Miss Osage County wrote:
Hi "curious what happened",
In typical Miss Osage County fashion, here are some long-winded answers to your questions... ;-) thanks
(1) So did you get positively diagnosed for a labral tear?
Yes. It took from Feb '09 to Jan '10 to get a referral. When I got it, I chose to go to SimonMed in Scottsdale, AZ because: 1) Dr. Lund there is highly regarded in the west and considered the best hip radiologist among the professional sports teams there, and 2), because they have 3Tesla MRI machines which have the strongest magnets presently in use and consequently produce the best images. (Knowing labral tears aren't always visible on MRI, I wanted to reduce the likelihood that it would be missed by getting a 1st-class radiologist and a 1st-class machine.) My arthrogram confirmed a large anterior-superior quadrant labral tear from 1-3 o'clock.
(2) How bad?
I'm not sure as the next step in this process is for me to have an ortho-consult and I haven't yet. I've been told that's when things will be explained in detail. From what I've read, in almost every surgical procedure, there are issues that may not have shown up on the MRI but are visible when the surgeon gets into the joint. If they found the tear when I was 23 instead of now, the prognosis would probably be a lot better as I've been dragging around my left leg for quite some time now!
(3) Which physician?
The process has been explained to me that you contact a few surgeons and you will be asked to send your supporting materials and it goes from there. They will determine if they want to do surgery on you, and you determine if they are the surgeon you prefer. I don't have a surgeon yet.
(4) What was/is the treatment?
There are 2 types of labral tears: a flap tear that comes off the wall of the labrum and fissure that is a disruption or crack in the labrum. Flap is like when the skin comes off a blister but is still partly attached. Fissuring is like when extremely dry bare earth cracks. Conservative treatments like PRP (platelet rich plasma) can be tried on fissuring because it can help the labrum cartilage regrow and fill in the defect. But, I have a flap tear, and that type must be surgically repaired as it causes the hip joint to lose stability and thus inhibit proper functioning of the joint. (and when the joint is unstable and the muscles try to compensate to continue to allow the joint to try to function properly, we get the gait disorder/loss of muscle coordination)
(5) How long recovery?
From what I've read, 4 months till you're up to even running 30 minutes continuous and 12 months till full recovery. But, there are always outliers and I hope to be one of them. I will be as cautious with running as I'm told, but I'm going to do my rehab like a madwoman.
(6) Are you completely recovered and back to running as before the problem?
n/a... BUT I sure as hell plan to be! I think the thing we all have to remember is what a special group we are that we've lasted this long and have been this tirelessly dedicated to finding out what is going on with us, all the while still trying to do the best with our own running as our bodies allow. That is part of our inherent nature and those traits of tenacity and optimism are going to be the same traits that increase our likelihood for maximal recovery, be it from surgery or anything else. If you've believed in yourself enough to keep looking for an answer and reading and posting on this board for years, don't you believe in yourself enough that you can successfully get through the most arduous of rehabs that a doctor may have to throw at you, that no matter what recovery may call for, that you can do it? I mean, we're all here. Just as we've looked for an answer together, we can help each other get through the next steps.
(7) Was 'pilates type' core strengthening (as suggested in this thread by foomiler, et. al.)prescribed as follow-up?
Since our bodies have all managed to keep us running through this injury by figuring out various ways of compensating for the loss of stability in our hips, I've been told I will most definitely be doing a lot of core work and retraining the muscles to do their job as they're supposed to. I imagine I've created some pretty bad neuromuscular patterns that will have to be addressed.
(8) Did a weak core, resulting in fatigued pelvic tilt, contribute to injury, if it wasn't the primary culprit?
No. I don't know what caused the labral tear and it's been very hard for me to get over the fact that it will probably remain a mystery and to stop obsessing about it. It could've been anything. I may have fallen one day and don't really remember-maybe I did something, my hip was tight, and I don't remember that I did have hip pain for a couple of days after a run or something back in 2001. Even the impact of falling hard on your knees can cause damage to the labrum in the hip socket as that joint absorbs some of the shock as well when you fall. I think it's key to understand that you don't *have* weakness that CREATES a tear. You *develop* the weakness or muscle imbalance because of an INTRINSIC CAUSE, the tear itself. My left VMO didn't become 25% weaker than my right and then my hip couldn't take it and then the labrum tore. It doesn't work that way. Again as I mentioned in earlier posts, I trained intensely with Bob Kennedy's trainer in Indianapolis for over a year and despite all the core work, my gluts *still* wouldn't fire properly and were *still* weaker on the left side; and that was even back in 2004 when my symptoms were much less severe... (I only name drop for credibility and for perspective; I had the opportunity to work with someone very accomplished in his field and even he couldn't help me get over the hump of one leg being stronger than the other)
(9) Were there other factors involved, like improper form/technique, etc?
Improper form didn't cause my tear, but I certainly developed some ugly tendencies in my form when my loss of muscle coordination problem would kick in. ie: I have big arms and it's not from lifting weights--- it's from a way of compensation my body has developed where I use my upper body more to run when my left leg starts dragging. It's as though my arms and back are trying to make up for what the leg can't do. But, my form wasn't this way before my injury- it evolved this way because of my injury.