First off, thanks again for the excellent content barbell medicine puts out; it’s hugely appreciated by myself and, I’m sure, many others. Also, apologies in advance for the length of this post, but I want to make sure I describe my situation in sufficient detail.
About me:
26 y/o male, height 6’1"/186cm, weight 87KG. Based in London, England.
I have been playing tag rugby for around 18 months, which is a non-contact version of the sport involving lots of short sprints and evasion through twisting/turning, side-stepping etc.
I have been strength training in earnest since around September 2018, during which time I ran SSLP for around 4 months and then switched onto the Bridge 3.0 and have just started the 7-week 3-day GPP hypertrophy template.
About my pain experience over the past few months:
Around July/August 2018 I started experiencing some discomfort in and around my left hip while running, in particular when raising my knee towards my chest.
Over the next weeks and months, the pain worsened and started to radiate into my left buttock and down my hamstring towards my knee. The pain is most intense during running/sprinting, but I also feel pain during walking, sitting up (particular from lying down) and coughing.
The pain tends to be worse for a few days after playing and then gradually subsides (although never disappears completely).
I haven’t really had any problem with my strength training, apart from sometimes having to slightly narrow my stance on the squat or press.
By the end of last year, I reached a point where I couldn’t play anymore due to the pain and finally sought help from my doctor (see below)
About diagnosis/treatment thus far:
My doctor suggested it might be a hip ligament issue and said I should take some time off my sport and referred me in the first instance to a physio, but said that I should come back in the event that the pain continues and we would look at other options.
I took 8 weeks off, at the end of which I saw the physio who said it was merely a combination of quad tightness, fallen arches and an issue with the way I move my left foot when I walk and recommended a combination of stretches, insoles and ‘mindful walking’; its safe to say I didn’t buy any of this, but I played along so that I could at least be happy with myself that I didn’t just dismiss him.
The physio arranged a follow-up for 4 weeks after the initial appointment and said that it would be fine in the interim to introduce low intensity running again.
During those 4 weeks, I didn’t have any pain comparable to that I had experienced prior to my 8-week break, so by the time I went back to my physio he was happy that everything was fixed and discharged me. I didn’t protest too much because I didn’t feel he was going to be of much help in the long-run.
This leads us to the past week or 2, when I have started testing my ability to run at higher speeds and for longer periods of time; in doing so I have experienced the same pain as I was having at the end of last year and it feels as if I have made little to no progress.
I plan to go back to my doctor and push for a referral to a specialist sports injury clinic. I understand without examining me it will be difficult to say much about what might be causing my pain, but what would be really helpful is some tips on how to approach the subject with my doctor and any subsequent specialists I encounter. What kinds of questions would you ask in my situation? And do you have any thoughts on how to maximise the chances that I’m seen by someone who is appropriately equipped to help me?
Thanks for getting back to me. To be honest, I’m really not sure what I should expect. There is this voice in the back of my mind that just wants a diagnosis at all costs (i.e. via imaging or otherwise), but I’m trying not to listen to it for obvious reasons that you guys have talked about before. I feel like I’m ready to ‘embrace the process’ but I need there to be a process to embrace with someone I can actually work through the issue with.
That’s completely understandable. Although, my skepticism is quite high any game plan for return to activity will be outlined at a specialist visit. Likely a structural diagnosis will be sought out but this isn’t likely going to be overly beneficial for prognosis (likely outcomes) based on the information you’ve provided so far.
Overall, this sounds like a mismanagement of loading and fatigue leading to tendinopathy like symptoms (given rest felt better but then return to activity felt worse). We’d be happy to consult on the case and get a practical game plan together for return to activity and move you towards your goals. Contact Us | Barbell Medicine