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  1. #1
    ICN Member Antonia11's Avatar
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    Hip Pathology and Bladder/Pelvic Pain

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    After 20 years of IC, and relatively little pain in the last decade (barely enough to notice), I have my bladder pain explode in July of last year after suffering (though it took until January to get diagnosed; those MRIs are apparently pretty hard for local radiologists to read ) a labral tear in my right hip. Seriously, the pain shot straight to the bladder, and groin in general. I have since had surgery, discussed this with an expert in hip pathologies and pelvic pain (luckily, my surgeon), and noticed on a multitude of forums and around the web in general, that hip conditions (from labral tears to FAI to dysplasia) can have an astoundingly major effect on the entire pelvis and all organs and other tissues involved.

    I added this to my signature, and my intro here as well, but I have become rather dedicated to trying to help others who are possibly suffering from hip pathology induced pelvic pain, so please bear with me and allow me to share some of the information I have. If it helps just one other person, I will consider it time well spent. I am also curious as to how many people here with IC also have hip pain or have possibly had improvement of symptoms with treatment of hip issues, etc.

    First of all, I found this link to be very informative: http://www.hss.edu/hip-pain-center-f...p#.U2HIxeZdWx4 It's a FAQ from the Hospital for Special Surgery in NYC, home to some of the top hip specialists in the world. Note some of the symptoms of both FAI and labral tears:

    "Hip pain, also described as “groin pain,” “groin pull,” “fork in my groin” “aching ovaries,” or a deep aching pain in one’s hip, can occur from injury to the hip brought on by mechanical dysfunctions in the joint, or the result of trauma from the high impact and deep flexion occurring in sports such as football, downhill skiing, martial arts and wrestling."

    (...)

    "Labral tears often cause what feels like “groin pain.” Most patients describe the injury as a sharp pain that feels very deep. The pain level usually rises with increased activity and is easy to reproduce with high degrees of flexion and internal rotation of the hip joint."


    (...)

    "Why is a labral tear so painful?

    The labrum contains nerve endings that can stimulate pain fibers, which can cause pain in the hip region."


    There is also a description of FAI (femoroacetabular impingement), a hip condition that can result in pain as well as wear and tear on the joint itself, or labrum. The problem is that labral tears are frequently misdiagnosed, undiagnosed (mine was missed until I demanded a 4th MRI with a different radiologist, and even then, local doctors were rather ignorant when it comes to the amount of referred pain that can occur from either FAI or a labral tear or both). "The average length of time from injury to diagnosis of a hip labral tear is 2 ˝ years (Groh and Herrera 2009). By that time, much more damage, including permanent damage to cartilage and bone, could occur." (http://www.modernmom.com/c176b34c-3b...64e04a41e.html). Mine was 6 months, and in physio after surgery where I was operated on, I met women who had gone anywhere from 2-10 years.

    The problem is that, as noted above, hip injuries (or diseased hip joints) can refer pain that is rarely even felt in the hip itself. My first symptom was something I thought was some horrible new form of IC, worse than the worst flare of all time. That spread to the whole area around the bladder as well, which I know to be problem areas for so many IC patients. Muscles around the joint spasm in the body's attempt to protect the joint (in my case, this led to the tearing of 10 of the muscles that attach at the pelvis...not fun!). This leads to other muscles taking over, suffering minor tears, leading to spasms through the pelvis (pelvic floor dysfunction, anyone?). Muscle tears in the core area (sports hernias, athletic pubalgia) are so ignored that there are currently only 2-3 surgeons in the country (known enough to be recommended) who even do this type of surgery, and a small muscle tear can cause a LOT of symptoms in the pelvis, especially combined with a labral tear. (Sports hernia link showing how many variants to these injuries and their surgical repairs even are possible, it is here noted that there can be 121 different possibilities. Lots of muscles attaching in the pelvis: http://vincerainstitute.com/core-inj...sports-hernia/)

    I just met over a dozen women who all had torn muscles following a labral tear and were misdiagnosed for years, but we were all in the same boat. As a minor example, due to my labral tear, I tore 10 muscles, including the rectus abdominis, which attaches at the pubic bone and runs right over the bladder. It was frayed, and barely on the bone, so it was spasming severely. Over my bladder. I'm assuming everyone here is well versed enough to understand what muscles spasming over an IC bladder feel like! Actually, it feels like a REALLY bad IC flare, and had I not had IC for 20 years already at the time and was able to tell my doctors, "NO!! This is COMPLETELY DIFFERENT! This is NOT regular IC or due to it!", they would have just kept trying to DX me as "pelvic floor dysfunction, IC, SI Joint Dysfunction, Pubic Symphysis joint dysfunction", despite me having had 2 injury dates. It didn't help that most of these doctors seemed to suffer from "ignoring woman with pelvis dysfunction" or "can't read an MRI to save my life dysfunction".

    I realize labral tears, FAI and dysplasia are not the cause of IC in general, and not even likely in the cases of most people here. But I was found to have VERY minor FAI, enough to be irritating the joint (my tear was caused by trauma). My IC journey began in my first year of college, when I went from being rather sedentary to suddenly walking everywhere. The hip pain I started having was suddenly eclipsed by the bladder symptoms, then diagnosis of IC. 10 years later, I experienced this again, but a different symptom set (I knew I had IC, so I discounted the elevation of symptoms), after starting a rather heavy program of exercise. 10 years after that, at the healthiest point in my life, I had minor hip pain and a sudden increase in bladder symptoms, followed by a tear to the labrum of that hip by an irresponsible medical professional. My immediate symptoms caused not an appt. with a hip specialist, but instead a run to get what HAD to be a UTI diagnosed and treated along with a trip to the Ob/Gyn to see if my ovary was rupturing, it referred that much pain to those areas.

    I just had the FAI repaired along with the labrum. I can't help but wonder (the FAI was so minor it was missed by local hip specialists who even finally acknowledged the labral tear) if that hip irritation is what caused my IC in the first place, as they both flared at the same time. My hip surgeon said that it is entirely possible to have been the original cause of my IC, though there is no way to definitively prove that! 21 years, and possibly due to a hip? That is major news for me! Fixing it won't bring back the lining of my bladder, but the reduction in referred pain to that battered organ is already much appreciated! (Having 10 muscles sewn back onto the pelvis has it's own new world of soreness, so I'm hardly out of the woods, but I AM getting there.)

    I also cannot, in good conscience, NOT share this information with others who suffer from IC or even any other undiagnosed pelvic pain. If there is any chance that anyone else can be spared additional pain or can reduce their symptoms, or eradicate the original cause of their IC, I want the available information out there and posted to reach as many sufferers of this awful disease as possible! I'm not trying to get everyone to run to their doctors, demanding MRIs or referrals to orthopedists, but usually there is some degree of hip pain as well as the referred pain, and if you find yourself in this category (or have fallen or suffered a sports or accident related trauma to the hip), it's worth getting it checked out.

    (Thank you VERY much for putting up with such a overly long post, I have been a bit too verbose since surgery and the excitement over this fascinating possibility--and I'm still fired up enough over Dr. Drew's comments that my fingers are still flying on the keyboard. Seriously, thank you. I went on FOREVER there.)
    DX IC (cystoscopy) 7/93
    Meds did little-nothing, but Paxil (98) calmed it down. (No longer on an SSRI; hate meds)
    IC went to "barely noticeable" status for years. (I put it on 'ignore')
    MAJOR flare 7/13 along with 2 injuries, especially the first, labral tear, right hip.
    Unable to urinate hardly at all with undiagnosed muscle tears (10) & labral tear Fall/Winter 13/14.
    Surgery successful for muscle and hip repair, 4/14. Researching the connection between hip injuries and pelvic/bladder painhttp://www.hss.edu/hip-pain-center-f...-questions.asp as well as muscle tears: http://vincerainstitute.com/core-inj...sports-hernia/ (just some helpful links)

  2. #2
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    Re: Hip Pathology and Bladder/Pelvic Pain

    I would LOVE to talk with you about this! I've had a hip problem for 22 years or so. Saw ortho and they think labral tear. X-rays and MRI scheduled for Thurs.

  3. #3
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    Re: Hip Pathology and Bladder/Pelvic Pain

    Reading this post brings a rush of relief to me. Six weeks ago I had surgery by talented Dr. Meyers and the Vincera Institute in Phili to repair my sports hernia. So little is known about this injury to common doctors that I wasn't properly diagnosed for 8 months. Being in constant pain and agony I was seeking out doctors and had 3 MRI's to see what the hell was going on. But here's how it all began.

    I was a very active athlete/weekend warrior for 3 years doing Crossfit, long distance running & trail running, and swimming. Recently in 2014 I moved to San Francisco and ramped up my workouts with pretty intense work outs and more running. Dec '14 I ran a half marathon that was apart of the North Face Endurance Challenge in the Marin Headlands just north of SF. The trails up there are extremely steep for miles at a time. I had been training for the race for a few months including running along the same trails that the race was on. My body was ready for the race and the run itself actually wasn't that bad. But after the race is when everything took a downward spiral.

    I noticed right after the race it felt like I had to urinate but when I went to the restroom it felt like I force it out more than I should have but I shrugged it off thinking I was just sore. Few days later I noticed the urge to urinate was appearing more and more, especially when I would do a Crossfit workout or go for a run. I went to the doctor not know what was going on. They ran a bank of tests on me including blood & urine to see if there was some infection present or maybe a STD. Everything came back squeaky clean but I sought out a Urologist to be sure. The Urologist I saw ran the similar tests including a prostate test but came back negative for anything alarming. They still diagnosed me with Prostatitis! I was given a round of antibiotics but I still felt that this was the end of all of this, it didn't make sense!

    I went on a brief vacation for a week and half after that and wasn't working out or running. The urinary symptoms began to subside and I thought it was the antibiotics doing their job (most likely this is due to my body resting so the muscles began to calm down). When I returned home I started up Crossfit again and the urinary symptoms began to creep back. I would get an odd burning and slight pain around my bladder and pubic symphysis when I was working out but my meat head mentality would kick in and I said ignore it, bad move! I month or so had gone by since the race and I was doing a series of sit-ups on a GHD machine when I felt a high pitch "pop-pop" in my lower left rectus abdominis. When I stood up I had a really strong urge to urinate but when I went to the restroom I stood there for 10min and not a drop came out. The pain would subside after I sat down but I knew something was really wrong.

    I started doing my own research and came across pelvic floor disorders. It fit all the patterns that I was going through so I began to see a pelvic floor specialist that performed soft tissue and internal releases on my pelvic floor. After a month or so of these massages I began to feel better, and low and behold I decided to do another trail run. During this run I felt a twinge in the front around my pubic symphysis and two steps later again in the middle inside rear of my pelvic bowl. After the run I had a real hard time putting weight on my left leg.

    Following this I knew something was seriously wrong. I decided to take off a few months from all workouts to let my body heal. After two month I didn't feel any better so I got an MRI and it showed mild sports pubalgia, bi-lateral psoas strains, bi-lateral hip labrum tears, and hip FAIs. I didn't know what to make of the news or how to handle my recovery. My doctor wasn't the greatest at advising a course of direction for recovery. Being a fit young 28 year old I thought my body would heal itself, boy was I wrong. For over half a year I suffered from horrible pain in my pelvis region. It was all day every day. My hips were constantly rotating forward which caused extreme pain around my pubic symphysis and a urge to urinate. Even when I went to go to the bathroom I would have to force it out. I could only sit and lay down in certain positions and I could barely walk for a month. I started doing PT in July to try and have my body adjust to the injuries. My body slowly began to strengthen and after 2 months of PT 3x a week I was able to manage a day without any crazy pain flare ups. But the PT just made the injuries manageable and by no means healed anything.

    Looking back at all of this I should have gotten the MRI's right after I got hurt and sought out options to correct the injuries A LOT sooner. I just had the surgery with Dr. Meyers six weeks ago and he told me that my rectus abdominis attachment point on my left side (where I heard that high pitch "pop-pop") was over 50% torn, and the right side was badly torn too. He also released my adductors in my left and right leg. The day before surgery his office gave me a round of steroid shots in both my hips. They explained to me how the tears in my hips have the potential to refer pain all over the pelvic region and if the steroid shots ended all my pain then I should get my hips taken care of ASAP. The shots definitely brought the pain level down substantially but I wasn't out of the woods so I went through with his surgery.

    So coming back to your blog post. Now that I have my sports hernia taken care of I now have to get my hip labrum tears and FAI's taken care of. I'm still experiencing pelvic floor spasms and it feels like my SI joints are locked up. After reading your post a light clicked in my head that the tears in my hips are the prime suspect to all of this. I most likely tore them doing the half marathon which caused my pelvic floor to tighten up bringing on all the urinary symptoms. When went for my second trail run I likely tore some pelvic floor muscles because they were so tight and gave myself the sports hernia. Since my body is trying prevent further damage to my hips it's tightened up everything to take stress of the hip socket.

    During all of this it was so incredibly hard mentally for me to grasp what the hell was going on and how long it would take to heal. The "not knowing" aspect was the absolute worst thing I experienced because I had no idea when I would get better. For anyone else reading these posts that have a similar situation the first thing I would recommend is to seek a really good sports medicine doctors and get MRI's and X-Rays. Injuries and pain in the pelvic regions are hard to diagnose without proper imaging and specialized doctors to review them. I hope this helps anyone who is in the same chair I was.

  4. #4
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    Re: Hip Pathology and Bladder/Pelvic Pain

    @Antonia11 Thank you so much for your post. You helped save my life! I had a terrible car accident 4 years ago. A few weeks after that I began experiencing intense bladder pain and frequency, pelvic burning, and vulvodynia symtpoms. I got tested for every infection and STD in the book. Everything came up clear. Eventually, I was diagnosed with IC and vulvodynia. No treatments helped my pain and I was feeling pretty desperate. After reading your post, I decided to get tested for a labral tear since I've also had pretty bad hip pain since my car accident as well. Low and behold, I was diagnosed with a severe labral tear in my left hip (my pelvic pain is left sided mostly), bilateral FAI, and core muscle tears where my rectus abdominus was completely ton off the bone. Anyone who is interested can read my blog post here: http://mermaidsreel.blogspot.com/

    Had I not discovered these injuries, I would have gone my whole life thinking I had IC when in fact my symtpoms were actually from bio-mechanical injuries. I know there are probably many reasons for bladder pain, but I wanted to share my story in case this helps anybody else. Keep up the hope <3 -Meg

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    Re: Hip Pathology and Bladder/Pelvic Pain

    WOW! I am sitting here in complete awe that I never considered that my hip pain could be to blame for my bladder pain. Could any of you guys on this thread let me know what your main hip symptoms are/ were? I started to experience bladder pain in May 2017 and here we are in October 2017 and the pain has not gone away. I have been to several doctors and have had many tests done to try and rule out different things and ultimately was given a possible diagnosis for IC. No one wanted to do any tests to officially diagnose IC unless I was getting an installation done. Not sure if it's because the tests can cause a flare to be worse?

    I went to a Physical Therapist back in February for my hip. I had been in quiet a bit of pain, limping a lot and felt like maybe my workouts were aggravating it or possibly caused an injury. My PT did some tests (super painful) and concluded that if it was a tear, it was probably minor enough that it would heal on its own and that I had weak hips. So I faithfully followed his exercise routine to strengthen my hips and help to potentially heal a tear. I even backed off of workouts that seemed to make the pain worse.

    Fast forward to today, my bladder pain rules my life and is the main focus of my attention as I know all of you can understand. I have not been able to exercise at all, so my hip pain while still very much there, has become less severe as when I was more active and less of a concern. I can't wear tight pants as it hurts my hip, but now also hurts my bladder. If I am walking a lot in a day, I do tend to start to limp a bit. I have an appt with my doctor to get some imaging in a month, so I will keep you all posted. Thank you so much for posting this information, otherwise I may have never connected the two! How is everyone doing today with their hip and bladder pain?- Star

  6. #6
    ICN Staff ICNDonna's Avatar
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    Re: Hip Pathology and Bladder/Pelvic Pain

    It's strange what pain can do --- hip pain could be referred pain from the bladder --- and bladder pain, I suspect, could be referred from the hip or even lower back.

    I think it's a good idea to ask your doctor if you feel this could be your problem.

    Donna
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    Re: Hip Pathology and Bladder/Pelvic Pain

    Hi Star, your hip and bladder symptoms sound just like how mine were. I'm doing amazing after my surgeries. If this is what you have, it is fixable, and there is hope! I had labral repairs in both my hips. (FAI)bone Spurs shaved on both hips, and sports hernias repaired on both sides of my abdomen. 4 total repairs, and two total surgeries 6 months apart planned from the start. I'm doing incredible now. I have my life back. My last surgery was 8 months ago. Make sure you get checked by a reputable orthopedic doctor. FYI one of my labral tears didn't show up on my first MRI. I needed to have a second one where they injected my hip with contrast die called and MRA (athrogram). Make sure you speak up and advocate for yourself when you meet with your doctor. Unless your hip surgeon specializes in pelvic and bladder pain like mine did, they might not be aware of the connection at all. If you need any other help please feel free to message me on my blog mermaidsreel.org or YouTube channel, YouTube.com/c/mermaidsreel

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    Re: Hip Pathology and Bladder/Pelvic Pain

    Thank you Donna. I will keep you all updated!

  9. #9
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    Re: Hip Pathology and Bladder/Pelvic Pain

    Mermaidsreel,

    I went to your blog and read your story, what an incredible journey you have been through! I am so glad you were able to advocate for yourself and find out what was going on. On top of my bladder and hip pain, I have what I suspect to be an undiagnosed sports hernia from a running injury nearly 5 years ago. I had an ultra sound and MRI, but they were not able to find anything. I still experience pain in that area and can no longer jog or run without pain. I also experience pain if the area becomes bloated from my IBS, so I for sure feel like I need to find a doctor that specializes in Orthopedics. I have seen 6 different doctors and even had a colonoscopy and ultrasound of my reproductive organs to rule out anything in that area. I did not have the dye in my MRI, that might be something I ask for the next time around, especially for my hip. How were you able to find a hip surgeon that specializes in pelvic and bladder pain? I have also had pelvic pain with my bladder pain on and off.

    Since you have had your surgeries, has your bladder/pelvic pain gone away? That is incredible! Thank you for all of your support and I will for sure reach out to you on your blog and keep you posted!

    Thanks again,

    Star

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    Re: Hip Pathology and Bladder/Pelvic Pain

    Star,
    A sports hernia, or core muscle tear is very different than a typical hernia. A sports hernia is an actual tear of your rectus abdominal or adductor muscles. Most docs aren't experts at spotting that on an MRI. It's difficult to spot, and needs multiple tests to be found. I needed a special MRI and ultrasound with injections into my pubic bone region to see it. I believe only a few specialized hospitals in the country do it. I went to a place that treats tough chronic pain cases and top pro-athletes. Luckily, I was able to find this place because my pelvic floor physical therapist was experienced in labral tears and sports hernias because she had another patient who had all of the same symptoms as me. Her other patient went to the same hospital in Philly that I eventually went to. My pelvic floor Physical therapist referred me to two doctors there. My pelvic PT's other patient became completely free of her bladder pain, vulvodynia, and Abdominal pressure after her labral tear and sports hernia surgeries. I also am out of pain! Yay! Thank God! I have no bladder pain or bladder symptoms. Sometimes my pelvic muscles still get mildly tight as my hips continue to strengthen (such a minor inconvenience, like a 1 on a pain scale). I used to be a 9 out of 10 on a scale daily. I'm only at the 8 month mark post-op for my last surgery and my surgeon said that it takes a full year to be back to 100% as far as strength goes. My life is amazing. I work full time, and before this I couldn't get off the couch and only could work part-time. I exercise without any pain or flareups. I have a wonderful social life, and I a great relationship. It's as if I was never even injured. It's the best possible scenario!!!I'm not sure if I'm allowed to mention specific hospitals or doctors names on this forum so if you want more info please email me: meganemcgorry@gmail.com.

  11. #11
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    Re: Hip Pathology and Bladder/Pelvic Pain

    Quote Originally Posted by Mermaidsreel View Post
    Star,
    A sports hernia, or core muscle tear is very different than a typical hernia. A sports hernia is an actual tear of your rectus abdominal or adductor muscles. Most docs aren't experts at spotting that on an MRI. It's difficult to spot, and needs multiple tests to be found. I needed a special MRI and ultrasound with injections into my pubic bone region to see it. I believe only a few specialized hospitals in the country do it. I went to a place that treats tough chronic pain cases and top pro-athletes. Luckily, I was able to find this place because my pelvic floor physical therapist was experienced in labral tears and sports hernias because she had another patient who had all of the same symptoms as me. Her other patient went to the same hospital in Philly that I eventually went to. My pelvic floor Physical therapist referred me to two doctors there. My pelvic PT's other patient became completely free of her bladder pain, vulvodynia, and Abdominal pressure after her labral tear and sports hernia surgeries. I also am out of pain! Yay! Thank God! I have no bladder pain or bladder symptoms. Sometimes my pelvic muscles still get mildly tight as my hips continue to strengthen (such a minor inconvenience, like a 1 on a pain scale). I used to be a 9 out of 10 on a scale daily. I'm only at the 8 month mark post-op for my last surgery and my surgeon said that it takes a full year to be back to 100% as far as strength goes. My life is amazing. I work full time, and before this I couldn't get off the couch and only could work part-time. I exercise without any pain or flareups. I have a wonderful social life, and I a great relationship. It's as if I was never even injured. It's the best possible scenario!!!I'm not sure if I'm allowed to mention specific hospitals or doctors names on this forum so if you want more info please email me: meganemcgorry@gmail.com.
    It's okay to post a doctor or hospital name --- as long as there aren't negative remarks naming specific individuals (for legal reasons).


    Donna
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    I am not a medical authority nor do I offer medical advice. In all cases, I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.
    [IMG]

    Anyone who says something is foolproof hasn't met a determined fool

  12. #12
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    Re: Hip Pathology and Bladder/Pelvic Pain

    Thanks Donna!😊 My amazing surgeons-

    Sports hernia and core muscle surgeon: Dr. Meyers-Vincera Institute-Philadelphia, PA

    Hip Ortho Surgeron: Dr. Struan Coleman-Vincera Institute-Philadelphia, PA & HSS in New York City.

    (Doctor Meyers and Coleman are the only docs I'm aware of that do dual hip and core muscle surgeries together on the same day so it's an easier recovery progress for patients). They are experts in chronic pelvic pain. They are both two of the top pro sports doctors in the country as well. They treat the best NFL players with groin injuries too. Coleman usually works in NYC, but he travels to Vincera once or twice a month to work with Meyers. If you want to be checked for core muscle injuries and hip injuries at the same time it is best to call Vincera and book an appointment on a day when Coleman is there. That way, you can see both doctors on the same day. You can get all of your MRI's and tests done on one day, and receive your diagnosis that same day. I was so impressed by Vincera.

    -Megan

    My channel and My Blog: YouTube.com/c/mermaidsreel
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