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Re: Labral tear in hip [syncopated] [ In reply to ]
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I'm bumping this thread a 2nd time (there's enough new threads already).

I had my surgery 6 weeks ago and have been off crutches ~2 weeks. The tear was small and they found no arthritis in the hip despite my running since the 7th grade. Rehab was progressing nicely - I was able to swim (not allowed to do flip turns and no pushing off the wall w/ my R leg) and riding the trainer (20-25 minutes in a very easy gear)...no pain.

Then last week, the head PT had me increase DURATION and RESISTANCE on the trainer. The recommended time went up to 45 minutes and resistance went up (increased by ~2 gears, still in lil ring). My heart said AWESOME, but my head questioned it "Hmm, that's strange, increasing TWO variables?" I followed the guidelines and now for the past week, I'm experiencing the most pain I've had in 3-4 weeks. I was walking fine before, and now it hurts to walk and I may even be changing my stride because of it. The trio of therapists I'm working with could all tell I was bumming when I walked into my PT session on Monday. Ok, enough whining. Here are my questions:

Question1: Have others had recovery/rehab setbacks related to this type of surgery, and if so, how severe were those setbacks?

Question2: Have others had their PT's change two variables at once (training time and training resistance) when rehabbing?

I'm now back to no exercise for at least a week and will start again. While it is frustrating, I still feel fortunate I can do the things I do. Although my wife is VERY ready to give lawn-mowing responsibilities back to me.

Thanks,


Tad

It took awhile, but I finally discovered that its not the destination that's important, but rather the journey.
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Re: Labral tear in hip [sportschick] [ In reply to ]
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I'm bumping this topic again even though its a little old because I really need advice. I have been having this crazy phantom pain in my right front thigh (tight and knawing) which eventually became unbearable pain in my right hip for the last 9 months. I went to a thousand doctors and was finally diagnosed with hip bursitis. After several cortisone shots to the hip bursa my doctor had my MRI reexamined and it was found that I have a labral tear in my right hip.

I went to go see Dr. Boettner this past week at HSS. He has done a tone of research on labral tears, studied under Phillipon and is now known as one of the best doctors at HSS for labral tears. He took a look at my MRI and said the tear really didn't look too bad but that most adults have a tear of this nature at around my age (26). He also felt that the type of pain I had was weird and uncharacteristic of a labral tear and he is very skeptical to do surgery (which I kind of understand). He did send me for a fluoroscopic guided injection yesterday which cured me of the pain almost immediately. Of course this is a good sign because it proves that all of my pain is a result of the tear.

I guess I'm just wondering how I can suggest to my doctor that he does an MRI with dye to take a better look at the tear. I don't want to step on his toes, but I have been reading plenty of online postings that detail situations where a regular MRI did not show a labral tear well and once surgery is completed it is discovered that the tear was very serious. I'm skeptical the the injection will last very long and even if it does last a few months I really don't want to live the greater part of my young adult life going to HSS for injections.

I know this sounds crazy but I just really want this surgery so bad. Before this injury I was very active in bikram yoga (attended 3-4 times a week) and now I can barely go out shopping or to a bar with my friends for longer than an hour. Sometimes I feel like I can't even get out of bed. I'm young and I want to be pain free so that I can go back to living a normal 26 year old life. Any suggestions.

Also I would love to hear stories from anyone else who has had a similar situation with a hip labral tear. Also anyone out there who had pain in the front thigh?
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Re: Labral tear in hip [Randala] [ In reply to ]
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In Reply To:
I guess I'm just wondering how I can suggest to my doctor that he does an MRI with dye to take a better look at the tear. I don't want to step on his toes, but I have been reading plenty of online postings that detail situations where a regular MRI did not show a labral tear well and once surgery is completed it is discovered that the tear was very serious. I'm skeptical the the injection will last very long and even if it does last a few months I really don't want to live the greater part of my young adult life going to HSS for injections.


Randala, I've seen a hip specialist since October 2009 for anterior hip pain. My contrast MRI (with dye) showed bursitis and a small labral tear. I could not run from Oct 2009 to Feb 2010 due to anterior hip pain. I've had two cortisone injections (Feb 13 2010 and Jan 4 2011). The first one allowed me to run again; at the time of the second one, I could run, but had pain with hip flexion (cycling, sitting in the car, sitting in class/at my desk.) The injections have been in the bursa surrounding the psoas tendon, as it sounds yours have been. They think my labral tear is small and asymptomatic. As you mentioned, a lot of adults have labral tears that may or may not cause them pain.


Per your wanting an MRI with contrast, I think it's a perfectly valid request. It sounds as if you can either ask for one, hopefully get it, and have a more firm diagnosis (and maybe then have surgery), or be biting your lip for the next several years while you're in pain. I've spent more time than most in doctor's offices (chronic illness :P) and I'm pretty good at saying "hey, can we try [this med] or [this test]." Be assertive and ask for what you need/want. The worst you'll get is a "no."

Proud member of Fishtwitch and the ST Grammar Police
disclaimer: I am a PhD, not a medical doctor. The closest I get to surgery is topology.
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Re: Labral tear in hip [Randala] [ In reply to ]
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No pain in thigh, my pain started in the hip flexor and migrated to the groin. Many times groin pain originates in the hip. I amped up my running intensity and went more aggressive on my TT bike - two factors that tore up my right hip in 2009. Tore up my left hip about 6 months later. I'm 1 year off hip scope on the right hip and 6 months off a left hip scope - Dr. Byrd in nashville. Labral tear and FAI was my diagnosis - I was told the condition was congenital or may have happened during a growth spurt as a kid. It was not due to a fall/injury.

If you do have a tear, make sure you have a conversation with doctor about the cause of the tear - frequently a misshapen femoral head is the cause and they have to reshape it in surgery to eliminate another tear. Surgery went smoothly although I'm still struggling to run again. Cycling came back quickly - I hope to resume racing later this year.

I did try other options prior to surgery - p.t. and rest for 6-9 months before i went under the knife. Tears do not fix themselves it is purely a matter of how much pain they are causing.

My diagnosis was done partially with a contrast MRI but mostly during the doctor consultation. Doctor indicated that even a really good MRI doesn't necessarily tell the whole story about what is going on in your hip. The surgery is actually fairly easy - back on the trainer with no resistance within 1 week - 12 weeks to resume normal activity and 6-9 months before you feel 'normal' again.
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Re: Labral tear in hip [lakerfan] [ In reply to ]
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Hi
I was wondering how your adductor strain healed? Rest physio etc? I have obturator spasm along with hip labral tear seen on MRI 6 months of rest no improvement.
Thanks, fiona
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Re: Labral tear in hip [cranky] [ In reply to ]
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All you people talking about it being caused by a crash! I've just gone in with similar complaint after living with the symptoms since 2009 when I had a minor crash at VaDu. Since then I've had nagging ache and pain in my right hip. The doc x-rayed yesterday, and then wants to do PT if the x-ray is neg before considering MRI. Is this the timeline you all experienced? I've been living with this ache for a couple of years now, but after having a slack fall, I was back to training harder on the bike this spring and the discomfort is much more significant. I have no such issue in my left hip.

***********************
Back in the saddle!
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Re: Labral tear in hip [TriBriGuy] [ In reply to ]
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Typical course of action by the orthopedic surgeon is x-ray, physical exam, physical therapy, MRI and ultimately surgery if physical therapy fails and MRI shows labral damage. If you are only experiencing the issue on one side, that would usually indicate an acute injury (fall/accident). If the root cause is genetic it will most likely affect both hips. My pain occurred first on my right hip and 6 months later on the left.


My timeline on the first hip was injury in April, diagnosis in May, PT in June&July, MRI in August and then on a 4 month waiting list for surgery in January the following year. It has been almost a 2 year process since my first injury, but the surgery on both hips has helped tremendously with my power and comfort on the bike. Running is another story, but I'm slowly working my way up from 5 miles/week pain free!


Good luck.
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Re: Labral tear in hip [cranky] [ In reply to ]
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Thanks. As I've said on another thread...patience is not a virtue of mine when it comes to injury. Thankfully I've only had serious injuries a couple of times over 25+ years in the sport.

And my injury is most definitely acute from an accident. I had no issue before the accident, but have had the discomfort since then, sometimes worse, sometimes less. Really hard efforts on the bike in the TT position seems to aggravate it. I don't really notice it on the run so much other than a dull ache after long runs.

***********************
Back in the saddle!
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Re: Labral tear in hip [TriBriGuy] [ In reply to ]
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i had the surgery. be very careful who you choose to do it. there are very few docs who do the procedure well. I flew from miami to nyc to get it done by Dr brian Kelly, a protege of phillipon. Many drs claim they can do it but will not address it correctly. They may only shave some bone or just staple your tendons back. Beware of FAI impingement. PM me if you need more info
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Re: Labral tear in hip [jmoskovitz13] [ In reply to ]
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We're still working toward positive diagnosis. If that is what comes to pass, I will keep what you wrote in mind. I have access to those kinds of doctors through an ER doc friend who moonlights as a race doc at US Pro Tour cycling events. He's got contacts with some of the best surgeons in the country in terms of sports-related injuries. I'll trust him to steer me toward the right surgeon.

***********************
Back in the saddle!
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Re: Labral tear in hip [TriBriGuy] [ In reply to ]
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Any doctors in Boston?
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Re: Labral tear in hip [bsarge] [ In reply to ]
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Any doctors in Boston?


Dr. Joseph McCarthy in Boston does hip scopes
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Re: Labral tear in hip [TriBriGuy] [ In reply to ]
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Well...8 months into evaluation and finally have diagnosis and pending date for the repair surgery. The friggin MR contrast dye injection hurt like hell! But now I'm a month out from surgery and hopefully 2-3 months from returning to training. Any hints on recovery? 2012 has been a tough year mentally with essentially zero training and racing. I tried to run the other day and struggled through a few 8:20 miles. A year ago I was still flirting w/sub-16 5ks. This is the first time in 25+ years I've been anywhere near this out of shape and although it has brought some perspective, its certainly not comfortable.

***********************
Back in the saddle!
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Re: Labral tear in hip [TriBriGuy] [ In reply to ]
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TriBriGuy wrote:
Well...8 months into evaluation and finally have diagnosis and pending date for the repair surgery. The friggin MR contrast dye injection hurt like hell! But now I'm a month out from surgery and hopefully 2-3 months from returning to training. Any hints on recovery? 2012 has been a tough year mentally with essentially zero training and racing. I tried to run the other day and struggled through a few 8:20 miles. A year ago I was still flirting w/sub-16 5ks. This is the first time in 25+ years I've been anywhere near this out of shape and although it has brought some perspective, its certainly not comfortable.

Good luck with your surgery and thereafter.

I had the surgery on 2/28 (labral repair and bone removed from the femoral neck). I then got laid off two days later, so I couldn't just lay around. I was up and about, had interviews that week and had to drive less than a week later. I think moving around actually helped, in that my range of motion and muscle mass weren't affected as much. 13 days after surgery, I was swimming (one legged push-offs, which makes swimming in a pool a lot harder) and starting PT. Four weeks, onto the trainer. Six weeks, lost the crutches and started biking outside. Eight weeks, started running. Within about three months, my biking was really good, the running not so much. I probably pushed the running (and the biking) too much, though. Still, managed sub-7:00 for a 5km in a sprint triathlon after biking about 24mph for 11mi (at age 53). Aquabike races are looking better :-)

Do the PT, do the stretching/strengthening, take it easy on the running.

----------------------------------
"i disagree with your analysis [or judgment], nevertheless you have the responsibility of moderating this board so i honor your authority to make the moderating decisions."
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Re: Labral tear in hip [TriBriGuy] [ In reply to ]
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Brian, there's been a number of similar threads about labral tears in the last week. I'm 5 weeks post op on full FAI surgery w/ a small tear. So far I'm very happy with recovery process. Only 4-5 days on crutches and off pain meds after 3 days or so. Been on the trainer after the 4th day and now doing 35 to 45 min. up to twice a day, and swimming w/ pull buoy every other day. I see the surgeon on Monday and HOPE to be cleared to bike outdoors and open water swim too. Started PT after two weeks and haven't done much really hard therapy yet because range of motion takes awhile to come back. I've been told running won't happen until at least 3 months but I can live w/ that as my running was so bad due to the impingement that when I start running it has to be an improvement. I had a lot of tightness in glutes and SI joint and riding the tri bike was really starting to wreck my hip flexors. I'm also 53 like Klerner but a solid MOP athlete. So overall it's been a very positive experience so far. I felt like I made the best choice to go w/ the surgery - and I'm planing to do the other Hip in November too! I'm sure it will go well for you also. Keep posting as there are a number of STers who have had great results now for a couple of years who will give a more long term view of their success from this surgery. Anthony
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Re: Labral tear in hip [sportschick] [ In reply to ]
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I had an MRI arthrogram and was diagnosed with a torn labrum. At first I couldn't even make a bicycle motion with my leg. Now it's fifteen months after my injury and I can ride for 15 minutes if I don't push the pedals very hard. I am still deciding whether or not to get the surgery.
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Re: Labral tear in hip [robob] [ In reply to ]
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I have a small tear and the only thing that seems to work is rest, but even after rest it doesn't take much to agitate the injury back to being unable to train. It's such a shitty injury and probably not worth the risk of the surgery unless its catastrophic. It's putting me in a real pickle when it comes towards my future in triathlons.
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Re: Labral tear in hip [enovate] [ In reply to ]
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Small Tear: did you get a MRI to confirm it is a tear? If yes did they give you an injection? I have two small tears that came about a few years ago after I ran a very aggressive run on a very steep half IM course. I started out very light stiffness and soreness but over a few weeks I could not walk. I needed to finish IM AZ to collect my Legacy spot so I was determined to get help. I spent countless hours in PT with only slight improvement, my PT recommended I get an MRI, so I did they found a tear on both my hips, most likely old injuries re-aggravated by my run, but it wasn't intil I got a Floroscope and injection did I find relief. The injection allowed the inflammation to go down and in my case I haven't had any major set back, the occassional twinge of pain but thats it. My doctor said he wouldn't operate and that he recommended coming back for another injection if needed but to try and rehab through it. Since then I have done Kona twice and put down so of my best times.. Good luck
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Re: Labral tear in hip [sportschick] [ In reply to ]
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I have one. Here's the thread I had on it.

http://forum.slowtwitch.com/...5;search_string=mra;

Get the MRA so you know what's going on.

I'm competing just fine with mine (knock on wood).

Good luck with it!

Oh and my doc (also at HSS) told me that if you took 10 regular people, some 5 or so would have some degree of labrum tear. If you took 10 athletes, probably 9 of 10 would have a tear. They just wear out. You can strengthen the area around to compensate (but they don't heal).
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Re: Labral tear in hip [Mendeldave] [ In reply to ]
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Is there a scale of some sort that measures the severity of the tear?
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Re: Labral tear in hip [enovate] [ In reply to ]
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I've read other peoples' reports as to how sever their tears are. Mine seemed pretty small. I think my MRI said it was a suspected or likely tear or something. Another ST person commented on mine in the thread that I posted and they threw down the laymen's terms for the MRI report, basically stating mine didn't seem too terrible. Other than that, I don't know the answer and only assume there is a scale. Maybe someone with a medical background can weigh in.
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Re: Labral tear in hip [mag900] [ In reply to ]
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This is very good information . This is going to sound dumb , but when you got the injection into the hip , what would have happened if there was no pain relief at all ? Would that mean that the problem is the soft tissue /tendons , and not the joint . My daughter is having this done next week .
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Re: Labral tear in hip [gallen] [ In reply to ]
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point of order: this is a semi-old thread. we have a new utility here to help find and archive information like what you're looking for. if you hunt around the top or top-right of the forum you should see a blue navigational rectangle with the title HOT FORUM TOPICS. drop that menu down, i've created a sub-category "hip labrum tear" under "injury and illness." you may find some help in those threads.


Dan Empfield
aka Slowman
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Re: Labral tear in hip [sportschick] [ In reply to ]
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I have a friend in her mid 40's. She's just had her labral tear repaired surgically. She's bloody good local marathoner and a respectable triathlete. She had the local top surgeon guy (also a handy triathlete, doing Kona several times) repair it. Being an OCD person, she followed the prescribed recovery plan to the letter.
It was 6 months before she was allowed to run, but she rode and walked leading up to the 6 month time. Obviously she lost fitness and speed etc, but she is over the moon with the quality of the work and her ability to run again now.

Make sure you get the right advice from the right surgeon. If possible get a surgeon with lots of athlete experience and hopefully an athlete themselves. Remember too that if you ask a "cutter" a question, you'll get a "cutting" answer. I'm not saying they try to generate work/income, just that everyone in every field tends to solve problems based on their own experience. It's a rare person that will send a customer away. Soooo, get several opinions if you can. If the answer is surgery, then go for surgery, but get the right surgeon for you.

Base on my friend above, and several other people I know that have had surgery by the same surgeon, I HIGHLY recommend following the recovery plan to the letter. Friends that have followed the plan have had excellent results and those that have recovered too fast haven't recovered as well. A 6 month recover is frustrating to be sure, but if you plan on living more than 6 months, it's a small price to pay for the best recovery possible.

TriDork

"Happiness is a myth. All you can hope for is to get laid once in a while, drunk once in a while and to eat chocolate every day"
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