I am going to have a much different opinion than some people on here. But I’ve tore both, had surgery on both and it was the easiest surgery and recovery I’ve had. Which is like 10 surgeries right now.

The key is to go to someone who primarily only does the surgery. If they only do it sometimes or rarely it will go poorly I can almost guarantee that. Most people that I’ve seen who have issues with it didn’t go to someone who is good or someone who rarely does it.

Dr. Michael Ellman is who did both of mine and the surgery was cake. I was running in 10 weeks after the first. Second was longer but that’s because we did it right after my knee surgery on the same side. That said the normal is always 12 weeks, I was the first person he ever let run early.

The easiest way to tell that it’s probably that, is if you take your hand put your figures on the side of your leg and the thumb in front of your hip flexor if it hurts where your thumb is that’s a pretty good sign.

PT can help but it just depends. I had cam impingements on both sides which was causing the tears (from hockey), so nothing would fix it but surgery because they had to fix the actual bone also.

Anyways that’s my story with it, I wouldn’t hesitate to do the surgery if it’s the right doctor.

I’m 7 weeks post op from a torn labrum and fai on my right side. I had my left surgically repaired back in 2015. Both were cam’s with torn a labrum.

Most of pain on my left side was on the lateral side of my hip. On my right side, it more in the groin and actually started to cause issues with my knee. Tried to avoid surgery with lots of PT beforehand but neither were successful. Also had injections in both hips prior to surgery.

I tell everyone to avoid surgery if they can. Some are fortunate, others are not. If you do surgery, you need someone that has done this 1000+ times. It is a rather technical surgery. I’ve seen a lot of dr’s actually stop doing the surgery. I had 2 different dr’s do mine and I can tell you they have been night and day difference. The 2nd dr was much more experienced and is one of the go to dr’s in the entire country for this surgery.

Here’s my recommendations:
- talk to your dr - find someone who specializes in fai/torn labrum
- get an mri with a high fidelity machine
- start pt - strengthen glutes, posterior chain, core
- ultrasound guided injection - if your dr recommends it
- surgery - last resort

Happy to answer any questions

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Did your recent increase in Ortho visits coincide with choosing your forum name?
Okay moving on.

You said they checked the hips, so is the diagnosis from the clinical testing or from scans or both? X-ray is good to show articular cartilage thinning and to see if there is either too much bone (CAM/Pincer deformities) or too shallow a socket (dysplasia).
Did the Orthopod organise a hip MR arthrogram? This is really the only worthwhile MRI to see the extent of labral and cartilage tearing or separation.

'Groin' pain is pretty much the most common symptom which would be directly from the labrum but can also be hip flexor muscle or hip capsule. However people report multiple other symptoms including stiffness, low back pain, abdominal pain, hamstring tightness, thigh pain etc etc.

Conservative measures work very well and should be tried for 3-6 months before undergoing surgery. Don't be surprised that if you visit a surgeon they recommend surgery and don't be surprised to have a physio recommend rehab. That's the tools at their disposal. Only with a combination of clinical signs of pain during tests, changes seen on scanning and a failure of conservative measures is it really warranted to go for surgery.
Have you tried to gauge what aspects of training are aggravating the hip in the first place and then making any particular adaptations?
Link in with a good physio but the simple obvious things are reduce the hip angle so avoiding deep squatting below seat level or too aggressive a bike position and see do they help for starters. If the labrum or capsule is inflamed it can take 3-4 weeks for this to settle back down.

I would echo many of the aspects a previous poster wrote about seeing a surgeon who has a lot of experience doing the surgery and would definitely enquire what they do with the hip ligaments on the way back out. There is a difference between having a capsule repair and not.

The ultimate success to the surgery is a combination of: correct surgeon who does a lot of them, correct techniques used, and how good or terrible your hip is underneath it all. The rehab is pretty straight forward really, similar to the conservative management and easy enough. Big positives. Stationary bike is recommended from day 1 (easy), and pool exercise once incisions are healed around 2 weeks (no breast stroke kick). So there's 2 out of 3 disciplines right away. Running is variable and depends on cartilage damage. Could be anywhere between 6-12 weeks depending on the multiple factors stated above.

So to answer your questions more simply.
Did it feel like a strained groin for you? Yes
Were you able to remedy with rest, PT, etc? Yes, and helped for a long time
Did a change in bike fit help? It can and should be one of the first things to try. Personally I wasn't into triathlon before having the issues but know many that it helped.
Any experience with surgical repair? Recovery? Yes. Easy peasy

I had my labrum repaired (along with femoral head reshaping) on my right (dominant) side this past May and I'm stilling dealing my original symptoms, but to a somewhat lesser degree. In my case, there's something else (currently undiagnosed) going on and labral repair surgery did not resolve it.

A couple questions for those that have had a similar injury:
Did it feel like a strained groin for you? - No. It felt like (and still feels like post surgery) like a strained medial glute where it attaches to the top of the hip in the back. Very localized pain. Almost like sciatica, but without the issues further down the leg (no numbness/pain anywhere else). Walking (and running) were my main triggers, but could also be in pain for several hours after biking. Mowing the hard would put me in pain for a day or two and have me limping.


Were you able to remedy with rest, PT, etc? My first trip to PT generally aggravated the issue (which consisted of mainly stretching of everything in the kinetic chain from calves to back). The only thing that really helped was a cortisone shot (but that's a very short term solution). I took ~3 months off from running and biking with no real improvement from rest. Post surgery, the last month or so of PT was mostly focused on trying to resolve my initial issues, but I had minimal change in symptoms during that time.


Did a change in bike fit help? Post surgery I have made some changes to bike fit (shorter cranks, raised cockpit, increased saddle tilt) that have seemed to help. Biking no longer seems to be a trigger for prolonged pain. There are still motions where I can "feel" it, but they don't trigger lingering issues off the bike like it did before.


Any experience with surgical repair? Recovery? The recovery for someone reasonably fit is fairly quick. I was walking some without crutches in around 1 week. Swimming with an ankle buoy once they incisions scabbed over. Started the return to running program after ~12 weeks. Formal PT twice a week starting around 4 weeks post surgery.

All that said, I know of 3 others that have been diagnosed with a torn larum and all had different treatment paths and outcomes.

• One did not have the surgery. Primary complaints seemed to be compensation based (sore calves/planter fasciitis with some soreness and tightness in hip). Did some PT with minimal improvement, 10 weeks of no running (biking was never a problem). Eased back into running slowly and had one of best year of running and triathlon she's had to date. She still complains about lingering "tightness", but not pain. The non-surgical success story!
• Another had issues while running. Initial complaint was it felt like a very deep glute strain. She had surgery and is back to running with no complaints. The surgical success story!
• Another had surgery and still has lingering pain/pinching issues when biking, even after several fit changes. He never had issues running (ran 13 mi the day before his surgery for example). The surgical partial to non-success story?

We're all in the 30's/40's if that matters. I'm beginning to formulate a theory that most of us have a damaged labrum that can be found by looking hard enough (MRI w/ contrast), but that it's not the cause of a lot of symptoms. For me, I think it was probably damaged by the 25 years of soccer due to impacts and more extreme range of hip motion and was not the primary cause of my issues. It may have been an aggravating factor, but only time will tell.

Glad the surgery went well! What injections did you try beforehand? Did they help/buy you time before surgery? I’m considering PRP.

Thanks for the feedback!
MB

Haha, no but it should have!
The did and x-ray as well MRI without contrast for the right hip. Nothing for the left (I went in for right knee issues and just discovered the bonus hip issue. Hips/groin have started hurting worse since then).

I’ve been doing PT for the knee and hips for about a year now. The hip pain has seemed to slowly increase and seep into my daily routine. We’ve been trying new exercises at PT to more specifically address the hip. Hopefully they help but who knows.

Thanks,
MB

I’m sure some of the wiser or at least grayer ST’ers will tease me about this but is 30’s when aging really starts to kick in? I feel like I’m going from one mild or not so mild injury to the next no matter how much PT, stretching, warming up, eating healthy, and sleeping I do!!

MB

Not sure what you did before your 30s but all of the stuff I did before then finally gave out then. I played 8 years of very full contact hockey and that’s where all my stuff came from. It wasn’t as much aging as much as those issues finally wore out the whole way.

It was just a steroid injection. It bought me a few days on my left side (tried running 5 days after the injection and pain came right back). I did get some longer relief on my right side but I was already set on surgery and just checking the pre-operative boxes.

The injection seems to be more used as diagnosis confirmation that your pain is coming from the labrum. I do know some people that got the injection, did some pt, and are pain free or at a point that is manageable. Not sure if insurance requires the injection before surgery but it does seem like a pre-requisite for the dr’s to do surgery.

I wouldn’t recommend PRP. I don’t believe there’s much research out there with success on hips.

Saw that you have been doing pt for a year. If you haven’t gotten any relief from pt, I would seriously be considering surgery at this point. What did the mri report say?

FWIW, I’m 37 and had the first one done when I was 29.

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If you need surgery, 100% find someone who specializes in hip preservation. I've heard horror stories of people worse after surgery. I work with a lot of ortho docs and there are a lot of them I wouldn't trust, not just for hip preservation but for other surgeries.

I didn't know Dr. Michael Ellman was a hip guy. I've never met him but he was dating my friend, his now wife, when he was doing his ortho residency at Rush in Chicago. My hip guy is Dr. Nho who also trained at Rush and works there too, he's pretty well known. I'm sure they know each other. My best friend is a PT and insisted that I see him for my labral tear. Dr. Nho recommended PT first and that was in summer of 2020. I was careful to return to running and biking. I think biking might have been the cause as I can feel a click when I flex my hip to ~90 degrees. I ride mostly indoor and try to ride more upright and only go aero leading up to races (not hard for me for 70.3 and shorter).

Since my diagnosis, I've done a couple sprints/oly, three 70.3 and a marathon. PRs at each distance. I'll have occasional hip/groin discomfort but only mild and hasn't worsened. I have no hesitation to getting surgery if needed as I've come to realize I can't give up tri's and running.

Up until recently the PT was focused on the knee. As the hips got worse we threw in a couple more exercises for them. Seems like a lot of overlap in the exercises.

MRI showed it was torn with some delamination and cystic changes on the femoral head.

My big takeaway from this thread is if I need surgery find a good doctor. Any advice on how to go about doing that? Google searches bring up a bunch of junk sites about best surgeons near me. I’m in a smallish town and don’t want anyone near here.

MB

Where do you live?

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That’s funny. I love Ellman, he’s done both my hips PCL revision w/LCL reconstruction. 80-90 percent of what he does is labral repairs and then the rest is the complex stuff no one touches. Like the PCL/LCL combo. He also took out one of the bursa’s in my knee mainly because I probably put one of his kids through college at this point otherwise that surgery is too boring for him haha.

My understanding with my left one was that it wasn’t torn as much as detached from the hip, so when I’d move I think it was rolling which was causing an insane amount of pain. I went to another hip guy here and he didn’t think it could be my hip because of how much it hurt. Ellman’s PA proceeded to call him an idiot given that they tested it in like 5 minutes with an injection. Also with both of my hips having cam impingements there was nothing that would help. It was so bad I remember going to one of our friends party’s for beating cancer. We were in the care for all of 30 mins and I could barely stand when I got out of the car. It was miserable.

To your first point. I was in med school for a year and half before I decided it wasn’t for me. There are a lot of doctors that I would never trust. They may be book smart enough to get there, but holy moly outside of that completely clueless. I am lucky being in Colorado, we generally get really good orthos.

I’m in Texas.

I don’t think I’m at the point that surgery makes sense. Right now it is just a dull pain a few hours a day with the occasional sharp pain. What has me concerned is that it has steadily gotten worse over the last year. I’m not sure if this is one situations where you lump it along as long as you can without surgery or if an early intervention would prevent more damage. As of now I can still train. I’m more concerned by the presence of the pain than the pain itself if that makes sense. It does worry me that I may be in a hard workout or race and it tear worse.

MB

Not sure where in Texas you are but my buddy has had good experience with Sheena Black for his hip issues.

https://www.sheenablackmd.com/

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I can't help aside from offer sympathy that you're dealing with this.

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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

Where Is your doctor located?

how are you doing?

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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

What was the name of your doctor?
What city and state?
Can I email you?
Tim.Richardson@fyzicalhq.com

I had a torn labrum in 2017 and PRP was used by my doc, it was very successful and I was running within a couple weeks with no pain at all, and have not had any issues there since. I am not sure PRP will be helpful in your case, but I would look into it as a potential option.

Best of luck!

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