Hip Labrum Tear - Next Steps - Western NY

Hi All - Diagnosed w/ Hip Labrum Tear (no FAI that I’m aware of). It’s a week since my first cortisone shot. Ortho says I have no restrictions. Stairs and running remains painful (2 or 3 out of 10), but less so than pre-cortisone. I can run through the pain, but pay for it afterwards w/ inflammation and pain shooting down my quad even after two (2) miles and can’t run for days after. Cycling, swimming, etc. is fine.

I just moved to Western NY (Buffalo Area) from Philadelphia. Quality of care and options up here are not the same as Philly. Can anyone recommend an ortho in WNY? Seems other posters say they had an MRI w/ contrast (mine was w/out) and also seek out an experienced surgeon and PT (not even sure how I would start this process!?). Most the doctors showing up in other threads seem quite a ways from me (Colorado, Connecticut, etc.). Asking because I assume, since cortisone wasn’t sufficient for me to start running again … surgery is unavoidable. Every thread I’ve read, most say they wish they hadn’t waited so long to get it fixed so I’d rather get a jump on it.

Gutted because I signed up for my first IM in July (LP) and my training was going great.

I’m sorry to hear this. I wish you were in CT. I know you know how important the surgeon is. I can’t speak highly enough of mine. My daughter had bilateral hip labrum tears when she was in high school (just a few years ago). Her pain never went away after surgery (we took her to a “teen” ortho). About a year after both of her surgeries, my bilateral hip labrum tears were diagnosed. My pain was gone immediately after my surgeries (done six weeks apart). Got us wondering… After almost all of high school in pain (before surgery and then after), my surgeon fixed her.
I guess there’s no point here, but to say 1) you are smart to be taking the surgeon search so seriously & 2) I wish you were in CT.

Oh - let me add -

I knew I needed surgery in late June. I got on the surgery schedule for late August and early October. I asked if anything could impact the surgery and/or recovery after, and the doctor told me no, I could do anything I could tolerate, pain wise. I had pain, but I ran my ass off that summer. I didn’t do anything more than 5-7 miles a day and a few sprints, but - Placid could very well be a possibility. Let’s say you figure your surgeon out, get on the surgery schedule for after the race, and the doctor says gives you the go ahead…

I had both mine done (bilateral FAI and large labral tears) 8 months apart in Rochester by Brian Giordano. I’m not sure if URMC could/would coordinate post-op PT and so on after the fact locally in Buffalo for you, but it may be worth inquiring. I was ultimately happy with the result. I will never be the runner I once was, but much of that is aging and fear of training how I once did in my teens and 20’s.

Not saying your diagnosis is wrong since it probably isn’t, but shooting pain down the quad sounds odd. I assume femoral stress fracture has been ruled out? The MRI w/ contrast was no picnic but ultimately was part of the equation for me. I am happy to answer any questions you have, either here, via private message, email, etc.

I’m sorry to hear this. I wish you were in CT. I know you know how important the surgeon is. I can’t speak highly enough of mine. My daughter had bilateral hip labrum tears when she was in high school (just a few years ago). Her pain never went away after surgery (we took her to a “teen” ortho). About a year after both of her surgeries, my bilateral hip labrum tears were diagnosed. My pain was gone immediately after my surgeries (done six weeks apart). Got us wondering… After almost all of high school in pain (before surgery and then after), my surgeon fixed her.
I guess there’s no point here, but to say 1) you are smart to be taking the surgeon search so seriously & 2) I wish you were in CT.

Please share your docs name anyway! I am not opposed to traveling if it means a material difference, like what you described above!

I knew I needed surgery in late June. I got on the surgery schedule for late August and early October. I asked if anything could impact the surgery and/or recovery after, and the doctor told me no, I could do anything I could tolerate, pain wise. I had pain, but I ran my ass off that summer. I didn’t do anything more than 5-7 miles a day and a few sprints, but - Placid could very well be a possibility. Let’s say you figure your surgeon out, get on the surgery schedule for after the race, and the doctor says gives you the go ahead…

My doc has already told me he won’t ‘rush’ into surgery. Since it’s only been a week since cortisone and a week of PT … he’ll want to see how things are over time. Also might do a second cortisone shot in May. Personally, from everything I’ve read, if a cortisone shot doesn’t help the pain ‘go away’ a surgery is almost always inevitable. So just a matter of determining if I can endure the pain for 26 miles! Stinks Ironman doesn’t permit deferments to next year.

I had both mine done (bilateral FAI and large labral tears) 8 months apart in Rochester by Brian Giordano. I’m not sure if URMC could/would coordinate post-op PT and so on after the fact locally in Buffalo for you, but it may be worth inquiring. I was ultimately happy with the result. I will never be the runner I once was, but much of that is aging and fear of training how I once did in my teens and 20’s.

Not saying your diagnosis is wrong since it probably isn’t, but shooting pain down the quad sounds odd. I assume femoral stress fracture has been ruled out? The MRI w/ contrast was no picnic but ultimately was part of the equation for me. I am happy to answer any questions you have, either here, via private message, email, etc.

Thanks for sharing the name. It’s worth a shot since Rochester is only ~1 hour drive. I’m 38 and new to tri so really would like to continue with it!

The pain in my quad only presents itself when my labral tear is really inflamed/agitated. I’ve had stress fractures before and what I’m feeling is too intermittent to be a fracture. Thanks for offering PMs with any questions!

Hi All - Diagnosed w/ Hip Labrum Tear (no FAI that I’m aware of). It’s a week since my first cortisone shot. Ortho says I have no restrictions. Stairs and running remains painful (2 or 3 out of 10), but less so than pre-cortisone. I can run through the pain, but pay for it afterwards w/ inflammation and pain shooting down my quad even after two (2) miles and can’t run for days after. Cycling, swimming, etc. is fine.

I just moved to Western NY (Buffalo Area) from Philadelphia. Quality of care and options up here are not the same as Philly. Can anyone recommend an ortho in WNY? Seems other posters say they had an MRI w/ contrast (mine was w/out) and also seek out an experienced surgeon and PT (not even sure how I would start this process!?). Most the doctors showing up in other threads seem quite a ways from me (Colorado, Connecticut, etc.). Asking because I assume, since cortisone wasn’t sufficient for me to start running again … surgery is unavoidable. Every thread I’ve read, most say they wish they hadn’t waited so long to get it fixed so I’d rather get a jump on it.

Gutted because I signed up for my first IM in July (LP) and my training was going great.

Welcome!
I live in Lockport(just north of Buffalo). I would use UB Orthopedics(https://www.ubmd.com/find-doctor/profile.html?ubit=msf5) for the Ortho/surgeon. They also have a PT but I would use and have been going to Steve Gonser(https://buffalorehab.com/blog/steve-gonser-pt-dpt/) at Buffalo Rehab Group. He works on a lot of local runners and triathletes.
PM me if you need more info or help.
The cortisone also takes a little while to start working. I have had multiple shots in my shoulder.

Hi All - Diagnosed w/ Hip Labrum Tear (no FAI that I’m aware of). It’s a week since my first cortisone shot. Ortho says I have no restrictions. Stairs and running remains painful (2 or 3 out of 10), but less so than pre-cortisone. I can run through the pain, but pay for it afterwards w/ inflammation and pain shooting down my quad even after two (2) miles and can’t run for days after. Cycling, swimming, etc. is fine.

I just moved to Western NY (Buffalo Area) from Philadelphia. Quality of care and options up here are not the same as Philly. Can anyone recommend an ortho in WNY? Seems other posters say they had an MRI w/ contrast (mine was w/out) and also seek out an experienced surgeon and PT (not even sure how I would start this process!?). Most the doctors showing up in other threads seem quite a ways from me (Colorado, Connecticut, etc.). Asking because I assume, since cortisone wasn’t sufficient for me to start running again … surgery is unavoidable. Every thread I’ve read, most say they wish they hadn’t waited so long to get it fixed so I’d rather get a jump on it.

Gutted because I signed up for my first IM in July (LP) and my training was going great.

Welcome!
I live in Lockport(just north of Buffalo). I would use UB Orthopedics(https://www.ubmd.com/...ofile.html?ubit=msf5) for the Ortho/surgeon. They also have a PT but I would use and have been going to Steve Gonser(https://buffalorehab.com/...steve-gonser-pt-dpt/) at Buffalo Rehab Group. He works on a lot of local runners and triathletes.
PM me if you need more info or help.
The cortisone also takes a little while to start working. I have had multiple shots in my shoulder.

Thanks for chiming in! UB was scheduling weeks out and only Excelsior Orthopedics could get me in quickly. Doc has been fine, but for surgery I might need to reassess. I’ve heard Gonser’s name a lot. A few folks in Buffalo Tri Club see him.

Can you elaborate on the cortisone? Did the first shot take a while or did it take multiple shots to make a difference. I’m supposed to get a second in mid-may, but by then I really need to be close to 30 miles of running a week. Running this morning for the first time post cortisone was not fun, but I could do it. We’ll see how it does under increased volume / frequency.

When the shoulder was bad I was getting 3 per year. Was able to strengthen it in the gym and I haven’t had a shot in over a year now. Surgeon said any more than 3 and we will need to talk about surgery again.
Once you have the shot it will take a couple weeks to really be noticeable. If you can i would cut back on the running and maybe mix it with elliptical for another week or so. You don’t want to create more inflammation in the meantime. I did my first IM at LP on the heals of an injury to my knee. If this is your fist your better off going in a little undertrained than injured. It’s gonna be a learning experience the first time. Went in the following year with the experience and a better year of training and cut 2 hours off my time and felt great the entire race.

When the shoulder was bad I was getting 3 per year. Was able to strengthen it in the gym and I haven’t had a shot in over a year now. Surgeon said any more than 3 and we will need to talk about surgery again.
Once you have the shot it will take a couple weeks to really be noticeable. If you can i would cut back on the running and maybe mix it with elliptical for another week or so. You don’t want to create more inflammation in the meantime. I did my first IM at LP on the heals of an injury to my knee. If this is your fist your better off going in a little undertrained than injured. It’s gonna be a learning experience the first time. Went in the following year with the experience and a better year of training and cut 2 hours off my time and felt great the entire race.

Thanks for sharing your story. My doc is similar in that he’s not going to even consider surgery until 3 shots that are ineffective. So away we go haha.

This is my first. I’ve been doing the high-volume IM plan from TR since maybe December. Really hard to pull back on the runs, ugh. I’ve run 3x2 mile runs over the last 5 weeks. Prior to injury I was doing ~20-25 miles a week. Running is by far my worst discipline so not sure what my ‘drop dead’ date would be to build to a marathon. Good news is the bike and swim I’ve kept up with without injury.

Hi All - Diagnosed w/ Hip Labrum Tear (no FAI that I’m aware of). It’s a week since my first cortisone shot. Ortho says I have no restrictions. Stairs and running remains painful (2 or 3 out of 10), but less so than pre-cortisone. I can run through the pain, but pay for it afterwards w/ inflammation and pain shooting down my quad even after two (2) miles and can’t run for days after. Cycling, swimming, etc. is fine.
I just moved to Western NY (Buffalo Area) from Philadelphia. Quality of care and options up here are not the same as Philly. Can anyone recommend an ortho in WNY? Seems other posters say they had an MRI w/ contrast (mine was w/out) and also seek out an experienced surgeon and PT (not even sure how I would start this process!?). Most the doctors showing up in other threads seem quite a ways from me (Colorado, Connecticut, etc.). Asking because I assume, since cortisone wasn’t sufficient for me to start running again … surgery is unavoidable. Every thread I’ve read, most say they wish they hadn’t waited so long to get it fixed so I’d rather get a jump on it.

Gutted because I signed up for my first IM in July (LP) and my training was going great.

Welcome!
I live in Lockport(just north of Buffalo). I would use UB Orthopedics(https://www.ubmd.com/...ofile.html?ubit=msf5) for the Ortho/surgeon. They also have a PT but I would use and have been going to Steve Gonser(https://buffalorehab.com/...steve-gonser-pt-dpt/) at Buffalo Rehab Group. He works on a lot of local runners and triathletes.
PM me if you need more info or help.
The cortisone also takes a little while to start working. I have had multiple shots in my shoulder.

I’m in Clarence, X2 on UBMD. I saw Wind for my shoulder as did my wife. I’m not sure who does hips/lower extremities, but good experience if surgery is essential. If not, Jason Matusczak is a non-surgical physio guy at Excelsior. Julie Wolfley is an excellent PT.

Hi All - Diagnosed w/ Hip Labrum Tear (no FAI that I’m aware of). It’s a week since my first cortisone shot. Ortho says I have no restrictions. Stairs and running remains painful (2 or 3 out of 10), but less so than pre-cortisone. I can run through the pain, but pay for it afterwards w/ inflammation and pain shooting down my quad even after two (2) miles and can’t run for days after. Cycling, swimming, etc. is fine.
I just moved to Western NY (Buffalo Area) from Philadelphia. Quality of care and options up here are not the same as Philly. Can anyone recommend an ortho in WNY? Seems other posters say they had an MRI w/ contrast (mine was w/out) and also seek out an experienced surgeon and PT (not even sure how I would start this process!?). Most the doctors showing up in other threads seem quite a ways from me (Colorado, Connecticut, etc.). Asking because I assume, since cortisone wasn’t sufficient for me to start running again … surgery is unavoidable. Every thread I’ve read, most say they wish they hadn’t waited so long to get it fixed so I’d rather get a jump on it.

Gutted because I signed up for my first IM in July (LP) and my training was going great.

Welcome!
I live in Lockport(just north of Buffalo). I would use UB Orthopedics(https://www.ubmd.com/...ofile.html?ubit=msf5) for the Ortho/surgeon. They also have a PT but I would use and have been going to Steve Gonser(https://buffalorehab.com/...steve-gonser-pt-dpt/) at Buffalo Rehab Group. He works on a lot of local runners and triathletes.
PM me if you need more info or help.
The cortisone also takes a little while to start working. I have had multiple shots in my shoulder.

I’m in Clarence, X2 on UBMD. I saw Wind for my shoulder as did my wife. I’m not sure who does hips/lower extremities, but good experience if surgery is essential. If not, Jason Matusczak is a non-surgical physio guy at Excelsior. Julie Wolfley is an excellent PT.

I’m about 99.99 percent convinced this surgery all comes down to the surgeon. Even if the surgeon can do the surgery if they aren’t doing the surgery all the time the outcome won’t be as good.

I had Dr. Brian Ellman do both my hips here in Colorado and then he did my knee cause he’s the complex knee guy at Panorama Ortho here. I was able to run at 10 weeks after my first one. The 2nd was hard to tell because I had it during my knee recovery. But 90 percent of what he does is labral tears.

But with how polar opposite mine and others experiences are on the good side, versus how bad some of the stories are from a different group of people the surgeon sounds ridiculously important.

Hey bbd-have you done any strength training exercises to help? I also think I had a similar issue and have been doing some exercises at night to help. I feel it has definitely gotten better. I will try to find the youtube video I watched with a guy who was straight to the point and didn’t have a lot of fluff.

Good luck. Sorry to hear.

Hey bbd-have you done any strength training exercises to help? I also think I had a similar issue and have been doing some exercises at night to help. I feel it has definitely gotten better. I will try to find the youtube video I watched with a guy who was straight to the point and didn’t have a lot of fluff.

Good luck. Sorry to hear.

Not trying to poo on your advice but I wouldn’t do anything from YouTube for injury. I would do what the PT says based off actual doctors diagnosis. This is not a situation wheee you wanna guess. If he’s gonna stay on track for his race he needs to be very smart with what he is doing and how much he is doing. Just my 2c

Hi All - Diagnosed w/ Hip Labrum Tear (no FAI that I’m aware of). It’s a week since my first cortisone shot. Ortho says I have no restrictions. Stairs and running remains painful (2 or 3 out of 10), but less so than pre-cortisone. I can run through the pain, but pay for it afterwards w/ inflammation and pain shooting down my quad even after two (2) miles and can’t run for days after. Cycling, swimming, etc. is fine.
I just moved to Western NY (Buffalo Area) from Philadelphia. Quality of care and options up here are not the same as Philly. Can anyone recommend an ortho in WNY? Seems other posters say they had an MRI w/ contrast (mine was w/out) and also seek out an experienced surgeon and PT (not even sure how I would start this process!?). Most the doctors showing up in other threads seem quite a ways from me (Colorado, Connecticut, etc.). Asking because I assume, since cortisone wasn’t sufficient for me to start running again … surgery is unavoidable. Every thread I’ve read, most say they wish they hadn’t waited so long to get it fixed so I’d rather get a jump on it.

Gutted because I signed up for my first IM in July (LP) and my training was going great.

Welcome!
I live in Lockport(just north of Buffalo). I would use UB Orthopedics(https://www.ubmd.com/...ofile.html?ubit=msf5) for the Ortho/surgeon. They also have a PT but I would use and have been going to Steve Gonser(https://buffalorehab.com/...steve-gonser-pt-dpt/) at Buffalo Rehab Group. He works on a lot of local runners and triathletes.
PM me if you need more info or help.
The cortisone also takes a little while to start working. I have had multiple shots in my shoulder.

I’m in Clarence, X2 on UBMD. I saw Wind for my shoulder as did my wife. I’m not sure who does hips/lower extremities, but good experience if surgery is essential. If not, Jason Matusczak is a non-surgical physio guy at Excelsior. Julie Wolfley is an excellent PT.

So am I … thanks for the PT names!

Hey bbd-have you done any strength training exercises to help? I also think I had a similar issue and have been doing some exercises at night to help. I feel it has definitely gotten better. I will try to find the youtube video I watched with a guy who was straight to the point and didn’t have a lot of fluff.

Good luck. Sorry to hear.

Not trying to poo on your advice but I wouldn’t do anything from YouTube for injury. I would do what the PT says based off actual doctors diagnosis. This is not a situation wheee you wanna guess. If he’s gonna stay on track for his race he needs to be very smart with what he is doing and how much he is doing. Just my 2c

I am just doing what the PT says, even though some of it I don’t understand the why/how. My PT is a guy that used to work the IM tent in Placid so that gave me some comfort that he knew what he was doing haha.

Harsh truths

I would never have more than one cortisone shot for an area

Literally decades ago the research shows the horrible damage cortisone shots can cause after even just 2 shots

I would figure your Ironman race is a DNS. Getting into a race and possibly causing life long injury, pain etc isn’t worth it. As you said you are just getting started in triathlons.

Take your time get it done right and loom forward to years and years of racing

@MrTri x2 on this. A labrum tear will also truly never go away on its own. You may be able to manage the symptoms but the tear will never repair itself. That said, the surgery is a major commitment as well.

In April 2020 I was diagnosed with a labrum tear in my left hip with FAI and a bruised femoral head. I couldn’t run more than a half mile without pain. Probably a 5-6 out of 10. I consulted with a surgeon who suggested i go on Meloxocam and to begin going to PT 3 times a week before Cortisone. If cortisone failed then we would consider surgery.

Fast forward through about 10 weeks of pt and no running (probably biking 200-250 miles a week/ 3 swims) I started running again. Started slow and easy and eventually built up to 30 miles a week by December and also weened myself off the NSAID’s. I’m still doing 35-40 miles a week this year with lots of stretching and strength exercises specific to my hips. I do have occasional low level pain and when I do I back off for a few days and all goes back to normal.

Dr. Michael Joyce, in Glastonbury, CT. We call him the GOAT at my house.