Chapter 4 - Looking for Answers

 

Seeking Professional Help

A couple of weeks after returning from Walt Disney World, I started wondering if I had become hyper-sensitive about the discomfort in my hip.  I had tightness and aches all summer while I was running 35 miles a week.  Focusing on stretching and foam rolling seemed to relieve the discomfort so I could run the next day. But what if I had some major damage and I was going to cripple myself if I ignored it?

About that time, all my bills from my July bike accident had gone through the system and I had met my medical insurance deductible.  It was mid-November, I still had about 7 weeks left in the year, perhaps I should try seeing an orthopedic specialist.  I made an appointment at an Orthopedic Sports Clinic close to my home.  An x-ray did not show any obvious damage, maybe some Femoral Acetabular Impingement (FAI) and perhaps a minor labral tear.  But nothing obvious and no structural damage.  Recommended course of action was Physical Therapy.  

Getting a Second Opinion from The Oracle, the Internet!

After going home and doing my own research on FAI and hip labral tears, I was convinced that surgery was not in my future, regardless of diagnosis, so I was going all in on PT and strength training. 

My research of course led me to YouTube where several physical therapists and personal trainers offer their opinions and advice on dealing with FAI and Hip Labral Tears.  A YouTube channel from Upright Health provided me with a lot of optimism early on in my hip pain journey.  After listening to personal trainer Matt Hsu discuss his opinions on conventional orthopedic treatment for FAI and Labral Tears, and running through a few of his suggested exercise routines, I started reciting his mantra in my head, “ATM - Always Think Muscle”.  Matt’s videos resonated with my own thinking, and he convinced me that muscle weakness and imbalance were the sources of my problem.  

Here’s one of Upright Health’s videos:

Disclaimer: There are dozens of YouTube channels that offer advice and exercises to correct all types of physical issues. To keep things in perspective, however, using YouTube as a source of medical advice is fraught with peril.  There are no peer reviews for YouTube videos.  We each must filter through what we see and hear and pick and choose what resonates with us, with the understanding that the Internet is not a substitute for a professional medical diagnosis.

Starting Physical Therapy at the Sports Clinic

I managed to get three PT appointments in before the end of the year, while my out-of-pocket costs were still small.   At first, it seemed much of the same, with some basic stretching and exercises.  After a couple of visits, however, it became more intense.  My Physical Therapist was figuring out where I was weak and imbalanced. The exercises prescribed were similar to ones I had seen from Upright Health and other YouTube channels.  I decided to continue with PT into the new year, just less frequently.  By mid-January I had an exercise regimen that took me nearly 2 hours to complete and I was starting to feel muscle soreness in muscles I did not know I had.  

My Physical Therapist included single-leg strength exercises in my routine.  Oddly, they were easier to do on my right side, the side where I was experiencing pain.  I struggled on my left side, even though I only had limited soreness on that side.  My left leg was noticeably weaker than my right!  I also became aware that I was putting more burden on my right side than my left.  When I pushed the pace while cycling, I was driving the pedals with my right side and left my left came along for the ride.  When going downstairs, I was slamming down on my right foot and was not activating my left side to slow down my momentum. I assume this left side laziness and weakness transferred to many daily activities, including walking and running.