Running... but what IS that pain???

[MaryEllen]

Hi all,
I've begun running, and am "pretty successful"... by that I mean, I can run 3.5 miles, but.... Here's the "but". After that (3.5) some pain creeps in. Groin, and sometimes down my leg. There are times I will be limping pretty badly the next day. However, the pain ALWAYS goes away, and I'm able to walk without problems once I get warmed up even on the limping days.
My question is this: What is causing the pain? Is it soft tissue? Is it the prosthesis? And how does one hasten it's finally going away for good?!!
Thanks!!

[David]

Muscles are not strong enogh yet...I am a couple of months ahead of you still dealing with it at longer distances.

[Arrojo]

So, stick with 3.5 miles every other day for a few weeks.  Then gradually move up.  You are smart for listening.

[ScubaDuck]

I found that pace is as big a contributor as distance/time for me.  Granted I wasn't been able to run for over ten years prior to surgery so I suspect I have more muscle work to do than most.

I have been following a very conservative build up.  After three months I am now at 36 min three times a week with a 20 min. thrown in.  I was feeling good and started to push the pace since I was sticking with the shorter times.  That is when I really started to experience some pain in the IT band, groin, and hip capsule.

I have found that I can comfortably run 9:00 minute pace as I build up.  Yesterday I ran 3K at about just under 10 min. pace with my girlfriend and then turned around and finished with 8:40 pace which stressed my muscles so I was limping for a short time after.  I do recover quickly though and I quit limping within an hour of stopping.

Dan

[Rob6297]

Dan,
How sore were you after that tri? You ran way faster than 8:40 pace, just interested in the recovery from that effort.
Thanks
Joe

[MaryEllen]

Thank you all for your answers!! I truly appreciate all of them. I have experimented with the Galloway method of run/walk/run...and am able to do 6.5 with no pain at all. Now, would I rather run the distance? You bet. I will get there!! For now, I'm happy with the fact that I can run!

[ScubaDuck]

Joe-

Well I didn't push the bike for one thing.  Even though I had done a brick workout I wasn't sure how I would respond to running after bike.  I was right at 33 kph for the bike.

I started really feeling the hip at about 2.5k.  I eased off a bit but not much.  I had felt the same pain during some running workouts earlier.  Not a sharp pain but an ache.  Once I stopped running it took about 2 hours for the pain to basically diminish to very minor soreness and not just in the hip.

I felt great the next day and went for a 40k bike ride.

Dan

[Rob6297]

Dan,
That's great! Glad to hear you can still push and not be hurting for days.  Thanks for the info.
Joe

[Jerome Arnold]

Mary Ellen,  I have experienced similar pain while jogging.  At about 3 miles at an 8 minute pace, the pain at the top/outside of my hip socket was quite uncomfortable.

My solution was to adopt a Pose running style.  On flats, a consistent Pose running style will take much of the impact off of your hip joint.  On flats I try to pace myself at 9 minutes per mile.

I also trail run hills.  Running uphill will force you into a Pose running style and slow your pace.  I have never experience hip pain while running hills.

I now run pain free at a distance of 5 miles.  I plan on slowly building up to 10 miles.

Jerome
Left Hip Resurfaced:  BioMet Recap, uncemented
Dr. Gross
June 2010

[MaryEllen]

Very encouraging Jerome!  I ran a 10k this past weekend, and though I completed it in almost the time I wanted to, I had the familiar pain... And lots of pain the day after.
I try to utilize the Chi Running method. I'll google the Pose method and see if there's more I can do. Thanks!!

[23109VC]

I am a Dr. Gross hip resurface patient.  My hip was done Feb of 2011.  So I"m well over a year post op...  I don't run much... but I tried it out a bit at 6 months...  I couldn't run very far at all at 6 months before I had to stop....  I tried running maybe every few weeks...  just doing a bit further than I had done the prior time...and gradually was able to get to a point where I could run about 1/2-3/4 mile before I felt ANY pain... it was very very minor..but it creeps up on me.

I would describe the pain as being at/near the incision point....it's gradual and comes on slowly.  the second I stop running and start walking.. the pain pretty much goes away completely.  If I keep running and force it.. I notice that the next day I will have some discomfort/soreness... but it always goes away.  I seem to be able to do the elliptical / bicycle with no pain...something about the running agitates my hip.  I haven't made it a point to try and really push myself to see if I could break through this..and build up my soft tissue/muscles and get even better... instead, I have backed off and pretty much stopped running.

I mean, I can run.  the other day I ran up the down the street to try out some new tennis shoes I bought... I ran fast in them... I can run full speed no pain / no problem. the only thing that seems to agitate my hip is running distance....  like 1/2 mile+......   

what some of you have described..sounds kind of like what I notice...albeit maybe mine sets in sooner. any idea what it is?  is it something that could be fixed or relieved with some kind of treatment?  i wondered if it was bursitis? or maybe scar tissue in the area of the incision?  I don't know....  for  me, running was never really a big deal... so if I don't run, it's not a huge deal to me.. but I would love to go back to playing racquetball...and I have not done that b/c I figure if I can't run, I probably can't do racquetball either...

i have zero pain in my day to day life - which is amazing..given how much 24/7 pain I was in pre surgery...so don't get me wrong, i'm not whining... i'm a zillion times better than I was... i'm only 40....and it sucked to not be able to tie my shoe, not be able to run AT ALL... i limped everywhere.. you all know the story...  now I can run up /down stairs, tie my shoes.. etc...  BUT.. running is not something I can do 100% pain free.

are we supposed to be able run pain free?  i know when I had the surgery, I had hoped I would be 1005 pain free, able to run/jog/etc... now I can do most of the things I want, but since it hurts a bit when I run, i'm worried that I shouldn't do it...

what do you all think about the pain we are feeling?  it is normal?  it is anything to worry about?  like yours, my pain goes away shortly after I stop, i might have some soreness the next day... but it goes away pretty quickly...

thanks.

[hernanu]

Hey Sean, maybe it's scar tissue, since it seems to be centered around the incision.

Have you tried any of the massage therapies that were mentioned by some of the runners? (I forget the name). I am not a long distance runner, but do want to do sprints for soccer / basketball, so I'm working into that type of running now.

Have you done the roller to focus on the incision area? might loosen scar tissue if you have some.

[jjmclain]

You should be able to run pain free at some point. Just build up the surrounding muscles and listen to your body. I was cleared to run again at about 5 months post-op and started very slowly and maybe that is why I have never had any pain running. I am at a year and a half post-op now and still have no pain when running and can run whatever distance I feel like. You have been given great advice by some of the hippies here and I think you will get there soon!

[23109VC]

I have not tried massage or the roller.... maybe I will give that a try.

out of curiosity - you guys who can run pain free - what is your range of motion like in your operated hip?  My range of motion PRE surgery was HORRIBLE... now it's close to normal but NOT quite as flexible as my non operated side.  on my "normal" hip I can bend down and touch my nose to the tip of my knee.  on the operated hip, I cant quite get it there.. maybe a couple inches away.....  i'm not complaining....  before surgery I couldn't even tie my shoe....  but i was cu rious if post op my hip should be as flexible as the other one... if I try to bend and touch my nose to knee.. i feel a slight pinch in the front of my joint area.. not bad pain..just a sensation like something is pulling/pinching and doesnt like it.. so I don't force it...

is scar tissue near the incision site something that can cause inflammation and pain during running?  i'm not worried aobut it.. as I dno't have pain most of the time... my day to day life is pain free... sometimes if I do a lot of exercise I might feel soreness, but nothing major.... but the running seems to be what agitates it..and the pain does seem localized around my incision...  on my butt, the incision goes up/down... i feel it mostly at the base of theincision....  but it's more toward the outside of my body...  it's not that old "deep inside my body" pain that I used to have..so I don't thin it's the implant/bone anythign like that....

as soon as I stop running and slow down to a walk.. it prettym uch disappears.....  it's some kind of agitation..

since i'm almost 1.5 years post op..I was kind of hoping this would NOT be happening... i was hoping to be 100% pain free and able to go run as far as I wanted..but i'm not there yet.  some doctors have hinted that full recovery should be at a year..and whatever shape the hip/joint is in at 1 year is how it will be forever..  i'm hoping that is not the case and that this nagging litle pinching sensation may go away with mor ePT, stretching, etc.

i'm trying to do more weigted leg raises.. the ones where i lay on my bakc and side and lift my leg up.. to work the front and sides of my hip..  any other exercises you recomend?

is this massage thing something I can do on my own or do I need to see a sports massage therapist person to give it a try?

thanks again guys!  i'm not a runner ... but used to run for exercise..and while I don't know if I'll return to runing full time, it would be nice to have that option....

are you guys running regularly on your impants??? 

[Dannywayoflife]

Sean
       Mr Treacy told me that its totally impossible to place a device where it NEVER catches. But the skill in the surgeon is in putting it in where the patient will hardly ever notice it.
In theory a resurface hip will never be quite as flexible in rom as a natural hip because of the decreased head neck ratio.
Deep scar tissue can cause problems way down the line if it's not sorted and the longer it's left the more difficult it is to get rid of.
I have read that soft tissue can take up to 18 months to fully mature.
I can't offer much advice on the running side as yet as I won't consider it for another 6 months or so.
Danny

[John C]

Hi Sean. A few thoughts:
I do run around the tennis court every summer morning for 90 minutes or so pain free, and some occasional sprints on the beach or short trail runs in the fall. However I don't do any distance running anymore, mostly due to other sore parts.
When skating on skis, I did feel that twinge you are talking about for a couple of years. It is gone now, and I think that it went away somewhere between two and three years. I hear what you are saying about most of the improvement happening within the first year, but I still had noticeable improvement for well over two years.
Not everyone agrees with this, but I would consider listening to that pinching sensation you have when you are going to the extremes in stretching. There have been some cadaver studies showing that with resurfacing, impingement can happen between the femoral neck and the edge of the acetabular cup during the extremes of stretching. This would obviously not be good for the health of the femoral neck or the cup, and is something to be aware of. The points of these studies were that in a THR where the neck is gone and replaced my a thin metal rod, there is no impingement against the cup, and therefore more potential range of motion than with a resurfacing. For me this small tradeoff did not come close to offsetting all the benefits of a resurfacing, but I do try to be aware of any sensations that feel like impingement when stretching, and I do feel it in extreme forward flexion.
As a side note, my understanding is that this impingement issue is one reason that the ASR cup was designed with less coverage, so that the neck would have less chance of impinging against it. As we all know now, the reduced arc of coverage was not a good idea.

[Rolls]

Hello,
Finally I have heard from some Surface Hippies who have what I have...I think.  My RBHR still is not right after 5 yrs.  I get that impingement feeling when I kneel down, lunge and run.  It is like an elastic band tightening around my upper thigh.  I also cramp up very easily in my groin, calf and thigh.  If I raise my leg in the air for any extended period of time, I get severe painful cramping.  I get some relief from IT Band stretching.  It has effected my knee to the point where kneeling is very painful.  But, I must say...running is feeling better and better, if it wasn't for my knee pain.  I did the metal ion testing about a year ago and things were alright.  I plan on talking to my doctor about it pretty soon, even though he was not the one who did my RBHR.  My LBHR is great.  Any more great ideas??
Rolls

[Woodstock Hippy]

Rolls, there's no way you should be putting up with all of that after 5 years.  Talk to you doctor, talk to another doctor, go see a good physical therapist.   I'm guessing that you probably did minimal PT after your surgery. A lot of HR doctors seem to not emphasis PT. They say to just walk and do the exercises on the chart. But who tells you if you are doing it right?  I'm just guessing but I think your problems might be solved by a good physical therapist.

Good luck with this and don't give up.

[Arrojo]

Sean, look into active release technique (ART). It is a technique by licensed practitioners to break up scar tissue. Many world-class athletes and weekend warriors swear by it. It is amazing.

Go to activerelease.com and read up on it. You can also find a provider near you. It's not magic or snake oil but sound science. Most of my running friends swear by it.

Short of needing surgery, which it does not sound like is your issue, ART can fix anything. Good luck

[Rolls]

Hi Again,
Been kind of discouraged with everything.  So, busy at work that I have had no time to get my RBHR checked out more.  I did have PT after surgery, a year after, etc; and believe me I go online to find exercises and try anything and everything, but nothing lasts.  I know it is my own fault for not following up with doctor visits, but you don't know how discouraging it can be.  I had my one year anniversary with my LBHR by Dr. Marchand, RI and it is the BOMB, it is excellent, but my RBHR is still a nagger, it ruined my knee and now my ankle hurts.  I tried running all summer long, but it was just no use, the knee is shot.  I did the treadmill ok, and now my ankle is killing me.  So, I am sticking with the Bike, stretching and weightlifting.  I will eventually contact Dr Snyder and NWH again, then I will pursue Dr. Marchand to check on my RBHR and go from there.
Rolls