Running is considered to be one of the best forms of exercise. Running can add many benefits to your overall health in addition to being great for your heart, strengthening your bones and toning your muscles. Coupled with proper stretching and adequate amounts of hydration are essential if you want to maintain a healthy and toned body. Nonetheless, running a lot can do a great deal of damage to the body and pelvic injuries are an example.
This type of injury is more commonly found in women than in men, and about 45% of the women who have complaints in this region are due to stress fractures, which are small cracks in the region. For many women, they follow a restrictive diet that can prevent them from menstruating.
Menstruation produces the female hormone, estrogen, and when a woman lacks estrogen it weakens her bones, favoring the statistically higher number of women with this type of injury.
DEFINITION
Runners’ pelvic injury is the injury felt in the pelvic area that comes from excessive running (overload). Runner’s pelvic injury is a major injury that affects runners who run on difficult or uneven terrain and for individuals who run with biomechanical changes.
TYPES
The areas along the hip where pain is felt and possible causes are: Anterior Hip Pain: This form of pain comes from the hip flexors or hip joints; Lateral Hip Pain: Pain can be felt in the iliotibial band or more commonly known as bursitis or IT band friction; Posterior Hip Pain: Pain and tightness are felt in the piriformis muscle; and Groin pain: pain simulates inguinal hernia.
SYMPTOMS
Any pain you experience when trying to run is a sign that you may have developed some form of pelvic pain. There are some symptoms that we can identify to discover: Lesser to intense pain in the groin; in the hip, in the pelvic region; hip misalignment; Minor to severe pain felt in the leg and foot/feet;
Bruising or swelling in the pelvic area; Discomfort when sitting, standing, walking; Discomfort when having a bowel movement Tingling sensation in the groin area; Diarrhoea, constipation, bloating; Discomfort when urinating or sexual intercourse; Progressively painful menstrual cramps; Bleeding/discharge. In all of the above cases, look for a sports doctor to make the differential diagnosis.
CAUSES
There are many causes that can result in someone suffering from hip pain. The pain comes from many sources and is usually found in bone, joints, muscles, tendons and bursae. Most injuries are caused by overexertion or overtraining.
Injury suffered in the past (history of previous trauma): It is a common cause for an individual, especially if they are running, to develop pelvic injuries if they have had a history in the past of having had trauma to the region.
bad posture: Bad posture can happen for a variety of reasons, such as how we sit, whether we’re hunched over, or whether we’re leaning over. Often when we run, we use a supporting side, preferably our strong side, which distorts our alignment and biomechanics. What bad posture does to the body: It increases the level of stress and overload on the side that receives the most impact and misaligns the joints and vertebrae of the spine
Strength imbalance (or asymmetries): favors one side by putting more weight on one side while walking, sitting, or running.
Landing: there is a correct way to run the race. If you are running with posterior overload instead of the forefoot you will cause pain not only in the hip but also in the lower back (lumbar).
Resistant surfaces: the surface you’re running on, if hard, can also put a lot of stress on your spine and hips.
EXAMPLES OF PELVIC PAIN
- IT band bursitis: causes lateral hip pain
- Piriformis Syndrome: This is a common cause of posterior hip pain in many runners. This syndrome causes severe pain that occurs during running in the back of the legs.
- Sacroiliac Dysfunction: The sacroiliac is the joint where the pelvis and lower back come together.
- Arthritis: it is a joint disease that can affect the hip causing pain when moving the joint.
- Hip misalignment: Hip misalignment can cause severe hip injury and pain. In addition to affecting nearby muscles
- Pelvic Stress Fracture: This is a fracture usually found in the large bone of the pelvis. This is caused as a result of repetitive impact. For those who suffer from it, they often experience groin or hip pain.
In this article, we are focusing on pelvic pain related to running, therefore correlated with injuries and strains. It is equally important to understand that pelvic pain can have other causes, unrelated to overuse injuries, such as disorders of the spine, organs and nerves, infections, injuries, fractures, tumors and so on.
DIAGNOSIS
There are many ways to determine if you’ve developed a pelvic injury. Pelvic injuries are notoriously difficult to find early on. I myself had my first pain (sacroiliitis) after 3 years of running. This is because, at first, when the pain starts, it is misinterpreted as a simple muscle contraction.
This misinterpretation of pain causes the injury to become much worse later on and develop. The best way to determine if you’ve developed some form of pelvic injury is to speak with a sports doctor.
TREATMENT
Pelvic injuries are quite common and the associated pain can keep many runners off the track for weeks to months. But luckily there are ways to treat this injury as they are most commonly associated with the hip but can be a source of pain in other parts of the body. Such as the lower back and thigh.
There are treatments that can help align the hip, strengthen and rebalance it. For most pelvic fractures, the best treatment is simply to rest and encourage healing. However, there are some injuries that are so severe that they require crutches, weeks of extreme rest, and in some cases, surgery is required due to the severity of the injury or possible dislocation.
Ana Paula Simões is an Instructor Professor at the Irmandade da Santa Casa de Misericórdia de São Paulo and Master in Medicine, Orthopedics and Traumatology and Specialist in Medicine and Surgery of the Foot and Ankle by the Faculty of Medical Sciences of Santa Casa de São Paulo. She is a member of the Brazilian Society of Orthopedics and Traumatology; the Brazilian Association of Ankle and Foot Medicine and Surgery, the Brazilian Society of Sports Arthroscopy and Traumatology; and the Brazilian Society of Sports Medicine
