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SI Joint dysfunction treatment?

guest — Fri, 14 Sep 2012 06:31:42 GMT

I clearly have SI joint dysfunction...been gradually getting worse for years. I can get a chiropractor or good manual physiotherapist to get things back in shape, but it doesn't last for long any more and it takes little exercise to aggravate it again. Has anyone tried prolotherapy for this? Any success? Any other successful treatments? Anyone had surgery? I don't want to be a couch potato! I want to continue to be a triathlete! Jo

Very LARGE labral tear concerned about treatment

guest — Mon, 03 Sep 2012 21:38:33 GMT

Hi Taramike2012:

So sorry you are in this awful predicament. Most people who post on labral tear/arthroscopy threads have degenerative type tears with some underlying abnormality in the bone structure that predisposes them to a labral tear. I have mild hip dysplasia and had an arthroscopic repair done in 2011. Others have some form of FAI (impingement). IMHO, since your tear is traumatic, if you have no other damage to the hip joint, and if you have no underlying abnormalities in the hip, then I think you would have a very high chance of a good result if you have it arthroscopically repaired. It's usually the underlying problems that result in a poor result from hip arthroscopy, especially if there is already some arthritis. However, you may want to ask your surgeon if there would be any advantage/disadvantage to having an open repair.

Who said no exercise AT ALL? I would think that's a bit extreme! How about isometric hip exercises to maintain some strength? How about some exercises to maintain strength in the parts of you that are still functioning well? How about 1 legged cycling on a stationery bike? Heck, even 1 armed swimming with a pull buoy so you don't use your legs! A good physiotherapist who understands your injuries, should be able to help design an exercise program that will benefit you. Nothing worse than an athletic person who can't exercise!

Good luck and I'd love to hear how things progress for you. Jo

Hip Arthroscopy & Labral Tear

guest — Thu, 12 Apr 2012 06:12:12 GMT

It's nice to see a lot of the "old gang" back posting as well as some new folks! Re vacation and sitting....At 2 weeks post-op I went out to a restaurant/music night and sat just fine for probably 3-4 hrs, but I took my own "wedge" cushion (thicker at the back than the front so there is not so much bend in your hip). It wasn't till later when I was allowed more weight bearing that I ran into problems. My visits to my surgeon my husband did the driving (5 hrs) while I reclined in the passenger seat. At 3+ months we booked an oceanside condo for 3 nights (not far from my surgeon) which turned out not to be much of a vacation other than a change in scenery. I was suffering with inflammation, on crutches, and the only saving grace was good weather and I could lie on the beach! So to reiterate.... prepare for the worst and hope for the best. Don't make any plans you can't get out of. Similar to Tonya, I was figuring 12 weeks off work. I finally got back 5-1/2 months later part-time, then full time a month after that. Fortunately, my employer has an excellent sick leave and long term disability plan so I didn't lose any income. Anyway, the good news is after all the setbacks and struggle and months of my husband asking me if I regretted having the surgery, a year later, I can now say, No, I don't regret the surgery! I can be active again! Now after listening to all of our horror stories, remember that the people who recover well, and quickly, don't hang about on these forums! Jo

Re: Hip Arthroscopy & Labral Tear

guest — Mon, 09 Apr 2012 03:30:07 GMT

lunahip:

I totally agree with Effie. I am one year post-op labral repair (on a mildly dysplastic hip, no arthritis, no impingement). I tried to come off crutches one month post-op...thought I was feeling pretty good. But the added wt. bearing kept flaring my hip up and everytime I flared it up (deep aching in the joint) it would last for a few days (and nights). It didn't take much to cause the inflammation. I ended up mostly on crutches for 3-1/2 mo, pretty much still doing the exercises I had done in the first 2 weeks post-op! Finally at 7 mo. post-op I got a cortisone shot and that made all the difference. However, having not been able to do much pre-op and then such a long recovery, although I am now "jogging" (it's not even close to what I used to run), cycling, skiing, at the gym, etc. my speed and stamina have a long way to go yet! I was swimming from a few weeks post-op and did a lot with a pull buoy but I can now do kicking including breaststroke. It's really just in the last 2 months that I've even be able to start to do this stuff. I was a triathlete before this and the tear became symptomatic during an Ironman in 2009. I did one more Ironman in 2009 and it didn't bother me, but when I resumed training after recovering I could never get my running back without pain. It was another 1-1/2 yrs before I got surgery. I'm twice as old as you, so I am sure even with a long recovery you will come back quicker. However, at this stage of the game REST! You won't recover faster by doing activities that cause it to flare up. Do what you can do painfree, but not beyond. My OS was very insistent not to do stretching or any exercises that caused pain. My problem was that, because it was inflammation, the pain didn't happen till hours after the activity. My OS doesn't have a specific protocol, his main mantra is NO PAIN, and sends you to PT 1 week post-op to start to work on range and strength as you are able.

It's a very frustrating recovery, lunahip, especially when you are used to being very active. But honestly, patience and rest with GENTLE activity is your best bet and YOU WILL RECOVER....even it feels like you never will. Good luck! Jo

Hip Arthroscopy & Labral Tear

guest — Wed, 21 Mar 2012 13:39:06 GMT

@ Larry: hmmmmm.....not sure about getting sore if I don't exercise...I don't think I've gone a day without some kind of exercise since I've been well enough to exercise. I think I'd likely be good with a couple days rest, but if I had to sit toooooo much AND no exercise I think I would be uncomfortable, but that would be my whole body not just my hip!

I went downhill skiing on the weekend....fresh snow, brilliant sunshine, no wind - perfect! I'm still a crappy skier, but loved it! I've never been able to balance well on my dysplastic leg (but didn't know I had dysplasia) and now I think the dysplasia is maybe why I can turn my skis way better to the right than the left....I'm uncoordinate for a reason at least!

Hip Arthroscopy & Labral Tear

guest — Sun, 11 Mar 2012 20:11:18 GMT

Hi Everyone:

It's been ages since I posted. I'm sorry some of you are still having major struggles...I hope everything comes right eventually. I see lots of new folks on here too...you'll get lots of good info here.

For myself, the last month has finally been really positive. Short history...labral repair with 2 anchors April, 2011. Mild dysplasia, no FAI, no arthritis. Should have been a simple enough recovery. Ended up on crutches for the better part of 3-1/2 months, diagnosed with inflammation but the surgeon kept hoping it would settle down with antiinflammatories and rest. No such luck. Eventually at 7 mo. post-op got a cortisone shot and the positive turnaround started. However, I have episodes of my SIJ and L4 causing problems (this has happened for years) and that flared up again. When that settled my muscles were still so weak from months of inactivity my muscles would kill me when I tried to up my activity, but I knew it wasn't that deep joint ache I had before the cortisone. So I had to be cautious about not overdoing things trying to get my strength back up. It's taken tons of patience, a good PT, a lot of hard, regular work BUT....I'll tell you what I can do now. I've been x-c skiing for up to 1-1/4 hrs, cycling over an hour, jog/walk (4 min. jog/1 min. walk) 50 min. (muscles feel like I've done a marathon, but hip OK), swimming including up to 150 m. breastroke at a time, at the gym 3-4 x/wk work all the hip muscles and stretching. I'm still not quite at full strength, now 11 months post-op. Of course, the dysplasia is still there, which explains why I've never been able to balance well on that leg....and I expect never will. But I can do most of the activities I want to and still building up stamina. BTW, I'm 57.

In the end, the surgery has been worth it....but it's been a longer road than I had anticipated. Jo

Hip Arthroscopy & Labral Tear

guest — Fri, 20 Jan 2012 03:41:08 GMT

Yahoo! I'm getting e-mail notifications again! Is everyone getting the e-mail not'n again? Are you getting some but not all. Tonya, are you getting them all now? It's so nice to see so much more conversation already!

Let me know if any problems and I will pass on the message. thanks!

A friend of mine just got diagnosed with osteophytes, cysts, and impingement. He'll be seeing an OS soon. Anyone know what the significance of cysts are?

Hip Arthroscopy & Labral Tear

guest — Thu, 19 Jan 2012 03:52:08 GMT

Hi Larry:

Always fun to describe a technique without pictures! To mobilize my hip to try to get it flex more I start by lying on my back with the 'good' leg down flat and the 'bad' leg bent up, 90 deg. at the hip, and 90 deg. at the knee. I clasp my hands behind my thigh (near the knee) and push my leg into my hands, but not too hard (isometric contraction of glutes). Then keeping the hip and knee in the same position I move my hands to the front of my thigh (quads) near the knee and push my leg into my hands (isometric hip flexors). I go back and forth alternating between pushing one way then the other 6-8 times. Then I bring my knee a little closer to the chest, but just short of where I start to feel the pinch. I repeat the whole process in that position. Sometimes I do it a third time a little closer again if I can get it there without the pinching. Then I relax and then gently pull my knee toward my chest and usually it will come further than doing it before I start this procedure. I'm hoping if I keep at it the improvement will become more permanent. Right now it doesn't seem to last long, but it seems the potential must be there!

I can certainly relate to the muscle imbalances! This whole hip pinching might be part of that...my physio feels the head of my femur isn't sitting central in the hip joint, it's being pulled offcentre, which is why I feel pinching. This technique is supposed to help it sit more central, but then I also need to work on the overall strength and muscle balance to keep it there! Of course having dysplasia I'm sure doesn't help...

BTW - I had an e-mail saying they think they've solved the problem of us not getting e-mail notification of new posts...can you post back and let me know if you got an e-mail? Plus if you post I'll know whether I am getting the e-mail notifications again too!

Hip Arthroscopy & Labral Tear

guest — Sun, 15 Jan 2012 19:51:41 GMT

Hi Tonya: Good to hear you're recovering much better this time around! Ready to go back to work? Ya! Do you have a job to go back to or do you have to start job hunting? I am mentally so much better being back at work and having the routine and more contact with people.

ART (active release therapy) is done by various professions who have taken the special training. It seems Larry and I both have physios who do it. But I have also been to an occupational therapist who does it, and I believe some chiropractors do it too. Some people hate it because it can hurt quite a bit while they are doing it. The therapist really digs into a spot while she/he gets you to move a limb/joint in a certain way, so the muscle is being stretched under pressure while being actively (as opposed to passively) moved. At least that's what it feels like!

I'll probably find out more this week about what happened with the MRA dye problem with my friend. Curious.... I expect to get another MRA there in 2-3 months at the same place! Now I'm a bit worried! My previous MRA was elsewhere and I had no problems.

Cheeers all! Jo

Hip Arthroscopy & Labral Tear

guest — Sat, 14 Jan 2012 18:55:22 GMT

Hi KellyVin :

Welcome, but sorry you have to be here! I'm a long way from PA so can't help you with surgeon's in the area (heck, I'm not even in your country!). Before you push for surgery and finding a surgeon, find out as much about your injury as possible as that may affect your decisions. Most labral tears are the result of some underlying hip abnormality, often either dysplasia (shallow hip socket which may or may not be in a too forward or too far back position) or a femoral acetabular impingement (may be a problem with the shape of the bone either on the socket or the head of the femur). Sometimes labral tears occur in otherwise normal hip joints, but usually only with major trauma, not "wear and tear". If you have a labral tear, there may be other problems in the joint too, cartilage wearing, arthritis. Sometimes not all the problems show up initially on x-rays and MRI with or without contrast. Or sometimes the problems are visible but the radiologist doesn't pick up on it or report it. What investigations have you had done so far? Make sure you find a surgeon who is a hip preservation specialist and has lots of experience with these injuries. If there are significant problems in the joint besides the labral tear, the statistical success of arthroscopy is much lower. I don't mean to scare you or overwhelm you, but it can be much more complex than what we are often led to believe! Another good web forum is in the hipchicksunite website.

BTW the "e-mail notification" function on the web forum is not working so you just have to keep checking in for updates....I've e-maileld them about this a few times!

Jo (arthroscopic labral repair Apr/11, "mild" dysplasia)