General Discussion Triathlon Talk » Hip Labral Tear...need advice Rss Feed  
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2014-04-23 10:55 AM


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Subject: Hip Labral Tear...need advice
I’m in desperate need for advice. In February, I started experiencing pain in my right hip. I am a 45 year old male. 6’-2” 195lbs. I am not a long distance runner. I do a lot of high intensity training (uphill sprints, burpees, air squats, etc.). I don’t lift heavy weights, mostly body weight exercises. The pain wasn’t too intense but it has gotten worse. It was a dull throbbing deep in my groin, especially when I cross my legs. I also had pain in the front and outside of my hip. I kept training through the pain and ended up developing pain in my left knee (opposite side). This made me slow down and I went to see Dr. John Salvo at the Rothman Institute in Philadelphia. My x-rays looked good so he sent me for an MRI with a dye injection and a CT scan. The MRI showed a large tear in the anterior labrum of my right hip. The CT scan showed NO impingement (FAI). Based on everything I’ve read, this is unusual. Most labral tears are caused by impingement. Dr. Salvo recommended 6 weeks of PT to see if my conditions improve. The PT tested me and said my glut, core and hip strength is very good. He gave some stretches and exercises (clam shell, knee to chest, etc.). Here’s my question: is there any reason to go through the 6 weeks of PT instead of just scheduling my arthroscopy? I’ve become deeply depressed over my situation. I would very much appreciate any suggestions. Thanks.


2014-04-24 5:10 PM
in reply to: mcmric

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Subject: RE: Hip Labral Tear...need advice
I had surgery after 15 years and it still worked….

So I don't really know what the heal rate of an acute tear is, but waiting 6 weeks is not to long. You could even wait a year if you wanted.

But if you chose surgery: CHOSE YOUR SURGEON very carefully. Hip arthroscopy is very complicated/specialized compared to shoulder/knee. The surgeon has to know what they are doing. Don't go to the guy that does 12/year. Go to the guy that does 12/week. In 2008, when I had mine done, there were only 3 surgeons in the US who met that criterion…..
2014-04-25 6:03 AM
in reply to: DrTriKat


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Subject: RE: Hip Labral Tear...need advice
Thanks DrTriKat. After much consideration, your comments like yours and a visit to another orthopedic doctor, I am going to stay the course with PT.

You’re right; I need to avoid surgery at all costs. My x-rays and CT scan show no sign of impingement. I’ve made a decision to work towards eliminating the pain and to stop focusing on the fact that the tear may never heal.

My pain is moderate to mild. I am not working out at all because I want to get better as fast as possible. This is really creating a mental struggle for me.

How long did it take for your labral tears to become asymptomatic?
2014-04-26 7:05 PM
in reply to: mcmric

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Subject: RE: Hip Labral Tear...need advice

As a general rule 80% of people get 80% better after labral repair and maximum improvement after surgery is typically a year. My partner had labral repair 6 years ago and is at about 90% of where he was before his surgery. 

I've had 2 labral tears and repairs on the same hip.  Both involved bone revision, *much* less the 2nd time.  2nd time was on the same hip; I re-tore it when I slipped on the kitchen floor 6 mos. post-op (grrr!!).  My surgeon, who trained with Dr. Phillipon, the hip guru at Steadman Hawkins, said I was only the 3rd person in her practice to re-tear post-op so I wouldn't worry about repair making you more prone to injuring it again. 

Prior to 2nd surgery, my pain was 3-4/10 on a daily basis and sometimes as bad as 7/10. I couldn't stand or walk for more than about 15 min without increased pain.  2nd surgery was a much easier recovery than the first, partly because I did "prehab", strengthening the muscles I knew would most be affected, partly because there was less bone work, and partly because the surgeon also did a partial psoas release to reduce psoas pressure over the hip capsule.  I'm currently 9 mos. post-op and still have some achiness if I overdo it, ~3/10 pain at worst and it's gone by the next day.  I also need to use a foam roller on my ITB fairly regularly.

All that being said, I discovered the 1st labral tear while doing PT for a back issue.  After the 1st surgery, the surgeon said that there was a fair amount of scar tissue in the joint so the tear was probably old.  In hindsight, I think I should have held off on the hip surgery and focused on my back.  Could have saved me a lot of pain and depression.  At the time, though, I was just so relieved to find that there was actually something fixable that I jumped at the chance. 

Definitely give the PT a try.  If it's not better after 6 weeks, you can rethink surgery, but as DrTriKat says, really research your surgeon and use someone who specializes in working with athletes.  You might have to wait longer for an appointment but it's worth it.  The first surgeon I saw told me that I'd be back to work the next week and probably wouldn't need PT.  Since he specializes in minimally-invasive hip replacements, I'm sure he saw an early-40's fairly active woman and figured my recovery would be a snap.  Probably was compared to a hip replacement, but I still did PT regularly for about 3 months after both of my surgeries.

Constant pain sucks and can be really discouraging.  Hang in there and good luck!

2014-07-23 1:18 PM
in reply to: mcmric


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Subject: RE: Hip Labral Tear...need advice
Would love to know how this worked out for you.

I had the surgery back in 2011, have not raced or seriously trained since. It was a success, but I still get a burning pain in my hip. After a few MRIs, different doc's and PTs, no permanent solutions
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