Tuesday, November 16, 2010


Labels: I have a few new ones.

Last Monday I had a cortisone shot. It was supposed to be a diagnostic tool and I guess it was.
The shot was great. I didn't feel a thing just a small needle  pinch. Nothing hurt or got sore afterward either. That night I ran 1 mile on the treadmill. The next morning, I woke up and ran another mile. Everything was OK, so I ran 3 miles that night. I was still fine so I looked forward to the next day. I ran 8 miles. Everything around the hip felt loose (no muscle problems) and at the same time the hip joint felt firm and tight. I had no problems on the run or after the run. The next morning I could lift my leg up without the stiffness that I usually would have. I liked the feeling. I ran 8 miles again the next day with the same result. This was unusual. Nothing was making my hip sore. I didn't want to overdue it so I took a day off and Saturday ran again. My left foot was rotated a bit to the outside and my stride wasn't the best, but I decided to "test" things. About a mile into the run, I felt "something" in the muscle of my right back side-lower ribs. It was like a muscle "let go". I have had this a couple times in the past and I end up having muscle spasms or a back pinching for a week or two after. I kept running, but I wasn't as loose as before. I felt things deteriorating and my left glutes were having a problem. After 30 minutes of running, I had to stop. The back hip "glute medius" or "piriformis" had tightened right up and was in something like a spasm. It was cold and I was in shorts. I had to walk for an hour to get home. It hurt to lift my left leg and swing it forward as well as put it on the ground each step of the way. This felt like a  muscular pain, but I also noticed a tightness or rubbing in the hip joint. If it wasn't so cold, I would have just sat on the ground because it hurt to walk. That was the last I have run. My lower right ribs still have a stiff spasmy spot and my glutes have been sore since the run. The cortisone was great while it lasted, unfortunately it didn't last long.

Today, I saw the physiastrist again. He looked at everything again and thinks it is not so much tibial torsion, but femoral anteversion. He thinks it is the hips that make the leg do what it does. Labels! He said that it looks like the cortisone wore off. I think it is still a bit of being out of balance. I have felt like a truck has hit me since Saturday's run. I think that my body was running smoother and then  muscles reacted to a new pattern to protect itself-even though nothing hurt. I have had the upper back go off like that before, and it was usually after I had some body work done to relieve tightness in the hips.

The physiatrist wants me to get a gait analysis done to see exactly what my body is doing with the tibial torsion and femoral anteversion. I am not sure if insurance will cover this. He thinks my body has done a remarkable job compensating through the years to keep me running and doesn't want to alter that much. He is also sending me to a physical therapist to work on stretching my left internal hip rotators and adductors, and to strengthen my left hips external rotators and abductors. He made an extra label on my referral slip: "high level runner". Well, I have never been called that before, but I like it. At least he is not treating me like a joke. I do feel that way when I see the other people who are in all sort of pain and distress in his office.  I can't really complain about my problems, but I like the challenge of figuring this all out.

What is femoral anteversion? 

Femoral anteversion is an inward twisting of the thigh bone, also known as the femur (the bone that is located between the hip and the knee). The physiatrist thinks that this is causing an impingement in my hip due to the rotation and that is the source of my pain. The twisting of the femur means my left glutes get weak and stretched and that is why it is sore. He showed me where he thinks the small labral tear is, but isn't sure if this is the real problem. Anyhow, he wants to treat things conservatively with therapy before he looks into more aggressive  things like surgery. The surgery to fix a femoral anteversion is usually only performed on children. He doesn't think it has is performed on athletes to keep them running. It seems to involve breaking the bone and having it grow back again. I don't think I want to be the first or next runner to have this type of surgery!

Anyhow right now I am back to being a low-level non-runner. The cortisone was great the few days it lasted. That was the longest string of days without pain of many in years! I was really enjoying the added hip mobility and the feeling of what a normal leg would feel like.

Here is a very cool web site  I found to learn about muscles. You click on a muscle and the animations show you the origin, insertion, and actions of the muscle. It is called Get Body Smart.


Matt Metzgar said...


Just my two cents here, but it seems you are overthinking things here. Looking at the photos, you have some obvious basic movement dysfunction.

I would just go with something simple like Athletic Body in Balance done with barefeet. Have you tried their functional movement screen yet? Based on the running photos, I don't think you'd pass all the screens (not trying to be negative). Just saying I would go with the basics first and get the basic functional movement up to par before anything more exotic.

Good luck!

Anonymous said...


hi mr. hansen - try one of these - they really helped me. Didn´t really get any more dorsiflexion but all the twists and pain up my kinetic chain especially knees and hips went away. I have a straight gait now and don´t walk like a penguin anymore


P.S.: I´m not an advertiser
P.P.S.: Sorry for my english - it´s not my native language

Jim Hansen said...

No Matt, I haven't had a FMS. It is among a lot of things I would like to try that cost too much right now. I know I wouldn't pass a screen. I think it is more than just moving wrong as I am trying to figure out why things get stuck. I am working on a "stuck" fibula (according to podiatrist). The book you recommended with the "listening feet" is one of only a couple of sources I have found. Then I am thinking about lax ligaments in the sacroilliac joint and trying to figure out if prolotherapy would work and be covered by insurance. If those can be fixed then I could work on movement again. Not running is helping me really see what doesn't work.

Jim Hansen said...

Hi Markus,
I did try the posture control insoles for almost a year. They seemed promising but didn't help. The orthotics I have now have a cutout under the 1st MPT joint. I can't tell if they help or not, but they were expensive.I have talked to a few people online that the Posture Control insoles seemed to belp. I think there is even a commment I made on a message board a few years ago on the Morton's Foot website.