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Rowena

Registered: 03/30/09
Posts: 2
Reply with quote  #1 
Just as the snow melted & I prepared to resume running after enforced winter idleness, I fell off my horse and landed on my left hip. Initially, I thought I was uninjured but a growing pain in my left groin area quickly developed and I limped home to ice it. That was exactly two weeks ago.

I'd had a groin pull 8 yrs ago when training for NYC marathon & it didn't heal without PT, so I got myself to a PT the next day. He diagnosed a gracilis strain and has been treating that with gentle stretching & heat. It seems to be improving slightly, though not as fast as I'd hoped.

I also felt some achiness in my hip, hard to describe, but picture a flat horizontal plane running from groin to outside of hip/thigh, interior to exterior & anterior to posterior. There is soreness through that entire plane. Left hip bone is tender to touch, left sit bone is sore when I sit down. Unlike the groin pull, this is getting worse, not better. One of the worst problems is that I am having trouble sleeping. I normally sleep on my left side & the ache is too much now. I have tried running but literally cannot run a few steps, so I have been taking 2 mile brisk walks instead.

I am concerned that the groin pull will heal but I still won't be able to run due to hip problem. I didn't have any visible bruising & I do have quite a lot of padding on my hips. Could I have fractured/injured something else within hip/thigh area on landing? The acute pain of the groin pull has been the focus of my attention but now the hip ache is beginning to take center stage. I am anxious to be back out running & feel I am losing time now that snow is gone.
RunDoc

Registered: 10/26/05
Posts: 743
Reply with quote  #2 
Rowena,

I would see a physician as soon as you can.  If you fell onto the outside of your hip and feel pain on the inside, I doubt a groin strain (just not the right mechanism of injury).  I would worry more about a pubic rami fracture and/ or combination with a bursitis problem to the outside part of your hip.  Surprised your PT didn't recommend an x-ray especially with a fall from a height like that (much different from falling from a standing position).  Any numbness/ tingling or back pain?  Did your leg get caught in the stirrup (could explain groin pain mechanism)?  I would see a sports doc/ ortho and get an x-ray.  NYC is pretty far away, so right now the important thing is getting a good/ correct diagnosis.  I don't know if you are local, but I happened to see my schedule for tomorrow before I left the office and I do have an opening in the AM tomorrow if you would like.

Nilesh
Rowena

Registered: 03/30/09
Posts: 2
Reply with quote  #3 
Thank you for your response. I delayed posting until today because I just got the MRI results. I had an X-ray exactly 2 wks post-injury and it was normal. Had an MRI a week later (yesterday) and it shows 3 fractures:

1) left pubic fracture extended anterior acetabulum
2) ishium fracture near hamstring
3) small nondisplaced left sacral fracture

No numbness/tingling or back pain, just an achy soreness in left hip area. PT did not suspect anything broken. Fall was so fast I do not remember getting foot caught in stirrup but I figured I must have done something, such as tightening left inner thigh as I started to fall off, that pulled left groin muscles.

I'm still in shock about this. I have been riding since injury, and was just getting ready to return to running as the gracilis pull seems to have mostly healed. My hip is still a bit sore and stiff, but I can't believe there are 3 fractures. I wish I were local but I am in western MA. I have a referral to an orthopaedist but there were no openings for 3 weeks, but which time I hope it is nearly healed. I am also getting a bone density scan and Vitamin D test as I cannot believe I could get multiple fractures from a run-of-the-mill riding fall into the relatively soft footing of the arena at 39. I brushed myself off & got back on that day, and rode the next day. I only didn't run because of the groin pull. Now, I don't have a clear sense of how long I will have to wait to safely run again. I am going to pick up the MRI pix on a CD tomorrow & see if I or the PT can tell how big the fractures are. This is just bizarre. I really need to start building base mileage for NYC training which begins in July. I am so annoyed & disappointed; I thought only little old ladies and motor crash victims broke their hips!
RunDoc

Registered: 10/26/05
Posts: 743
Reply with quote  #4 
Rowena,

Sorry about your bad luck here.  If you have followed some of the last few threads/ posts, I mentioned how difficult this Internet doctor advice is, but I may have been right on with this on with the pubic rami fracture.  Of the fractures you have the one that worries me the most is the one that goes into the acetabulum.  Are you limping at all?  If you are limping then I would have you on crutches.  Without seeing the pictures, it is hard to make a definitive on when you can run again.  Hope your ortho is a sports ortho - general ortho may tell you "just don't run."  Now, based on the fracture, that may be the best thing for you, but hard to say.

In terms of the bone density scan etc - you had a fall from a height.  Like I mentioned in my first post - that is a lot different then falling while running.  Your fractures would not be considered a fragility fracture.  Those are mainly one that occur from standing height or less, not from falls from a height.  "Little old ladies" fall in their homes and fracture their hips with low velocity injuries.  Your running probably helps your bone density as well in your lower extremities anyway.  Keep us posted.  Hope things go well.  If you are looking for a sports doc in your area, try http://www.amssm.org and search for a doc in your area.  May be able to get in sooner with one of them if you don't want to wait3 weeks (not that you may necessarily need to get in sooner). 
Robin

Registered: 02/10/13
Posts: 1
Reply with quote  #5 
Very interesting story which I found by googling "groin pain after fall on hip". 

I too have groin pain similar to what Rowena described.  I crashed off my push bike at about 30kph when I hit a mud patch and couldn't steer.  Landed on R side and suffered # clavicle & rib, huge contusion R hip & thigh & my helmet was broken.  I also had R groin pain and wondered if this was due to pelvic fracture but thought as a retired GP I was probably over diagnosing.  This happened 11 days ago.

I'm in a sling and started walking again 4 days ago.  Tonight I went for my first fast walk and after 2Km got severe pain R groin such that I couldn't weight bear and had to hop home - fortunately I was only 20 yards away.  The pain was not sharp, more a severe ache and it reminded my of compartment syndrome or claudication.  I was still unable to manage stairs an hour later.

I've just tried walking up and down stairs again and the pain has gone!  This is after another hour sitting at the computer.

Hope you don't mind me writing.  I thought your advice to Rowena was bang on and you deserve congratulations on having this website along with your expertise.

RunDoc

Registered: 10/26/05
Posts: 743
Reply with quote  #6 
Robin,

Interesting set of symptoms and how easily the pain want away after some short rest, despite such significant pain with your walk.  I would still recommend an x-ray - could have had a pubic rami/ pelvic fracture - most if which are stable allowing you to walk some, but not too much before it lets you know there is an issue.  Groin pain always makes me think hip joint - depending on your age, possible there may be some osteoarthritis that got irritated by your fall.  Also, with the trauma there could be an issue with your acetabular labrum.  I think start with a good evaluation and an x-ray.

Nilesh
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