Trigger Points and Bursitis

I was back at the pool yesterday, getting in a hydrotherapy session before going on holiday this Friday. Things had been feeling good and for the first time in I don't know how long, I didn't have any specific pain/restriction in my hips/legs whilst in the pool. Of course, this meant I tried to do a little bit extra. I did more walking and I did 10 extra reps of the leg curl/press exercise. I came out of the pool feeling like I'd had a good workout.....

….Will I never learn?!

An hour or so after getting home the aches started. At first it was my left hip stabiliser (gluteus medius), and through to my lower back on the left hand side. As the afternoon and evening wore on, the aching was pervasive, through my hips, lower back and down my legs. It ached like you wouldn't believe! I tried massaging the trigger points (Link) with the tennis ball, I applied heat and lay down for an hour to rest all the muscle. In the end the gnawing ache was reaching the point of unbearable so I took the maximum doses of paracetamol and ibuprofen. That didn't completely eradicate the pain but it certainly helped. I also developed muscles twitches at various sites all over my legs and hips. Basically, I’d fatigued the muscles beyond their limit.

The main trigger points seem to be through the Gluteus muscles, Tensor Fascia and/or the Quadratus Lumborum in the back. Most often they are particular to the left hand side.

Trigger Point Diagrams (taken from here)

Gluteus Medius

Gluteus Maximus

Quadratus Lumborum

This morning, the aches through my glutes and the lower back on the LHS are still present but not nearly as overwhelming as last night, thankfully. I’ve had a 5-10 minute slow/gentle walk and thoroughly stretched out my legs, hips and back; did some tennis ball massage again and applied heat. Hopefully, the muscles will recover in a day or two.

The other news today is I had the ultrasound scan of my left shoulder. Essentially, it’s good news. The main tendons are healthy and intact. They are below average in thickness which could be because of my slim build or because they need some building up, who knows. Anyways, they’re healthy. The main finding was inflamed bursa around the infraspinatus tendon. The bursa fill with fluid to protect the tendon when it begins to rub on surrounding bone, hence the inflammation. It’s probably what is causing the pain and restriction on external rotation and abduction. The doc is recommending more physiotherapy, an xray to check for bone spurs and perhaps guided aspiration of the bursa.

Edited 01/09/2009: Saw the ortho guy today. Ultrasound (US) also revealed mild Supraspinatus tendonitis and an x-ray confirms no bone spurs. So, it's now a course of physiotherapy and hopefully I'll avoid the US-guided bursa injection!