After my third training run (3 1/2 miles) my right hip was killing me, and it persisted through the next day. (If you want to catch up on the first two chapters, start here.)

This could seriously affect my progress toward my goal of running the half-marathon. I had to find a way to address the problem.

The picture above shows exactly where my pain was emanating from – that knob of bone on the outside of the pelvis called the trochanter. The trochanter is a protruding part of the thigh bone to which numerous muscles attach. Because it bulges out, these muscles gain mechanical efficiency, increasing their leverage in actions of the thigh.

Pain around the trochanter is sometimes called “trochanteric bursitis,” since there’s a bursa in the area that gets inflamed. But there are plenty of people who have pain in the area without evidence of an inflamed bursa, so usually it’s best to call it just “trochanteric regional pain syndrome.”

That’s what was going on with me. But instead of taking advil to squash the inflammation, better to analyze the biomechanical reasons that area was under stress and build some strength into my system.

The muscles and connective tissues around the trochanter are responsible for balancing the weight of the trunk over the leg. These muscles include:

• The gluteus medius – connecting onto the trochanter from above
• The piriformis – connecting onto the trochanter from across the buttock area, and
• The fascia lata (sometimes called the iliotibial band) – connecting onto the trochanter from below. (Not a muscle itself but it can be tautened by contraction of a smaller muscle, the tensor fascia lata.)

When you’re walking, and to an even greater degree when you’re running, there are two components to the forces these muscles have to control:

Vertical compression – with ever step, walking (and running) requires controlled deceleration of your landing, and

Lateral shear – with every step, you’re also shifting weight-bearing from one side to another, creating shear stress of the sacroiliac joint. The trochanteric muscles have to activate to limit potentially excessive sacroiliac motion in response to shear.

Simple!

I could solve my problem with a rehab exercise program to strengthen the muscles involved in

• vertical deceleration: a chain that begins with the toes, through the knees, hip joints, and low back; and
• lateral weight-shift support: the piriformis, adductors, and other muscles comprising the “rotator cuff” of the hip.

Next up: Chapter 4 — My rehab program

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