Author Topic: Hip Impingement was Re: Inguinal Hernia  (Read 1167 times)

Hip Impingement was Re: Inguinal Hernia
« on: December 02, 2019, 01:05:23 pm »
Ultrasound scan says no hernia. Back to the GP whenever I can get an appointment - wonder what the next step is.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #1 on: December 02, 2019, 01:43:34 pm »
Ultrasound scan says no hernia.
That happened to me a couple of years ago.  Swelling, constant low level pain and a slight feeling of nausea like a aftermath of taking a knock in the nuts.  Ultrasound showed a collection of what they thought was fluid.  I was told "it is not going to kill you, so the choice is yours" (this was going private).  I went for surgery where they found a benign deposit of fat.  After removal, recovery was quick and all my symptoms went away.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #2 on: December 16, 2019, 04:35:55 pm »
Ultrasound scan says no hernia.
That happened to me a couple of years ago.  Swelling, constant low level pain and a slight feeling of nausea like a aftermath of taking a knock in the nuts.  Ultrasound showed a collection of what they thought was fluid.  I was told "it is not going to kill you, so the choice is yours" (this was going private).  I went for surgery where they found a benign deposit of fat.  After removal, recovery was quick and all my symptoms went away.
They didn't find anything strange at all. Saw another doc today - he's somewhat confused and is taking the "don't know what's wrong - lets get some more data points" approach and signed me up for a bunch of blood tests. I find it unlikely that will provide any more information though.

I figured I might as well go see a physio too. He took the "there's no hernia" for granted given the ultrasound and gave me a set of exercises. He thinks I've been compensating for weak abs and an old foot injury by over using my hip flexors and groin muscles and has given me some stretches and exercises (and told me to put arch support in my bike shoes). He also suggested I raise my bars as being crunched over will make the hip flexors more crucial. I guess we'll see how that goes as well. Maybe I should finish my recumbent (or redesign it so that I can get a 26" wheel on the back so it can go on the turbo). Presumably that would unload the hip flexors...

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #3 on: January 02, 2020, 11:53:11 am »
Blood tests show nothing interesting.

I've persuaded the doctor to refer me to the Sports Medicine team at the Nuffield Orthopaedic Centre. I'll probably give them a call on Monday and see how long it would be before I can see someone through this referral. I can't imagine it would be quick, so might have to see if I can speed it up by going through the parallel private clinic.  ::-)

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #4 on: March 03, 2020, 03:36:17 pm »
After much pestering, I got a letter giving me an appointment on 8 June.

Gonna go to the same people at their private clinic in mid March.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #5 on: March 24, 2020, 04:06:19 pm »
Bah!  Mid March would have been OK. The actual date was yesterday, so it's been cancelled because they don't know when they can reschedule it for. Also, my WFH setup is not good for my hip flexors. :( I think it will restrict me from getting very much Turbo work done on lockdown as well.
I know, first world problems... ;)

bludger

  • Randonneur and bargain hunter
Re: Hip Impingement was Re: Inguinal Hernia
« Reply #6 on: March 24, 2020, 04:37:45 pm »
Bad luck Duncan. I'm sorry to read about your delay. It isn't to be made light of, your mental and physical health is valuable.

Think of it that you're being community spirited in your ration of NHS goodness is being used to save lives.
YACF touring/audax bargain basement:
https://bit.ly/2Xg8pRD



Ban cars.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #7 on: May 07, 2020, 12:08:10 pm »
Surprising news on this - I had a phone call today from the doctor who I was due to see on 8 June (also the same doctor that I would have seen privately if it hadn't been cancelled and refunded). I've been referred for an MRI for a proper view of what's going on, and hopefully it won't be too long a wait as all of those got cancelled and are now being re-booked.
And I've completed my WFH setup so now that's much more ergonomic, and I'm back on the turbo (though taking it easy and doing traditional base).

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #8 on: May 29, 2020, 06:22:24 pm »
The doctor who referred me for an MRI said she thought that my issue was one caused by compensation for an issue somewhere else. That made sense, because 3 or 4 months before it started happening, I tore a ligament in my foot, meaning I couldn't walk properly for a while, and my right foot still has a lower arch than my left. Today, when I mentioned this to the physio (first physio appointment via video), he did some stretch and strength tests, and our conclusion is that I'm using the outside of my right calf loads more than the rest of it.  This means that the groin muscles then have to take the burden of straightening everything out again. So to treat my groin problem, I'm doing calf raises focusing on using my big toe!

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #9 on: June 14, 2020, 10:17:11 am »
Yay, MRI appointment last Friday due to cancellation.  :thumbsup: Now 2 weeks wait to see if it found anything.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #10 on: June 30, 2020, 09:36:30 am »
Saw consultant (different one to who they told me it would be on the phone, so had to do my history again, only without my notes). He did all the usual leg wiggling tests and made my hips pop incredibly loudly.
The MRI shows a cam on the femoral head consistent with FAI, but he couldn't get it to impinge when manipulating my leg. His conclusion was that it was muscular, and that my super tight hip flexors are the problem (and the foot injury compensation idea is a red herring, it was just the straw that broke he camel's back). So yet more physio, this time with the head guy at the Nuffield Orthapedic Centre who is interested in FAI and hips in particular. Dunno when that will be though, or if it will amount to anything.

I've stopped riding completely as getting 15 minutes into a ride, everything tightening up and having to stop was too depressing. The turbo is packed up for now, the garage is getting a long overdue clear-out, and I'm thinking I'll stick a project car in there instead.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #11 on: July 15, 2020, 09:19:11 am »
I called the Nuffield yesterday and asked about physio. They aren't even able to say how long the wait time is they are so far behind. Also, they are only doing online physio (which is odd given I had to go on prem to see the consultant).

I'm going back to my private physio tomorrow, and we'll see what he says given my MRI results (if he can see them).
Not ridden a bike since May. I've stopped missing it, though I do get a pang when I see cyclists out training.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #12 on: August 10, 2020, 01:42:42 pm »
Update - physio couldn't see the MRI stuff, I just had to give him the letter from the consultant. He did some work on my foot/calf and hip flexor, and encouraged me to keep up my exercises. I've been doing them and loads of stretching regularly, but it seems to make no difference. Beginning to wonder what the point is. Still no bike riding. :(

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #13 on: September 15, 2020, 10:33:58 am »
Letter from the hospital arrived yesterday with an online appointment to see a physio. For today!  :o And not the physio that the consultant had requested.  ::-)

I remain unconvinced how a physio is going to be able to assess my hip mobility over zoom. He's going to have to be pretty spectacular, given 2 other physios have been unable to fix it over the course of months, even with in person appointments. I'm missing riding my bike again now, and my fitness must be terrible. Also, the local gym still hasn't opened, and I can't see that happening any time soon given we keep dipping into the amber Covid region.

Edit - actually, it was useful, and he seemed properly focussed on getting me back on my bike. More exercises and stretches, but with the aim of doing more contract-relax stuff than simply just trying to make the muscle stronger/longer, which makes loads more sense.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #14 on: November 12, 2020, 05:03:22 pm »
I had another virtual physio appointment yesterday. I'm clearly getting loads stronger, as I can do more reps even though using a swiss ball has made them more difficult.
However, it doesn't feel like my hip/groin has got any better. :( As a result I now have an in-person appointment in 2 weeks.

I might try riding my bike if the weather isn't crap this weekend and see if it's as bad as I think it's going to be. I no longer miss riding them, every so often I consider selling up, but it's not like I can do some other sport if my hip is like this.
The most frustrating thing is that after over a year, 2 GPs, 2 consultants (one virtual), 3 physios, an ultrasound and an MRI  - still no-one has an explanation. Makes me wonder if it's pain referred from somewhere else that they haven't looked at. I'll see what the physio thinks of that idea when I see him.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #15 on: November 16, 2020, 01:46:52 pm »
I tried a gentle pootle of a ride yesterday.
It was nice and sunny, the views were lovely and the wind didn't bother me too much. :) My hip/psoas did though - initially just over 200W, and toward the end of a 30 minute ride if I was over 150 for any length of time. :(
I can't ride like that - it's just soul destroying to shift down and crawl up little rises that I want to just blast up in the big ring. I don't know exactly how much fitness I've lost over the last 5 months (I didn't do any efforts at all), but it doesn't make much difference at this point. And just to emphasise the point, it bothered me for the rest of the day. :(

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #16 on: November 18, 2020, 09:35:00 am »
Sorry to read this Duncan.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #17 on: November 18, 2020, 10:54:09 am »
I tried a gentle pootle of a ride yesterday.
It was nice and sunny, the views were lovely and the wind didn't bother me too much. :) My hip/psoas did though - initially just over 200W, and toward the end of a 30 minute ride if I was over 150 for any length of time. :(
I can't ride like that - it's just soul destroying to shift down and crawl up little rises that I want to just blast up in the big ring. I don't know exactly how much fitness I've lost over the last 5 months (I didn't do any efforts at all), but it doesn't make much difference at this point. And just to emphasise the point, it bothered me for the rest of the day. :(

I'm in the same boat, but kayaking rather than cycling. Last year; good sprint speed, good endurance. Now? Absolutely pathetic.

We need to give ourselves time for the fitness to come back. It will return faster than it took to originally build up, but will take time. I'd encourage you (me?) to stick to tempo rides for a month.
<i>Marmite slave</i>

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #18 on: November 18, 2020, 11:14:00 am »
I tried a gentle pootle of a ride yesterday.
It was nice and sunny, the views were lovely and the wind didn't bother me too much. :) My hip/psoas did though - initially just over 200W, and toward the end of a 30 minute ride if I was over 150 for any length of time. :(
I can't ride like that - it's just soul destroying to shift down and crawl up little rises that I want to just blast up in the big ring. I don't know exactly how much fitness I've lost over the last 5 months (I didn't do any efforts at all), but it doesn't make much difference at this point. And just to emphasise the point, it bothered me for the rest of the day. :(

I'm in the same boat, but kayaking rather than cycling. Last year; good sprint speed, good endurance. Now? Absolutely pathetic.

We need to give ourselves time for the fitness to come back. It will return faster than it took to originally build up, but will take time. I'd encourage you (me?) to stick to tempo rides for a month.
I can live with being slow and building up the fitness, but the fitness is not the problem (at no point was I breathing hard). I stopped riding in May because it felt like it was making my injury worse (even Traditional Base), and it's still the same 5 months of physio later. I have an in person appointment a week tomorrow, so we'll have to see what the next steps are at that point.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #19 on: November 27, 2020, 09:05:19 am »
Physio appointment this morning was in person, so actually useful!
He was able to recreate the pain I get by providing resistance for me to pull my knee against. After some other physical test and a little discussion, he was then able to do the same thing, but applying extra force to hold my hip in the middle of the join - this meant that I could do the same thing with no pain!
So I have to continue the stretches etc, but I have more specific exercises to strengthen the glutes, so they can pull against the hip flexor and hold the head of the femur in the middle of the hip socket. It's the most believable theory about what is going on so far. So fingers crossed my exercises will actually make a difference and when I go back in January it will be improved.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #20 on: November 27, 2020, 09:27:51 am »
That's good news Duncan.

My wife recently tore her gluteus medius (badly enough to warrant morphine, and a green and yellow taxi to A&E for assessment) It's the hip adductor muscle, which sounds similar to your injury.  Subsequently she's had physio (fortunately paid for by my company health insurance, and all face to face at a sports physio practice) to strengthen her glutes.  The supposition is that, post hip replacement 15 years ago, she avoided painful exercises (no shit, Sherlock!) which has led to systemic weakness.

The good thing is that she gets a consultation every three weeks, and the physio gives her a new set of exercises to stave off boredom. Plus she gets to do "oyster" in her usual weekly Pilates class, no more slacking!
We are making a New World (Paul Nash, 1918)

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #21 on: December 09, 2020, 10:45:44 am »
More not hernia stuff - Mods - can you spin my posts from March 2020 off into a Hip Impingement thread so as to stop polluting this one?

Video call with consultant today. He seemed to think the idea of muscle tightness pulling the hip forward was plausible, but he wasn't sure whether it was the hip or the muscles that were the primary cause. He also said that the MRI showed an old muscle tear, which I didn't know about. I've got to get to see this MRI at some point! Anyway, he said I should continue with the physio and have a follow up with him in February. If things haven't improved by then he thinks it's worth having a steroid injection into the hip to see if it will bring down the inflammation (and also because the local anaesthetic would mean they can test the things that normally hurt and see if they still do).

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #22 on: December 10, 2020, 11:11:32 am »
Duncan, this is all very familiar to me so you have my sympathy. I also developed hip pain when cycling or walking, at it's worst I was using a walking stick and unable to walk half a mile without significant discomfort. My hip also became very clicky. I first went to the medics in 2004 aged 23,

At first the physio suggestion was a difference in leg length and a heal raise mitigated the walking issues. Reoccurrence when I got new shoes without an insole reinforced this idea until 2011 when after a long flight I couldn't keep up with a 65 year old when walking round a sewage works.

On return to the UK my GP finally referred me to orthopedics and investigations started, ultra sound to rule out a reoccurrence of childhood hernias, CAT scan to measure leg length, MRI and then contrast MRI. Eventually the diagnosis from MRI was FAI and a possible tear of the acetbular labrum. In 2012 I had an athroscopy to remove the Cam and definitively diagnose the labrum which wasn't torn. Recovery was good and I had about 6 years without problems and then it started again, click and sore hip unable to ride my best bike etc.

This time round it was also associated with back pain and like you the Psoas muscle was implicated. I found the basic exercise of sitting on a kneeling stool while doing embroidery was a good core exercise and strengthening which alleviated issues. With regards cycling I was always able to ride my more upright bikes and commuting but the lower the front end and the more rotated my hips were the worse I found either power or distance. I also have found that I get more issues when I let my weight increase.

Re: Hip Impingement was Re: Inguinal Hernia
« Reply #23 on: December 10, 2020, 01:28:58 pm »
Thanks for posting that Matthew. We tend to think of hip issues as being something that old people get, it must have really sucked to get them in your early 20s (I'm 43 and still think I'm too young for this sort of thing). I'm not keen to go down the surgery route, so I'm kinda hoping that strengthening and flexibility work will make some difference. One other thing I'm thinking might be worth trying again is a recumbent - have you had a go with that? The most upright bike I've got is an MTB, but that's still quite long and low, and I have pretty much everything I need to construct a recumbent. I need to do some more regular exercise other than 20 minutes physio exercises every couple of days  - I weighed myself this morning and discovered I'm the heaviest I've been in something like 10 years. :(

barakta

  • Bastard lovechild of Yomiko Readman and Johnny 5
Re: Hip Impingement was Re: Inguinal Hernia
« Reply #24 on: December 10, 2020, 02:01:11 pm »
I got told by my GP in 2018 when I finally went for a hip clinic referral here in Brum that the average young (under 65yrs old) person with hip issues suffers for 10-20 years before getting help. I was unable to walk at this point but had been told my Xrays were normal so... 

I did try and get help 6 years before in 2012 with private physio which just hurt like hell and 10 years before that in 2008 when also unable to walk for months on end. But my London GP was shit, barely looked at me, wouldn't listen and while she sent me for an Xray it was a fob-off. The radiologist was clearly not told of my medical history (which was actually relevant) so said "Xray normal" so serious issues were missed.

In 2018 seeing the "young adult hip service" with my medical history DEFINITELY read by doctors (who admitted to a sneaky Google) combined with my NOT normal Xray and my walking, the hip surgeon immediately suspected 'mild' hip dysplasia and femoral anteversion. I also have impingement as a as well and scans have since confirmed all those things. And cos I have to be awkward, my dysplasia is the rare way round and hip physio says I've got about contrasting issues going on. 

I'm quite pissed off my issues were missed cos my range of motion is WILDLY out and I had legs issues as a child and all the classic signs. Even if they didn't know my syndrome has "dysplastic joints" as a general issue.

I hope you can both get your legs behaving better. I'm looking at major ortho surgery as nothing else is helping and I'm not a candidate for arthroscopy and if I do have a labral tear that'll be additional surgery cos it can't be done at the same time as the stuff I need.