Monday, February 2, 2015

New Pathways back to Running: si joint dysfunction and Prolotherapy?

I have given up on running. I have never been able to figure out what is going on with my hip post labral tear surgery. Last year I only ran a total of 88 miles (most of those during snowshoe races). I did not run an actual running race for the first time since I started running in 1973 and decided it was not worth it to do more snowshoe racing this year knowing that after each race, I would spend a few days with my hip area all beat up and uncomfortable. I have read everything, tried everything, and have found nothing really helps that hip area: strengthening, mobilizing, or rolling things out, PT, doctor, and injections have not been helpful either. I say my hip is sore, but it really is not the hip socket, but everything connected to the hips within and without.

I have even been feeling uncomfortable riding my ElliptiGO. I am getting my rides in indoors this winter, but my hips always feel rotated or off level. Before Thanksgiving I was really off and sore in the sacrum area. I again researched ways to fix a stuck si joint. I worked on some self mobilazations,I found that were way beyond my flexibility, but low and behold a heard a pop and then everything calmed down for me.

I started getting more discomfort in the si joint after a few weeks and kept trying to work through it. I decided to research more and it hit me quite clearly that what I have been fighting is an si joint problem. The more I read, the more it made sense and everything I read about the symptoms matched me totally. There are methods that can pop a stuck si joint back into positions,, but the problem that people have is that the ligaments connected to the si joint get stretched and don't stretch back, thus chiropractic adjustments can make things worse.

One method that claims to fix this is something called Prolotherapy. I certainly have read about this before and found comments I made (TDF) on running message boards about this from back before my hip surgery. I had ignored it, because it considered experimental and insurance does not cover it. Basically, they inject a sugar type solution into the ligaments and that is supposed to stimulate recovery. It seems to work well with the si joint and tightens up the ligaments and making the joint strong again.

I am in the process of trying to get an appointment with a doctor for this and then I will have to see if it is for me and if it is even something I can afford.

Update: I have an appointment at the end of March with a doctor that specializes in this at the same clinic that I had my hip arthroscopic surgery. Surprised that the doctors, physiatrists, and PT people that I saw there didn't mention this, but maybe they were just focusing in on the hip.

Here is how it makes sense to me. I always had an awkward running stride, but I made it through high school and college running with no problems except my knock knees and  weird stride (due to femoral anteversion). Then two years post college, I got into triathlons. Six months and after only two races, I completed my first Ironman distance triathlon. There was no such thing as bike fit back then and I had problems with my left weird leg getting comfortable right from the start and jamming up my hip-lower back. That winter, my back was already sore, so someone recommended I see an osteopath. He did manipulations on my si joint and I would feel good for a day or two and then it would hurt, so I started lying down an pressing on that si joint myself until it clicked and I felt better. By the end of my my fifth season doing triathlons I could barely stand comfortably and was clicking my back 10-30 times per day. I had my first PT to try to figure it out in 1988 right before my wedding because I didn't think I could stand comfortably through the ceremony. I was told to never run again.

I now know that was the si joint and if the ligaments remained stretched, then I have been fighting that unstable joint for over 30 years (and yes, that is what it always feels like even if I am riding my ElliptiGO). I think once I run and put all the weight on that one joint, my body tries to compensate and that is why everything falls apart when I run. It literally feels like it needs to be stitched back together.

This video even shows how an si joint dysfunction is a cause of a hip labral tear (particularly someone with a long standing dysfunction). Well if I have run for over 30 years with this (I have never been comfortable since 1983- but have controlled it better at times) then that may be a real good reason why I developed a labral tear.

Another video explains the symptoms of si joint dysfunction. Instead of saying, "You can have pain.." she could have said, "Jim has pain..." as it describes my last 30+ years quite accurately.

I will be curious about the Prolotherapy or anything else I learn along the way. So far, the best appointment I can get is in July! If anyone reads this and has comments or has had good or bad results from prolotherapy, I would be interested in hearing them.


Ron Day said...

Good luck with this Jim. I have had very similar problems this year as you have had for years, complete with funky forefoot pronation etc., so I keep coming back to your posts. I do have moderate arthritis, but I have doubts about this FAI stuff, to be honest--not the diagnosis, but reasoning as to why one has it. I, too, have thought this is SIJ caused. The pain goes down a bit sometimes if I focus on pushing the opposite hit back (rotating the pelvis that way) and if I sleep in a way that doesn't hike up the bad hip (just starting the QL approach that you investigated years ago). Funny regarding a sugar solution injection: I just read about some study in the UK that claims that a sugar solution may be good for knee arthritis. Anyway, thank you for your posts. I'm very sorry for your pain and that you can't run (I can't either) and I hope that these injections prove beneficial to you. Ron

Jim Hansen said...

Sorry to hear you are going through similar stuff. I am hoping that prolotherapy might tighten up my ligaments enough (if it is recommended for me and I can afford it) to get rid of a lot of the dysfunction and alignment issues I have. A couple of people I know so that it worked great for them. We'll see. Matt at Upright Health puts out a lot of videos on FAI and he is a doubter too . Thanks for writing, Ron and best wishes!

mikey said...

i'm curious what has happened since he Prolo. Prolo saved me - though i no longer run because it is simply not worth the pain and return to dysfunction. biking and swimming are great though. i do find that i need new injections about once a year, as the ligaments loosen up and i get the same ol' trouble starting up again.


Jim Hansen said...

I have had two prolotherapy sessions. They worked real nice for me. I felt better right away-probably due to the lidocaine, but then things kept getting tighter for me. It seems to have really strengthened my si joint. I also had shots in the lower back and near the glute medius. A different doctor (osteopath) noticed the improvement to my so joint right away. I went in for a third injections and the doctor decided not to do it (I was flying to Africa the next day) and she thought my si joint was doing good. Originally she had planned for at least 6 visits. I did run up to 7 miles, but my muscles are still not balanced so I am leaving that alone and riding my ElliptiGO for now (350 miles this week). I have found recently that stretching my tight hip flexors leads to problems, so I do a few things I found online for femoral anterior glide syndrome and that seems to help. I see the doctor again this month. It will be interesting to see what happens in a year if you say that it can loosen up again.