09 January, 2018
Running & Pelvic Pain
Pelvic-related pain can be a tenacious problem that could lead to weeks of rest and rehabilitation. Oftentimes, pelvic pain and hip pain are considered one and the same by runners. What runners often think is hip pain is actually pain that affects the pelvis. Understanding the form and function of the pelvis can help runners to better identify pain and avoid potential long-term injury.
The pelvis is essentially a ring-like bone structure located near the bottom of the abdomen and is responsible for supporting the upper body. Both sides of the pelvis consist of three bones: the ilium, ischium, and pubis. Ligaments connect the pelvis to the lower back; in front, the pelvic bone structure joins together to form the pubic region. A hollow cup on each side serves as a socket for the hip joint.
An injured or broken pelvis is most often characterized by painful swelling. Keeping the hip or knee bent in a certain direction often helps ease pain somewhat. X-rays can sometimes identify the extent of the injury, if it is a fracture or break, for instance. CT scans are also effective at exploring the extent of the injury and whether surrounding blood vessels or nerves might also be affected.
Pelvic fracture is a major type of pelvic injury that affects runners, and is often mistaken for a pulled muscle. A fracture occurs when sudden muscle contractions tear a small portion of bone away from the ischium, where the hamstring muscles attach. Among runners, this type of injury can especially impact teenagers who are still growing.
The sacroiliac, or SI, joints are the place where the pelvis connects to the lower back and can cause significant pelvic pain when injured. SI dysfunction describes any injury or stress to the SI joints that, in runners, is most often caused by overstriding, particularly when running downhill. The condition impacts the pelvis by causing the affected side of the bone to rotate slightly, thereby creating a functional leg-length difference, explains Cathy Fieseler in Running Times. That, in turn, applies extraordinary stresses on the opposite side of the pelvis and can force a runner to alter his or her gait to compensate for pain.
For pelvic fractures, nonsurgical treatment options include taking time off--often for a few months--to allow the fracture to heal. Crutches or a walker are used during this period to keep weight off the pelvis, and over-the-counter pain medication is generally recommended. Surgical treatment is often relied on for more serious fractures that result from high-impact injuries, and consequently is not generally needed for running-related injuries.
Treating SI dysfunction typically requires a combination of pain relievers and ice massage over the affected areas. Physical therapy is sometimes necessary. When the condition improves, pelvic stabilization exercises can build strength in the SI joints. Again, time off the road, trail, or treadmill is a necessary prerequisite to fully benefiting from treatment and recovery; pool running and swimming are effective alternatives for injured runners to keep up their fitness regimens without further impairing the pelvis.
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