Okay, so I know I know, another Hip Labral Tear thread. But I thought I'd share my experience so far in hopes it can help someone that has been like me and looking for more info and discussion.
Slowtwitch has been a great resource for information around this injury, probably because the forum is (as described by others) a place for "old timers trying to hold on." Well, old timers get injured. :)
I've read quite a bit here already, the threads linked below are terrific reads if you're falling upon my thread here and want more info.
Running with hip impingement/torn labrum
Hip arthroscopy recovery - training methods and timelines - NEW
Kona_with_a_torn_hip_labrum_and_sports_hernia
FAI/Labral Tear Surgery..... and rhabdo
Check all of those out, great resources there and I appreciate all of the detail provided by everyone in their experiences.
My experience, yes, it's long:
Diagnosis:
I'm 46, mostly a runner, but I cycle too and dabble in duathlons. Passion is trail running, but racing the marathon is what really narrows my focus and gets my fitness high. About 2 months ago, I was coming off a 40m trail race where I mostly took it easy as long run, and hoping to transition back into my marathon plan right after. But I started getting inner groin pain which eventually progressed to the point I saw an orthopedist and he diagnosed me with an adductor strain and told me to resume running. That only lasted about a week before I knew it was something worse. I've had experience with SFX and this pain felt like that so I got an MRI which revealed no SFX but a "sublabral tear" of the "supraacetabular right hip." My ortho and I were both surprised by this but it did fit the symptoms. Based on prior symptoms (occasional "high hamstring" pain going back 4 years) he suspected the tear had been there for awhile but was aggravated by the 40m trail race and my subsequent jump back into training. He's also an endurance athlete and suggested that this was something I had recovered from previously and could do so again.
Adjusting Plans
I eliminated the running and in an attempt to maintain fitness during this "break," piled on the cycling, stairmill, incline walking treadmill, and other cross training (I normally do all this XT but I just did more to compensate for the lack of running). I also maintained my strength training and core work (more on this a bit later). Somewhere about a week after the MRI I distinctly remember having to climb into my garage attic via ladder to load/unload some stuff for my wife and WOW that was some sharp pain that left me with severe groin pain afterwards. I learned that type of twisting and flexing in the hip was not good. About 2 weeks after symptoms started, there was a scheduled race I "had" to do so I loaded up on NSAIDs and gritted it out. Frankly with the NSAIDs the pain was not that bad in the race, but I was definitely favoring the hip walking around afterwards.
2 weeks later
No running, but continuing all of my cross training I had 1 more race (a 10K) that I "had" to do and again loaded up on NSAIDs and gritted through it. Again, it didn't feel too bad and I was even fine walking around right after. But later that night, I recall playing a marathon Monopoly game with my kids where I had a lot of trouble getting up and down off the ground to move all those little @#$%^ pieces around.
But at some point after that race that the biking and the cross training started to decline as well. Whereas the bike (road, mtn, and spin) previously made the hip feel better, it got to the point where it was aggravating it as well. Same with the stairmill and treadmill it seemed. That's when I started to do my hip labral research and read all of the FAI/Surgery horror stories. Some depressing stuff to say the least. It didn't help that I randomly ran into a guy on the 10K race trip that had FAI surgery that basically ended his cycling career - he was 51 and regretted it, even complaining of pain after mowing his lawn. Ugh! Of course I read on Slowtwitch too which was more encouraging.
No more CrossTraining & Got Shot
Since the cross training was not helping I figured I'd just eliminate all of it too and allow my body to recover while I mulled over options. I was thinking I could scrap the rest of the race season and just try to get back to it when I no longer had pain. I went about a week feeling better and better so decided to do a "test" 1m run. I went about 50 yards before I felt that familiar "pinch" in the groin, continued on for a half mile to see if it would go away and ran back home. Trying the bike later in the day also produced that same pinch. Discouraged, I talked to my ortho who suggested a steroid shot. His thinking was it could get this flare up down and get me back to my baseline and also provide a diagnostic tool that it was actually the labrum giving me trouble. I got the shot on 4/20/17, about a month and a half after my symptoms originally showed. He said no leg exercises for 3 days and then I could try some light cycling or elliptical. The 2 days after the shot were miserable! I must've had a cortisone "flare" because my entire leg was on fire the following 2 nights. But that eased the following day and I felt pretty darn good. Since it was 3 days post shot, I figured I'd test out some work on the leg. I did 15min treadmill walking to loosen up, 15min elliptical, and my strength and core routine. Felt great and even did my PT work (elastic band resistance work for the hip) that night.
The next day though was rough. Woke with achiness down in the hip joint, especially sitting at my desk. Just a nagging, burning sensation that strangely would only go away when I'd get up and walk around. Did no type of exercising at all and fought the depression that something bad was wrong. Basically the same the next day, but this time the pain was outside the hip (like bursitis) and had extended to my other hip too? WTH? Doc said Steroid can sometimes take 7 days so wait a bit more.
Travelling
Finally, after those 2 days of rest I felt a bit better and this was the day I travelled to the marathon I was supposed to be running. I already had the flight and my buddy was still running it so I tagged along. Did I mention it was in Vegas? Heck, I figured I could enjoy some time there if anywhere. I even originally had plans on renting a road bike and following the marathon course around. But I scrapped those right before the trip. Travelling out was not too bad but I did a lot of walking. The next day in Vegas I walked over 8 miles based on my fitness tracker and generally felt okay doing it. That evening I went to the hotel gym and didn't do any cardio but I went through my weight training and core routine.
Things declined badly the next 2 days. I was able to support my buddy at his marathon but I did not feel good sitting OR standing. Despite trying to rest that day as much as possible, I still walked over 6m over the course of the day. The bursitis-like pain returned in my hip at the end of the day and I went to bed that night in a significant amount of pain, probably the worst it's been yet. Still there the next day I was a slug, and only took around 2K steps according to my watch. I was miserable and really worried. My appetite through all of this was next to nothing and I had trouble sleeping. NSAIDs wouldn't touch it but I did find that Tylenol Arthritis. Finally, BLESSEDLY, on the day I returned home I could walk without a limp and started to feel a lot better taking the Tylenol and sitting most of the time. Doc said it sounded more like bursitis now since the inner hip pain was gone presumably from the shot. Was encouraged by that, felt good the next day, and got back into my weight routine, this time eliminating the core stuff.
Can you guess what happened? Yep, all the pain came back with a vengeance, and in BOTH hips now. Couldn't get comfortable sitting, standing, lying down, etc. Sleep has been rough. Now, in my best Forrest Gump voice, I'll say I may not be a smart man but even I will start figuring things out. Something in my weight routine was seriously jacking my hips up. Since I only did 3 leg machines I am pretty sure I know what it is.
Leg Extension
Leg Curl
Hip Abduction
I think it's mostly that Leg Extension machine that's the culprit. It involves straightening the legs out with a weight on the ankles, in order to strengthen the quadriceps. It also puts a ton of strain on the hips. I had read to avoid straight leg raises while prone so I wasn't doing those anymore, but this machine is doing that same movement but WITH WEIGHTS.
I also think the leg curl is not helping either but I should be okay with that Abductor since it's replicating the elastic band stuff my PT instructor has me on in order to strengthen the hips. But I also sorta think it is aggravating the bursa out there.
2 days after my last weight session, like clockwork, things are starting to feel better again. Meaning, I can sit without a great amount of pain and constantly thinking about it. So, obviously I am still not healed...nor will I ever be...but while I continue to mull over options (surgery, rehab, PT), at least I've figured out a few things along the way.
What I've learned to avoid
While I've gotten a lot of good information here and elsewhere on what can be done with this injury, I haven't seen a lot about what to avoid. So, I'll recap here in the hopes someone else can benefit:
I'm still not sure about these:
I'd welcome any discussion or advice on dealing with this injury. I want to return to sport of course, but frankly I have been reduced recently to just worrying about basic quality of life and being able to hike/walk with my children. Thanks in advance.
Slowtwitch has been a great resource for information around this injury, probably because the forum is (as described by others) a place for "old timers trying to hold on." Well, old timers get injured. :)
I've read quite a bit here already, the threads linked below are terrific reads if you're falling upon my thread here and want more info.
Running with hip impingement/torn labrum
Hip arthroscopy recovery - training methods and timelines - NEW
Kona_with_a_torn_hip_labrum_and_sports_hernia
FAI/Labral Tear Surgery..... and rhabdo
Check all of those out, great resources there and I appreciate all of the detail provided by everyone in their experiences.
My experience, yes, it's long:
Diagnosis:
I'm 46, mostly a runner, but I cycle too and dabble in duathlons. Passion is trail running, but racing the marathon is what really narrows my focus and gets my fitness high. About 2 months ago, I was coming off a 40m trail race where I mostly took it easy as long run, and hoping to transition back into my marathon plan right after. But I started getting inner groin pain which eventually progressed to the point I saw an orthopedist and he diagnosed me with an adductor strain and told me to resume running. That only lasted about a week before I knew it was something worse. I've had experience with SFX and this pain felt like that so I got an MRI which revealed no SFX but a "sublabral tear" of the "supraacetabular right hip." My ortho and I were both surprised by this but it did fit the symptoms. Based on prior symptoms (occasional "high hamstring" pain going back 4 years) he suspected the tear had been there for awhile but was aggravated by the 40m trail race and my subsequent jump back into training. He's also an endurance athlete and suggested that this was something I had recovered from previously and could do so again.
Adjusting Plans
I eliminated the running and in an attempt to maintain fitness during this "break," piled on the cycling, stairmill, incline walking treadmill, and other cross training (I normally do all this XT but I just did more to compensate for the lack of running). I also maintained my strength training and core work (more on this a bit later). Somewhere about a week after the MRI I distinctly remember having to climb into my garage attic via ladder to load/unload some stuff for my wife and WOW that was some sharp pain that left me with severe groin pain afterwards. I learned that type of twisting and flexing in the hip was not good. About 2 weeks after symptoms started, there was a scheduled race I "had" to do so I loaded up on NSAIDs and gritted it out. Frankly with the NSAIDs the pain was not that bad in the race, but I was definitely favoring the hip walking around afterwards.
2 weeks later
No running, but continuing all of my cross training I had 1 more race (a 10K) that I "had" to do and again loaded up on NSAIDs and gritted through it. Again, it didn't feel too bad and I was even fine walking around right after. But later that night, I recall playing a marathon Monopoly game with my kids where I had a lot of trouble getting up and down off the ground to move all those little @#$%^ pieces around.
But at some point after that race that the biking and the cross training started to decline as well. Whereas the bike (road, mtn, and spin) previously made the hip feel better, it got to the point where it was aggravating it as well. Same with the stairmill and treadmill it seemed. That's when I started to do my hip labral research and read all of the FAI/Surgery horror stories. Some depressing stuff to say the least. It didn't help that I randomly ran into a guy on the 10K race trip that had FAI surgery that basically ended his cycling career - he was 51 and regretted it, even complaining of pain after mowing his lawn. Ugh! Of course I read on Slowtwitch too which was more encouraging.
No more CrossTraining & Got Shot
Since the cross training was not helping I figured I'd just eliminate all of it too and allow my body to recover while I mulled over options. I was thinking I could scrap the rest of the race season and just try to get back to it when I no longer had pain. I went about a week feeling better and better so decided to do a "test" 1m run. I went about 50 yards before I felt that familiar "pinch" in the groin, continued on for a half mile to see if it would go away and ran back home. Trying the bike later in the day also produced that same pinch. Discouraged, I talked to my ortho who suggested a steroid shot. His thinking was it could get this flare up down and get me back to my baseline and also provide a diagnostic tool that it was actually the labrum giving me trouble. I got the shot on 4/20/17, about a month and a half after my symptoms originally showed. He said no leg exercises for 3 days and then I could try some light cycling or elliptical. The 2 days after the shot were miserable! I must've had a cortisone "flare" because my entire leg was on fire the following 2 nights. But that eased the following day and I felt pretty darn good. Since it was 3 days post shot, I figured I'd test out some work on the leg. I did 15min treadmill walking to loosen up, 15min elliptical, and my strength and core routine. Felt great and even did my PT work (elastic band resistance work for the hip) that night.
The next day though was rough. Woke with achiness down in the hip joint, especially sitting at my desk. Just a nagging, burning sensation that strangely would only go away when I'd get up and walk around. Did no type of exercising at all and fought the depression that something bad was wrong. Basically the same the next day, but this time the pain was outside the hip (like bursitis) and had extended to my other hip too? WTH? Doc said Steroid can sometimes take 7 days so wait a bit more.
Travelling
Finally, after those 2 days of rest I felt a bit better and this was the day I travelled to the marathon I was supposed to be running. I already had the flight and my buddy was still running it so I tagged along. Did I mention it was in Vegas? Heck, I figured I could enjoy some time there if anywhere. I even originally had plans on renting a road bike and following the marathon course around. But I scrapped those right before the trip. Travelling out was not too bad but I did a lot of walking. The next day in Vegas I walked over 8 miles based on my fitness tracker and generally felt okay doing it. That evening I went to the hotel gym and didn't do any cardio but I went through my weight training and core routine.
Things declined badly the next 2 days. I was able to support my buddy at his marathon but I did not feel good sitting OR standing. Despite trying to rest that day as much as possible, I still walked over 6m over the course of the day. The bursitis-like pain returned in my hip at the end of the day and I went to bed that night in a significant amount of pain, probably the worst it's been yet. Still there the next day I was a slug, and only took around 2K steps according to my watch. I was miserable and really worried. My appetite through all of this was next to nothing and I had trouble sleeping. NSAIDs wouldn't touch it but I did find that Tylenol Arthritis. Finally, BLESSEDLY, on the day I returned home I could walk without a limp and started to feel a lot better taking the Tylenol and sitting most of the time. Doc said it sounded more like bursitis now since the inner hip pain was gone presumably from the shot. Was encouraged by that, felt good the next day, and got back into my weight routine, this time eliminating the core stuff.
Can you guess what happened? Yep, all the pain came back with a vengeance, and in BOTH hips now. Couldn't get comfortable sitting, standing, lying down, etc. Sleep has been rough. Now, in my best Forrest Gump voice, I'll say I may not be a smart man but even I will start figuring things out. Something in my weight routine was seriously jacking my hips up. Since I only did 3 leg machines I am pretty sure I know what it is.
Leg Extension
Leg Curl
Hip Abduction
I think it's mostly that Leg Extension machine that's the culprit. It involves straightening the legs out with a weight on the ankles, in order to strengthen the quadriceps. It also puts a ton of strain on the hips. I had read to avoid straight leg raises while prone so I wasn't doing those anymore, but this machine is doing that same movement but WITH WEIGHTS.
I also think the leg curl is not helping either but I should be okay with that Abductor since it's replicating the elastic band stuff my PT instructor has me on in order to strengthen the hips. But I also sorta think it is aggravating the bursa out there.
2 days after my last weight session, like clockwork, things are starting to feel better again. Meaning, I can sit without a great amount of pain and constantly thinking about it. So, obviously I am still not healed...nor will I ever be...but while I continue to mull over options (surgery, rehab, PT), at least I've figured out a few things along the way.
What I've learned to avoid
While I've gotten a lot of good information here and elsewhere on what can be done with this injury, I haven't seen a lot about what to avoid. So, I'll recap here in the hopes someone else can benefit:
- Prone leg raises of any kind (see here for the core routine I have been doing now for over a year - look at all the raised leg stuff!)
- Stretching the hips in any way (I may be able to do this at some point but not while I'm flaring up)
- Any kind of weight machine that involves straightening the leg (leg extensions are a big no-no, I think leg curls are probably not good either)
I'm still not sure about these:
- Bodyweight squats
- Step ups
- Sissy Squats
I'd welcome any discussion or advice on dealing with this injury. I want to return to sport of course, but frankly I have been reduced recently to just worrying about basic quality of life and being able to hike/walk with my children. Thanks in advance.