Madeline Frank never thought of running as an activity. For her, it has always been a way of life.
“I'm someone who is super active,” she says. “I just love being outside, especially running. It’s even the way I socialize with friends.”
Madeline says running was also a part of her family culture. She learned to love running from both of her parents, in particular, her father who was a seasoned marathoner. She picked up the sport when she was in elementary school and never stopped. After running competitively in high school and college, she settled into a daily routine of running and found a close-knit, like-minded community in Chapel Hill, N.C. They trained together and set their sights on the 2024 Boston Marathon.
But Madeline’s plans were derailed in December 2022, when she experienced a sharp sudden pain in her groin.
“One second I was completely fine, and the next, I couldn’t walk,” she recalls.
That painful memory marked the beginning of a long and challenging battle with what was later diagnosed as obturator nerve entrapment, a rare condition in which a nerve that goes through the groin becomes compressed by the adductor muscles of the inner thigh. The obturator nerve helps move and feel things in the thigh, hip and knee.
Difficult to Diagnose
Dr. David Price, a sports medicine specialist at the Atrium Health Musculoskeletal Institute, eventually diagnosed Madeline’s condition. By the time she entered Dr. Price’s office, she had spent more than a year trying out numerous different therapies including physical therapy, dry needling, the Graston Technique (to break up scar tissue), cross training, strength training and of course pain medicine and rest. Each failed attempt to find relief brought new frustrations.
"I was constantly in pain, even just walking," she said.
But the biggest frustration for Madeline was seeing the Boston Marathon date quickly getting closer on her calendar, and yet, she had no real answers as to what was causing her pain. Madeline felt like her doctors and physical therapists were not fully addressing her concerns. And when one specialist finally told her there was nothing more they could do for her, she even began to wonder if the injury might be in her head.
About that time, a family member recommended that Madeline see Dr. Price at Atrium Health, who explains that Madeline’s injury is pretty uncommon but typically occurs in active individuals with well-developed hip adductor muscles.
“It doesn’t show up well on MRI or with nerve conduction studies, which makes it difficult to diagnose,” he says.
Madeline reflects on the first time she met Dr. Price and finally heard a name for her injury.
"He was so unbelievably kind and helpful,” she recalls from her appointment. “He really listened to me and did an ultrasound on my adductor. He explained all my options clearly."
Finding the Right Treatment
Dr. Price had seen this condition before and recognized the signs immediately. He recommended an ultrasound-guided steroid injection with a high-volume solution, also known as hydro dissection, to release the nerve from the surrounding tissue. This technique, which requires precision, is designed to alleviate compression and inflammation around the obturator nerve.
When asked why the previous treatments hadn’t worked, Dr. Price candidly explains, “Sometimes the steroid in the right place plus releasing the nerve just makes it better. The other treatments can’t release the nerve that well.”
For Madeline, her next steps were clear.
“At that point, I was willing to try anything,” she shares.
Dr. Price administered the injection during the same appointment, and Madeline began to feel gradual relief in the days that followed.
Setting Her Sights on the Finish Line
Following her injection, Madeline tested her injury slowly but with the knowledge that at that point, the Boston Marathon was just a month away. She had only a short amount of time to finish her training. And she had to overcome a major fear that had developed. She wondered, could she even complete the race?
“I was only able to complete one 18-mile run before the race,” she admitted. But her desire to cross the finish line outweighed the uncertainty.
On race day, Madeline completed the Boston Marathon with a time of 3:07:04 — a personal victory given the circumstances.
“Considering my training cycle was terrible, I was just grateful to be able to run it," she said.
Reflecting on the race, Madeline notes that she was tired and sore but motivated to finish, telling herself, “I am going to finish the marathon, and I am not going to be injured.”
She crossed the finish line with a close friend by her side, making the moment even more special.
Moving Forward Without the Pain
Today, Madeline is still running and hasn’t needed additional injections or physical therapy.
When asked about the possibility of the injury reoccurring, Dr. Price notes that while the chances are low, given Madeline’s active lifestyle, it is possible the nerve could become compressed again. If that happens, Madeline could receive another injection or explore surgical options to fully release the nerve.
For Madeline, this experience was not just about overcoming physical pain but also about finding the strength to persevere and advocate for herself.
"It was really special to be able to cross that finish line," she says.
It was a moment that symbolized more than just completing a race — it was a testament to resilience, patience and the importance of advocating for oneself when facing both physical and emotional challenges.
If you or a loved one experience an injury or pain, schedule a same- or next-day appointment with one of our orthopedic and sports medicine specialists at 704-863-HURT (4878) or AtriumHealth.org/HURT.
