Hi, I’ve been dealing with lower back and hip problems for a year and a half now. Dr has ordered MRI of lumbar and si joint and results are fine. I am now waiting for another MRI of the left hip but without contrast, will that even help with diagnosing my problem? If any STers have had this problem or experience please share with me as I would like to get more info. Thanks
Soya: I’m two years post surgery for a labral tear. You need the MRI with contrast (MRA). But one thing thats becoming apparent… just because you have a tear, doesnt mean that thats your problem. A lot of people have tears that are asymptomatic. So get the MRA and they can inject a pain killer at the same time. If that eliminates your problem, then the tear was the problem. If not, its probably something in your back.
I did a big analysis on my blog about a year and a half ago for another slowtwitcher… so I can let you read about MY experience if you want.
Dealing with some similar issues, would be interested in seeing that link as well…
Thanks tree. So do they do an injection to test for pain relief with the regular MRI?
Yep. If you get the MRA, they put a pain killer in the contrast dye. So if you continue to have pain, its probably referred pain from somewhere else and not hip stuff. If you get pain relief… its most probably the hip.
I found the actual surgery to be pretty much no muss no fuss. But the distraction of the hip, does a good bit of damage,and I had real instability issues that required a lot of work to correct post surgery. I also had some issues like a frozen shoulder that required stretching to correct.
If you do it with an epidural like me-- be advised that your crotch area will be numb. I drink- a LOT. Im laying on the couch on about my 4th soda a few hours post surgery thinking, “geez, I should have to pee by now…” Uh-huh… too late. When I told the surgeon that I thought he was going to double over with laughter. Its the little things that they dont tell you…
I’m 2.5 years post-op - arthroscopic labral cleanup and bone debridement.
Tree Hugger already gave you good advice concerning diagnosis; I can give you my experience concerning the surgery and recovery:
- Surgery was same-day (outpatient)
- On crutches for 8 days
- PT started 8 days after surgery
- On stationary bike 10 days post-op
- Running 3 months post-op
- “Fully” recovered 5-6 months post-op
- I did a sprint tri less than 6 months post-op and set a PR on the bike and just missed my PR on the run
My understanding is that the arthroscopic approach is a relatively new procedure, so finding an orthopedist with the requisite amount of experience can be challenging.
Good luck,
Kevin
I just went to a course this past weekend about the rehab following arthroscopic surgery of the hip. It was based off of Dr. Philippon’s (one of the top guys in the country) protocol. The PTs went through the basic rehab and mentioned that their patients would start riding the stationary bike with no resistance on the day of the surgery. If the surgery is a labral repair only then the patient could begin swimming with a pull buoy after 3 weeks and begin running at 6 weeks. Obviously every patient is different and how quickly you would progress through the protocol depends on a lot of things, including what your goals are and what race you are aiming to get back for.
Tree, thanks for your info, it has helped immensely. I was wondering what specific symptoms u experienced pre-surgery and were they mainly on the side of the bad hip? Also, if you don’t mind, could u give me a ballpark number of how much the procedure was (or pm me).
Btw, I am also doing ais, I actually just finished a 2 week session with phil Wharton.
Thanks for your help
I think I had pretty atypical symptoms. My biggest one was that climbing on the bike or running uphill, my leg would go numb. I had no power in the affected leg. At times I felt like I was doing one legged drills.
As things got worse, I had a bad pinching in the hip area when I was sitting, and if I had to fly anywhere, or drive for any length of time, that leg was dead. I had to get up during the day and stretch all the time. I thought I was crazy (probably am…)
The day after my surgery, all that stuff was gone. I still had pain, but hey, I’m 43, and have put an awful lot of miles on this body. Stuff hurts. Just different stuff.
But my suggestion… do it arthoscopically if you can, and get someone who does shoulders. Shoulder- hip, its a very similar surgery. But they have to have done this stuff before. My surgeon said that a lot of surgeons think they can do it, and can really f up.
Cost? Well, insurance paid squat. But if you are uninsured, I’d bank on 30k. My surgeon billed about 18k, and Anthem paid him 3500, and the hospital about 12k. I went out of network, so I got billed 1500 for my innetworkd ded (hosp was in network) and 3000 for my out of network. I negotiate for a living, so I got that down to 3000 total. I dont regret how I did it, but I sure wish my doc had been in network back then. (he is now)
I’m glad you’re recovered! At this point I almost wish I do have that, at least I know it can be treated. You wouldn’t by chance know of any dr’s in Canada would you?
Thanks
bump for anyone else out there
.
Tree hugger pretty much hit on most it but I’ve had hip flexor and adductor problems off and on for about 2+ years. My doc noticed I had an SI joint problem which got worked on by a chiro but it didn’t fix things. Eventually my doc sent me to get an MRI w/contrast (contrast is required to determine if you have a labral tear). My doc had me run immediately after the test because they numb that entire area. I had immediate pain when I started running so even though the tests later showed a small labral tear in my hip, we ruled it out since my pain was obviously caused by something else.
I continue to have adductor problems as my volume ramps up. I get ART done every so often. Hip flexor problems seem to have gone away but I had chiros messing with my hips a lot last year so that might have fixed it. ART does magic for my adductor.
Thanks, Chris
Here goes, sorry about the length up front.
Starting in 1987 and going all the way until 1995 it hurt to run. I continued to race and race hard for the first three years (qualifying for and doing Ironman, USTS championships etc.). Then in about 1993 I gave up, the pain was too much. Lower back and left hip pain like you wouldn’t believe (or maybe you can relate). To ease the pain I had orthodics made but I broke them over and over again. I had chiro work and all others working on me but pain continued. I ran limited during those two years. In 1995 my best friend Chris Maund came by for a visit. He had been in New Zealand starting his career. He was training to become a Chek practioner (http://www.chekinstitute.com/). Today he runs his own clinic in Ecninitas. Anyway he was at the house and we started talking about hip pain. He turned off the lights in the kitchen asked me to stand up, close my eyes and then asked me to turn around, and do a couple other movments with my head (can’t remember everything). He asked me to turn and then come back to where I was. I came back way off. He says “You have an Atlas V problem”. Gave me a business card of a Chiro that specializes in it. (Don’t let just anyone do it, trust me). The Chiro found huge alignment problems, made small ajustments to my atlas. I saw him two more times. At the same time Chris did a full body analysis and gave me strength stuff. 2 weeks later I was running and have been running pain free since. I’ve had flare ups and have gone back to the same chiro to get it fixed but I haven’t had a flare up for 5 years.
What happened? In 1986 I had a massive bike crash. Hit a Bronco II with my head. Her fault and it cost me 2 years of surgery to my face. Nobody looked at body damage just head damage. So that was the big one. But there is more. The flare ups were caused by two head to head bumps. First it was my Dog. She got a bit excited and took off full speed into my head. The second was simple when my then 3 year old son stood up and smacked my chin.
What did I learn. Pain does not always indicate source. My hip pain was being caused by the smallest bone in the spine furthest away from my hip. I’m not suggesting anything about your pain and it’s source. I highly suggest if anyone has pain, go see a certified Chek practioner. They do it differently and they are good at what they do. If you live in San Diego (Encinitas), find Chris Maund. He’s the best there is. Don’t expect a warm heart and soft bedside manner. Chris will shoot straight and call you out for being less than good to your body. If you want soft and laughs every minute see his wife Janet. (she can also really help your golf swing) You can also find the guru himself Paul Chek in the San Diego area.
I hope this helps.
Dave
you will need an MR-arthrogram to detect intra-articular and labral pathology (MRA is MR-angiogram, and MRI with contrast usually means intravenous)
if you have a labral tear, arthroscopically performed or assisted surgery would be ideal, however,
you need to see an orthpaedic sports medicine specialist that does a lot of hip scopes. shoulder surgery does not compare in any way, shape or form. the surgery, positioning, etc is completely different, and while most all orthopaedic surgeons can scope a shoulder and likely do an all-inside labral repair, there are few guys who do hip scopes on a regular basis. and even fewer than can repair a labrum through the scope.
good luck.
I dealt with hip and back problems for years. I had the MRI with contrast done, and one doctor believed that I needed to have my hip scoped. His view was that all of my problems with my hip and back (scans all came back fine for me as well) stemmed from extreme muscle guarding due to what appeared to me a very minor defect inside the joint. That was the only thing that ever showed up on a scan, so the doctor basically said “that must be what is causing the problem.” FORTUNATELY I DID NOT HAVE THAT SURGERY. Just this February, I got to the root of my problem, and it had nothing to do with my hip joint and a hip scope would have done virtually nothing to help me. It turned out that I had massive adhesions from a C-Section way back in 2001 that prohibited any normal function of my core muscles on the right side. Hence, all of the problems with the back and hip and the “extreme muscle guarding” that the doctors identified. My gut instinct was always that my problems related to my c-section and, therefore, I declined to have the surgery, fearing I would make the problem worse. I had major abdominal surgery at the end of February and am on the road to recovery. I am confident that I finally figured out the problem. My son is now 8 years old. The moral of my story? Hip and back problems can be caused by many, many things. I found that many doctors were willing to diagnose within their comfort zone, making it impossible for me to get anyone to look at the bigger picture. Get the MRI with contrast and make sure you are confident that any problems identified are really at the root of your back and hip pain.
thanks for sharing, that is good to know! I hope that’s my case too, but i’m still waiting for an MRI in Aug and I’m not even sure if this dr ordered the right kind of MRI (i need an MRA or one with injected contrast) and will need to clarify this tomorrow with him!
thanks
I’ve had groin pain for the past 5-7 years. I didn’t think anything of it, as I’ve played soccer for basically my entire life and have pulled my groin several times. I would rest and then I’d be back to playing. However, about 2 years ago, I started running to get back into shape and noticed some groin pain and lower back pain. I went in for an MRI and it showed that I had a labral tear. I think this injury is often misdiagnosed as some sort of groin pull. Who knows how many people are out there with this very injury. Not wanting to take the time out, I started strength training with weights. At first it hurt to do squats etc…but I built up the muscles and focused on stretching. I also changed to a racing flat instead of a cushion shoe. I can now run without back pain, but every so often I have hamstring/butt pain. Nothing serious, but it tells me it’s there. I’ll get surgery at the end of the year, but it’s not going to keep me from doing another 4-5 sprints this year.
It’s frustrating, because I know I’m much faster when not injured. However, I have to focus on staying relatively healthy and not go all out to further cause pain at times.
The MRI will tell you if you have osteoarthritis or a labral tear, or neither. There are a number of exercises that strengthen the muscles that support the hip area for adduction and abduction. Easy to do, google it. The movements in squats are one, just be really careful to support your back and start with light easily manageable weight. Most gyms will have machines for the abductors and adductors. Be careful.
I think I had pretty atypical symptoms. My biggest one was that climbing on the bike or running uphill, my leg would go numb. I had no power in the affected leg. At times I felt like I was doing one legged drills.
As things got worse, I had a bad pinching in the hip area when I was sitting, and if I had to fly anywhere, or drive for any length of time, that leg was dead. I had to get up during the day and stretch all the time. I thought I was crazy (probably am…)
The day after my surgery, all that stuff was gone. I still had pain, but hey, I’m 43, and have put an awful lot of miles on this body. Stuff hurts. Just different stuff.
But my suggestion… do it arthoscopically if you can, and get someone who does shoulders. Shoulder- hip, its a very similar surgery. But they have to have done this stuff before. My surgeon said that a lot of surgeons think they can do it, and can really f up.
Cost? Well, insurance paid squat. But if you are uninsured, I’d bank on 30k. My surgeon billed about 18k, and Anthem paid him 3500, and the hospital about 12k. I went out of network, so I got billed 1500 for my innetworkd ded (hosp was in network) and 3000 for my out of network. I negotiate for a living, so I got that down to 3000 total. I dont regret how I did it, but I sure wish my doc had been in network back then. (he is now)
I actually am having my MRA next week…doc thinks odds are Labral tear (hip) over sfx, and one of my symptoms is “loss of leg”. It turns into a floppy crappie at about mile 3.
But your insurance paid NOTHING? Holy balls…if my doc weren’t in network, I’d find another who was.