“Labrum tear”& cam deformity

I haven’t been injured since I got stress reactions in colleges in 2014, well injuries that have sidelined me from running. I’ve had little tendinitis and some shin splints, but nothing that has made me take time off from the pain. I’ve done PT more times in the last year than I have in my entire life. I started PT on December 2018 when I got my hamstring strain, and I think that lead to a cascade of other injuries. I could run relatively pain-free with my hamstring strain, which probably made it a lot worse because I’m stubborn. I was getting over my hamstring problems and getting back into marathon shape. I was so excited, feeling excellent and motivated; then I ran for a month straight. I remember the pain started creaking in around July and took some time off when I went to New Hampshire for my best friend’s wedding. I decided to go for a run after my long weekend off, and when I ran 2 miles and felt stabbing, it was honestly the worst running-related pain I ever felt. Every time I extend my leg out and push-off, my whole leg would be in so much pain no matter how fast or slow I ran - it was killing me. Then I would take a couple of days off, and it would still be throbbing. I made an appointment with an orthopedic surgeon who said it was IT band syndrome and hip bursitis, and a cortisone shot would help, and I figured why not I wanted quick relief! Getting a needle stuck into your hip IS NOT FUN. Holy sh!t. I hobbled around for a few days, did some research on how long it would take for it to work, and after two weeks, and it was still bothering, I decided I needed to do something else.

I got a follow-up appointment and reached out to my friend, Melanie, who is an inpatient PT and whose husband is an outpatient PT. I told them my pain, and Mike brought me in for an evaluation. Mike is such knowledge and noticed so many tweaks in my running form. For example, he saw my ponytail would deviate to the right, not something you would look at, but my whole body was leaning to the right, extending my left hip more and pulling on my IT band. When I did PT for my hamstring, it helped, but we did the same exercises every single time, which become a little frustrating because I could do them at home, and it felt like a waste of time going in. When I did PT with Dr. Quinitians, it was a different thing every single time; he did strengthen exercises, plyometrics, and stuff not only to help my hip but my running form and gait. I never realize how messed up my gait because I was used to running this way basically for my whole life. I was overstriding, wasn’t driving my knees up high enough, and my right hip would drop, causing more stress and pull on my left side.

So I finally got a second opinion, got a full workup, and the doctor decided it was best to get an MRI done to make sure I didn’t have a stress fracture in my hip. I am not claustrophobic, remember having the feeling of like I need to get out of this damn MRI machine (thank you anxiety). The last time I got an MRI I remember doing it in the morning and went to sleep, and this was 5:30 on a Monday night my body was in hyperdrive. I was terrified I would have a stress fracture, and my training would be shut down. Spoiler alert I didn’t have a stress fracture but still had an injury that would almost make me shut down my practice. When I went for the results, I was excited when my doctor started with, “You don’t have a stress fracture…..however, we think you have a labrum tear because of your cam deformity.” HUH, what the…. is a cam deformity? I immediately thought. She showed me the MRI, and the best way she could describe it was like a bone spur from my hip being “abnormally” formed. As for the labrum tear, my symptoms led towards that, but I would have to get a diagnostic test done. I honestly wasn’t too concerned about the labrum tear but more of the BONE SPUR sticking off my hip?! The head of my femur is abnormally shaped, and a part of the head can jam into the socket when the hip is bent (running). As running is repetitive, the bone keeps rubbing against cartilage, wearing it down (osteoarthritis), and can cause a labrum tear.

So, my doctor *recommended not* to run Chicago Marathon but technically didn’t really run it ;) I ran walked it. This build-up was the hardest one I’ve ever had; you never realize how lucky you are to be healthy. I could have quickly just said no, I give up and don’t want to put myself through the pain, but my stubborn self was like oh well, I can’t defer because I have a charity bib and I want to do Chicago because my whole family had planned a vacation around it. I really wanted to throw in the towel; I remember telling my running best friend Ashley (she is running her first marathon in June at Grandmas and fundraising for Brave like Gabe; donate here!) I’d be happy if I had a stress fracture so I would force myself not to run, that’s how low and depressing my thoughts got. I thought I was going to be in worse shape after; I thought I was still going to break my hip the week before. Mike and my wonderful coaching friend, Christina, was confident that I could make it to the finish line and believed in me when I didn’t want to. With many rounds of PT and slowly increasing my mileage, I peaked at 16 miles run-walk relatively pain-free and was still nervous but was still optimistic. I feel like this is exactly what needed to happen to get me mentally strong. I am so so so glad I did Chicago, it was the best, happiest marathon I have ever run!

Here are some notes Mike my PT sent to me
-left gluteus medius tendinopathy, posterior/ lateral hip pain.
-Key objectives: poor left hamstring flexibility, poor left hip mobility, soft tissue, and flexibility restrictions of hip flexors, rectus femoris, and psoas major. Right lateral lean, anterior rotation of left innominate and left gluteus medius weakness.
-treatment: manual therapy consisted of joint mobilizations to address deficits in hip mobility, soft tissue techniques to hip flexors and plantar flexor, and correction of anterior innominate.
-strengthen: closed chain gluteus medius, core stabilization, dynamic balance, and heel raises
-running cues: cadence increased to 165 steps per min, land forefoot under her body, minimize time with the foot on the ground, bring knees up in front.

I am almost two weeks post-Chicago Marathon, and was planning on pacing Philadelphia Half Marathon but decided to give that up to make sure I am healthy by getting a follow up on Monday, October 28th. I did a 4-mile run-walk (3-mile walk and 1 mile ran) last weekend because I needed some movement, and my hip was still bothering me. I am frustrated because it wasn’t bothering barely during the marathon, but I ran a marathon, so my body needs rest! A lot of people have asked me if surgery is an option, and my doctor didn’t even suggest that. I believe the next step would be to make sure I have a labrum tear. Like I said before I am not concerned about the labrum tear, I don’t want to be a permanent injury because of the cam deformity. I might have to end up making a decent amount of time off and do PT and still if my pain subsides with that. I will keep all of you posted regarding my next steps after my follow up. I am so thankful to have so many people who have been in my position and have given me positive thoughts and vibes. Grateful for my family and Joey for listening to me cry when I thought my whole world was ending.

Special shoutout and I highly recommend:
- Dr. Mike Quinitians out of Physical Therapy Wellness Institute
-Dr. Kate Temme from Penn Center for the Female Athlete
-My fantastic coach, Christina Roberts of Enflyte