Female Runner With Bilateral Hip Pain - Page #1

Author: Jared Kam, BS; MD
Co Author #1: Steven Scharmann

Patient Presentation:
A 28 year old female was evaluated for left hip pain in the medical tent of a local marathon in May of 2010. She began the race pain free and noted increasing hip pain around mile 17. She began walking and limping and slowly made her way to mile 23 when she dropped out of the race secondary to her pain.

She began her training in December of the previous year with a running series including 3 days of running per week interspersed with 2-3 days of weight training. Her training pace was about 10 min/mile, logging approximately 20-30 miles per week near the end of the her training. Her longest run prior to the marathon was 20 miles.

She had previously experienced some right hip pain several months before the marathon which resolved with rest. She further had poorly localized deep achy left hip pain several weeks before the race which had again resolved by race day. This pain was not evaluated by a physician. The patient has had three pregnancies with the last occurring 3 years prior to the race. She reports regular menses without amenorrhea or oligomenorrhea. She is otherwise healthy with no significant chronic medical issues and does not take any daily medications.

Physical Exam:
The patient had a BMI of 26.6. She had symmetric internal and external rotation at the hip bilaterally with no leg length discrepancy. She had painful extension of the left hip with resistance in the supine position. Left hip external rotation was also very painful. She had point tenderness over the left iliac crest and into the gluteal muscle posteriorly. The patient was unable to stand on the left leg to balance without any pain or fully weight bear to ambulate and was released to home with crutches.

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