winchester wrote:
What was your approach since you decided against surgery?
To be fair and that you can draw or dismiss connections between your case and mine, as we are all different, few facts about my diagnosis.
I checked in with these symptoms:
Lower left sharp abdominal pain, just at the tip of pelvis, yet still to the side toward hip. I have no hip symptoms. No clicking, no locking, no pain in hip until arthrogram was administered. That is another story in itself.
Initial diagnosis set at Rectus Abdominis strain/ Sports Hernia- ugly term, I know. Doc wanted to eliminate hip as a potential source so he ordered MRI with contrast and run after Lidocaine test.....
According to studies there are possible connections between hip dysfunctions and sports hernia. So doc had a smart intent.
1. I pass every impingement clinical test on the table, two doctors and PT yanked and twisted many times, nothing, I am zero pain in hip.
2. X-ray shows small mixed deformity Cam and Pincer type
3. Lidocaine injection into hip that precedes the arthrogram, run test after, negative too, I could not run after, not a chance, had no relief, actually felt worse.
4. MRI with contrast results:
Multifocal labral tear in left hip, anterior and mid superior side, moderate in size 7mm, no chondral damage, no fragmenting, space preserved between femoral head and acetabulum. Normal femoral head morphology.......no mention of FAI, no tears in soft tissue, all tendons and insertions around unremarkable.
In discussion, concluded, labral tear could have been there for long time but asymptomatic. Not uncommon. I exhibit more symptoms of atheltic pubalgia - aka sports hernia. Due to this lack of definitive answer, I opted for multiple rounds of PT and rest.
PT program resembles Mike Boyle's sports hernial protocol, almost to the T. The trend is not linear but improvement is obvious. I am sure any hip/glute/core strength routine programmed and monitored by experienced PT will do.
Keep in mind that facing this surgery, I opted to scrap the season and I am not on any timetable or any kind of hurry to get back. Wisdom prevails. I take it day by day. I have not made anything that resembles breakthrough but managing to run 20min at a time with some post run pain, however, no escalation in intensity. My pain is all abdominal as indicated above.
Arthrogram in itself nearly destroyed my hip. I felt pressure in joint for 4-5 weeks after, all sorts of soft tissue pain on the side of hip, injection site burning, numbness and tingling in thigh skin below, 6-7 weeks after. Little is written about side effects of arthrogram.....I am an exception.
When you do your research, you will find that it is still very new procedure and evolving. Until 2010 time frame, they were removing torn labrum and causing hip joint instability, to have patients return for a full hip replacement 18 months later.
Labrum functions are still not fully understood. Repair is now the goal and the way that is done depends on whether the person is active or not.....Only a small number of doctors do this routinely. Steadman clinic made it's name with this and Dr, Phillipon. I went too far with "learning" about it, enough to scare myself. What got my direct attention is the length of recovery post arthroscopic procedure, unprecedented. Come to find out about the special table, peronial tendon post, application of traction to gain access to joint, occasional lack of patience and requesting more traction for longer.......or dude presenting to his doc colleagues makes a comment, I will miss the actual professional lingo, but to the tune of put the protection on the side of that 5.5mm burr so that when you maneuver you don't inadvertently contact structures you don't want to......hahaha, thinking some moron is swinging that burr around like that it deserves a comment in the lecture.....My local area does not have a doc that I would let touch my hip labrum.
In American medicine practice, culture of knife happiness prevails as it is a cash cow. PT and rest don't bring as much money. They crank them out of medical school like that. It is good for business, good for industry.
Exhaust every option and make a decision accordingly. I am just in no rush. If I were told the only way to return to IM competition is to go under knife, I would not blink, I would take the risk. But it is not the case. Time is on my side.
This is just my 2c. It only applies to my case. I could be entirely off mark. And, I have a bunch of health pros in my immediate family, I live with them. My doc that is leading my case had his labrum torn 3 years ago, still did not have surgery. There are newer and still experimental treatments in regenerative medicine, stem cell injections, PRP......Dr. Phillipon uses those for post operative occasion. Some docs administer those as a part of more conservative treatment.