I am 12 weeks out from having my right hip labrum repaired and my iliopsoas “lengthened.” I have been doing physical therapy with the Ironman Sports Medicine Institute since the day after my surgery, twice a week.
My question is: has anyone used a particular running/jogging regiment or training program to get back into running after this surgery? I am planning on using my PT’s advice, but would like to cross check with others who have gone through this surgery and rehab. Looking to find a sweet spot between pushing too hard and taking it too easy.
Sounds like your surgery was a lot less extensive than mine so take what I am going to say with a grain of salt.
I had my surgery in January of 2012. I was on crutches with partial weight bearing for six weeks and then full weight bearing thereafter. I was ridiculously anal about my rehab and PT to the point that I was way ahead of schedule in every regard. I was cleared to resume cycling by mid-May and running by the middle of June. While I had no real issues with cycling running took a while and never was comfortable. Once I actually got some pace back I found that my hip would become sore so in the end I decided that it just wasn’t worth it and shut it down and restricted myself to cycling and swimming for a full year after my original operation date.
According to my surgeon this is the best plan and offers the best hope for long-term repair health BUT, again, I had micro-fracture surgery and this is probably why he said that.
In January 2013 I returned to running and have had no problems at all though I restrict myself to two runs per week and never more than 10km each time.
My best advice is to listen to your body, CAREFULLY. Any soreness or pain should be heeded. I am very happy that I gave up one season because had I forced it I likely would never have had the kind of year in 2013 that I did.
I can’t help with advice, but this is the internet so I will chime in anyway. Mostly to say good luck and take it slowly.
I was diagnosed with a torn labrum back in February. I met with the surgeon and she said that it cannot heal on its own and must get repaired. 10 months later when surgery was finally scheduled and I had been off of running for most of a year and the pain had really subsided, the surgeon just shrugged her shoulders and said “athletes are aliens” She did know how I had recovered on my own but mentioned some people just go asymptomatic. No surgery! So, I am counting my miracle and getting back into running slowly. REALLY SLOWLY. I am so afraid that it is going to come back.
Anyway. Take it easy. I hope your recovery is full and complete as soon as it can be.
I find your experience a little curious. I hope that you are indeed ‘recovered’ but I worry that instead you are just in an asymptomatic period and not actually recovered.
Labral tears are believed to result from anatomic issues that inevitably result in the development of osteoarthritis. Look up femero-acetabular impingement or FAI for short to get a sense of what I am talking about. The surgical repair or reconstruction of the labrum is a necessary procedure to stabilize the joint and the associated osteotomy that is often done is performed to relieve FAI and prevent recurrence.
You may wish to look into it and consider speaking to your doc again.
Thanks for the kind words and personal accounts of this injury…it’s been a tough one to deal with, and much different (healing, pain, etc.) than any other injuries I have had. My doc and PT blame hip angles in the aero position, so I guess that’s the first place to start making changes…
I concur with the advice of having an additional conversation with your doc (or getting a second opinion from another orthopedist). This injury is not something that heals on it’s own, and if truly a labral tear, requires immediate attention as the long-term effects of ignoring can really limit your activity levels.
Labral tear healing itself? If it is true then I am happy for you.
I however also second the advice to get a second opinion (MRA, MRI with dye for better contrast).
Letting it drag, resuming training while not fully healed could lengthen the overall return to optimal form.
I have been out for more than a year now and wish I had not hesitated so long and consulted other specialists then.
Sorry guys, could not disagree more. Study last year showed that 69% of asymptomatic people in their 30’s had a labral tear. The study was done with a 3T MRI without arthrogram, which is very sensitive. In a hip that doesn’t impinge, and isn’t dyplastic (read as under-developed), and doesn’t hurt, I wouldn’t recommend touching the labrum if it is torn. There is some evidence that in under-developed hips it may provide some stability. In a hip that impinges you treat the impingement and repair the labrum while you are there. In this case there is some merit to "if it ain’t broke don’t fix it).
Let’s hope you are right. For his sake and many other people’s sake suffering from labral tears.
Letting it drag and accepting the pain caused more damages for me (I also needed a bone graft) and it has been a very painful experience.
I hope the OP will stay pain-free but also mindful that what caused the tear might cause it again later on (cam impingement, family history in my case= bad bad hips).
Merry Christmas, lots of tri presents, no pain and lots of gain!
That post was in response to prajna101 who stated they had no pain… Of course if someone has a painful hip diligence needs to be done to find the cause. Unfortunately nowadays, given the prevalence of labral tears, it is all too easy to blame it on that and rush to getting it fixed.
I agree that there is no need to rush to conclusions, that is why I recommended a second opinion and maybe an MRA in my first message.
When Prajna101 mentioned that the pain had ‘really subsided’, I read that he was feeling a lot better but not that the damage was gone or that it was a long-lasting relief. It might also had been the result of not engaging the area (he almost completely stopped running).
When I stopped running and biking the pain also reduced greatly but was still lingering.
Any return to even moderate intensity brought it back in full swing.
I also remember feeling a lot better after a hyaluronic injection as well but the damage was still there.
The ‘masking effect’ operated but the impingement (and femoral head necrosis in my case) was still likely to tear the labrum again or even further.
I also heard of many people living well with the tear. I guess the pain threshold must be determined. How much can you take and also does it impede you in reaching your maximum potential while training or racing.
Many options out there but I have great empathy to whomever suffers from a labral tear.
It is a true daily torture but there are ways to be better.
Before I made my decision, I enjoyed reading testimonials of success stories and studies like that to make an educated guess.
(raising hand in the air)…yup that’s me. I have a labral tear in my left hip and mild FAI is what I’ve been told and mild arthritis, I am 50 it’s expected. I have seen 3 surgeons, two in Indy and 1 in Chicago. All said they could do surgery, but lets try the conservative route. I’ve had the steroid injection, totally helped for 5-6 weeks then came back as before. Had PT then had to stop as I found out in this whole process that I had two inguinal hernias which were just repaired on the 4th. I am feeling great now on the left side. Not sure if all this hip pain was related to the hernias, a few weeks will tell for sure as I am healing very well.
Like Mcass mentions, many people have labral tears and never know it. I have reduced exercise to almost nil and guess what…no pain in my hip. This is NOT what I want, I want to be able to swim/bike/run again. I am on the fence as to what to do. I have immersed myself with understanding this hip thing since August. My insurance wouldn’t cover any sort of surgery until March. I still have time to investigate what to do…hoping all guys/gals here get theirs sorted out!
I am happy to report that I am back to moderate training approx. 5 months post-op. It is important to note that I completed a very intense physical therapy regiment, 3x/week, for 12 weeks to get to this point. That and I am 33 yrs old (Yes, age is a metric for healing time). Does my hip still hurt? Yes. Does my iliopsoas still hurt? Yes. But the pain is manageable and I am quick to stop training when it scales up to what I consider an 8 of 10, which is followed by a day or two of complete rest until I am level 3 or below.
Let me be clear about what “training” is now. It is not ironman training and would probably not fall into half-ironman training. Maybe 5150 training. A look at my Garmin Connect will tell you that I have lost a fairly significant amount of running fitness in terms of attainable pace, cardiovascular is about the same. I would say I am 15% slower on a 4mile test. I just can’t get the repaired leg to move as quickly and efficiently so I am off-balance. This is unfortunate as it has led to other aches and pains, which is common. I get pains in my calves from over-compensation and I have a small amount of Achilles tendonitis in the repaired leg from the sore calf muscle. It’s a snowball. Moral of the story, this injury takes a long time to fully heal and it will drag you into other injuries if you push yourself too quickly.
On a positive note, the injury has had zero effect on my swimming and biking fitness and the rehab process has actually helped to improve these disciplines. I’ll take it.
Glad to hear it’s getting better! Hopefully you’ll gain back that lost 15% in time.
I’m in a similar-ish boat. Sore hip for 2+ months now, started off as dull ache/tightness, now it’s worse, causing me a limp and destroying my running mileage. Been to a PT for a couple months without change, got an MRI and no labrum tear, BUT I went to my chiro last night and he said the MRI I had was not the kind that would show anything regarding a tear.
He’s confident he can work everything out but feels I probably *do *have a small tear. He really worked out a lot more of my leg/hip last night than my PT has been, I feel better today than I usually do after PT, who was only focusing on the adductor/flexor.
If a few visits with the chiro don’t do it, he’ll send me to get the MRI with the injection for better contrast. He also said if it is a labrum tear we’ll work on strengthening the area and he would not recommend surgery since it’s pretty invasive. Guess we’ll see what happens.
Correct, I’d advise having both the MRI with contrast and the x-ray Fluoroscopy performed so that your surgeon knows what he’s up against before they cut two holes in your quad muscles…you can do them both in the same day in about 4 hours and it will give the doctor a road map. It might also confirm that rehab and PT is enough to correct the problem. Hopefully the latter!
I’ve read a lot now about people just dealing with small tears but that the labrum will never heal on it’s own (w/o surgery). So, what does that mean exactly? Are people able to get back to their normal run routine just strengthening the area around it? Seems like dealing with pain forever just isn’t a great idea. I’d hate to imagine I’m always going to just hurt.
I am just now 8 weeks out from labral repair surgery accompanied by FAI correction…
I will caution my fellow triathletes tro stay on top of any hip pain, especially those that do not go away and just sort of linger, even though you can train through it…I waited 5 years, trying various methods to keep going. Now that my hip is strong again, the damage I did to the nerves and muscles around the hip is what I am working through right now…
After surgery, I went right into physical therapy the next day riding the bike (my doc deals with a ton of athletes and is, in my estimation, very aggressive in his rehab timelines) and I have gone twice a week since then. I am now in the very beginning of my “return to running” protocol and last night was my first “running” and impact workouts. I did lunges, skipping and a short run (2 x 3 min with 2 min walks in between). I was definitely more than I anticipated but the results today a favorable as I don’t seem to have any negative effects from the increased activity or impact.
My advice would be to work with your PT an doc to build a return to run program that is right for you and your healing progression…as with so much on ST, YMMV…and if it begins to bring increasing discomfort, check with your doc and perhaps they will adjust your PT schedule…
