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rru2s -> Pose Method runner w/ Hip pain, post meniscus rehab. (February 8, 2007 9:48:00 AM)
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I am a Pose Method (ball-of-foot) runner. After months of conservative rehab from a serious knee meniscus injury (volleyball), I had to learn a new way of running over 01/2006 to 12/2006, but then recently I injured my hip in Dec. 2006.
SIDETRACK: Pose Method of running is different biomechanically, but easier on the knees. You land on the forefoot/ball of foot, land with slightly bent knee, no foot pushoff just a pull of the rear foot, short compact strides, and landing directly under (NEVER FOOT IN FRONT) of center of mass.
CURRENT HIP INJURY:
In December, I had been running 6 miles X 3 days per week, plus elliptical 80 minutes X 2 sets per week. Over the fall/winter 2006, running distances were held constant for each three to four week period, then I would increase each run by 0.5 miles.
Hip injury occurred new years eve 2006. I have stopped running for 3 weeks after having anterior pain in RIGHT HIP with each weight bearing step with delayed onset beginning 1 hr. after (but not during) running. Event No.1 occurred on Dec. 31 after a 6.7 mi.run. One hour later strong hip pain approximately near the iliopsoas bursa whenever I tried to initially stand up and put a foot down, or with each step of walking, etc. This lasted for 3 days, gradually subsiding. No pain on any type of non-weight bearing leg or hip motion/rotation. After the pain was gone, then tried to run again 2 more times that week; each time strong hip pain returned immediately after running and gradually diminished over following 2 days. So then I rested 10 days, NO impact sports, then I tried to run an easy 3 miles on Jan.17, but afterwards had severe pain once again. Since Jan. 17 I have completely avoided running, distance walking (other than day-to-day getting around), even avoiding elliptical. All achiness in right hip has been gone since 1 week after my last run Jan. 17.
This could possibly be an injury to either iliopsoas muscle, it's attachment area, the iliopsoas bursa over the hip joint, or even a stress fracture of the femoral neck.
So far I have only been examined by my GP, who recommended 4 weeks rest. No MRI, bone scan, or Xray were recommended yet. Since femoral neck stress fractures can be misdiagnosed as hip flexor in runners (found many cases of this on running web forums), therefore I am being cautious and am restricting myself to 4 weeks of only upper body workout - swimming and upper body weights. After 4 weeks have elapsed since my last attempt to run, I will do core strengthening workouts (non-impact) for two weeks, then at the 6 week point I will resume elliptical (3X per week), and then at 8 weeks begin walking 1.5 to 2.5 miles (3X per week). After 11 weeks, will beging easy sets of pre-running drills, then if no pain, after 12 weeks, begin actual running with 1/3 mi. intervals X 3 sets X 3 per week, then over next 3 weeks I will gradually increase running volume until I try continuous runs of a total distance of 3 mi. each X 3 per week (by week 16 after the last injury event).
WHAT IS THE SOURCE OF THIS INJURY SO IT DOES NOT RECUR IN THE FUTURE?
BACKGROUND - PREVIOUS KNEE INJURY:
LEFT KNEE, MRI confirmed torn lateral mensicus after injured in volleyball, July 2005. Could not straighten knee past 30 degrees for a week (catching). Did long workouts sitting and flexing knee ("air bicycles"), and after 10 days made tear go back into place. Several other catching incidents, gradually diminishing over next 6 weeks. 14 days post injury, started elliptical 3X week. Knee ROM restricted to 3 degrees less than full extension for over 6 months, with sharp anterior joint line pain and feeling of hyperextension if I suddenly applied a straightening force to front of knee or otherwise accidentally forced knee to extend more fully while standing.
I immediately felt harsh pains from the planar contact area of tibial plateau and femoral condyle when I first tried to jog 100 feet about 8 weeks post injury. My walking gait was quite abnormal for months, but very gradually improved. I started limited treadmill jogging (heel striking) from 2.5 to 3.5 months, but stopped jogging when pain suddenly returned after I increased duration to intervals of 0.8 mi. X 4 sets. Harsh and achy interior joint pain occuring during 2 runs and lasted 3 to 7 days afterwards. So I stopped running from month 3.5 to month 7 and only did elliptical (which I have kept doing since knee injury through Jan. 17 2007).
NEW RUNNING METHOD AFTER KNEE INJURY:
7 months Post-injury of knee I started Pose Method of running...NO KNEE PAIN. Over 12 months worked up from 1/3 mile intervals (1/06) to 3 miles continuous runs (4/06) to 5 mi. in fall '06 and 6 to 7 mi. in December 06. ALL RUNNING 3 days per week ONLY.
Before each run, I do drills as follows: Stand with 75 percent body weight on front foot, 25 percent on rear trailing foot. Pull front leg up with hamstring rapidly and let it drop, 45 reps. Also, 2 sets of stand on 1 leg on ball of foot, pull other leg up like flamingo, then let it drop rapidly, barely touch ball of foot, and pull rapidly again. Meanwhile support leg's heel taps with each drop of other leg. These drills have more impact stress and are harder than actual running.
BIOMECHANICAL ASPECTS:
Suspect biomechanical imbalance may have contributed to RIGHT HIP overuse given 18 month earlier I injured my LEFT KNEE MENISCUS. Had abnormal gait for about 6 or 7 months, lack of full extension. My lower back would always be "tired feeling" on RIGHT hip flexor attachment area. But the recent hip injury is felt only in the FRONT of HIP, right over the femoral head, but also diffuse pain radiating over iliac crest and somewhat down over the upper thigh. Not likely labral tear because no pinching feeling, or pain DURING run, or pain with non-weight bearing rotations.
QUESTIONS TO ANSWER:
What should I do to come back to running so this does not recur? Is the Pose Method flawed? No one on the [URL=http://www.Posetech.com]www.Posetech.com[/URL] website has had hip flexor injury or femoral neck fracture so I doubt it. I posted a running video to their website and nobody noticed any imbalance or left-versus right running gait discrepancy. They did note that I had been crossing over my legs -- knees would almost touch and both feet touchdown are in center of body, not directly under hip.
This post serves 3 purposes: (1) Testimonial to conservative rehab (air bicycles initially and then 300 minutes per week elliptical) for long term rehab of torn meniscus, even given locking catching for first 6 weeks off and on; (2) Testimonial for Pose Method of running for reduced knee shock (actually there is a research paper on their website which measured impact forces); and (3) intriguing questions on the influence of my past LEFT KNEE INJURY on my current RIGHT HIP injury and how to come back to running safely.
Note -- I was a heel strike runner for 27 years before tearing meniscus during volleyball in 2005, never any serious long term injuries. Previous mileage averaged 30 mi/wk, 3 runs per week for all those years. Since beginning Pose in Jan. 06 worked up to 18 mi./wk, 3 runs per week. Currently 49 years old.
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