Question
QUESTION: In 2008 I was in a bicycling accident and fractured my right hip. I had 3 screws inserted and now have some slight hip rotation limitations (femur jammed into the hip socket). I am still cycling but am also a runner (for the past 10 years). Since the accident when I run I have a popping sensation in my hip which is causing SI problems (so I've been told). Are there any exercises that I can do that would help the SI problems? Could it be that my hip flexors are weak? This causes soreness in the SI area and sometimes in the groin. I really can't imagine giving up running as I do duathlons so I'm looking for any advice possible.

Thanks for your help.

ANSWER: Lynn,

You need to have this thoroughly examined.  This includes hands-on physical examination to determine if your pain is coming from the hip joint or the SI joint or a surrounding soft tissue structure.   Painful hip joint popping is not good.  Snapping hips that are not painful are often from the psoas tendon snapping over the knob on the inside of the femur (lesser trochanter) or the IT Band snapping over the large knob on the outside of the hip (greater trochanter), and sometimes even the hamstring tendon will make repetitive snapping sounds.  An unstable popping in the hip most commonly points to a tear in the cartilage that lines the socket.  It's called labral cartilage.   If you potentially have a labral cartilage tear (your hip was jammed in to the socket as a mechanism of injury), then you must undergo a hip MRI-Arthrogram.   Contrast dye is injected into the hip joint which lines all the nooks and cranny's and then the MRI is performed.   It will pick up a labral tear if you have it.  The MRI will also show other issues in the surrounding hip.   As a serious competitive athlete, it's likely the best option for diagnosing your hip and not letting various providers fool around guessing what's causing the popping.  Rule out tears to the labrum and/or the joint capsule ligaments before doing anything else.   

'Hope this was helpful.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: I''m sorry for sending a second message but I forgot to include that when I broke my hip in 2008 they identified that I have osteoporosis in my hips.  None in the spine, just the hips.  I was put on Evista and have been taking this since the accident.  I wasn't sure if that was important but wanted to let you know this too.

Again, thanks for your help.

Answer
Lynn,

Osteoporotic and young?  Hmmm.  Make sure also to have your vitamin-D levels checked.  Vitamin-D, or D3, is actually a hormone and not a vitamin and it is crucial for bone and muscle health.   I cannot emphasize the importance of this.  Do not accept the standard spiel that your levels are okay when it is close to the low end.   The range is 30-100 and when your blood test says 30 and "considered in the optimum range" that is not accurate.  There is a ton of information on this.   Go to www.vitamindcouncil.org and see for yourself.   You need to have serum levels around 80.  Olympic athletes are recommended to have it close to or at 100.  Evista is not the cause of your hip symptoms, by the way.   I hope this guides you in the right direction.     Also, I noticed that in my original response to you I had a grammatic error in one of the sentences, and I wanted to be clear that you get a MRI-Arthrogram and not to let providers keep guessing or tinkering around with your hip.  

'Best of luck with this.

Dr. G