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Labral tear in hip
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Has anyone ever come across a labral tear in their hip? I have one from falling off my bike and wanted to see how long it takes to recover. Does it heal on it's own? What sort of results has one had? Is surgery always required? I hear different things from different doctors and wanted someone elses opinion. Thanks for your help.
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Re: Labral tear in hip [sportschick] [ In reply to ]
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I have one too ( I think, b/c it's self-diagnosed). The textbooks suggest that it'll heal (or at least become less painful) by itself. If your doesn't I'd look for an orthopedist with expertise in hip arthroscopy.
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Re: Labral tear in hip [sportschick] [ In reply to ]
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Often due to congenital bony abnormality of the head/neck of the femur which causes wear and eventual tear of the labrum with rotational forces.
Common in kicking (taekwondo) sports and butterfly swimmers / waterpolo athetes.

Because they're not often traumatic as you say yours is, the type of tear you have may be more aggressive. Does it heal on its own...likely not, due to lack of blood supply. Can one live with a tear, sure. Can one function in high level athletics with one, likely not, especially in an aggressive aero (bike) position and high-mileage running.

However, surgery MAY help with proper rehabilitation. As for timeline after surgery, give yourself at least 6 months till 100% recovery


JC
Twitter: http://twitter.com/jeffcubos
Website: http://www.jeffcubos.com
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Re: Labral tear in hip [sportschick] [ In reply to ]
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In Reply To:
Has anyone ever come across a labral tear in their hip? I have one from falling off my bike and wanted to see how long it takes to recover. Does it heal on it's own? What sort of results has one had? Is surgery always required? I hear different things from different doctors and wanted someone elses opinion. Thanks for your help.

I can only offer you what my sports med doc told me.

I have a small labral tear (with a flap). I was experiencing pain in the area of my adductor so she had me do a specific MRI to see if I had a labral tear. I did but after further tests that isolated the labrum, it was ruled out as a source of my pain.

Does it heal on its own? Likely no.
Is surgery always required? Absolutely not.

If it causes you pain then surgery is recommended. The recovery process is fairly long -- around 6 months. However, with no pain you should be able to perform fine with the tear. My doc has a labral tear too and she never had surgery. Hasn't hurt her one bit. So far, my adductor finally healed and my tear hasn't impacted me at all. I don't even know how long it's been there. Maybe for a couple of years. Hard to say.

I'd say if you have no pain then don't worry about it. Again, that's what my doc told me.

Thanks, Chris
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Re: Labral tear in hip [sportschick] [ In reply to ]
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lets see the MRI!
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Re: Labral tear in hip [sportschick] [ In reply to ]
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First off I don't agree with qboss's statements at all. It's a wear and tear issue or from blunt trauma as what you are experiencing. I was diagnosed with one in April. To determine this you should have a arthrogram MRI. Did you have this? It's the only way to see it and confirm it on an MRI with the dye.

Don't go the surgery route unless absolutely necessary and if you do, make sure you have someone that specializes in this type of surgery. I saw both an orthopedic specialist and then a very well known hip specialist at Mass General here in Boston that specializes in hip tears. No surgery was suggested UNLESS it flairs up again. Mine resolved or settled down so that I could resume normal training again after about 6 weeks. Being in an aero postion on my bike or running hard intervals coupled with increased run mileage is not an issue now.

_________________
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Re: Labral tear in hip [gabbiev] [ In reply to ]
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Yup...the OP wants an MR-Arthrogram...plain jane MRI isn't good enough. You want to see if the dye fills in the space of the tear to be able to detect one.


JC
Twitter: http://twitter.com/jeffcubos
Website: http://www.jeffcubos.com
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Re: Labral tear in hip [sportschick] [ In reply to ]
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yes. i had one scoped in jan '07. the hip is a complicated area of the body and there aren't any general rules regarding who needs surgery and who does not. i believe that there are lot of people walking around with torn labra but, because they live sedentary lifestyles, either don't care or don't know about them.

i knew that something was wrong with me following imlp '06 because i could not run fast no matter how hard i tried and i had pain in my hip that was a new pain that was deep and not one i had experienced before. i got an mri, which showed the tear. however, as discussed above, that does not automatically mean surgery. i next got an x-ray guided injection to see if that stopped the pain. it did and i was able to run relatively painfree for a couple of weeks but once it wore off i was back to square one. that told the surgeon that my pain was in the hip joint itself (and not soft tissue around it) and i therefore was a candidate for surgery, which i opted for.

once the surgeon got in the hip, he saw that the tear was much worse than the mri revealed. the labrum looked like grated cheese in the pix i saw and it was flapping around in the hip joint. i also had a bone spur that the surgeon shaved down. however, and i don't even want to get started here, the surgeon failed to shave down the head of my femur, which was what more than likely caused the tear in the first place, and i had to have a second surgery this past june to get that done (by a different surgeon). the first surgeon is supposed to be the hot shot hip surgeon at HSS -- bryan kelly -- but i would avoid him like the plague. he screwed up the surgeon and his only concern is how to get the most surgeries in per week with no regard for his patients. the 2nd surgery was done by coleman at HSS and i would highly recommend him. i'm not fully healed but i should be by this winter (i started biking 1 week after surgery and running 2 months after surgery).

as someone else stated, a tear in the labrum will not repair itself -- you just have to figure out whether you can deal with it or not. one of my friends has one and has been able to avoid surgery so far (i couldn't). they are working on creating an artificial labrum that would be sewn into the hip but it isn't available yet. pm me if you want more info.
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Re: Labral tear in hip [sportschick] [ In reply to ]
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I am 11 weeks out from surgery. missed a few big races. one was in october on that island in the pacific. anyway, i am glad i got it done. they do not repair on their own. my surgeon was philipon in vail colorado. he is the best. the rehab was awesome. i stayed out there for 3 weeks. i have been running, biking, and swimming for the last 6 weeks. today was a 30 min run with no pain. so there is hope. you certainly can live with the tear, but to get back to the lifestyle, i felt i needed to get it fixed. hope this helps. email me if you have any other questions.
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Re: Labral tear in hip [sportschick] [ In reply to ]
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Good replies from all. FWIW: I will add that you absolutely need a specialist for the hip. Don't let anyone get in there unless they are well known for labral tear repairs. I have seen many orthopods try and fail in the hip. Good luck!
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Re: Labral tear in hip [Trigirlpink] [ In reply to ]
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Don't mess with qboss, he is one of the smartest docs in Canada......

Anyhoo....why dont you (the OP) post the MRI?
We are all dying to see this 'diagnosis'
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Re: Labral tear in hip [Trigirlpink] [ In reply to ]
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Actually, I think you DO agree with me as you state

"It's a wear and tear issue"

But just to make you agree with me more, let me explain a bit further. Acetabular labral tears are often a result from Femoral-acetabular impingement (FAI), typically due to CAM-impingement and pincer-grip anomalies....those "bony" anomalies that I had mentioned earlier.

PS. a tear is a tear. it cannot resolve and there is no such thing as "settling down". You either leave it be or repair it.


JC
Twitter: http://twitter.com/jeffcubos
Website: http://www.jeffcubos.com
Last edited by: qboss: Nov 14, 08 19:23
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Re: Labral tear in hip [qboss] [ In reply to ]
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A traumatic labral hip tear......WTF.....show me the proof....
Come on sportschik... why dont you post a 'critique this MRI' thread....
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Re: Labral tear in hip [Supermartin73] [ In reply to ]
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Sorry, don't know how to post pics on ST so here is a link of Sportschik's MRA:

http://i10.photobucket.com/...g/chocolatecream.jpg


JC
Twitter: http://twitter.com/jeffcubos
Website: http://www.jeffcubos.com
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Re: Labral tear in hip [qboss] [ In reply to ]
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mmmmmm.....labral tears.....
15 posts later and no sportschik.....I am going to bed.
See y'all in Penticton
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Re: Labral tear in hip [Trigirlpink] [ In reply to ]
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Hi Trigirlpink -
I am in the metrowest area and have just been diagnosed with a tear - I was sent to a specialist at NWO by my PT (and Tri-teammate of yours) - I was wondering who at MGH you saw in case I want to seek a 2nd opinion?
you can email me at: triwess7 at gmail dot com
Thanks!
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Re: Labral tear in hip [rockettt7] [ In reply to ]
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I'm bumping this thread as I found out a couple of weeks ago that I will need to have surgery for this injury.

My question is not whether or not to do the surgery (I'm doing it), but how long is the recovery process. I'm reading a wide range of timeframes. One poster said he/she was timetrialing on the bike after couple of weeks post-surgery, and others have said give it 6 months. What's typical? I'm in Cincinnati. My Ortho Dr. (Kremcheck) is saying 4-6 weeks on crutches typically.

Separately, thumbs up to rroof, who has helped many ST folks over the years, for the various Ortho Dr. recommendations.

Peace!


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 [TMT] [ In reply to ]
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My wife had the surgery last year. She is a an impatient physical therapist and pushed her self as much as safely possible during the rehab. She also aggressively strengthened the hip muscles prior to surgery, but she isn't a IM triathlete. If I recall correctly, she was basically in bed for a week, on crutches for about 4-6 weeks and back to normal in about 4-6 months. If you are on crutches for over a month, it takes a while to recondition yourself.
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Re: Labral tear in hip [TMT] [ In reply to ]
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Dr. Byrd in Nashville scoped my left hip last November for a small labral tear, which he sealed over with an Oratec probe (whatever that means); and for degenerate ligamentum teres, which he debrided. FWIW, neither of these problems showed up in the MRI arthrogram. Dr. Byrd did the scope based on my symptoms and on the fact that I got complete pain relief from the anesthetic injected with the dye for the arthrogram.

Four months post-op, and I am a long way from being fully recovered. True, I have no pain at all in the daytime, which is a huge improvement over where I was before surgery. But any stress on my hip at all, and I mean just a 15-minute walk, and I am awake all night with pain. I am not despairing--yet--but have emailed Dr. Byrd's office to let them know my recovery seems to have stalled.

Surprisingly, the most immediate and enduring effect of whatever Dr. Byrd did has been that my back problems have resolved.

Susan
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Re: Labral tear in hip [greggtri] [ In reply to ]
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I am at Pittsburgh now and the guy who was supposed to take over for Philipon already got his walking papers... I have a friend who played football and had his hip scoped - I dunno exactly how Philipon does it, but he has incredible results.

"Ride it like you just stole it"
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Re: Labral tear in hip [susanherself] [ In reply to ]
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byrd's pretty much the man with hip arthroscopy, so i would see him before anyone else given the choice
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Re: Labral tear in hip [gabbiev] [ In reply to ]
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Can you tell me which doctor ( in the Boston area) did your surgery? did you get several opinions? You obviously seem happy with him. Was it a repair or just cutting? How was your follow up?
My friend had a repair done and 6 weeks later still has lots of pain. Her doc does not believe in rehab.This seems odd to me. Is this very unusual?
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Re: Labral tear in hip [pinktulip] [ In reply to ]
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hooslisa -

This bump's for you!
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