Strange injury

[amela321]

I am a runner.  Three days ago, I noticed a dull pain that felt like a pulled muscle of some sort in my pubic area.  It seems to be lower than the area I understand to be the groin area.  It didn't stop me from any activities and I continued to run with it.  I could always feel it, but it wasn't that painful so for the most part I was able to ignore it.  

Yesterday, I was on mile 4 of a 6 mile run when the pain became much more pronounced.  There was no apparent cause.  I had to slow down quite a bit, but was able to finish the 6 miles.  However, ever since that run, I have been in a fair amount of pain.  Moving my right leg at all causes pain in the pubic area that radiates inside my right leg.  The worst pain seems to be from putting weight on the right leg, sneezing and coughing.  I have to walk quite slowly and even at that, it is still painful. The area is also tender to the touch.  

This seems different than the descriptions I have read of groin injuries.  Because of the location of the pain, I have been hesitant to see a doctor.  If it's something that's just going to get better on it's own, I'd rather continue to do the rest, ice, compression thing myself.  I guess what I'm wanting to know is if there is a possibility that this is something more serious that I would need additional treatment for.  If so, I may try to get over my shyness about seeing a doctor.

Any help, suggestions or guidance would be greatly appreciated.  

[amela321]

Thank you for all of your advice.  I just wanted to let you know I finally got into the doctor and was diagnosed with a stress fracture of the inferior pubic ramus.  It was easily visible on the x-ray.  The recommendation is 4 weeks with no elliptical or bike with re-evaluation for those in 4 weeks and no running for at least 8 weeks.  I am able to swim but am having a hard time finding somewhere to do that that fits my schedule so I feel I am losing aerobic fitness rapidly.  Do you feel these recommendations are a bit too stringent?  If riding a bike doesn't cause pain, do you feel it's safe to go ahead and do that?    

Again, I appreciate your assistance.

[Michael L Gross, MD]

A stress fx of the pubic ramus poses no danger, and you can do anything that doesnt cause pain. HOWEVER, a stress fx of the femoral neck, can easily displace with activity and end up needing surgery. I would try to be seen sooner than two weeks from now!

[amela321]

Thank you for your response.  From everything I've read I fear you are correct about the stress fracture of the pubic ramus, but I can't get into the doctor until July 11th.  Do you have any recommendations on how long I should stay away from running?  Is cross training such as cycling and the elliptical ok if it doesn't cause pain?  Would I be better off if I stayed off it completely for a while by using a cane or a crutch?  How long do these types of injuries typically take to heal?

Thank you again.  I appreciate any help you can give.

[Michael L Gross, MD]

Stop running immediately.  See a doctor and have Xrays! The two dangerous things this can be are either a stress fracture of the pubic ramus, or of the hip itself. (Hip injuries usually cause pain in the groin, not out on the side where most people think their hip is located.) There are other diagnostic possibilities, but these both can get significantly worse if you continue to run on them