Aggravated Hip

Hip update- no fracture.  YAY!!!!  I finally got in to the doctor today and we looked at the MRI.  There is no obvious fracture, which is great.  There is a lot of edema in my hip that is more diffuse than a typical greater trochanteric bursitis, but there are no obvious tears on the MRI.  So,  basically, I have a edema from my posterior hip and lateral hip that covers a much larger section than is typical.  He sent my MRI to a conference this weekend to have a sports specialist in radiology review it, but they ran out of time.  We can't really figure out the mechanics of it, and the area is pretty large, so something else is going on but it is just not clear from the imaging.  I don't present with typical bursitis (although I would say this is more bursitis than anything per MRI)- you can push on my bursa and there is not specific pain.  He doesn't think I have piriformis syndrome or injury because we can mash on that, and I am okay.   My SI joints and spine look okay on MRI (although they don't feel great- thanks to my new mom body).  So, whatever I did in that November race was just some sort of nice injury to my hip that has caused unresolved pain and swelling.  I am really not too worried about it in a big picture sense.  (knock on wood) As long as we haven't missed a tear or fracture, then this is repetitive, not backing off immediately, training load error stuff.  (The blame 100% goes to me for poor race planing, probably).  Interestingly I took a several weeks off back when it happened, which I would have thought would have knocked this out.  It's all good- I love solving problems.  Worse case scenario is in 3 months I am having more serious issues and then we have to consider that we did miss something, and that is just how it goes when trying to get to the underlying cause of large areas like the "hip," which really also includes the femur, pelvis, scrum, lunar spine, and lots of muscle attachment.

Treatment:  I definitely would be taking some time off if I didn't have Boston in 5 weeks.  I didn't really budge on going, since we didn't see a tear, even though I am fine with revising goals.  I am willing to work with this and back off even more, and the doc was willing to work with me.  We went ahead and decided together to do a cortisone shot to two areas in the hip today.   And I love it when I can be a collaborator.  He and a few others suggested it, I mulled on it, I pulled the trigger.  I know people get weird about cortisone, but in this case, I didn't hesitate for long.  (I am not a huge steroid fan and see the results of chronic steroid use in my PT practice.  I think I have only had maybe 2 oral steroid packs in my life.  The only other time I have gotten a cortisone shot was years ago for my knee I had a strong feeling it wouldn't work because it was bone and cartilage damage.  But, I was really grasping for straws.  And it didn't work- I got surgery shortly after, and all was well.)  With this, though, I felt good about our decision to put some anti-inflammatory assistance in the area.  It has been going on 5 months, so it is angry and needs to calm down.  So, that is that.  And then I will probably start taking just your normal ibuprofen for a little time, which I haven't been taking, along with ice, rehab, rest, etc.

And I keep saying I am going to be 100% in on this, and work/life/big changes keep dominating my day.  (And insomnia my night, which is why I am blogging at 1:30am).  There are so many great things to do for inflammation and I have not been doing them.  So, there is room for improvement in these next 5 weeks.  

So going forward.  Boston is still on the table.  Of course I will continue to modify as needed and try to get there as healthy and pain free as possible.  Seriously I am not even stressed about it.  I hated racing in so much pain last race.  It zapped the joy out of it for sure.  But, I think I can make some adjustments and go have a positive day in Boston.