Expert: Dr. J. Shawn Leatherman - 1/20/2008

Question
I was wondering if you would agree with me and what to do about it:  I was in a head-on collision twenty-five years ago and was wearing a seatbelt.  Unfortunately, dispite that, I was in a Rabbit, driving, and a police car hit me head on.  Now, at age 46, I have pretty severe hip and knee pain, my knees hit the dashboard hard enought to render them partly numb still, and I have alway had narrow hips and been super athletic.  I can no longer run on pavement due to hip pain and even walking for any distance is very painful.  Have you heard of this before?  Do you think it is related to the accident (there is no family history of this)?  Do you have any idea what I can do about it?  I have been to drs. here with no positive result.  Thank you-- Jennifer

Answer
Dear Jennifer,

I absolutely agree with you...the initial crash could be the reason why you are having the hip pain issues today.  It is often the case that frontal impact collisions result in the front seat occupants having hard contact with the dash or steering wheels, especially before airbag use. Even with airbags, we still see the knees getting jammed into the dash, and sometimes, femur/hip fractures occur.

You probably had internal trauma to the hip joint due to the transfer of energy from the knee impact that went undiagnosed.  This could be in the form of small cartilage or ligament damage, and these types of injuries often lead to degeneration inside the joint and arthritic changes over time.  This may lead to muscular imbalances or weakness, and dysfunctional movement patterns which will also accelerate degenerative processes.  Bottom line is that the main anatomical problem needs to be determined to identify a proper treatment program.

you have obviously been to some doctors, but have they imaged the hip joints?  X-rays, or an MRI would be appropriate considering the timeline of the pain and problem.  Active ranges of motion and orthopedic tests to stress the joint space should have been performed... Functional evaluations would be needed of the low back/hip/pelvis and associated musculature. Were you evaluated like this? The main actions that cause pain need to be identified as well as the structures involved.

The only advise I can give you is to find a better doctor who will specifically address the dysfunction, and find the ultimate source of the pain.  Once you know that, then you can explore the various treatment options available.  I wish I could offer you more than that.  If you have any further information, feel free to write back with it, as I might be able to convey more information.

Good Luck Jennifer.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net