hip impingement/ labral tear surgery

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Hey man. Good luck with the surgery. I had arthroscopic surgery to correct CAM-type FAI in my right hip last month (it will be 5 weeks this Friday). So far so good. I got to ditch the crutches last Friday (4 week post-op; was instructed to put 50% weight on the operated leg right out of the hospital). It's been a little weird walking around, trying not to limp and all. The only real pain I still have is some surgical pain, but it's probably just scar tissue and the such getting broken up by the physical therapy.

I first started having hip pain (more accurately side of hip/buttock pain) last April and really wasn't able to run at all after that. The pain was fine but my stride was WAY OFF and I developed other leg issues as a result. I was misdiagnosed with a muscle strain, but months of rest and treatment did not help. Finally an MRI arthrogram in November revealed the impingement, along with a partially torn iliofemoral ligament (either from the impingment itself or having an "off" stride).

The surgeon shaved off the impinging bone bump, and that was about it. My labrum was fully intact, but had started to bruise. My cartilage was fully intact and I had no arthritis in there. I think I would have had a torn labrum/cartilage if I had tried to train to through the problem. Glad I didn't. I don't plan on even trying to do ANY running until June (4 months post-op), and I don't dream of being back to my usual self (100-120 mpw) until AT LEAST the fall (6 months post-op or so). By that I mean I hope to venture back up to a higher mileage buildup beginning in the Fall, but I won't be doing any marathons until next year. I was feeling ready to bust a marathon in the mid 2:20s at the time of the "injury" last April. I've been told there's no reason why I won't be able to get back to that form again.

If you have any questions about the surgery, go ahead and ask. I never heard of this problem before the MRA came back in November. I hope to never hear about it again once I've fully recovered.

Are you having the scope or the open procedure? (Or the newer "hybrid" procedure?) What's the damage you know about now from MRI/MRAs? They never know the full extent until I poke around inside there.

Good luck, man.

I had a surgery to correct a labral tear and an FAI in December of 07. The FAI wasn't found until about a week before I was supposed to have the less invasive arthroscopic surgery. For the FAI, though, they had to make a frontal incision about 3in long to shave some of the femoral head, along with the 3 incisions for the labral tear.

They kept me overnight doped up on painkillers. One thing that was weird was the sensation that my legs were asleep when I woke up. Both legs were numb from the groin down for about a week. The nerves get jacked around during the surgery, but sensation comes back after 3 days or so. You will also probably have to wear compression leggings for a month to prevent blood clots. Also, prepare yourself for the aches and pains of a removed catheter. 8==> ----

As for recovery, I was completely off crutches after 8 weeks. Because of the bone-shaving, the recovery is longer than just labral repair with the arthroscope. Right now, I am just getting back into light running (up to 4 miles at 7:30-8 pace).

My doctor said getting back to competitive running and 100 mile weeks again is a question mark, but things are feeling so-so. My pain was radiating around the groin/hip flexor, but most of that is gone. However, the muscles are weak from being off them for 6 weeks.

Good luck with your surgery! All in all mine wasn't too bad, but then again, you don't have many viable options with labral tears and FAI's. Good luck, keep us posted!

Hey, thanks for the reply. I get an MRI in two weeks. My doctor said he expects there to be some damage to the cartilage and maybe a labral tear. I actually haven't run for about a year because of a sports hernia, but I have had this pain for the last six months or so. Hopefully since I haven't really run on it there isn't too much damage. Were you able to bike at all before and/or after surgery? I also have groin pain with mine that makes even biking painful.

I was able to use the elliptical right up to the date of the surgery (1 hour+ per day). I haven't tried anything post-surgery. The PT has had me use the recumbent bike for 5 minutes so far. I never had groin pain, just pain on the outer portion of the hip/buttock area. Seems for some folks the issue is the impingement is further "in" (i.e., groin pain), and for others, like myself, the pain is more "out" to the outer part of the joint.

I was able to bike and swim 4 weeks after the surgery. The first couple of weeks all I could do was use a CPM machine for 6 hours a day. After 8 weeks I could bike, swim, and do the elliptical, which didn't bother the hip too bad at all. I just started running again(3 months post-op), which is so-so. It has been getting better as the weeks go on, though.

Unless your surgery is much less invasive than mine, however, don't count on doing much for the first 4 weeks or so.

Good luck!

My surgery is going to be arthroscopic, so hopefully less invasive. What does FAI mean? I hope you guys will keep me posted on your progress, and I will do the same. Good luck healing!

Oh also, as far as lifting and core strength goes, how long before you guys could do that? I have some low back issues, and I like to keep my core strong so it doesn't flare up.

FAI = Femoroacetabular Impingement, which is the fancy way of saying hip impingement.

Are you getting contrast material/dye injected prior to the MRI (i.e., MRA or arthrogram)? Regular MRIs don't always show the impingement/labral tears. My MRI just showed a strained gluteus medius muscle. The MRA told a very different story.

There's a pretty good yahoo group dealing with this issue:

http://groups.yahoo.com/group/Femoroacetabular_Impingement/

However, there aren't really any other runners in that group, but the info and their experiences are helpful. Be forewarned though, most of their cases are a bit more severe than ours (presumably) because many of them waited years and years to get checked out. Many of them have had multiple surgeries, etc. I just didn't want you to freak out. Most people who have success don't end up posting once they're "fixed." I guess the running (or sudden inability to do so) at least got us into the doctor's office relatively quickly!

Yeah I'm getting the dye injected. Thanks for the link too, I have ran less than 50 miles total since this hip started hurting so I am hoping it hasn't progressed to far.It sounds like you are doing well though which is very encouraging. Just out of curiosity, what is your age? I am 24 which seems young to me, but my doctor said it isn't unheard of for it to occur in younger people.

justintherunner wrote:

Yeah I'm getting the dye injected. Thanks for the link too, I have ran less than 50 miles total since this hip started hurting so I am hoping it hasn't progressed to far.It sounds like you are doing well though which is very encouraging. Just out of curiosity, what is your age? I am 24 which seems young to me, but my doctor said it isn't unheard of for it to occur in younger people.

I'm 28 (was 27 when first started having problems last April). My operating surgeon (OS) mentioned that when FAI is diagnosed, it is not uncommon for it to be seen in "younger" athletes like ourselves. Non-athletes might not see the symptoms until a little later in life. I know my OS has operated on a number of NHL/semi-pro hockey players.

I was 22 when I initially blew out my hip at NAIA indoor nats. I went through 6 months of misdiagnosed rehab, though. I'm 23 now, but these tears and FAI's are being diagnosed better at a younger age.

Have fun with the dye injection. It's a hell of an experience having a bunch of doctors going after your groin with a huge needle. Not too bad, though.

Good luck with the diagnosis!

Hi, I just had my surgery last Thursday. I had extreme pain in my buttock and outer hip area. I had been misdiagnosed for over 3 years until I found a specialist who found the root of the problem. My pain intensity would come and go in waves. Since the surgery I have very little pain. It is just a bit sore. I had fai and a \\\"very impressive\\\" labrum tear. The doctor I had the surgery with is one of the best in the country. Luckily, he was able to anchor the tissue back together which will allow me to continue my professional bicycle riding career. Yes, the cathedar (sp?)part is not pleasant. Rehab will be a long road. 4 mos of PT three times a week. 3 hours a day on the cpm machine, and many restless nights from stiffness. It is all worth it though. The pain I was experiencing is something I hope to never revisit again. I wish you all the best with your surgical plans.

wow, it's really amazing to read about runners who have the same problem that i have! i've actually stopped coming to this website because i haven't run in so long. i was constantly misdiagnosed (for 7 years!). and in the past 4 years, i have been able to do very little running, and no running in the past year. actually, i think i have been misdiagnosed once again -- after all of these years, I finally had a doctor who thought this injury is a labral tear and he sent me for an MRI arthrogram. the radiologist on staff read the MRI and said, "normal hips, no tear." i felt really disappointed because i actually wanted the tear, i wanted an answer. but after reading through some threads on letsrun, i am more sure than ever. it prompted me to make an appt with a Boston specialist. I have all of the symptoms: impingement, clicking deep in the hip, pain in the left buttock, and hip flexor.

Have any of you tried to correct the impingement with hip mobilization? this is what has been recommended to me, but it's incredibly difficult work. i can't easily have surgery because i'm a mom to a 15 month old.

Welcome to the trick-hip club. Sorry that you were misdiagnosed for so long. Labral tears are hard to pick up, even with the MRI and Dye injection.

Your symptoms are spot on with a labral tear and/or FAI. If your Orthopedic doctor won't agree with your suggestion, maybe get into contact with a surgeon with labral tear experience.

If it is just the tear, you may only be on crutches for 3 days or so (good news). If there is a FAI as well (most likely), you may be on crutches for a month or so.

From my understanding and 6 months of rehab, the tear/FAI will not heal well, regardless of any strengthening, mobilization, etc. The joint is avascular, and will not repair itself very well. If yours has gone on this long with no improvement, surgery might be a must.

Good luck with getting properly diagnosed, and welcome back to LetsRun!

Thanks for all the new replies, it helps to see that some of you have recovered well from this.

I am getting an MRI (with contrast) on Wednesday to check for a tear. Just curious what were your symptoms? I have been in pain for 5 weeks with no running. No one seems to know what is wrong with me.

Justin- I have so much info! write to me.

thomasand3@aol.com

Mich

naty,

I have had groin pain and hip pain for quite a while, not just with running but with walking, etc. The pain goes into my butt and down my thigh. The groin pain is likely a adductor strain, caused by the hip impingement.