Megan’s Story: “Not Interstitial Cystitis, PNE, Pelvic Floor Dysfunction, or Vulvodynia, but an Orthopedic Hip Injury?”

Hi everyone!

I’ve just discovered the most moving and informative story of one woman’s four-year quest to resolve debilitating pelvic pain.  It’s from Megan McGorry, and her blog is Mermaid’s Reel.

There are SO many reasons why I wanted to share this with you.  Really, her post speaks for herself.   But for the purposes of learning about the SI joint, I wanted to draw your attention to a few main points about her story.

acetabulum_03_anterior_view

The hip socket

Point #1.  The cause of Megan’s pain turned out to be a hip labral tear— which is something that’s very important for SI joint sufferers to be aware of.

The labrum is a ring of cartilage that sits in our hip socket.  It’s job is to cushion the joint, where the head of the femur (thigh bone) sits.  Sometimes, due to an acute injury or chronic overuse patterns, the labrum can become inflamed or torn, causing a wide range of symptoms.  (Don’t worry, it is treatable with surgery!).  You can check out this article from the Mayo Clinic for more.

In my story

If you’ve read my entire story, the second physical therapist I ever saw was so alarmed by my symptoms that she wouldn’t treat me until I saw an orthopedist to rule out the question of a labral tear.

A t the time, I was just annoyed.  I knew I didn’t have one.  But I’ve learned a lot since then, both in my classes and in doing research for this blog.  Now I see that she was completely right.

Maybe I didn’t turn out to have a labral tear, but it would have been totally irresponsible for her to continue to treat me without knowing for sure, based on the symptoms I had.

If you read Megan’s story, you can see exactly how many different symptoms can be caused by a labral tear in the hip socket.  It can send pain radiating just about everywhere through the pelvis.  Megan had burning pain throughout her pelvis, tailbone area, bladder, “lady parts,” and, as she describes it, an “almost constant urge to urinate.”

All of these symptoms ended up being caused by a labral tear in the hip socket, as well as some damage to the muscles of her core.

You can see, in her case, exactly how many medical professionals totally ignored the question of a labral tear.  It took her four years and over $100,000 to get to the truth.

So… thank you to my PT from 5 years ago.  You were totally right.

#2 Many of the symptoms she experienced, and the treatments she explored, are also relevant to SIJ sufferers. 

SIJ dysfunction and labral tears can share many of same symptoms, and many of the same co-existing conditions (and are, of course, often co-existing conditions themselves).  You may encounter these diagnoses on your own journey.

Throughout Megan’s journey, she also explored treatments for vulvodynia and interstitial cystitis.  These can be real conditions in their own right, with treatments that (hopefully) can help.  However, they can also be caused by a larger issue (such as tight muscles pulling on a nerve or, in Megan’s case, a labral tear of the hip).  So her post gives you a good sense of what to rule out.

Megan also explored pelvic floor physical therapy, which is, again, something you might investigate as a patient as well.  I was pretty surprised that not even the pelvic floor physical therapists thought of a labral tear.  I’ve also been to pelvic floor PT and found that, like regular physical therapy, there really can be a wide range in skill level.  There are relatively-unskilled pelvic floor PT’s just as there are relatively-unskilled regular PT’s.

Pelvic floor disorders are, again, a real thing, with a wide range of symptoms and possible treatments.  However, they can also be symptoms of another condition that’s been missed– which, again, in Megan’s case was a hip labral tears.

#3 There can be many layers to a complicated injury or musculoskeletal condition.

As Megan writes,

“After doing some research, I learned that… when a hip labrum is torn, it can greatly alter the stability of your pelvis. It can negatively affect your posture and your gait. In order to prevent more damage to your hip and pelvis, your body has a natural mechanism to protect itself—muscle tightening. The pelvic floor muscles and abdominal muscles tighten and “guard” to help keep the injured hip in place.

This made so much sense to me. My hip labrum easily could have torn due to the massive impact of my car accident in 2012. If that was the case, my pelvic floor muscles weren’t tightening due to “stress” as some experts suggested. They were tightening as a natural response to protect my injured hips. The downside of that tightening is that when muscles become too rigid they can cut off blood flow or tear. This creates a pain cycle of terrible nerve irritation.

On top of the tight muscles impinging nerves, there are also sensitive pudendal nerve endings near the labrum itself. When a labrum tears, it can irritate those nerve endings as well. When irritated, those nerve endings refer intense burning pain to various areas of your pelvis including: Bladder, female/male reproductive organs, vagina, labia, clitoris, penis or testicles.”

You can see how complex the implications of her labral tear were– the muscles around the hip joint tightening up in order to protect the injured joint, which then irritated the nerves that connected to her urinary and reproductive organs.

#4. However– one way to quickly get information is to do imaging, such as an MRi.

Honestly, as I read through this story, I can’t believe that none of her doctors were willing to do a pelvic MRI.  This, of course, is not Megan’s fault at all.  She’s the patient; it’s not her job to know these things.

But I just really can’t believe it.  Sometimes, in life, we can hit a string of bad luck for no apparent reason, and through not fault of our own.  (On a lesser scale, I’m thinking about how many different physical therapists I had to go through, before I found someone who could treat me).

#5.  That’s why it’s so important to keep going, which is what Megan did.

 As I read through her story, I was so struck by the fact that Megan didn’t seem to blame herself for anything that had happened to her.  Not that she should have!  She had exactly the right mentality– she knew her problems had answers, and she knew the doctors she saw weren’t getting to the root of the problem.  This is something I’ve really struggled with throughout my own journey.

I still struggle with it sometimes, to be honest. Why didn’t I try harder, sooner?  Why didn’t I just know to try X, Y, or Z?  Because I did lose a ton of time and money (not to mention missing out on life) to my sacroiliac joint saga, not to mention my earlier battles with chronic pain.

So that’s what I admire about Megan’s approach.  She simply lays out the facts, and kept going and believing in herself.

Okay… that is all I have to say for now!

Again… definitely check out Megan’s post!

And Megan, if you happen to see this (I don’t know if you ever Google yourself) thank you so, so much for sharing your story!  I know you are helping people.

–Christy

For more:

Hip labral tears

Body Harmony PT: Labral Tears

Hip socket illustration courtesy of BodyParts 3D.

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