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Hip arthroscopy 1/2018, still having issues... advice?
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Hello! I had hip arthroscopy for labral tear/fai repair back in January 2018. It's been almost a year at this point and I am still having pain when I try to increase my activities. I have had minor clicking and occasional catching still happening throughout the year, but wasn't told this was anything to be concerned about yet. Right before I had surgery I started having crazy back spasms, which resolved briefly after the procedure but started again around the second or third month during recovery. I did physical therapy until around August for both the hip and back spasms. The spasms have improved but it still happens and I still have to be very careful with how I move. Then, about a week and a half ago I developed a sudden severe pain when I moved my leg a certain way.

I immediately made an appointment with my surgeon, who believes the source of my pain could be bursitis (even though that isn't where the pain was felt when I moved my leg that certain way). I am scheduled to have an ultrasound guided injection tomorrow. But this is far from my first rodeo, I know this is basically a formality to see if it relieves any of the pain or not. To me it just delays finding the true source of what the hell happened when I had that sudden pain. Honestly it feels like it did before the surgery right now and I'm kind of freaking out.

The background on this injury is that I used to do a lot of running races and sprint triathlons. Back in 2011 I was working with a personal trainer who thought sprinting cold no warm up was a good idea and my hamstring tore. From there it was a downward spiral of tendonitis, bursitis, and then finding the labral tear a couple years later. It didn't cause me too much grief as long I managed the inflammation, until I did CrossFit for a couple of years. I stopped training like a psycho for about a year before the pain became unmanageable last fall.

I am a nurse and in the Army Reserves so being hurt for this extended time is extremely stressful. This could seriously impact my career(s), not to mention I have been inactive now for so long I'm losing my mind. I am considering a second opinion for treatment options.

Any thoughts, advice, personal experiences with this?? Thank you so much in advance!
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Re: Hip arthroscopy 1/2018, still having issues... advice? [moonswoon] [ In reply to ]
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I'm so sorry you're still having issues. I'd post this to the main forum so more people see it.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Hip arthroscopy 1/2018, still having issues... advice? [moonswoon] [ In reply to ]
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This post on the main page may be helpful. It's four pages long now.

https://forum.slowtwitch.com/...Tear_Story_P6624014/
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Re: Hip arthroscopy 1/2018, still having issues... advice? [jimmy d] [ In reply to ]
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My hip arthroscopy was 2/16 and I have not had any issues post op. I've posted about this on the main forum and was very conservative in my return to sport. Dr. Philippon did my surgery and I believe that and his PT protocol are the main reason for my success. I would suggest contacting his office and seeing if you can get a second opinion. I am so sorry that you are having so many problems post op. It is such a long recovery and hard surgery that having issues now has to be very upsetting. My recovery was slower than a lot of people who posted but I am also older (55) and my ability to do my job as a physical education teacher was also a huge reason for being so conservative coming back.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [milesaway] [ In reply to ]
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It is incredibly frustrating. I had so much hope to be back to some kind of activity by now. Being inactive is killing me slowly. I feel like I was very conservative with my recovery as well, I was non weight bearing for 3-4 weeks and partial for a few more weeks after that. I didn't start PT until 5 weeks post op. I did everything I was told to do. PT had me doing water therapy for about 4 months which was great. The progress from there felt slow but I also developed back spasms somehow during that time period. That interfered with a lot of things I might have been "able" to do. I still get back pain, and I'm sure it's all related to the hip (I had the back pain evaluated, it's not a spine issue so that's a relief at least). I'll try putting this on the main page as suggested. Thanks everyone!!
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Re: Hip arthroscopy 1/2018, still having issues... advice? [milesaway] [ In reply to ]
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Was it Dr. Philippon who did hip surgery on Wendy Whelan the ballerina?? I watched her documentary before I had surgery and wished I could go out there to see him. From what I gather, he is the authority on this surgery. You are very fortunate! :) I don't know how I would get out there from Pennsylvania or I would in a heartbeat. I doubt my insurance would approve it but I may try to find out anyway.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [moonswoon] [ In reply to ]
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I had hip arthroscopy (my 2nd) with Dr. Philippon in Feb 2018 for a large labral tear and FAI. PT started on post op day 1 (just like it did 10 years ago when I had my other hip done), and continued 2x daily for the first week, then daily etc, there is a very strict progression of exercises for the first 12 weeks. Water therapy also started within days of the surgery, and continued 2x/week. From the point of the hip labral tear, my pain is 100% gone, and I am at normal function and range of motion from a hip joint point of view.

Where is your pain? Is it the same exact pain you had before the surgery or something different/new?

If it's the same pain, there is a good chance the labral tear was incidental finding and thus fixing it had no long term benefit on the pain. If its a new pain, you probably injured something else?

Two wheels good. Four wheels bad.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [DrTriKat] [ In reply to ]
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I didn't think of it that way but that is a good point (pain being the same vs new). The pain I am having is similar, but also having new symptoms. The catching is new. When I lean forward to where my knee is about at a 90 degree angle it cracks like a knuckle and hurts. The pain I felt when it got really bad a few weeks ago was definitely new. The cortisone injection in the bursa has helped the soreness in that area but the ache in my thigh and catching hasn't changed.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [moonswoon] [ In reply to ]
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Yes, Dr. Philipon did Wendy Whelan's hip arthroscopy. We live in Texas but traveled to Vail for the surgery and stayed up there for 3+ weeks post op for Physical Therapy. They are use to having patients fly in for surgery and have great resources to help you arrange your stay in Vail.
Unfortunately, I was recently hit in the leg and may have re-torn my lateral meniscus . If that is the case I'll got back up to the Steadman Clinic to have surgery on my knee and stay again for a few weeks of physical therapy. I had a great experience at their clinic and would highly recommend going if you are able.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [milesaway] [ In reply to ]
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I posted on the hip thread in the main forum....I’m 47 and have FAI with a labral tear but declined surgery for a strength and increased mobility approach.

I think it’s still helpful and valid even if you’d had surgery as improving hip strength and function can’t hurt.

Take a look at Upright Health on YouTube to get an idea as whether this might be if interest to you

I’m more or less pain free, I’m a cyclist back training 5 times per week plus 2-3 strength training sessions...I also ski and run albeit less often...still have occasional days where imy hip is tight but overall feeling good
Last edited by: JANUS: Jan 22, 19 4:55
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Re: Hip arthroscopy 1/2018, still having issues... advice? [moonswoon] [ In reply to ]
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I don't know where in PA you are, but my S.O. and I had our surgeries at Vincera, which is in the Navy Yard complex in Philly. Another of those sites where people fly in from various other locations to see the surgeons.

I had surgery in March 2017. I also had many of the same discomforts return in the 9 month range. My feeling is that, while I had a labral tear and some FAI, my initial symptoms were due to an underlying muscle imbalance issue (that still hasn't been resolved). I tore my labrum worse in Nov 2016 and most definitely needed surgery when I finally decided to have it. My labrum is still good, I'm sure of it. But the underlying issue is still there.

I'm sort of given up trying to find it. My most recent physical therapy pursuit was PRI (postural restoration). I think there is something to that line of therapy, but the live PT sessions move at a snail pace and I'm not interested in continuing to pay for progress that is that slow.

I see many of these posts on ST, and can't recall if I responded to yours (if you cross-posted to the main forum). At any rate, if you'd like additional support, you could check out two groups on Facebook: Hip Impingement Awareness (FAI, PAO, THR), and RUNNERS with Hip Injuries(FAI, THR, PAO,...).

To breathe, to feel, to know I'm alive.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [Tsunami] [ In reply to ]
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I think it's fairly safe to say that if you have an impingement or a labral tear, you've got some asymmetry or movement dysfunction or other imbalance as a root cause.

I've spent the past year, post impingement shaving and labral graft, trying to resolve profound asymmetry in hip function. I'm about 70% functional now, and this is after every-other-day of about 90 minutes of physio, to reactivate reflexes and firing patterns that got corrupted by decades of compensation, baked in by tri training and racing.

this is by way of saying that in my case, the problem was comprehensive, and would never have gotten fixed had I simply gone back to my old ways prior to surgery. Whether I can compete again is a big question but I believe this trajectory is taking me back to healthy movement.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [moonswoon] [ In reply to ]
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Ah I just saw this post. Not sure if you’ve had resolution yet but here’s my 2 cents worth.
Hip stuff is my bag... I’m a physio and have an interest in hips and pelvis dysfunction, I see a number of people pre and post arthroscopy, particularly for anterior labral tears that actually have a sacro-iliac alignment issue. That results in increased pressure anteriorly (aka FAI - femoral anterior impingement) and glutes not firing properly at the back. See if you can find a physio or osteopath who specialises in assessing and treating pelvic and SIJ issues, if you’re in Australia, PM me and I can point you in the right direction.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [noodlecat77] [ In reply to ]
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that's interesting -- one-sided SI laxity is a big component of my problem -- as well as poor recruitment, and, I'm now realising, fascial stricture through all sorts of bad vectors.

You sound like a great physio! I've seen quite a few and none had this insight.
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Re: Hip arthroscopy 1/2018, still having issues... advice? [kiki] [ In reply to ]
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And I had a brain fart,,, FAI is femoral acetabular impingement ... but same end result. Loads of core work and glutes work and good SI position to make that possible. There are some treatments with PRP injection that work to stabilise the SI in cases where the joint has actually been ruptured but generally most people get good resolution with lots of strength training to hold, good position once someone can put you into good position. Good luck with it 🙂
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