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Sports Medicine

Torn obturator

12/08/2009

Question:

It appears that I have torn my obturator, not sure if it is the external or internal one in my left cheek. It happened while gardening, as I stepped on the shovel)(normally) while digging, I felt and heard a pop, causing me to fall down. That was about 4 weeks ago. The pain is deep inside my left cheek towards the center of my body, low rather than high. I have tried massage, chiropractic, electric stimulus, cupping, heat, ice, rest etc. I still have a lot of pain especially when pushing with that leg, such as depressing the clutch. I am very athletic and my body is in shape, but this injury just won`t go away. What is the course of action for this type of injury? Do I need an operation to repair it, like my torn achilles? It is a literal "Pain In The Ass", and I want it to go away. I need to start training again, but this is preventing me. Thanks for taking time to answer my question, hopefully!

Answer:

As with any injury which limits sports participation, cross-training on a regular basis - while not aggravating your symptoms in the process - is important at this time to maintain cardiovascular fitness and expedite your return to whichever sport for which you wish to resume training.

Although your diagnosis may be correct, alternative possibilities include a strain injury to your quadratus femoris muscle (another short/deep hip external rotator positioned close to the obturators internus and externus) or your proximal hamstring attachment, or an injury to your sacroiliac joint, or your hip joint (for example, to the acetabular labrum, which is the rim of cartilage which encircles/deepens the socket of your hip joint).

Since your pain has persisted and hasn't benefited from treatments tried thus far, it would certainly be reasonable for you to be evaluated by your physician, who may or may not refer you to a sports medicine physician, so an accurate diagnosis and course of treatment can be determined. Several sessions of Physical Therapy may be considered/tried, as may also, an MRI scan of your hip region on that side (if results will change management), among a number of other potential interventions.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University