I had been having hip pain for a little while and was just diagnosed with hip impingement and subsequently a torn labrum. Course of treatment for now is physical therapy + corticosteroid shot, with the option of surgery later. The doc told me its no problem at all to run on it as much as I want, as I won’t be doing any more damage. So the question to people with some experience with this type of injury is - how much will this affect my running? Will it force me to dial back the mileage significantly due to discomfort until I bite the bullet and get the surgery (projected time off running is 3 months), or am I looking at no real negative effects on my volume? Trying to plan out my year a bit and of course how much I can train is going to be a significant factor here.
I had been having hip pain for a little while and was just diagnosed with hip impingement and subsequently a torn labrum. Course of treatment for now is physical therapy + corticosteroid shot, with the option of surgery later. The doc told me its no problem at all to run on it as much as I want, as I won’t be doing any more damage. So the question to people with some experience with this type of injury is - how much will this affect my running? Will it force me to dial back the mileage significantly due to discomfort until I bite the bullet and get the surgery (projected time off running is 3 months), or am I looking at no real negative effects on my volume? Trying to plan out my year a bit and of course how much I can train is going to be a significant factor here.
In 2010, I started having pain in my left hip. After the season (in fact, in December 2010) I went to see my orthopedic surgeon who is also an Ironman triathlete. He immediately diagnosed my torn labrum (confirmed by MRI). He said I needed surgery. The choice was to have the surgery sooner than later, because if I didn’t have the surgery until after the race season, surgery might no longer be an option (think “hip replacement”). My hip situation might not have been the same as yours, of course, but my ortho said that racing/training on it could really mess it up. It’s hard to imagine that running on a torn labrum isn’t doing more damage (isn’t that what pain is all about?).
(BTW, I had surgery on 2/28/11, had 2 weeks before back in the pool, 4 weeks until I could do easy trainer riding, 6 weeks until off crutches, and 8 weeks until I was allowed to start running. I think my first triathlon was in June or July.)
No expert here, but I have had a torn labrum, articular cartilage “pot holes”, and muscle tears for quite a while but only formally dx’d with it in April. After 2 opinions, the thinking is to do what I want/can until a hip replacement in 2 years or so. The labrum protects the ball and socket, and if you have tears-it can speed the degeneration of the cartilage thus speeding up arthritis and replacement. I am past the point of any surgical repair, and at my age(55) I am on borrowed time. I will run, and still do, slowly with my Hokas, and not on concrete, to get as much out of this hip as I can.
Don’t know what your age is, but I would consider what your long term plans are. Just know that running on a compromised joint will come with a price later on.
Good luck!
I just got done with arthroscopic on my hip December 9th…here’s my story…YMMV!
Been having “piriformis” issues for years…always there, sometimes tolerable , sometimes not…so last Fall (Oct 2012), after finishing IMLou, I made a commitment to myself and my docs to do a full scale exploration of what might be causing this on-going issue. My sports med doc looked at everything thoroughly with sessions of PT thrown in to test areas to ensure no sneaky soft tissue problems…he finally gave me the “I’m sending you out for this last ditch test and if it comes back positive, you and I are done…we’ll be sending you to a sport ortho for further treatment” speech…the resultant MRI with contrast revealed a torn labrum and cam impingement.
So, armed with that info, I “shopped” no fewer than 5 surgeons locally to see what their recommendation was based on my situation. Three of the 5 would not repair the labrum and blamed the inflammation on arthritis/old age (I’m 51 currently btw for point of reference). The other two would both do the surgery but one stood out to me as the best option because he is a budding triathlete, understood my desire to continue to run as well as restore my range of motion, and gave me a voice in my treatment timeline. This all happened late Feb. 2013…
Because I could not see missing an entire summer of activity and because I had already signed up for IMAZ and hoped to at least complete that, we decided that I could do whatever races I could train for as he was farily certain that I was in no danger of “preventing” his ability to try the repair surgery and use the cortisone shots as both an aid in warding off heavy inflammation later in the training cycle and as a pre-race preventative to give me the most comfortable race day possible (my sports med doc, who did the injections, shared with my the additional diagnostic benefit of ensuring that the pain was in fact from the hip joint itself…indicating a better probability of relief via surgery). Having decided to do what I could to race, I allowed myself to train and focused mostly on the bike and swim…I rode the bike A LOT!!! But when it came time to get my run mileage up, the hip was not cooperative. Longer runs became a sure cause of pain the next day and so I decided to just RIDE!
I showed up to IMAZ after deciding that I could really only attempt one race and then have the surgery…if I’m going to do one last race, I might as well go BIG! I arrived in Tempe with a longest run of 6 miles under my belt and just let the day happen…had a fair day for me that included an IM PR bike ride of just over 20mph avg and “ran” a 5:15 afterwards (a “normal” IM marathon for me is 4:20-4:30)…I had fun, got it done and checked IMAZ off my “wanna do” list.
Two weeks and one day after IMAZ I had surgery…the doc found a “monster” tear in my labrum, very little arthritis (despite what the X-rays seemed to indicate they would find), and BOTH a cam and, to his surprise, a pincher impingement. My timeline post surgery has been, thus far…PT twice a week, riding the exercise bike (no real resistance) the day after surgery and each PT session since, was off crutches and braces effective the day of my post-op follow-up visit 8 days after surgery. I continue to work on range of motion and strength at PT and while water walking, which I started in week three post-op…
Today, the hip is still a bit achy at times but definitely getting better each day and stronger with each round of PT…protocol calls for me to get outside and ride (If the snow ever stops) in week 5 post-op and begin a return to running progression in week 9 post-op…so far I am very comfortable in hitting my progressions during rehab…BUT, I have been finding myself having to really resist overdoing as it seems too easy at time…I’m bad a being a patient patient…
So, work a doc you can trust…get a ton of opinions and work with the guy/gal that seems to best understand “who and what you are” both personally and athletically…don’t necessarily expect miracles but definite improvement is possible based on my experience… N=1
All the best with whatever you decide is best for you!!
Paul
When I trained for my 1st marathon 5 years ago, I ended up with hip pain. I didn’t know much about run training and was doing all of my runs at threshold, following some Nike training plan. hip pain got pretty bad- kept running. Racked up some great 20mi runs at MP (dumb) and then couldn’t walk without a limp and couldn’t take a running step for months.
Went to the doctor… took x-ray (sure, I had a little FAI like everybody), then had an MRI- which came back and said that I had “a full thickness tear of my superior acetabural labrum”. Doc said that I wouldn’t be able to run again without surgery and to buy a bike. Well, I bought the bike- gave up on my marathon hopes, and started cycling. Hip felt enough better after a few months for me to muddle through a 5K run so I entered my 1st sprint tri. Had a hoot of a time and fell in love with Tri’s.
I ran my 1st marathon (3:36) about 10 months after a doc told me that I’d never run again. I’ve since run a heck of a lot more, BQed, done many tri’s, etc. Now nearing 50 years old and training for my 1st 50mi ultra.
Labrum surgery is not a minor thing, and from what I’ve heard- there aren’t very many people who can do it properly. I would try everything else first. Rest, cross training, whatever. Granted, your issue may not be the same as mine, but surgery is a true last resort. The body has a remarkable ability to heal itself if you let it… and help it. Keep moving.
Oh- one of the things that helped my hip. ** I stopped stretching it-** and instead did hip strengthening exercises to tighten it up. A strong tight hip seems to be much more resistant to pain than my loose weak hips. imagine that?
I have the same thing - FAI hip impingement with ‘abnormalities’ on the labrum after having an MRI. My Dr is certain the abnormalities are small tears but he recommended not doing surgery unless the pain increases or get any type of catching. I trust him because he has done 3 knee surgeries for me and told me the labral repairs don’t always work.
He was explicit that I stop trying to stretch my hip flexors and continue to keep muscle balance to support my hips. It sounds like it’s a pretty normal thing for people to try and stretch out their hips to help with pain and discomfort. I didn’t know that in certain cases that does more harm than good. I don’t stretch my hips anymore and I haven’t had any additional pain or issues.
It’s a little different for everyone but seems like my experience is similar to yours.
…
He was explicit that I stop trying to stretch my hip flexors…
It felt so goooood to stretch my hips, especially when they were in pain. Opening up the hip joint took pressure off my inflamed bursa and labrum. But, that was just temporary relief.
Can you tell me who your surgeon is and where they are located?
Hi everyone-I am 7 weeks out from having hip surgery for cam impingement and labrum tear. My issues started in April/2012 during the end of my IM Texas training. My pain was throughout the hip, deep in the joint, and also in the buttock area. I began seeing a regular orthopedic doc, who xrayed , saw nothing big of a deal and started giving me injections into various areas thinking it was some bursitis. Rest-cortisone-PT didn’t help. I then got an MRI, labrum tear was shown, that doc sent me to a sports ortho doc who specializes in hip arthroscopy. (there aren’t many around, btw)
This doc explained the cam impingement, how the tear happened, ordered more PT, and gave me more cortisone injections (a few months apart). Upfront he explained that this issue would not heal itself, but that I needed to get to the point where the pain was far too much to deal with before he did the surgery, as surgeries do not always help. He reassured me that I could continue doing whatever activities that I could tolerate, as it was unlikely that I would do any more damage than was already there.
As most endurance athletes, my pain tolerance is high, so I kept on doing all activities for another year. Even though the doc said I wasn’t doing any more damage, I would disagree as I could feel the issue getting worse as time went on. Discomfort became pain, at times my hip would feel weak and like it was going to go out, and running became pure torture. My ‘normal’ slow pace became REALLY slow because of the pain. I would have to add frequent walk breaks into running just to get through.
Surgery was Nov. 2013. Doc took care of the cam by reshaping the femoral head, reshaping the cup, fixing the tear, and tightening the capsule. (He did find a bigger tear than he expected.) He said the surgery went well and that the hip joint otherwise looked good. I was supposed to be on crutches for 2 weeks, and braced for 6. I was off crutches in 1 week and out of the brace after 2 weeks. (with the understanding that if needed, I would use both) I began PT after my 2 week follow up, and per both Dr and PT reports, am far ahead of the game as shown by my ability to do various exercises. I began light spinning on the bike after 2 weeks (but this is a spin bike, NOT my road bike on trainer, as the doc said the angle of my hips on the road bike would be bad for my recovery.). He agreed to let me swim PULL BUOY ONLY after 3 weeks. I have only just started adding the elliptical for a few minutes at a time, but surely feel it afterwards (which sucks)
When I saw the doc last week for my 6 week follow up, I told him about the discomfort that I am feeling, which is very similar to the pain that occurred prior to surgery. He reassured me that this is NORMAL. And although he is the man with the medical degree, I am discouraged by the amount of discomfort that I feel. I am staying within the limits/boundaries that he has set for me. (still only spinning, pull buoy swimming, PT, lower body strength training as long as hips stay within a 90degree angle) I have done much reading (which is a good and a bad thing) and am reading that each person heals differently (duh) and that this healing process can take 4-6 months, on average. (mind rests assured until body has pain, then mind plays stupid games again)
My doc believes that active people can return to active lifestyles upon healing, contrary to the belief of some docs. (which is why I was comfortable with him) I had to travel over an hour to get to my doc as there aren’t many docs that specialize in this type of surgery, and there is a steep learning curve to the surgery. Do your homework. Get second opinions if necessary. Good luck.
Oh, for point of reference, I am 42 years old.
Thanks for your input, fitgirl5! Just for my own info, when your doc did the surgery, how did he access the hip joint? Was it arthroscopic only, mini-open or fully open? I hear that makes a significant difference on recovery and risk of the surgery itself.
You are very welcome, cloesch! My surgery was arthroscopy only. Two VERY small incisions in the hip flexor area. (Like 2 stitches each). No muscles were cut, only moved over so he could do the procedure. I also have heard that this makes a difference in recovery time. Do you already have the surgery scheduled, or are you just doing your homework at this point?
Oh- one of the things that helped my hip. ** I stopped stretching it-** and instead did hip strengthening exercises to tighten it up. A strong tight hip seems to be much more resistant to pain than my loose weak hips. imagine that?
X2
Anything past mild stretching in naturally flexible people does more harm than good. Don’t drink the Kool-Aid.
At the moment I can run as long as I don’t do back to back hard run days, it definitely acts up if I do that. Going with physical therapy for now, cortisone shot if it gets worse, and reevaluate after IM Chattanooga.
I completely forgot to mention something that helped me significantly but was only a short term solution, was a prescription strength anti-inflammatory. I am new to slowtwitch, so I don’t know all the rules on mentioning names of things. If a ST veteran wants to let me know if I can mention the drug name, I will certainly let you know what that is so that you can ask your dr. about it. I was able to get by taking it 1-2 times a week,(instead of daily) and only took it when I knew a workout would cause some pain, and I found it decreased pain and sped up recovery significantly. This med, however, was only meant to be short term (dr. said 1-2 years of use, because of potential organ damage) It did help though. Something to think about since you are training for IM.
Hey guys! So sorry to see this thread–it seems like labrums are tearing (on the) left and right. I blame Obama and/or Christie.
Okay, after the stupid ice-breaker, I’ll let you know my N=1. For background, I am a pretty serious runner. WHY SO SERIOUS? Because it allows me to eat lots of food, mostly.
Anyway, I was the 2012 USATF Trail 10k National Champion, was getting in my best shape in October/November, when hip go boom.
Hip impingement/labrum rebelling against the Empire Timeline
- Hip pain, diagnosed via normal old MRI in November
- 3 weeks mostly off, with lots of lifting and walking vigorously up stairs (the doctor said I could walk from place to place, so stairs were a loophole in my damaged brain)
- Try to get back to running for 2 days, excruciating pain, was hooked up with the best hip doc in DC
- Scheduled for surgery on Jan 22, and when I asked what I should do in the meantime, he pretty much said “go for it and rip that sucka”
- Started doing hardcore PT, almost 1.5 hours a day, mixed with hard ellipticalling (PT–hip mobility and strength, can put down the 20 or so exercises if anyone cares)
- Doc cancelled surgery due to strength/mobility gains
- Got back to running slowly but surely, in process now (did an 18.6 miler the other day, and a 12 miler at 6 min pace 1.5 weeks ago, planning on trying a 4:40ish mile today to see what happens)
So, in conclusion (if you’ve read this far, you probably have torn eye labrums), it seems to be mostly healed. That being said, I could be cruisin for a bruisin. I’ll update everyone when I know for sure. And follow my blog/strava if you want to see daily training updates:
http://www.strava.com/athletes/1733803
http://beautyandchange.blogspot.com/
Sending healing vibes to you guys! ST is awesome,
David
…
4. Scheduled for surgery on Jan 22, and when I asked what I should do in the meantime, he pretty much said “go for it and rip that sucka”
5. Started doing hardcore PT, almost 1.5 hours a day, mixed with hard ellipticalling (PT–hip mobility and strength, can put down the 20 or so exercises if anyone cares)
6. Doc cancelled surgery due to strength/mobility gains
7. Got back to running slowly but surely, in process now (did an 18.6 miler the other day, and a 12 miler at 6 min pace 1.5 weeks ago, planning on trying a 4:40ish mile today to see what happens) …
David
Just makes you wonder how many needless surgeries are done.
I was just diagnosed with hip osteoarthritis this past Dec 2013. I have always had IT band issues always had a dull ache in my hip after running but two months ago I started with a dull pain in my right groin limited hip movement and some stiffness after running even walking. At first doctor said I had a stress fracture and was ordered to get an X-ray and that showed some abnormal thinckening of my Acetabulum. Got a CT scan and FAI was ruled out and scan showed three small bone spurs forming on my Acetabulum. Doc said pain I was feeling was due to inflammation in the hip area. I got a cortisone shot and I take NSAID twice weekly. I hope to get back to running but doctor says that if I do I will degenerate the cartilage in the hip and could develop FAI and get a tear in the Labrum. So after reading all the post I am going for a second opinion and will look into getting some PT and will resume my swimming and cyling. I am signed up for IMAZ 2014 and I need to resolve this problem soon
…
4. Scheduled for surgery on Jan 22, and when I asked what I should do in the meantime, he pretty much said “go for it and rip that sucka”
5. Started doing hardcore PT, almost 1.5 hours a day, mixed with hard ellipticalling (PT–hip mobility and strength, can put down the 20 or so exercises if anyone cares)
6. Doc cancelled surgery due to strength/mobility gains
7. Got back to running slowly but surely, in process now (did an 18.6 miler the other day, and a 12 miler at 6 min pace 1.5 weeks ago, planning on trying a 4:40ish mile today to see what happens) …
David
Just makes you wonder how many needless surgeries are done.
Agreed … in part. Many athletic problems can be sufficiently remedied through a different course of fitness or training, eliminating costly surgical alternatives. By “athletic problems” I’m suggesting that not being able to run as well as you want is the problem. If you can train around a torn labrum, and achieve your goals, then you’ve spared yourself the aggravation of getting it fixed. Assuming it gets no worse, you can go on with a reasonably physical existence.
The reason that I only agree in part is that the torn labrum will not heal itself, and is likely to degrade under similar training loads and/or activity. I had a gross impingement and labral tear that I periodically worked around for several years until it became an obvious inhibitor to regular activity (outside of training). I had it repaired arthroscopically back in the spring of 2012, and have not had an ounce of associated pain or discomfort. It enabled me to run personal bests last season at several distances (15k to 50-mile).
…
4. Scheduled for surgery on Jan 22, and when I asked what I should do in the meantime, he pretty much said “go for it and rip that sucka”
5. Started doing hardcore PT, almost 1.5 hours a day, mixed with hard ellipticalling (PT–hip mobility and strength, can put down the 20 or so exercises if anyone cares)
6. Doc cancelled surgery due to strength/mobility gains
7. Got back to running slowly but surely, in process now (did an 18.6 miler the other day, and a 12 miler at 6 min pace 1.5 weeks ago, planning on trying a 4:40ish mile today to see what happens) …
David
Just makes you wonder how many needless surgeries are done.
Agreed … in part. Many athletic problems can be sufficiently remedied through a different course of fitness or training, eliminating costly surgical alternatives. By “athletic problems” I’m suggesting that not being able to run as well as you want is the problem. If you can train around a torn labrum, and achieve your goals, then you’ve spared yourself the aggravation of getting it fixed. Assuming it gets no worse, you can go on with a reasonably physical existence.
The reason that I only agree in part is that the torn labrum will not heal itself, and is likely to degrade under similar training loads and/or activity. I had a gross impingement and labral tear that I periodically worked around for several years until it became an obvious inhibitor to regular activity (outside of training). I had it repaired arthroscopically back in the spring of 2012, and have not had an ounce of associated pain or discomfort. It enabled me to run personal bests last season at several distances (15k to 50-mile).
I do not claim to know anything. In fact, I know nothing. My knowledge makes a climate denier look like Stephen Hawking.
But I just wanted to point out that I may still need surgery if some setback occurs, rendering my N=1 moot. In the meantime, I’ve been able to get back into training pretty hard, and I imagine there are success stories of runners much better than me.
Thrilled your labrum is feeling good!
Even if your condition warrants surgery, that wouldn’t nullify your n=1 observation. In fact, my anecdotal understanding is that your experience is quite normal. Mine was similar in that I could change any number of factors (e.g. form, cadence, strength) and essentially work around the issue. In doing so, I ran for several training cycles with no in situ hip pain or discomfort (though in most cases the pain would set in post-workout).
If you’re keeping the symptoms at bay, then you’re ahead of the curve in terms of strength and stability. As we all know, the best non-medical advice is to simply stick with what works.