For almost two years now (since I’ve been diagnosed with FAI) I’ve been working on my mobility by spending a fair amount of time on a foam roller, a ball, or anything else that helps break up the fascia adhesions and tightness that hinders mobility. I’ve discovered that releasing the “knots” in the quad of the FAI hip brings instant relief for any discomfort or pain, and therefore started to focus 99% of my energy on that area. During this time I’ve also taken up some body-weight strength training in the form of lunges, squats, hip thrusts, deadlifts etc. I was unfortunately not very religious about it and my routine was rather haphazard. Things were going okay until last summer, but as with most things in life, when things get tough or life gets busy, looking after oneself goes out the door. Admittedly, I’ve been rather lax the past few months about my hip. I didn’t have much pain, and when I did experience some discomfort, breaking up the adhesions in my quad did the trick. This happened a few times a week, and apart from that I didn’t bother to keep up my maintenance and conditioning in any of the other areas of my body, let alone balancing out left and right. This has turned out to be a big mistake.
The past couple months, I started to notice that my quad release trick was no longer working as well as before. I still put in some effort to break up the fascia adhesions, but it doesn’t result in instant relief like before. That made me panic a little, and was maybe the much needed wakeup call. And so it came about that the Monday before our first on-road half marathon event in quite a long while, I decided to have a solid two hours of foam-rolling, ball rolling and some stretching as a preventative measure for the half marathon (quads, hammies, adductors, abductors, gluteus, ITB, TFL, etc on both sides). This was partially the result of feeling guilty for having been a bit slack with my mobility maintenance the past few months, but also an attempt to start a regular routine again. The tissue work was probably a good thing, but then, to finish off my new-found enthusiasm, I also did 40 Bulgarian split squats, half with a 4kg weight. Not my best move, and just like that I stuffed up my body. Well, I have no other explanation for why things went south.
The next day my leg muscles were understandably sore. We tried to go for a run, but I felt tired and sore and generally just didn’t feel up to it, so called it quits halfway through. In the meantime, I developed a severe case of hip impingement. Where previously I’ve had the nerve “shock” pinch only a few times a year, it was suddenly happening all the time. It became so bad that standing at the door, just thinking about taking the step to go outside, would cause a sudden shock, making me gasp for air, followed by an uncontrollable yelp. The times I could manage to get down on the floor, I would spent on the foam roller. “Dissolving” the adhesions in my quad, made things almost bearable while I was on the roller. Stretching my gluteus while down on the floor, brought minor, short-lived relieve. Moving around the house was challenging to say the least. Sitting and getting up, was almost impossible. Any hinging at the hip caused hip impingement and severe pain.
The following day, we skipped our run completely. By the Thursday, I’ve been keeping up the routine of foam-rolling and stretching a million times a day. We opted to meet a friend for a run in the gorge and strangely enough, the run didn’t cause much, if any, problems. Getting in and out of the car, however, did. But on the run, not a single pinch on any of the hills, apart from the back-inside of the knee on the same leg that didn’t feel happy going up steps. This little niggle has been with me since end of January, but being a bit haphazard, I’ve been ignoring it for the most part. Sometimes it will be fine, and other times it would stop me dead in my tracks. I’m guessing it is most likely related to the hip problem. Fix the hip and the knee will come right by itself, maybe? For the 15km gorge run, it was fine, until the last few steps going back to the car. Still, the gigantic hip problem was mostly fine on the run which felt totally unexplainable.
Came Friday, we skipped our run again as my hip pinching pain took on epic proportions. I couldn’t tell if the run made it worse or not. Keeping busy and doing stuff (like running, gardening) was good, while sitting down and doing nothing (studying) made it worse. By the evening while having a cider and wondering what to do about the upcoming half marathon, things got progressively worse and I ended up having to take pain killers. We went to bed while I was hoping everything would be better in the morning. Alas, it was still deteriorating to the point where I yet again spent the biggest part of Saturday on and off the foam-roller, while mostly feeling like a total invalid.
Late afternoon we had to make the three hour drive to New Plymouth. Sitting generally seems to be the worst thing I can do for my hip, but in its current state, it is just pure torture getting up from a sitting position.
Still, I moved cautiously from one spot to the next, and foam-rolled a couple of times during the evening, as well as before the run. And strangely enough, I had no impingement during the run. How is this even possible? But with about 3km to go on an uphill section, I suddenly developed a massive pain on the inside/back of the OPPOSITE knee. I’m not sure whether it was from moving differently to compensate for my hip, or whether it was unrelated, but since then its taken two days of RICE before I could even manage an easy 4km walk. I’ve also started foam-rolling the left leg instead of the right leg where the hip problem is. This seemed to have worked somewhat.
We managed another walk of about 11km, but apart from these two outings, we didn’t run at all in the weeks that followed.
And then horror struck. Exactly one week after the half marathon, I suddenly had quite bad pain and pinching late that evening, barely managing to brush my teeth and get into bed. Unfortunately, the pain just got worse during the night and by 3am, Gerry had to get me some painkillers, as I couldn’t move or die from pain. The whole day long, I was in agony, crying with pain whenever I had to go to the bathroom, and I couldn’t understand what was going on. It was so bad, I could not fathom the thought of getting into a car to go to the emergency room. In fact, Gerry could not even attempt to help or carry me anywhere. I’ve generally thought my pain tolerance to be quite high, but this pain pushed me over my limit.
I spent the day in a trance from painkillers interspersed with voltaren tablets, while alternating between putting a hot bean bag and an ice pack on my hip, but mostly stuck to the bean bag. What was supposed to be an active day in the garden (it was a lovely day outside to boot) ended up being a horrible day in bed and in severe pain. I have never felt anything remotely like this pain in my hip – ever! I gather it was a nerve that got pinched somewhere, making any form of movement impossible.
The next day I got up and cautiously moved to the bathroom. Things seemed to be almost back to “normal” again, and throughout the day I started getting more “daring”, to the point where later on I started to hinge at the hip, and squat to pick stuff up, etc, things I did not dare do earlier in the day.
Needless to say, I stopped all forms of foam-rolling and haven’t done anything physical for another week. Maybe this is not what happened, but I suspect that I may have foam-roller myself out of balance by focussing mainly on the FAI leg. Especially with the excessive foam-rolling in the week leading up to half marathon and the week thereafter which led to the agonising, disastrous, and most painful FAI hip day yet. In combination with this, it was probably the Bulgarian split squads that pushed my hip over the edge.
After two weeks, we attempted a slow jog-walk, but I’m at a loss in terms of whereto now. I still strongly believe that the impingement is caused by muscle imbalances and unhealthy fascia (yes, I’m on the healthy fascia bandwagon), but my knowledge of anatomy is not enough to figure it out by myself. Unfortunately, no medical or health professional is vested enough in anyone to really help figure out their exact, unique problem. And every body is different, but all treatments seems to be sort-of “blanket” problem-solving routines, which is not doing anything for my specific needs. It could be as simple as one of the gluteus muscles on one side not firing, so a general gluteus activation exercise on both sides might not help? It’s all about balance, and as is the case with running training as well, specificity is what is needed. Hence, the quest for managing the “problem” continues.
Part of this, included signing up for a distance course with Mobility Mastery called CONFRONT YOURSELF (And Heal Anything) with Kinetix. I’ve mentioned previously that I follow the foam-rolling techniques of Elisha on YouTube, and maybe this all sound a bit wishy-washy to the next person, but I think she’s on to something. Since fascia is the connective tissue that wraps absolutely everything (organs, muscle, bones, nerves, blood vessels) and is one giant network keeping one’s body in one piece, I’m starting to believe that unhealthy fascia (sticky and knotted up fascia) could be the cause of a lot of pain. As a case in point – since doing a lot of foam-rolling over the past two years to break up the adhesions (apart from recently overdoing once specific spot that caused an imbalance), I have experienced far less muscles soreness after long runs, or tramping with a backpack. Usually the day following an ultra, or on day two of a tramp, I cannot move or get out of the tent from severe muscle pain. My pain always felt abnormally bad compared to the other parties of the group, but I now believe it to be a case of really unhealthy fascia.
You need a partner to do the course and it will take time to learn all the techniques. Time is unfortunately not something we have in spades at the moment, but hoping things will get better towards the end of the year so that we can really dig in and get to understand the process. Will report back on this in the future.