A hip tear means rest.

I pulled a hip muscle the week before my marathon. I went to the race anyway. It hurt from miles 3 to 12.5, where it went into a dull throb. At mile 23 the pain came back twice as bad, forcing me to walk to the finish. It turned black and blue. My orthopedic doctor thinks I have torn a hip abductor or piriformis muscle. He recommended various stretches. Two weeks after the marathon, I ran six miles. The hip felt exhausted and got stiff overnight. It is still swollen, though not black and blue anymore. What do you suggest for a speedy recovery?

Louis Claiborne

San Diego, CA

If you had a bruise, you did tear something. A bruise indicates internal bleeding. Your doctor was right in assuming the hip abductor or piriformis. The stretches are different for each, so make sure you write down the appropriate regimen once you have determined exactly what the tear is.

If you have that kind of pain--and bruising--you should not be running at all. This is serious. If you continue to run on a bruised hip, more injury to the soft tissue will occur and it can develop into a chronic and unstable condition. The good news is, the solution is simple. Rest for two and a half to three weeks. Take an over-the-counter anti-inflammatory, and stretch twice a day for five minutes. After the first week of rest and stretching, you can begin some gentle strengthening. Try step-ups on a stair forward and sideways, as well as lying on your opposite side and performing slow side kicks. The three weeks you need to sacrifice for the remodeling of the torn tissue are very important to getting you back to running. When you return to the roads, only do half of your normal distance for the first seven to 10 days. Increase after that, but by no more than a half-mile per week.

Ronald J. Kleinman, PT