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iliac crest pain


Question
QUESTION: Hello,
I am a 40 y/o female runner who is at a standstill with iliac crest pain. I have had PT and some deep tissue massage and the pain doesn't go away.
The pain is located on the crest most prominently lateral to a bit posterior. Hurt to run, walk, get up from a sitting position and to sleep at night. (I am a side sleeper.)
I read your post earlier that helped someone else out with this similar pain, but I believe her pain was a bit more anterior.
Any ideas would be so greatly appreciated as I am wanting to get back out there to run. Spinning is great, but I love to run.

Thank you so much!

ANSWER: Stacy,  I'm glad you asked this question, but I'm sorry you had to ask it.  Pain is no fun.  Because it hurts while you do things besides run (especially sleep) it could be a stress fracture. The good news that once it heals you are better. The bad news is that you have to let it heal.  

If you've seen a physical therapist and they didn't identify this then you either need to see a new physical therapist or it wasn't a stress fracture at the time.  I suggest seeing a physical therapist that has "OCS" next to his/her name.  They will need to palpate (push with their finger) to determine if the pain is from the bone or muscle.  There's also a chance it could be an inflammation of the insertion of the glute medius that attaches near where you describe. A good physical therapist will be able to determine what the problem is and inform you how long you need to rest before you start training again.  

Good luck.  If you need any more help please don't hesitate to ask.  

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

QUESTION: Thank you for the reply! I should have told you as well, I did have an MRI and an x-ray of my pelvis that were both normal. I also was seen by a chiropractor that specializes in sports medicine. He helped me get thru my half marathon, with very little pain. After resting for two weeks, I was upping my mileage again and the pain returned, after about 2 months and running a barefoot 4 mile run on the beach, I could barely walk.
The stretching you recommended for the other runner has helped me tremendously, and I would love to rid this pain completely! I am in agreement about the insertion inflammation. I see an ortho today for this injury and a knee injury.
Thank you again! Very helpful information.

Answer
All that is very good information, Stacy.  First, if stretching has helped you then that is a fabulous sign.  I assume you are referring to the stretching that I have on this answer (http://en.allexperts.com/q/Jogging-Running-1648/2012/3/iliac-crest-pain-1.htm). If that is working keep doing it.  The more you do, the better it will feel.  This basically means you just need to be rebalanced or brought back into alignment and those exercises/stretches will help do that.  If they don't completely then let me know.  If it is a problem with the attachment of muscles then after a 4-7 days of doing these exercises and rest you should feel a ton better.  

If the ortho diagnoses your knee pain as anterior knee pain (aka patella femoral pain) make sure you get exercises that will improve your abduction and external rotation strength at the hip.  He should do this, but just make sure.  It's magic.  You'll have less pain after one time doing the exercises.  This is the most common pain in the knee.  This isn't how this pain used to be treated, but within the last 10 years this method has been shown far superior. Some medical doctors and physical therapy doctors still don't do this though which is why I mention it.

Good luck and let me know if I can help in any other way!  

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