Jul 5, 2006 1:24 PM
Hip Arthroscopy & Labral Tear: Please help!
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Hello all,
Hoping a few of you have some experience with this....My MRI confirmed a labral tear. I'd suspected this since a December idiotic spring. It's been getting worse, and I feel like I've tried everything, massively cut back, x-train, core work, supplements, water training, PT, etc. Has anyone had this surgery? I've never had to before, and I'm naturally distrustful (fearful, I suppose). I need to distance run for sanity, so I'm feeling like it's a matter of time. And likely only have insurance for another year.
Wondering if anyone has had alternatives that work? A six month tear that did start to heal on own?
My knee on that side has been problematic since, and now I suspect it's coming out of there. They're talking 8-12 weeks before much of anythingI guess I'll lose allmost muscle/cardio investment. <br /><br />Sigh. Just this morning. Ready to get surgery if that's the fix. But anxious to hear from other runnersI tend to trust their experience more than a Q&A website.
Thanks for any help--
I responded to your other post this afternoon, but I just saw this one. UGH!!!!
Can you describe your pain in detail?
Here is what I have experienced in the past. Pain was only when I stood up and started to walk, not during a run. LIMPING pain, but would eventually work its way out with more steps.
I don't have a
real
dx only that my massage therapist was able to pinpoint the spot. And she knew the muscle! I have not had PT, only rest, and NSAIDs. My mileage has really suffered and I am starting to ramp it up again, wondering if I will experience the same pain.Thanks so much for the empathy. I wanted to post here because I can't deal with people that 'don't get' itwhat not running feels like. Part of why I probably have an injury is because I'm a moronexample A: After getting diagnosis I went out for 6 miles. It's definately getting worse. It's a tear through the "superior lateral acetabular labrum" if that means anything. Inner lining in"cup" that supports bone.
I feel like I have to be positive and it looks like PT starts quickly afterwards, hoping I"ll be able to resume upper body weights/core work/cardio quickly. Although it's time I listened to doctors.
This is only detectable by symptoms and MRI. If you suspect, it might be worth itI say this because I have insurance in one of the rare stretches of my life. But, yes, it numbs out somewhat in running, though even that's changing now. Hurts in morning. It feels like the pain starts between hip bone and pubic bone, deep inside, and sometimes goes up as far as lower absmy rather intense pilates work might have stretched it up there. Apparently a lot of people can have this and never feel itif you feels yours somewhat regular, or it worsens, probably a red flag. Also, it's usually related to a specific incident. Ohalso, feels "sharp." I supected it because it felt different than my other injuries that I've been able to work out with stretching/massage/ice baths/PT/etc. Hope this helps a litte.
Hoping to get surgery soon, and start the rest. Aim for spring marathon, sanity. I wish I could implant in the brain of all starting runners not to overtrain. I was told again and againand once again in life, apparently I have to learn by pushing it....<br /><br />Thanks again, and bestLaura
Well, hang in there and best of luck on your up-coming surgery, I will look for follow-up posts from you.
I will take this new knowledge into consideration if my pain returns as I increase my weekly mileage. I have only been running about 9-10 miles per week since Feb. to try to let things settle down in there. But a few things sound similar such as being related to a specific incident and the sharp pains that seem very deep and into the groin area. I remember the pain very well!!
Did your pain seem worse when you stood up to walk after being in a sitting position for a while?
Thanks and take care!!!!
~Billie
Hey Cololora-
I was recently diagnosed with an anterior acetabular labral tear, so we can be torn labrum buddies!
I have also had the pain for many moths (4 in my case). Pain was diagnosed as bursitis, and I was sent to PT. I have done the PT thing, the take 6 weeks off thing and its still something I am dealing with.
I have consulted a few doctors on this and it seems that these tears will never heal by themselves. The reason for this is that they are non-vascular. There is no direct blood flow to the area and therefore new tissue will not form to fill in the tear...the only solution is to either deal with the pain and hope that the tear stops rubbing the nerve (or bone) (or whatever is causing the pain) or have the arthroscope procedure.
I have an appt with my doc and the surgeon on Tues...but in the meantime, I have kept running through the pain (i had my first 20 mile week last week in 4 months!). One of the things I have heard is that you cannot make the tear worse by running, this is an injury, not an overuse problem...
I will need to make a decision to ColoLora as I am currently in the 4th week of Chicago Marathon training...if I have the surgery, I will have to put my dreams on hold for another year!
Anyways, maybe we can be labrum buddies..i wish you luck with your decision and recovery!
Jeremy
Jeremy!
Thanks so muchI'm having trouble finding "superior labral tear" buddies. I really appreciate the information thoughI did 14 this morning, the whole time wondering how idiotic it was, but only runners know the need...So, that's great. I was actually thinking of checking out the option of getting the surgery postponed and get a fall marathon in first. I'd rather be out of commision in the winter. Also, I've done two half marathons and a full May marathon since the tear, and it hasn't gotten that much more painful. I didn't know about the blood flow non-heal, makes perfect sense. I've definately noticed if I keep a slow pace (9-10 min miles), and avoid my beloved hill runs, that I feel the pain a bit less. For meForget speed with this guy. The good news is that my pilates teacher, who knows my neurosis with exercise pretty well, told me that studies really prove recovery time is about 1/2 for people who are taking pretty good care of themselves. I'm hearing 5 months, so I'm figuing 2/5 months. November 8th then, right?<br /><br />Good newsIt looks like I'll have a good surgeon, he's at the Steadman-Hawkin clinic (Vail) which I guess I was supposed to have heard about before this. Of course, I have insomnia nightmares of some 'error' in the repair work.
Definately keep me updated. I'm wondering if you had the MRI yet? I guess the 'worse' scenerio is if the tissue gets pulled away from the hip bone. I also did the rest/PT/roller ball/etc. work and nothing. These apparently always will be a lifetime injury until the surgery repair. I've heard if your sane with the recovery, it's unlikely to re-occur. About your marathon, I can't say I wouldn't go for itif you trust your source on the idea that we're not making this injury worse with running. How much pain are you in? My injury switched when I started feeling it more at rest. What's a bit strange is that I feel it the most when I have to move my right foot in that tiny motion to hit my brakes driving. I'll definatly also ask this guy about the running w/the injuryif so, I'd like to get another one in. I felt no cardio strain on 14 miles, and I'm not big on getting bothered by pain. I was also thinking it wouldn't be a problem to train for a fall marathon, and how frustrating to give that base up. I guess the day will come that we'll have to take the time off, but putting it off is sure appealing....
Good luck on your training--and keep me updated. I bet the adreneline will obliterate any pain once you've got your tag pinned on your shirt at the starting line!
Laura
Well from all indications, that Surgeon in Vail is the absolute best. I have also heard that since this surgery is fairly new (10 years or so) there are very few surgeons who do it (and do it well.)
While i totally understand your fear about an error in surgery it seems like going to the best doctor and the fact that this surgery is done with a tiny tiny camera and a laser should help to allay those fears!
I have had an MRI, which showed the tear (though they were looking for Stress FX)...
My suspicion is that since you had no cardio issues with 14 today, your superior conditioning will allow you to recover somewhat quicker than others. For me, I am not in as superiour shape as I am training for my first marathon (ive only been running for 2 years!) You may have to suck it up though and do the hand-bike for the first couple weeks out of surgery!
My pain is intensified when i run. And i agree if i take it easier, the onset takes longer. If i take a day off and then run, i dont usually feel the stabbing every step pain until mile 3 or so...then it intensifies until i stop. My pain is right in the groin are (sorry) and extends out to the outside of my hip...and at its worst feels like a sharp stabbing pain on a step..
The pt usually has me screaming when i am on my back and he has my knee up and is rotating it externally...ouch!
Question: Do you ever get the feeling that you are just getting used to the pain? I am remembering back to the first morning after i sustained this injury and i couldnt even walk without extreme pain and an insidious limp. Now it nags me, but i have no noticeable limp.
I was just so happy to be out there on a 20 mpw clip again!
So when are you scheduled for Surgery...ill be keeping an eager eye out for posts!!!!
Best of luck and enjoy Colorado (I went to college in Colorado Springs and I miss the 300 days of sunshine!!)
Jeremy
Sorry for such a late reply.... I was browsing around looking for a certain topic and came across this...
I had arthroscopic surgery for a torn labrum in November of 2004, and I'm so glad I had it done. It took 2 years to finally get a diagnosis for the hip pain I was having (I can't even tell you how many orthopedic doctors, PT's, chiropractors, etc., not to mention how many MRI's I had), but I finally went to the right doctor who knew right away what it was. The surgery was a breeze. It was day surgery. I was literally walking with ZERO pain in 2 days. The first day after the surgery I was sore, but I could not believe how I felt when I woke up the second day. I was told not to run for 6 to 8 weeks, and that was seriously all it took. I felt like I could have run sooner, but I thought it would be smart to listen to the doctor. During that time I was able to do the elliptical, bike, swim... anything that didn't cause impact.
Hope this helps.
Me too!
See my recent reply in another post:
I was diagnosed with a labral tear (two tears, actually) in my left hip (groin) about a year ago. The doctor gave me three options:
1. do nothing
2. cortisone injections
3. arthroscopic surgery
I decided to "do nothing," with the very important exception of strengthening exercises for my hips. The ortho recommended leg lifts targeting the gluteus medius muscles (very slow, 3x30 on each side). It has worked (for me) wonderfully well! If I slack off on my exercises, the pain comes back.
As a bonus, keeping my gluteus medius muscles strong seems to have prevented recurrence of my ITB issues.
Since my diagnosis, I have continued to run 20-25 MPW (same as before the injury) and race every couple of months, distances from 5K to 10 miles.
I've since added swimming to my routine and this does not seem to aggravate my hip in any way.
Good luck and let me know how it goes!
Susan
=====
I should add that my ortho doc said there was no reason I could not continue to run as much as I wanted. (No doubt he's waiting for me to have more pain so I can come back for the surgery!!)
Thank you both so much!
Actually, the new development yesterday was that I received an "Addendum to report" from the MRI folks. I'm not sure why they decided to re-review my scans, but it's now showing that there are actually two tears....There's also a bit of fluid. The other thing is that my pain is definitely getting worse. Yesterday was the first day where I was actually distracted by it while working at a desk. I think the Rebox x-trainer is putting too much resistance on it. I'm about ready to just resort to upper body and pilates.
I'm also hoping that somehow this injury could be related to the knee problems on that side. Any experience there? My theory is that perhaps that injury asked the knee for some compensation that resulted in a knee problem as well. Or, wishful thinking?
The frustrating part is that this doctor seems impossible to get a hold of. It's encouraging to hear that one of you was able to walk so soon--I feel like I need to have this surgery before teaching starts again.
But, wow, thank you SO much for taking the time to share your experiences.
I miss running. I feel like a little kid PROMISING that next time I'll be good. No over-training. I wish I could implant that message in all the enthusiastic, indestructible folks like me.
Again, thank you.
Hello all,
After 3-1/2 years, countless doctors and misdiagnoses, and never giving up... I finally found a doctor who ordered an MRI arthrogram and found an acetabular labral hip tear in my right hip, and loose bodies. Before signing up for Hip Arthroscopy, I’m having a "right hip intra-articular injection of local anthestic and cortisone" to be certain of the tear. Has anyone had this injection before?
The last few years have been awful to say the least. I went from being very active to nearly sedentary. So I'm grateful to finally have an answer, however I'm concerned how well my body will recover. The tear itself occurred 3-1/2 years ago... I'll never forget the sharp pain with each step, and yes, I remember the torture of moving my foot from the gas to the brake pedal. Since then though, the area surrounding my right hip joint has changed bio-mechanically in order to support the instable hip joint. My right pelvis developed an anterior tilt, the oblique muscle does not function as well, I have burstitis, lower back pain… I’m hoping if I go through with the surgery that this area of my body will eventually “move” back to it’s normal position and function.
Is there anyone who has had this type of experience? And has had the surgery years after the injury occurred?
I was also wondering how all of your surgeries and recovery went?
Personal experience, doctors, websites… any information and experience you would be willing to share would be greatly appreciated. I’m desperate to run again. To have an active life again. I’m just 31 years of age. Far too young to cash in my chips.
Thanks in advance!!!
Dear kcstone017,
HiI'm the one that started this thread, also looking for anyone with experience with this. I've now met with the surgeon at the Steadman-Hawkins clinic, but the price quote is insane and I don't hold out much hope for hearing back from my insurance company. Then again, like you, I'm 32 and not willing to give up running. <br /><br />From what I"ve been hearing, contrary to before, this is actually a somewhat rare injury in that the surgeons who treat it are not found easilyI'm wondering if you were referred to anyone? This guy is great, but he's also an elite specicialist, and I'd rather 'take my chances' and be able to get it done by another surgeon.
My MRI confirmed what yours did, actually two tears and fluid, and then the X-rays indicated that there is some ridging in the bone that they want to 'shave down.'
I'll still waiting to hear more and I tried to quit running, but I just can't, so I'm going about three times a week. But slow. If I go slow, it's okay. Some days I'm in pain afterwards, some days not. The longest I've gone is 11 miles. Epson salt baths after the runs seem to help (and they're a lot nicer than the ice baths I used to take).
Beyond that, that's my update. As far as your body "re-aligning"--I feel like I can assure you there. You're 31, you're obviously an athelete, and our bodies are amazing in what they can do. I'm a huge fan of pilates and in our class we do a lot of work on aligning/evening muscles. It's amazing how much even a 'normal' person has out of whack. So, I bet that will just be like a PT process.
Let me know anything you find out! Best of luck, Laura
Hi, just came across this thread and had to contribute if anyone is still checking in on it.
I just moved from Denver in April to NC. Getting in some end-of-season skiing at Copper in March I fell on a black run and pretty much landed hard on my right side. The next day I was a bit sore and by the next my hip was bothering me. I rested, did some massage therapy, anti-inflamatories and although it still hurt it was bearable.
When we drove 26 hours to NC it was really stiff so I decided to see a dr. just to be sure. My primary took an xray that was clear and referred me to sports medicine Orthopaedic - Dr. Hardaker at Duke University. He did an MRI and suspected a labral tear right away - yup that's what it was. He said many people live with them, some unknowingly. His advice was to resume activity if I was feeling up to it and see how it goes...now I'm training for a marathon and doing okay but started with some knee issues last week, going to Dr. tomorrow. I know with mine, the surrounding muscles (esp. glutes) contract to 'protect' the injury so I can get some pain from the tightness of those. I think that the knee issues are also from compensating for the hip (without realizing it) - we'll see tomorrow.
Dr. H. said that it will NOT heal, they need to cut the flap of skin off that is torn to reduce irritation and that 99% of people are perfectly fine and pain free after the surgery. So it was basically live with it or have the surgery. But he was well aware of the condition...I think it was a HUGE benefit seeing a sports-related dr. because they don't tell you you're crazy for running, they try to help you resume your chosen activity. He is a well-known surgeon for sports related injuries.
Have you tried a second opinion? I seem to remember when I was in the Denver area that there was a Broncos Sports Medicine facility - somewhere like that may be worth a consult.
Keep your fingers crossed for me that I can get my knee issues worked out and continue training. Please let me know if any of you went through with the surgery!
Y. 
Hi Laura,
Thanks so much for your reply. I hadn’t realized you responded already… I’m new at “message boarding”.
I’ve looked at the Steadman-Hawkins website after hearing about Dr. Marc J. Philippon. Is that who you met? I’ve heard the cost of surgery can be around $7-11k. I imagine insurance would only cover a portion, if that, and then add on travel costs (I live in the DC metro area).
I was referred to my current doctor by another doctor who moved his practice out of state a day later. He was pretty adamant about doing research on surgeons as not many are well-practiced/skilled with hip arthroscopy, and not to be a “guinea pig”, etc. He also advised finding a surgeon who’s experience began with shoulder arthroscopy and then moved onto hip arthroscopy.
Surprisingly, the cortisone shot my current doctor had me get has helped a lot in buying me some running time. And my alignment issues aren’t as bad. It’s pretty amazing.
Like you, if I run slow and break it up with walking intervals, take days off in between, and ice when needed, I seem to be okay. I have good days and bad days. My fear is I only have one- three weeks left before the cortisone wears off, and running becomes painful again.
Also a huge fan of pilates! I take reformer classes two-three times a week. However my instructors are now getting concerned and limiting what exercises I can do.
So now I too am questioning do I “take my chances”. I made another appt. w/my Dr. to discuss another cortisone shot and surgery options.
This I know… it won’t heal on it’s own, I can’t quit running, and I don’t want to be living an inactive life in discomfort for ‘xx’ number of years… that’s not a life.
Continuing to do research. I’ve read of other clinics to check out in the following states: Tennessee, Washington, Pittsburgh-PA, and Oklahoma (www.okss.com).
I appreciate you sharing your experience Laura. I’ll let you know what else I find out.
Take care,
Carissa
Thank for sharing too ybeal. That's just it. It won't heal. And I feel like all I need is the cartilage at the tear removed. There's just so few doctors that are well-practiced in the hip arthroscopy that taking my chances with a local sports med surgeon (I'm in the east) feels like such a risk. On the other hand, it's become obvious I can't live with the tear.
Anyway, some research to be done this weekend, and I have another doctor's appt next week.
Thx, Carissa
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