Started in 1974, the Western States Endurance Race challenges elite runners from all over the world to 100.2 miles of demanding terrain. Beginning in Squaw Valley, California, participants climb 18,000 feet in altitude as they wind their way through Emigrant Pass and the Granite Chief Wilderness before descending 23,000 feet to the finish line in Auburn, California.

For Drs. John Diana and Marko Bodor of Napa, the Western States is more than a representation of endurance in long distance running; it offers a singular opportunity to record the effects of running on the human body – specifically, the hips and hip labrum.

An ultra marathoner himself, Dr. Diana invited Dr. Bodor to join him in doing a study on runners. Dr. Bodor came up with the idea of studying their hips, particularly the hip labrum, which often gets injured in athletes and is critical to the health of the hip. Some athletes have a torn labrum and experience severe pain, necessitating an attempt at repair or trimming the frayed ends, while others are able to function well without knowing they have a tear.

Given the extreme demands of the Western States 100, Drs. Diana and Bodor thought it would be a great opportunity to determine how critical the labrum is to normal hip function.

For this study, Dr. Diana developed a survey of analyzing each runner’s past performance, orthopedic history, and symptoms relating to hip, if any. Then Dr. Bodor and one of his former fellows, Dr. Alison Ganong, scanned the hips of the runners before the race using a special high-frequency diagnostic ultrasound machine donated by Philips for the occasion.

After the race, Drs. Diana and Bodor analyzed the results and will continue to follow-up with the runners.The hip labrum is effectively a ring of fibrocartilage that serves to improve the stability of the ball of the hip joint within the socket, and by forming water-tight seal around the joint, keep the fluid inside and the joint well lubricated. Typical causes of injury to the hip labrum include: trauma, a structural problem such as pincer-cam deformity resulting in impingement that accelerates normal wear and tear, and repetitive motion, especially sports-related activities. With the visualization achieved through ultrasound, an accurate assessment of a labrum tear can be readily made and the proper treatment administered more rapidly.

Dr. Bodor was among the first to see and guide needles to hip labrum tears using ultrasound and has successfully treated many athletes, including a world class marathon runner, using targeted platelet-rich plasma (PRP) injection instead of arthroscopic surgery. The Napa Medical Research Foundation supports continued advancement of regenerative treatments like PRP to resolve various injuries sustained to ligaments, cartilage, and tendons.

Dr. John Diana will serve as the Principal Investigator for the study and is obtaining Independent Review Board (IRB) approval from St. Helena Hospital.

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