Rippling Hysteresis wrote:
If there’s scar tissue, EPAT/Shockwave therapy is great. It’s like a mini jackhammer and was the thing that turned around a 3-year hamstring injury.
It’s a little pricey, but for me at least was completely worth it.
Interesting. I haven't heard of shockwave so I'll look into it. Wondering if that could really get close enough to the joint in my situation.
Not My Real Screen Name wrote:
Hip replacement surgery.
I've considered this. Seems that people can have replacements and have a better outcome than I've had so far
Sp33dForc3 wrote:
Get another MRI, see if the labrum is torn again
I did have an MRI after the pain returned. It was negative. However, the Dr. also said it's very hard to determine after they've done a repair, but apparently it's not very common to retear(?)
I've had a total of three MRIs all at different place and with different radiology reports. All were without contrast. Some things I've read online say that you should use contrast, while others say it gives a lot of false positives. My second two MRIs were done at places in the northeast that work almost exclusively with athletes and are supposed to be among the best in the US, if not the world.
deathbycalf wrote:
Female. A few years older than you but had FAI and labral tears in both hips. Both repaired by world class surgeon. After both surgeries did well and return to running until at about 8-9 months, when pain came back. In both hips I had a second surgery expecting to find another tear but instead found only a big gob of scar tissue. If you have the predisposition to form it scar tissue is a beeetch. I’m fine now btw.
I would really like to know more about your situation because this seems like one of the likely scenarios for me. How long ago did you have the revision? Who did your surgeries if I might ask? Did they give you any indication about the likelihood of the scar tissue returning?
Ok...you need to "clear the spine" first. Most times this is referred from lumbar. Try this exercise 10x every 30 to 60 minutes. If it works your pain in hip will eventually abolish but you may experience increased low back stiffness. Dont let that stop you. Eventually the back pain will ease.
If you do that for 2 weeks and no change then try this one.... Make sure your opposite shoulder is on the wall. Perform 10 reps every 30 to 60 minutes. Same as above...hip pain should abolish but may increase low back stiffness...
Good luck
Make an appointment to see Dr.Philippon at the Steadman Clinic in Vail , Colorado.
If he fixes you, you can pay me $500 and save the rest . He is THE Best and the post surgical protocol ensures great outcomes.
done
i had this injury
chiropractor.
Did they re-shape your acetabulum or head of your femur? If so, after your surgery did you take any kind of steroid while going through the healing process? The use of a steroid after any joint remodeling surgery is important to keep down the inflamation and prevent the joint and bony surfaces from healing improperly and developing spurs. I was prescribed prednisone after my FAI surgery and personally know of one person who did not do this in conjunction with their FAI surgery and they developed imperfections on the bone surface and ended up tearing theirs a second time. There is a doctor named Jovan Laskovsky that I would highly recommend looking into, he is in Ohio and I believe you mentioned being from PA but he is the best of the best when it comes to the hip
Yep, this is the guy who does all the surgeries for the professional athletes in that area. If you can afford and it live near there, that's the guys to see.
i have had an injury going on 3 years and 1 month now. Like yours, mine started out minor and progressed. Seems like the problem just keeps moving to a new set of issues. I have the same dull pain in the hip and back on the right side (along with some hamstring tightness). I have gone ahead and trained through it - but it hasn't been fun.
My best source of treatments is two things:
1) smashwerx videos by Trevor Bachmayer (easy to find on you tube). He is absolutely excellent (way better than any of the chrino videos because he tells you what you want to know - why does this hurt, how to stop it, and how do i prevent it).
2) a lot of times what is hurting is not the problem but the result of tightness or scar tissue somewhere else. For me, i have discovered a hamstring injury from years ago was causing tight hamstrings = which is causing the tight back= which then causes the hip pain. what i find that works is deep message/rolling to break up that scar tissue and gain mobility in the hip flexors. I also do some light strength training.
My mistake here has been these strengthen drills works do well (often providing immediately relief) that i over do them. I have really had to learn to progress very gradually. Right now the two best strength drills that i do are
* step ups - i usually start with 10 lbs in each hand and simply find a small step or box and step up on it and back down x about 5 or 10. and do this twice. then because that starts to feel good i move up to 15 lbs per hand and reapeat (usually do a little less volume each time i step up in weight). then 20 lbs. i have been stopping there lately after learning that more is not always better. i will also move to a higher step/box - at first i do this with no weight. i should probably stop there, but again i push it sometimes and add a little. i need to add THERE IS PAIN WHEN I FIRST START but it goes down as i progress
* not sure what to calls this next one, but you prop yourself up by your elbows so that your legs are hanging free....and simply pull your legs up as high as possible (knee to chest is the idea). in fact in one of his videos, Bachmayers says if you are standing on the ground and cannot do this easily - you have a hip flexor problem (which i did). you can have some one push down on your knee as your balance on the other foot as another test of the hip flexor. if you can not resist at all - bingo you have just identified another weakness. which reminds me of a simple drill i did in the beginning where seated at a desk simply raise your knee into the desk and push - this will help strengthen that hip flexor. as you get stronger - the handing version of this can be done - with light, light weight added. maybe 5 lbs at first. i am up to 10 lbs now. first time i did it, i was so sore the next day - so keep the reps short - a few as 5 per set with only 2-3 sets first time.
* the other big thing i do is rolling, but not rolling the way most people do it. one problem with traditional rollers is they don't go deep enough if you have one of these scar tissue issues - as i think you do. So what i did was made my own homemade version. I took one of those long foam rollers and cut a 12-16" piece off the end. i then cut that horizontally so that i have to equal section with each having a round side and flat side (the flat side is what you need). I then place a tennis ball on the round part with the flat side down on a firm surface. what this does is props the tennis ball up so that when you lays on it or put it under your hammy it can really dig in. find the spots that hurt - and grind on them. spend as much time as it takes to make the pain go away...also you can move the out limb - like the lower leg when you do this - and this is the key because when you do this you are helping to break up that scar tissue. it won't magically go away over night, even though you will get immediate short term improvement. each day the tightness comes back. but over time it will gradually get better until one day you will notice it is gone.
i hope this helps you. i absolutely know the frustration you are going through because i am right there with you. i am so close to being injury free after 3 long years. i never went the surgery route but did try a chiro at one point with little success...because i was already doing all the things he did. this is where the smashwerx videos come in. just google the pain and smashwerx and you will get some drills you can do at home, right now. and they work!
finally i found a new exercise just this past week that really helped reduce the tension in my low back. sometimes you just have to try different things and will then find something that works. i had been doing rowing - which was working to loosen up the back. but one day i again over did it and it made it worse - so now i find that simple legs press machine is better for me because it is easier to control the speed. i use no weight at first and simply do a slow, deep leg press. x 10
i added just a little weight after a while (i think it was 2 50's, but have since cut that back to 2 25's - it is just enough to add a little pressure. this has worked great for the back tightness which then helps the hip. it is all connected. so keep trying different exercises. i believe the solution is in exercises = movement = and reducing the scar tissue from the original injury.
This might sound dumb, but try supplementing with 3g of taurine a day. It’s an amino acid, really good for you regardless. It has helped my hip pain immensely. Also would like to echo what others have said about pelvic anterior tilt. Good luck!!
Hi Disgruntled Pelican, it sounds as though you have comprehensively exhausted many medical options. In my experience, all the stress and such from that experience can and often will lead to compensatory patterns in hips and spine that appear only in specific postures or duration(s) of time under tensions. This would explain why it is difficult to reproduce the pain in a medical office... in those settings, they are often guiding you into alignment prior to assessing your movements. Taking this a step further, suppose one of your hips has dropped or risen (even slightly) during the course of treatment and repeated injuries, then that would accumulate over a long hike like you described and be very difficult to diagnose with imaging of any kind. Depending on your location and access, it may be worth your time to visit a Spine/Pelvis alignment specialist and/or have a PT with specific certifications/education evaluate your habitual and coordinative postural framework(s).
I don’t want any money. Happy to help. Was stuck for over a decade with lumbar/thoracic issues that sent me to doctor after doctor until a similar approach to the one I described above helped me to start “unwinding the knots” of years of injury and subsequent compensatory patterns. Hopefully this is helpful!
First of all, I’m not a doctor, and this is not medical advice. Just had to get that out of the way.
Now, it could be a plethora of things. You didn’t give us that much information about the pain location. You said that it first became unmanageable when you did a long hilly run. This led me to first think that the anterior hip pain may be caused by your rectus femoris, a quad muscle that acts as a hip flexor. It spans both the hip and knee joint and can cause both groin and anterior hip pain. This ones simple to assess. One can do this test but it’s easier to just stretch it like this and feel if it’s tight.
Stretch:
It’s important to keep the spine neutral and deepen only by keeping the hips forward btw.
Test:
With this injury, one might do the stretch above a couple of times per day after warming it up and/or foam rolling it. Not too much as to not inflame it further.
It could also be femoral or sciatic nerve pain. Not necessarily caused by a bulged disk or compressed nerve in the back but can also be cause to it being compressed anywhere along its path by a muscle or myofascia. Femoral is more the front of the hip but the sciatic nerve can also cause side/anterior hip pain (although pain is more posterior usually). With these, one could do a nerve tension test. They would hold the following positions and see if the pain is reproduced:
Femoral(skip to 2:13):
Sciatic (0:48):
For these, someone would do a combo of nerve flossing and daily stretching of the muscles along the path of the nerves in order to improve. That is if it’s not a back issue which a bit tougher and they would probably need to do the McKenzie method, which is best done with a certified PT (not all PTs know the McKenzie method so make sure to do your due diligence).
But yeah, just my 2 cents. If I get paid off of this info, great! But hope you feel better.
I’ve had hip issues for the last decade that started similar to yours - the ‘thon did me in (ok training 2x a day + stupid long/fast runs training for the ‘thon). I’m now 100% pain free and back to crushing masters races. How?
Electrified dry needling of the tfl, rectus femorous and illiacus. Charlie Merrill in Boulder is my guy, but there’s lots of folks who can do this. If it works please donate the $1500 to School of Mines XC.
Sounds extreme muscle tightness to me too. Short hot shower -> massage/foam roller -> stretching -> ice, in this order a couple of times a day. Might be painful in the begging and progress is slow.
Good luck!
Sorry to hear about all your problems with hip pain. I know what you're going through because I've had hip issues for the past 10 years off and on. I'm also sorry, but not surprised, to hear that no one has been able to help you, and that the so-called experts may have made the problem worse.
As others have mentioned, the hip may not be the issue. In my case, the first time I was having problems, they "found" a labral tear via MRI and wanted to do surgery, but I was skeptical, so I went to another doctor who was actually good (Terry Nicola in Chicago), who quickly ruled out the labral tear as the issue and did an x-ray, finding that I had inflammation in my pubic symphasis, and gave me a dextrose + lidocaine injection there. The injection basically "cured" me in the sense that I went from not being able to run at all to running with no pain within a week or so. Keep in mind that I never had any pain in my pubic symphasis. It was always hip and adductor pain.
The first time my pain recurred after a few years, I screwed around getting massages before seeing a different doctor who suggested a steroid injection in my pubic symphasis. This basically cured me again.
After 3 more years, the problem recurred again about 18 months ago, so I went straight to another doctor for an injection. Only this time, it didn't help. So I went to see a chiropractor who works with runners, and he found a lot of adhesions in my quads, adductors, hamstrings, and abs. After spending a lot of time and money with him, and also working on these muscles with a theragun, my pain is much better but not gone.
Since you have had the pain for so long, I suggest going to see a chiropractor, but ask around with your runner friends to find somebody who knows running injuries. It's possible that muscles and tendons connected to your hip have gone into a long-term panic mode, seizing up and adhering to each other. I know those aren't medical terms, but I'm not a doctor, and this is how my chiropractor described things to me in layman's terms.
If noone has said stop sitting down yet, I will win if it works.
Never sit in chairs, or on the floor, or anywhere, unless you absolutely have to. Stand up, or lie down. No in between.
Reengineer your sitting activities so you can do them lying down or reclined without hips flexed.
I've been in the same situation, struggled with hip issues for a few years. Also had arthroscopic surgery to fix FAI / labral tear. However, about 6 months post op, noticed some of the pain returning after returning to the regular gym workouts.
Originally was really bummed out, but did lots of internet research and at least what I think the issue was for me, was that the surgery solved the structural damage I had done to my hip, but it didn't solve the muscle imbalances and overcompensating movements I had built up over the years.
What solved the pain issue once and for all for me was incorporating a regular 5-10min routine of exercises and stretches I started by doing daily and then ended up just doing prior to exercise 3-4 times a week. The focus was on strengthening the glutes and abs (glute bridges, clamshells w/ band, etc.), while stretching the back and hips. And focusing on using proper form and muscle activation in the gym, running, etc. I'd even flex my glutes while walking around, which I'm sure would have got some weird looks if anyone actually noticed.
I think femoral glide syndrome is a real thing, where if your hips are tight they'll pull your hip bone forward, which can be damaging the labrum. Only by stretching the hips and tightening the glutes, can your glute muscles pull the hip tighter into the socket, keeping your joint free of obstruction when you move and keeping it healthy.
Oh and like others have said, take regular breaks from sitting. I'll sometimes kneel on a pillow in front of my work computer on 1 knee, allows me to stretch one hip at a time while working.
Good luck, hope you find your solution and can enjoy that money for yourself. I can definitely relate to times when I would have just paid whatever to someone who could fix my problem!
Could be EDS. Ehlers Danlos Syndrome
I'm a PT in the DC area that deals a lot with these kind of issues. Let me know if you'd like to discuss over the phone further, or if you are ever in the DC area stop in and I can check things out.