My Hip Labral Tear Story

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. :slight_smile:

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 squatsStep upsSissy 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.

The last link you listed is my post. Hopefully that helped for you.

I don’t have any suggestions on what not to do as everyone’s symptoms seem to be different. There was never one particular motion for me that triggered it every time. I tried to purposely trigger it just so I could diagnose it better but I never could figure it out.

My biggest suggestion: strengthen your glutes, strengthen your glutes, strengthen your glutes.

It sounds like you are in a lot of pain just sitting/standing around. Have you thought about surgery? Not trying to push into it… just honestly asking the question.

I have / had snapping hip and FAI on my left leg. Been fighting it for at least 6 years. I’ve done a ton of research and with my symptoms its a 60% chance its a labral tear, but the doctor says I’m good. Supposedly its hard to diagnose labral tears as they’re not always on MRI or XRay.

I will say with yoga, not sitting as much, losing weight, and strengthening my muscles it has greatly been mitigated and I don’t get pain out of it yet. Wearing a trochanter belt to fix a hypermobile hip muscle really helped as well.

The one thing I’ve learned about this is the hip area is super complex and the medical industry are not as knowledgeable in it as they should be. Physical Therapists know some good things, doctors know some goo d things, but they’re philosophies are miles apart and its yet to be figured out what the best path is.

The last link you listed is my post. Hopefully that helped for you.

Yeah it’s funny that I was actually going to call you and a few others specifically out as being particularly helpful but I was worried I’d leave someone out. There are a lot of good posters in those threads. I was curious though since you mentioned it, you said you had a blog that detailed alot of your experience?

It sounds like you are in a lot of pain just sitting/standing around. Have you thought about surgery? Not trying to push into it… just honestly asking the question.

Man, I have been thinking about nothing else! Early on, I was scared off from all the horror stories I read and decided to rest and see if that would resolve it (i read a lot of people where they did just that) but then it seemed like the more I rested, the worst things got. But now I realize I’ve been hammering that hip with all the weight and core work I’ve been doing and I’m hoping that eliminating that will provide some relief.

But certainly, surgery is on my mind no doubt about it.

Wearing a trochanter belt to fix a hypermobile hip muscle really helped as well.

I had never even heard of such a thing. My hip won’t snap, but it definitely pops a little when straightened out and lifted up/down. It’s been doing that for awhile, I noticed it many months ago when i started those iRunFar.com core workouts I linked above. Never hurt at all though.

I had an MRI a few months back that showed a small tear. I decided to rest it for a few weeks and then hit the PT hard. At least 2x a day of little PT stuff and then once or twice a week of an hour session with an actual PT. The combination of strengthening my glutes and not running for 6-8 weeks, now has me back to running and without any pain whatsoever. If I slack on the exercises, I’ll start to feel it a little bit though.

I suggest giving it a good month of starting off of it. Try not to be seated for too long, and if you have to be, drop that leg off the side of the chair to give it a good stretch. Work on balance and strengthening the glutes, and then just walk and upright cycling, if that doesn’t cause pain. Good luck. Not fun and i know that horrible feeling.

Do you guys have any glute exercises that you recommend? Some of these (like single leg deadlifts, bulgarian squats etc) seem to stress the hip too much in a flexed position.

All one legged stuff is good - bridges, clam, side leg raises, fire hydrants, one leg balancing, bosu ball balancing, step ups, etc.

Wearing a trochanter belt to fix a hypermobile hip muscle really helped as well.

I had never even heard of such a thing. My hip won’t snap, but it definitely pops a little when straightened out and lifted up/down. It’s been doing that for awhile, I noticed it many months ago when i started those iRunFar.com core workouts I linked above. Never hurt at all though.

I happened upon it one day during my endless research. My Sacrum and Iliac ligaments were weak from a fall, so when I would sit or bike, my left sit bone would move too far forward, extending the psoas and 24 other muscles. Random tears and strains in my left leg for years. The belt ‘locks in’ that Sacoiliac connection and helps it strengthen again.

Thanks for the info guys.

Anybody have experience with cortisone shots? I had mine 2 weeks ago today and I have been having some side effects in the last week and a half or so.

  • Sleeplessness
  • Depression
  • Elevated Resting Heart Rate (it’s gone from low-mid 40’s to upper 50’s)
  • Wild mood swings
  • Utter lack of appetite

I usually have NO problem eating, and I’m normally a pretty steady guy personality-wise so this stuff has rocked me pretty hard. Previously I had thought some of this was from cutting out all the cardio, but I think it’s the shot now. Last night I woke at 1am and was WIDE awake until about 230am when I finally gave-in and popped a couple of Advil and then managed to settle off to sleep. I have one of those HRV-tracking fitness devices and it has had me pegged as “STRESSED” for the last 7 days straight. I am not 100% confident in that thing’s accuracy but it sure as heck fits how I’ve been feeling.

The last thing I need right now is lack of sleep so I hope these start to resolve soon.

Update - The symptoms I described in my post above mostly resolved over the weekend. I took some AdvilPM Saturday night and managed to sleep through the night for the first time in a week and a half, and also got some hard-advice from a friend that I was overly stressing over this so one of those 2 treatments has me feeling more like normal again. Or the cortisone side-effect finally wore off after 1.5 weeks. Funny about the stress though, how do you stop stressing when you’ve been told that you’re stressing too much…isn’t that just another stressor? Ha ha.

Unfortunately as far as the hip goes, I have been mostly on crutches this weekend. I’m worried that there is something else going on with this hip above and beyond the labral-tear diagnosis so I figure going fully non-weight-bearing can only help in the short term. I have an appt with a different ortho on Tuesday so maybe I can get some more xrays to rule out SFX at least (I’d think it would be showing up by now after 2 months). I would pay a lot of money right now for it to be something as simple as an SFX.

Still getting most of my pain in the outer bursitis area but the deep-inside-the-hip burn/ache is still there when I try to sleep. The funny thing is that walking around a bit actually feels good - it’s just later that I get the ache/burn, so it’s hard to determine what to keep doing and what to drop.

I feel for you. It would be great to find a simple cause-effect relationship that could steer you as to activities to avoid, etc. I had a total of 3 injections into my hip, each Dr feeling the last wasn’t done quite right, none of them gave me relief. There was a subtle difference, but not what I’d call relief. I think people had no idea what to do. In the face of a known labrum tear, with my symptoms fitting that (except for the injections) the people I saw didn’t seem to be able to think around that. I had ART, chiro, accupuncture, was checked for SI dysfunction, sports hernia, all while the pain was distracting but mostly manageable so I carried on. Eventually a run led to a dramatic uptick in pain and this I felt was likely a worsened labrum tear. Had surgery. Plateaued with recovery. All the old pains returned while I was doing substantially less volume but still maintaining my post surgery rehab exercises.

So here’s a coincidental situation that may not apply to you. I had an IUD put in about a year ahead of symptoms showing. I had it removed a few weeks back. I swear, there’s a sharp point / edge to my sensations that’s now dropped off. I feel a bit of hesitation still at invoking pelvic muscles, like I’m expecting it to hurt. But it doesn’t. Current best guess: I may have become less effective at engaging some muscles due to the subtle discomforts caused by the IUD that over time contributed to a poor muscle recruitment pattern. Yes, I realize that sounds a bit far fetched. But single drops of water can become torture if delivered for a long enough period of time to the same spot.

Thanks for the reply. This seems to be a fairly common thing, misdiagnosing or missed diagnosis for something else. Although I’ve read a ton of success stories with this injury and surgery, there are horror stories out there too. It’s hard to determine the common thread with either one…although youth and absence of arthritis seems to indicate a lean towards success. I don’t have youth on my side (I’m 46) but indications are I have no signs of arthritis yet. Of course scope surgery will heighten the risk of that.

Additional risk factors for poor surgical outcome include hip dysplasia, retroversion, etc. I suspect some of the apparent random-ness as to outcomes stems from the first place of diagnosticians perhaps assuming there is only 1 thing wrong: torn labrum, and one contributing factor: impingement or accident; and in the 2nd place: sharing of information so readily on the internet, by people who may only half know what they are talking about (er, uhm, well ok - include me in that group).

As to the missed diagnoses… in my case, I don’t think I’ve ever had ideal muscle recruitment. I could bear down and get it done, working up to multiple long course races, playing ice hockey, field hockey. But that doesn’t mean I ever had really good basic underlying core strength and appropriate muscle recruitment. I think my activity level may have made people (e.g. doctors) assume otherwise. I wonder how many other highly active people may fall into this kind of category, where improper muscle recruitment ultimately sets the person up for a non-optimal surgical recovery and/or outcome. As one example, if we all understood and used proper muscle recruitment, would adult onset swimmers start out with better body position? Many people look to the glutes for hip issues. Maybe they should also be considering transverse abdominis.

Anyway, if you really want to be scared, join the Hip Impingement Awareness (FAI, PAO, THR) facebook group (https://www.facebook.com/groups/FAIhip/). That group has some sad cases. More people with less-than-ideal outcomes post, that’s just the nature of it. Happier cases are more often found in the Runners with Hip Injuries (FAI, THR, PAO) group.

Oh and FWIW, I’m 46. I had surgery at 45.

Anyway, if you really want to be scared, join the Hip Impingement Awareness (FAI, PAO, THR) facebook group (https://www.facebook.com/groups/FAIhip/). That group has some sad cases. More people with less-than-ideal outcomes post, that’s just the nature of it. Happier cases are more often found in the Runners with Hip Injuries (FAI, THR, PAO) group.

No way am I looking at that thread, I’ve read too many horror stories as it is. I have just come back down from a high-stress period that could’ve been from the cortisone but also was probably related to excessive worry. I don’t think there is anything to be gained by adding that kind of stress.

I appreciate the post though, it’s helpful just having a sounding board and hearing things out.

I’m so sorry to hear. I appreciate you sharing. One of the things I love about being a triathlete is that hopefully when a person gets injured in one type of discipline, they can fall back on the other i.e. swimming, running etc etc. I have plantar fasciitis and whener it flares up, I’m grateful that I can just hop in the pool and still swim, or get on a spin bike and take it easy until I’m actually able to run again.

Completely sympathetic to you. I have been having symptoms since March 2016 and trained through for IMAZ 2016.
Have not been triathlon training since.
After that I went seeking help and here is where I ended for now. Try to keep it short.
I was diagnosed with FAI and multifocal labral tear in Feb 2017.
I passed every clinical test on the table for FAI. I passed lidocane injection test that was administered pre arthrogram.
The only indicator of labrum tear was found on MRI. The conclusion was that my symptoms were likely not coming from torn labrum. Entirely aligns with how I feel.
My symptoms are most aligned with athletic pubalgia type.
I will NEVER allow another arthrogram. It jacked my hip and leg for two months. Pressure in the hip, pain that I never had before it. I was limping for 3 days after it. Burning and numbness from injection site on down the leg…
Doc admitted but wanted to keep poking the hip. I told thanks no, see ya goodbuy.
I left suspected athletic pubalgia undiagnosed and unconfirmed.
My pain is in rectus abdominis at the inguinal area. Also, adductor longus, pelvic insertion and upper area of is painful.
I did physical therapy for 3 rounds. It was the second PT that knew how to deal with this. My symptoms were on a scale maybe 2-3. He got me back on the road and running in Fall 2017.
In the mean time since, I switched to ICF kayak paddling and been ok with episodes of rectus abdominis pain on and off no longer tied to activity. Chronic state now. I am doing crossfit 3 days a week and paddle 60k a week. Run occasionally.
Pain in stomach is not gone and I am coming to grips that I will cave in and look for an expert to diagnose this completely. My hunch is I will end up on the table for sports hernia. Than there is research who do I let touch that. From everything I have gathered it would likely be Dr Muschaweck or somebody doing her minimally invasive method…In States that is hard to find.
I will NEVER let anyone touch the hip for FAI and labrum tear. I have a full range of motion in hip, no locking no clicking no arthritis and no other damage according to MRI. Based on horror stories that I have compiled, no clown will be allowed to touch that. There are plenty of those in US.
I live in Kansas City and we do not have experts with either issue. In everything I have read so far, proper diagnosis and separating the two is critical, however they are frequently associated according to different medical papers.

Appreciate the replies everyone. Sympathetic to everyone’s plight certainly too. I’ve had a number of injuries (SFX, broken ankles, etc) but it’s the soft tissue stuff that is often the death knell as it’s usually too difficult to pinpoint.

I have a fairly healthy respect for the surgical process so I’m hopeful I can forestall that as much as possible with a lengthy period of rest while I work on strengthening and correcting some issues.

Man, I have been thinking about nothing else! Early on, I was scared off from all the horror stories I read and decided to rest and see if that would resolve it (i read a lot of people where they did just that) but then it seemed like the more I rested, the worst things got. But now I realize I’ve been hammering that hip with all the weight and core work I’ve been doing and I’m hoping that eliminating that will provide some relief.

But certainly, surgery is on my mind no doubt about it.

Just to give you something else to think about :slight_smile:

I’m 42 and also have a labral tear. I was pretty close to pulling the trigger on surgery about a year ago when I decided to get a second opinion from a highly recommended orthopedic surgeon/sports medicine doc in the area. He was emphatic about NOT getting surgery until I had exhausted every possible conservative option. He said the success rate for patients under 40 is something like 80%, but there are no reliable markers for success in patients over 40. He’s actually in the middle of a study on patients over 40 at Mass General Hospital so it will be interesting to see the results he comes up with. Personally I’m glad I chose not to have surgery as I’ve had pretty good success managing the symptoms through conservative methods. It will never heal, but it doesn’t affect me much day-to-day and certainly isn’t getting worse.

Good luck!

Thanks, that’s basically the advice I am getting from both my orthopedist and my orthopedic surgeon (not a hip specialist though). Rest and some conservative treatment first.

Not only have I read those horror stories on the net but I actually know a couple of people (also 40+) that regretted their surgeries. So if I can get to some sort of baseline using other methods I am going to try that first.

I’m curious what methods you’re using that work for you? I know Stevej posted about glute strength, and mungu gave some other leg/hip strengthening stuff too. I’m looking to follow the methods in these links I found:

http://dynamicsportspt.com/services/hip-pain-specialists/before-hip-surgery-program/

http://morphopedics.wikidot.com/physical-therapy-management-of-hip-labral-tears