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Fixing My Wife: Hip Pain, Neuroma, and Hoka Oh My!

Posted on April 24 2013

Hoka One One Bondi B 2My wife Erin is a source of much personal frustration. The frustration doesn’t stem from any particular aspect of our relationship (thank goodness!), rather I am frustrated with her as a runner. I just can’t seem to fix her.

I have to be honest – my wife was a serious runner long before I ever was. In fact, she was a runner when I first met her in college. However, she runs for very different reasons than I now do – she’s not competitive, she hates racing, and she’s quite happy just to do her standard 3 miles as a way to relax and cut loose for a bit.

The problem with my wife is that for the past several years she has not been able to run consistently. We’re not sure exactly when her problems started, but we think it was sometime after her second pregnancy. She started having right “hip” pain after runs, and it got progressively worse to the point where she was ready to give up the sport altogether in late Fall of 2010.

I knew from filming her form that she was a horrific overstrider, and she has issues stabilizing her right foot due to a large bunion on that side (she may kill me for divulging this, but all in the name of education!). At the time she was running in traditional shoes and Nike Free 5.0’s (the old version from a few years ago), and the Free’s were caving medially in a big way on the right. I thought maybe the combo of bad form and problematic shoes might have something to do with it. She thought maybe it was caused by holding our son on one side all the time (quite possible). I wondered if maybe it also had something to do with her yoga practice (it was made very clear to me that stopping yoga was not an option). If the alterative was not running at all, I suggested we try rebuilding her from from the ground up.

I bought Erin a pair of hot pink Vibram Fivefingers and put her on an extremely gradual buildup on the treadmill during the winter of 2010-2011. All was going really well – she was running pain-free on the treadmill, and she didn’t seem to be having much trouble adapting to the minimal shoes. This was very encouraging to both of us.

Unfortunately, problems with the hip started to re-appear when she started running outside again in the Spring. She continued running sporadically, but never in complete comfort. It was clear that whatever was causing the problem was ticked off by the move from the treadmill to running outdoors. I wondered if maybe trying a minimal shoe with a bit more cushion might help. That turned out to be a mistake – one run in a new pair of transitional cushioned shoes and she was in worse pain than ever. She called me a fraud of a shoe expert, and any running shoe with significant cushion now scared her.

Toward the end of 2011 (I think) she went to see my friend Brett who had developed a reputation for success in treating local runners with various injuries. He did some manual therapy and identified a few problem spots. The gluteus medius seemed to be the problem on the right side, along with a ligament issue in the pelvis and some tightness in the quadratus lumborum. Manual therapy seemed to help, but the pain jumped around from place to place for quite a long time. She continued to run, but still experienced hip area pain most of the time. What finally seemed to help was Brett’s suggestion to start incorporating sets of walking lunges at the end of each run. Her pain started to progressively lessen and we though we might be onto something.

As seems to happen so often with somebody who is injury prone, it wasn’t long before another problem cropped up. Erin had gone for a run on the trails behind our house and came back complaining that her foot hurt. She said she stepped on a rock awkwardly and I worried that maybe she had broken something in her foot (she was wearing trail shoes with a rock plate…go figure!). Over the ensuing weeks and months the foot pain would crop up any time she walked a long distance or ran, and I began to fear that she had a stress fracture. She had X-Rays which came back negative, went a period of about 5 weeks without running, and when she came back to it after the time off the pain immediately returned in her foot.

Eventually she mentioned to Brett that she periodically had numbness in her middle toes, and that this had been an issue long before stepping on the rock (I recall her complaining about it from time to time, but it had skipped my mind). He diagnosed her with a neuroma in the right foot. A this point she was walking and running almost exclusively in Altra Intuition 1.5’s because they made her feet hurt the least (I assume because they let her foot spread out so the bones wouldn’t squeeze on the neuroma). She also got a pair of Correct Toes from Brett with the thought that they might space things out even more and she was using those on runs as well. She was managing to run, but the foot still hurt. I thought maybe a softer shoe might be worth another shot, but one run in the Skechers GoRun 2 caused her knee to start barking, and that was that.

I had been joking with Erin that since we’d tried almost every other type of shoe out there, I was going to get her a pair of Hokas. She thinks they look ridiculous and makes fun of mine all the time (I’ve only run in them once myself). But, one day my friend Nate came by and told her that he’d heard of people who have had success dealing with neuromas by running in the Hokas. As is typical, advice from non-husband is more likely to be heeded than advice from husband, and she told me to go ahead and buy her a pair.

Well, Erin has now done three runs in the Hoka One One Bondi B 2’s.I’m happy to report that they are the first three runs she has done in a long time that have not resulted in any foot pain. Her hip seems to be doing well too, with only a very minor twinge reported after one run (she continues to do her post-run lunges).

I think this story is also worth telling since to me it shows how difficult it can be to find the right shoe for some people, and also how chronic injuries can sometimes be really hard to resolve. We tried traditional shoes, we tried minimal, we tried stuff in between. We tried form change (she is no longer an overstrider, in fact she may have gone to far in the other direction) and various kinds of strength work. The Hokas along with post-run lunges seems to be working for now, so we’re going to stick with it and see how things progress.

I have no idea if this pattern will hold, but I’m keeping my fingers crossed – I need to prove to her that I’m not a fraud!

(Update 5/21/2013: It’s been a month since I posted this, and I’m happy to say Erin has continued to run in the Hokas 2-3 times per week and has not had any pain in her foot. It’s the longest stretch of pain-free running she’s experienced in quite a long time. Keeping my fingers crossed that it continues!)

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