.  Those were races I scheduled almost a year ago, when I was healthy.  I don’t have any other races until the Boston Marathon in April.  To do Boston, I would probably need to begin running in early March.  I don’t expect to be in shape.  I just want to get in a little running, so I’m able to finish the race.  The orthopedist thought that schedule sounded reasonable.

She couldn’t tell me much about my stiffness and cramps.  After reviewing my test results from last week, she ordered two more blood tests.  Today they tested my calcium and vitamin D levels.  My calcium level was normal.  I’m still waiting for the result of the vitamin D test.

My hope originally was that my stiffness and cramps would go away if I could return to my previous activity level.  That’s still the plan, but it’s going to take time.

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