Dear Ask The Doctor: I'm a fifteen year old girl who runs track and cross country. This year was my first year of highschool sports and it was a lot more difficult. Doing a track workout towards the end of my first high school cross country season I felt an irritation in my right hip right above the bone. We were doing 3,000 meters on the track, so it wasn't much of a sprint. I ignored it for a few days but the pain didn't go away so I stopped running and went to the doctor after about a week after the pain started. My pediatrician told me I most likely strained my hip flexor and to take two weeks off from running. I was also supposed to take ibuprophen often to help the swelling, and ice it when I start running. After two weeks I began running again, but much smaller distances than I was used to, and the pain came back very quickly. The pain then escaladed and I just ended up not running for the rest of the season. I then started indoor track about a month after my season ended, in hopes that my hip would have healed by then. About a week before track started I began taking ibuprophen again, and went online and found some great stretches for my hip flexor to use before and after practice. This helped for a little bit, but the pain came back again. I ignored it for awhile, but then my left hip started hurting in the same fashion, but twice as bad. I went to a different doctor at our urgent care, and he told me the same thing as my pediatrician. Getting frustrated, I decided to try to run through it, which was a terrible idea. It got so bad my left knee started hurting and there were times where it hurt to walk so much I was crawling up stairs. I quit track when it got to this point and my parents started to notice how bad it was getting. I stopped running for two months and outdoor track was going to start in a month, so I decided to slowly get my mileage back up to a reasonable amount in hopes I could run for outdoor. I decided a good way to do this was with my friend, who had never run before. We would run a mile a day in fourths. So we would stop for a minute break every fourth of a mile. After the third day in a row my hips started irritating me once again, so I took a day off and iced it and stretched it. I ran the next day and my pain got worse. So I decided to give up. Now I have gym and I'm having a hard time running the required amount. It's embarassing that overweight people can run more that I can, when I used to run up to five miles. I want to know if there is anything I'm doing wrong that I shouldn't be doing, or if the doctors I went to were wrong and there is something totally different going on. The pain is right above the hip bone, but not on the side, it goes down, following the bone, for about four inches. It doesn't go into my back often, but it has before. It feels like a nagging pain, that's a sharp stabbing pain when it is at it's worse. Spinning or using bycicles doesn't hurt my hips, but treadmills and running do. When I run, I don't feel the pain unless I'm going very slow. It's when I stop for a minute that the pain comes back. After stopped, the most pain is to start back up running again. My hips do cause me to slow down in my running. I think I don't have much strength as I used to, since I dont feel the pain when I run, but I still am going very slow, and not improving on my running abilities. When I sit down or lie down, the pain goes away. When I'm standing, I have to be careful to not put all my weight on one leg since it will hurt. Thank you :]
Dear Tessa: Overuse injuries or repetitive motion injuries make up over 50% of all athletic-related injuries seen by doctors. Simple everyday actions, such as throwing a ball, scrubbing a floor, running or jogging, can lead to this condition. The most common types of repetitive motion injuries are tendonitis and bursitis. These 2 disorders are difficult to differentiate and many times may coexist. In your case, most likely could be a bursitis of the hip due to a repetitive trauma, which can have various causes, for example: inadequate footwear, inadequate technique for running and/or for training, inadequate training surfaces. Bursae are small pouches or sacs that are found over areas where friction may develop and serve to cushion or lubricate the area between tendon and bone; common areas where bursitis can occur include the elbow, knee and hip. Traumatic bursitis is the type involved with repetitive motion injuries. Traumatic bursitis is most common in people younger than 35 years. Ice in the affected area can be used for relief of pain and swelling. The conservative treatment as follows: immobilization and ice during the early phase and moist heat during the long-term phase. Use of anti inflammatory medication NSAIDs (“aleve”, “motrin”) can help to ease pain and swelling. If your tendinitis or bursitis is not helped by NSAIDs, your doctor may choose to inject steroids into the surrounding area of inflammation. You should begin graduated range-of-motion exercise once your symptoms begin to improve. As a rule, you should not have more than 3 injections into the same area within a 12-month period. Alternative treatments include pain-killing creams, capsaicin cream (an over-the-counter pain relief cream made from an ingredient of cayenne pepper), and steroid medications if you are able to take them.
Regarding prevention measures for bursitis: Do adequate warm-up and cool-down maneuvers (crucial to proper tendon and bursae health). Avoid activity that makes your injury flare up. This will speed healing of both tendinitis and bursitis. A great majority of bursitis cases heal well. Just have to be patient and consistent with the treatment.