posted Jan-30-2007 06:03 PM               

1-30-07--I had this injury when I was 23 years old when I had refused to quit gymnastics, I'm now 50. Back then they called it a "hip sheer" and there was little that could be done for it. When I first injured my hip I was clutching my bedsheets in pain for two weeks. Every time I raised my leg or sat it felt like the bones were rubbing together, very sharp. And when I wasn't moving the joint ached like a toothache. The pain was very, very slow to subside, he rbut it did subside, due largely in part to total sports inactivity for 6 months and loads of pampering!

Now, ironically, my 23 year old daughter has the injury. The doctor tells her that it won't heal without surgery and will lead to problems later in life. My hip healed and I don't have problems so far. My daughter doesn't want to be inactive for 6 months and has scheduled the surgery. Personally, I would have the surgery too.

UPDATE 8/25/07
JUST THE FACTS- My 23 year old daughter (former division I soccer player) has now completed labral tear repair surgery on both hips. Her pain has subsided, but not completely and she's had to cut back on activity 75% for several months. Her healing process was similar to mine and I didn't have surgery. She has 2 scars and insurance paperwork.
MY OPINION- The surgeon did a sales job on my daughter. What he promised in the consultation was not what she received. In retrospect, I feel she should have gotten more opinions.

[This message has been edited by Buzz Monger (edited Aug-26-2007).]

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posted Jan-31-2007 05:00 PM               

How sure are you that it was a labral tear?

If it was--that is just fascinating, and I don't doubt that conservative treatment can work better than is generally credited here based on papers I've read; but my own experience, plus that with my torn knee meniscus, shows this process requires considerable time and rest, something inconceivable to most Americans let alone die-hard runners.

One other thing: you and your daughter might have an underlying congenital condition. She should check for impingement and dysplasia.

Brownie

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posted Feb-02-2007 10:57 AM            

FYI the surgeon best known for hip scopes in Boston is Joe McCarthy

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posted Feb-03-2007 09:38 PM               

Thanks so much for getting back. You have no idea how I appreciate it.

I need to know what, exactly, PT means. Also what you mean by cross-training. Scaling back I've already done, to an extreme. Here's what I've done so far.

Originally I only cycled, about 205 miles per week. Without medical help I can't say what the exact details of the tear are but judging from some of the agony here and what I've read, it's probably anterior-superior and small. Generally what I felt at its worst--late December early January--is a slight irritation which grows into a more annoying irritation; or if I hyperextend, sharp pain; if I abduct with flexion, that irritates and hurts out at the far end (80,90 degrees.) But I've stopped doing these things and COMPLETELY shut down, staying on a walker or crutches most of the time, since Jan. 8, except for crutch-gallops, crutch-walks, and a little cycling on an ATB (not a racing or road bike) around the neighborhood.I have those little pedal-thingies but I only used them one day.

First my left knee started to tell me it can't take on the tough job of being the gallop leg so I stopped that (my left knee's torn meniscus is really what started this whole mess in the first place but after 6 months it had gotten back to maybe 75 or 80 percent.) Then somehow my RIGHT knee woke up swollen and painful one morning. Both feel like ligaments have been strained (makes sense though?) The right leg is getting weak (also makes sense--but should we allow that?)

My hip felt like it was improving,. It's hard to objectively describe something so subjective, but it seemed to be almost like re-gluing itself and grew less severely irritable--something I dunno. but I remained careful, staying within my limts, until today. I went for a total of 9 miles cycling but also put weight on it walking a bit (to go to a meeting, run errand, etc.) and with a 20-lb. backpack. It wasn't until I got back that I realized it's gotten worse a little, gone back to being irritable, sitting, etc. I'd been ramping up the activity thiis week.

I can't say for sure I do or don't have OA issues in there but I can say I seem to have full ROM and then some (almost 180 degrees flexion, I didn't test the extension, sorry, at least 45 degrees lateral rotation, etc.) OPR, it's just that certain motions hurt or irritate and I avoid some now as a matter of course. I probably had at least a little OA before the injury, coming on fairly recently, like within the last 3 years or so and I only say that because I would feel a little looseness in my right hip when I would get up after sitting extensively--but that was the extent of it.

OPR I'm desperate to hear your analysis! Thank you so much!

BROWNIE

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posted Feb-05-2007 08:58 PM               

It's bitter sweet to find this forum. I only say that because I wish I wasn't looking for it. I have already had hip arthroscopy in March 2005. It went well and i was back on my bike quickly. Then as always i kept pushing myself too hard and had several severe crashes where i believe i reinjured my labrum. I still remember that day when i felt the all to familiar pain come back. It was probablly one of the worst days of my life. Like most of you i am absolutely obsessed with being active. I was an avid mountain climber, biker, skier, runner, and everything else before this lovely injury. I biked across the United States in 2000 and have climbed so many mountains. When i see others who can exercise without pain and do all of those things i feel like throwing up. My 4 brothers and my parents are extremely active and so i hate getting together with them because i always have to say i can't do that or this or whatever. I went back to my surgeon and immediately he told me i tore my labrum again and he advised me to have another surgery. I decided not to and since then I have tried EVERYTHING(alternative) to try to get better. One thing i tried was pro-lo therapy which hasn't helped yet. For several months I thought i was healed and i was just about to start racing my bike again and I was out buying a new bike and out of nowhere i am in excruciating pain. That was my second worst day of my life. As all of you have experienced it is on and off. I try to stay fit but it is just so discouraging. So I am back thinking about surgery. I am considering Dr. Phillipon in Vail. My first surgery was done by a local doc in Salt Lake City. Does anyone have any hard facts on success rates for these surgeries? Is there anyone out there that has gone to Dr. Phillipon and is out more than a year and still feeling good? Sorry this is so long but it feels good to know im not the only one out there. Like most of you i was misdiagnosed for 3 years before a PT said i should ask my doc about a labrum tear. Can you believe that????? One doc i wish i would have punched told me that I might be in a wheelchair for the rest of my life and he didnt even know what was wrong with me. Anyways sorry about venting i just have felt so much frustration about this injury. I would love to talk to anyone who has dealt with this.

Ryan

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posted Feb-06-2007 10:23 PM               

I am very pleased to meet you and feel free to vent--haven't you read the rest of this thread? Also I have at least two other threads full of stories--and lots of missed, incorrect diagnoses too.

First of all Phillipon is probably the premier OS for labral tears in the world. Many of the topnotch names reported are disciples or colleagues of his. You are in good hands with him; i.p. he will also check for underlying conditions that may predispose you to this type of injury.

My injury is right on the borderline and, like you, I have been trying to heal on my own for about four weeks now, because I don't have health insurance and a really qualified hip arthroscopist is probably nonexistent around here where I live, the CA desert. Like you I'm an avid cyclist, also swimmer, and had been an occasional runner; like you, I like to push things and be fit although I don't do it fast or competitively at least in recent years. You ask a great question--probably now moot if you're going to see Phillipon, you really should if you can afford it, at least get his expert diagnosis. It's really unfortunate what that one OS told you about the wheelchair etc., he is probably wrong but it might be believable if a patient were to keep going to all these OS's who don't know anything about labral tears. I have read over 30 papers now and the bottom line is, this injury was CONSISTENTLY missed until the 90's and still is not widely understood nearly on the same level as other injuries. These threads tell story after story of OS's telling people stuff like you heard. Labral tears are much more common than previously suspected: a recent study in Europe found that ONE FIFTH of athletes presenting with groin pain had a labral tear.

My tear developed insidiously. Actually, it really begins with tearing my left knee medial meniscus. For ten weeks I over-favored the left leg with a kind of peg-legging walk which put a lot of stress on the right hip, also I usually wore a 30-lb. backpack. Shortly before I stopped favoring the left leg my hip had developed this slight irritation, which became rather noticeable Sept. 8th when I went to a dinner party; the hip had developed a slight ache by the next weekend; but after I stopped favoring, it seemed to slowly improve but never completely recovered. I would especailly feel irritation when abducting the leg with some flexion (which lends a clue to the location of the tear.) Then I started favoring the left side again though not peg-legging and it started to get worse again. Then I had an episode where two thugs chased me on my bike (resolved peacefully), I did a lot of aggressive riding and had a minor crash; it's also possible that riding my ATB was slowly tearing it, what with lots of leaning of my thigh on the bar etc.--this was early December. I was still so focused on the knee, which had improved but was still not 100 percent, that I didn't heed the hip until about 12 days after that chase it took a turn for the worse, more and easily irritated, even more bothersome while sitting in chairs, able to feel a little bit walking, etc. Over the next 3 weeks I struggled to maintain my schedule, switching to swimming every other day but the swimming also probably worsened it, going from just irritating to painful and introducing a side pain in the buttock etc. etc., getting worse, kind of developing its own schedule as has been much documented by other sufferers in these pages. I tried doing everything more and more carefully, toward the end trying to eliminate abducting moves, etc., walking slowly and carefully, etc. but finally on January 9th it seemed to me it was worse yet, with small occasional clicking and me avoiding any pivoting moves on the femur and so on, so out of fear and desperation I completely shut down for the first time in my life, after 25 years of hardiness, heartbroken and terribly alone, searching for answers on the internet. Talk about venting, aye Ryan. .

Studies I've read are not very encouraging for 'conservative' treatment. One reported 13 percent of his study did in fact pull it off successfully; however I also read a paper from a clinic in Switzerland that actually said if you don't have other issues, such as a paralabral cyst or OA--I swear I'm not making this up--surgery is actually unnecessary. I have made a lot of effort trying to ask these guys what their conservative treatment consists of, that could be incredibly valuable but so far have not heard back. Believe me, you can't do better than Phillipon. And studies, though recent, on success of the surgery, although in these threads we probably get the least fortunate exceptions, are very promising and now they are starting to actually repair the labrum much as they can with certain kinds of meniscal tears. For example, I am quite confident a competent hip arthroscopist COULD fix me up in a jiffy, my tear is borderline.

But right now that is out of reach. I'm trying to learn how to conservatively treat this injury (you may have noticed I've been asking OrthopodRunner) and so far it hasn't gone too well. For one thing, I probably shut down too much, the lack of exercise is making my right leg weak and my knees aren't functioning properly. At first I figured I could work out on the crutches. NOT! My left knee--that's the one that wasn't 100 percent to begin with--can't take it, I think I've got several ligament strains (ACL, medial, and even a little lateral) and it is telling me in no uncertain terms. My righ knee also swelled up and suffered some ligament strain for some strange reason. I just decided to dump the crutching; how in the world I figured that if I couldn't CYCLE, I could do THAT, which is almost as bad as running (the gallops), shows my ignorance for sure. But by the 4th week it really did seem to be improving: more and more comfortable sitting, able to keep it quiet more and more, the symptoms growing kind of ghostly. So what mistake do most people make? I started ramping up the activity, cycling my ATB twice, walking on my own with my 18-lb. backpack on Saturday, a two-hour walk on Sunday. .and late Monday (yesterday) it was clear it had suffered a setback, again irritable and feels like that piece is loose and stuck somewhere. For the life of me I can't say exactly what motions did it in, if any, although I'm beginning to suspect it was stupid not to use my road bike instead of my ATB, road bikes are the best, the purest motion. Something about that ATB, probably my knees bowing to the side, intoduces just a slight side pull and I don't think I need that.

I am learning the hard way. . .

Brownie

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posted Feb-08-2007 03:45 PM            

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posted Feb-08-2007 09:19 PM               

You do at least make one good point. I'm not an expert and have NEVER experienced anything like this, so how do I know for sure it is just a labral tear. I'm a little leery of anybody in this place and I certainly don't want to go in there telling him what I think it is before he forms his own opinion, eg asking him 'can you diagnose labral tears?' I don't even know if they could do an MRa here--hm, maybe down in Antelope Valley probably, I could go there.

But I am curious, what other possibilities mighy you be thinking of?

BROWNIE

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posted Feb-09-2007 07:40 AM            

You are right a MRI arthrogram may not be accessible however many of the above could be diagnosed/excluded with a good examination and a x-ray.

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posted Feb-09-2007 10:59 AM            

I have an erie similarity in injury history to the above poster --
Knee meniscus injury followed by rehab and 18 months later a hip injury. Looking for advice on hip injury diagnosis and recovery/rehab.

RUNNING HISTORY -- Age 49. Runner for 28 years. Ran 10 miles, 3 times a week, 30 mpw for 27 years, very few injuries. Was a heel striker. Tore lateral meniscus playing volleyball, running sidelined for 7 months. Recovered and came back to gradually relearn to run differently in 2006, using Pose Method.

OLD KNEE INJURY

I originally had a torn lateral meniscus in July 2005, at first displaced for 10 days and could not extend to within 30 deg. of full extension. After 10 days tear slipped back, but went out off and on over 6 weeks until that was last incident.

However, still had ROM only to within 3 degrees, anterior joint line pain if force on top of knee to try to fully straighten or if accidentally tried to fully straighten while standing. That gradually went away over 6 -8 months (full ROM now).

Right after knee injury, I got an appt. for one of best OS in area. Scheduled earliest exam date for 6 weeks to see OS, at which time OS ordered xray and MRI, then radiologist confirmed oblique tear to outside of lateral meniscus. At the OS followup visit he said I had 3 choices - since tear wasn't in imminent danger of getting worse, I could either (1) wait and see if it got better on its own; or (2) get arthroscopic surgery. He said if it didn't get better, it would probably be a "heck of a nuisance" to live with it.

KNEE REHAB / RETURN TO RUNNING:

Well, knee did get better over next 6 months, got back full ROM eventually. Meanwhile, kept up 3 days per week, 100 min. per session of front wheel drive high resistance elliptical. Began 3 days per week jogging an easy 0.3 mi. X 5 sets on treadmill at month 2.5 post injury. But when I increased distance to 0.8 mi. x 4 sets at 3.5 months post injury, right away I had harsh bone-on-bone contact pain from deep inside joint near planar contact area of tibial plateau and femoral condyle, lasting for 3 to 7 days after. each time I tried running the heel striking way. Gave up running from month 3.5 to month 7 (did only 3 X 100 min./wk. elliptical).

In Jan. 06 started to learn to run on ball-of-foot by Pose Method. NO KNEE PAIN SINCE THEN. Running only 3 days per week, gradually worked up from 1/3 mi. X 3 intervals to 3 mi. continuous runs (by 4/06) to 5 mi. (by 8/06) to 6 and 7 mi. (by 12/06). All this time kept doing elliptical, but as running volume increased I cut back elliptical, ending up in Dec. 06 with 2 X 80 min./wk. elliptical sessions and 3 X 6 mi. runs each week. Throughout progress, I held mileage constant for every 3 - 4 weeks, then increased by only 0.5 mi. for each run. Also, with Pose Method, before each run I did 20 min. of intensive impact drills -- rapid foot drops, two 60 second sets each leg, and forward-weighted leg rapid lifting/dropping 45 second sets (more impact intensive than running).

RECENT HIP INJURY:

On 12/31, ran 6.7 mi. Not during the run, but starting 30 minutes AFTERWARDS, I developed strong pain with each weight bearing step, located in anterior of hip, feeling seems focused only to approximate location of femoral head or iliopsoas bursa and only the moment of weight bearing touchdown. Felt crippled like a 95 year old. BUT, NO HIP PAIN with any other activity --- either standing weight bearing while motionless, or sitting and rotating or flexing hip, or pressing on hip or groin, or when standing and lifting knee up.

Jan. 1 2007, first day after injury, pain in same area upon each walking step, serious but less severe. 3rd day, pain almost gone, just slight ache. 4th day, ran 6 mi., after which pain returned exactly as before, but less intense, lasting for next 2 days. Then ran 6 mi. again, 6 days after the initial injury, but once again pain came back as before for next 3 days. Rested 10 days, no running, just a couple days of elliptical and couple days of walking 2 miles. Very slight achiness when walking in anterior of hip. 10 days after that last run, on Jan. 17 I tried to run a slow and easy 3 miles. No pain during run, but strong pain developed 1 hour later with each weight bearing step. Serious pain next day or two. Stopped all activity and traces of pain/achiness in hip completely gone by 5 - 6 days.

Saw Primary HMO Dr. Jan. 19, he advised rest for 1 month, but didn't order xray or refer to OS for MRI or bone scan. Didn't "think" it could be a femoral neck sfx because I could walk without significant pain and pain was not all the time. He said I should NOT try any core strenthening exercises for a month, after that OK to try. But he wanted me to wait at least till 6 weeks before even trying a run, and even then limit it to less than 1 mile.

Right now I am only swimming and doing upper body weights, waiting for any elliptical or core strengthening workouts until I reach about 4 weeks after my last attempt to run.

Meanwhile, I am looking for advice on this hip problem -- should I ask my primary Dr. for an ortho referral even BEFORE attempting to run again so I don't further set myself back -- for example, to get the ortho to order diagnostic steps such as MRI or bone scan to rule out femoral neck sfx or show areas of edema or swelling near iliopsoas bursa, etc. Or maybe even order MRA if labrum is possibly indicated.

HMO may not grant me an OS referral if my symptoms are no longer active after 4 weeks rest since it went away by stopping my running. But if I restart a gradual progression of ellliptical, then drilling, and then short runs and the problem returns, I have just wasted a long period of time and set myself back to square one for recovery time. Not to mention if it is femoral neck sfx then there is a danger of possibly making a stress reaction or stress fracture worse.

[This message has been edited by rru2s (edited Feb-09-2007).]

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posted Feb-11-2007 09:28 PM               

Hmmmm. So it's your left hip, right? What exactly is this ball-of-foot motion you used? Also describe those 'foot-drops' and 'rapid leg lift/drops' more; I wonder what you were doing those for anyway?

Brownie

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posted Feb-12-2007 08:19 AM            

quote:

---

So it's your left hip, right? What exactly is this ball-of-foot motion you used? Also describe those 'foot-drops' and 'rapid leg lift/drops' more; I wonder what you were doing those for anyway?[/B]

---

My RIGHT hip was injured 12/31/06, don't know if somehow related to compensating after meniscal tear to LEFT knee 7/31/05. I'm getting worried as the rehab for knee was complete, but after sitting around with hip injury for 6 weeks knee motions seem less smooth.

BALL-OF-FOOT running is exactly the Pose Method (www.Posetech.Com), nothing more.

Two types of drills that I do before each run are impact intensive: Play the link "Warm-Up" and look at the rapid one-legged foot drops shown 40% into the movie (I do two sets of 60 on each leg, about one per second). I also do the forward-leaning foot drop shown 60% into the movie (I do one set of 45 on each leg, a little faster than one per second). LINK:

http://www.posetech.com/video/index.php/weblog/archives/P27/

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posted Feb-13-2007 08:36 AM            

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posted Feb-17-2007 01:49 PM               

Thanks,
Ryan

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posted Feb-19-2007 12:25 PM               

Well, after this nine month build up...I had my labral surgery on Feb 8th at Steadman Hawkins with Dr. Philippon--What was estimated to be a two hour 'standard' labral repair surgery, turned into a five hour surgery due to issues they found when they went in (I ended up with the bone shaving, but also an IT skin graft--I was pretty shredded in there--they said the surgery is generally two sutures and I came out with six sutures.) I'm about 11 days out of surgery now--if anyone is going to do this thing, write me first! I'm very optimistic, but the amount of time out of work, dependant, the amount of care that's required (and all of this for an extensive amount of time) is impossible to over-estimate--it is impossible to do this procedure, as his protocol indicates, without a 24 hour caretaker--which I am lucky to have.
Today I just started my 'week two' PT exercises and I'm feeling excited with very small victories--for instance, being 'allowed' to bend past 90 degrees! The 'full return' to sports dates are 7 months out, but my PT schedule has me possibly swimming in a month or so. Anyway--lots I could go on about, but just wanted to thank everyone and offer myself as a resource for anyone going into this thing---Best, Laura

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posted Feb-22-2007 02:32 PM            

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posted Mar-01-2007 11:08 PM            

quote:

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Originally posted by Yeehaaaa:
Brownie and all of my fellow hip sufferers,

Thanks you for responding back to me. Sorry it has been awhile since i got on this thread. I just had x rays done again for Dr. Phillipon. They have to have xrays and some other stuff before they see you. I have been talking to Madeline at the Steadmand Hawkins Clinic in Vail and she has been great. I can't wait to go see them. They found a large bone fragment in my hip joint after doing xrays last week. They want to do a CT Scan to get a better idea of what is going on. I'm wondering if the first surgeon that cut off some of my labrum missed the bone fragment.

Thanks,
Ryan

---

Hi Ryan--I'm not sure if you've followed any of my wordy posts, but I started this thread a while ago, after my first MRI that confirmed a labral tear, and long long before I knew the extent of all of this. Finally, a mere three weeks ago, I had my labral tear surgery with Phillopon at Steadman--If you're thinking about going further with this, I'd love to be use to you. Briefly, I plan to have no regrets, but there's a WHOLE lot of stuff I wish I'd known--just regarding the pre-op/sugery/post-op stuff. It's a pretty big deal to get this surgery, in terms of the recovery process--I AM very optimistic about my surgery, and they were fantastic up there, but I didn't quite know what I was getting into--If you have any appointments scheduled, I might be able to helpful in terms of some heads-ups with practicalities, etc. Let me know if I can be of use! Best, Laura

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posted Jun-08-2007 09:27 PM               

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posted Jun-09-2007 10:06 AM            

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posted Jun-15-2007 03:22 AM               

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posted Jun-15-2007 12:03 PM            

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posted Jun-15-2007 06:37 PM               

I just wanted to say hello and introduce myself. I am 19 and dislocated & fractured my hip in July 2006 in a freak waterskiing accident.

I'll keep it short for now, but I am finally getting an MR arthrogram next Thursday to find out why I am still in so much pain. The OS thinks it might be a labral tear.

I'm terrified. This injury has already put my life in upheaval, and to think that it might be more serious than I thought (and that surgery might be necessary) has got me going crazy. I was extremely active and still hope to be, but I've been told by my PT to lay off of it until we know what's wrong.

I just wanted to say I am SO glad I found this post. I know I'm younger than most people who have posted, but it makes me feel so much better hearing about your stories.

I hope everyone is doing well, and thanks again,
Christine

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posted Jun-15-2007 07:28 PM               

I went through all of that whenever I was 12 (now 20)(freak skating accident). And after one of the operations i was good for a while, then about 6 months later I began to have a lot of pain again. The doctors were stumped and couldn't figure anything out with x-rays mri's arthrograms...and every other test in there arsenal. At this point we were all desperate especially me. So they went in and removed all of the pins lug-nuts plates and screws out of me, tested everything. Here the cause was I had a staph infection in the equipment.

It sounds horrible i know but that was the best place to get one (if there is a best place) Bc of the plate and bone it created a self contained environment so well that the infection couldnt spread elsewere. My doctors were shocked and had never seen it before, bc of how long it took b4 i felt it.

Keeping ur options open and if you have equipment in your hip, maybe you cold suggest to them a biopsy.

Just throwing my experience out there, hope they figure out soon.

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posted Jun-17-2007 10:27 AM               

I'm so happy this post was started up again- I would love to start a "support post" if anyone is interested. I have been dealing with docs and evals since Aug, and they finally determined it was a labral tear after 3 MRIs and a CT scan. I am now working with Dr. Bryan Kelly out of NYC and hopefully will have the surgery end of August (getting married Aug 11th, so this injury has REALLY put a cramp in my plans).

What are those of you pre-op doing to keep busy? pretty much everything seems aggrevates it, including walking over a mile. was aqua jogging religiously but that made it worse. (just found out about a kayaking club in the area so might give that a go!)

Now i'm sticking to light roller blading and going on the exercise bike a couple times a week. miss the running, and would love to hear from those of you who are coping!!

also, i'm pretty nervous about the surgery- have most of you been back to normal w/the running after a yr post-op? I'm in my late 20s and in decent shape. scared this might take me out of the racing scene altogether.

thanks for your support!

fancyshorts

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posted Jun-18-2007 02:03 PM            

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