You might want to ask your Orthopeadic about Femoral Impingment. This is a very undiagnosed problem that results in hip pain, sometimes in the butt. Effectively the head of the femur is ever so slightly misshaped (not visible on a standard x-ray) and over time as it 'hits' the acetabular it will finally tear the labrum. The excercises you described will have agravated such a condition. Have a look at the following link for more information.
It can be very effectively treated with either an arthroscopy or hip surgery.
Labral tear - hip surgery
Hi, I'm living in Tauranga, New Zealand.
I'm to go for Arthroscopic surgery on my right hip, for a labral tear repair and removal of a cyst. This is booked for Tuesday, 14th February.
Although I've had several other unrelated surgeries, I'm a bit nervous about this one as I can't seem to get much information.
I've only recently heard that surgery isn't always successful long-term.
As I've had the problem for 9 years -
(was doing an exercise in aquarobics when I felt a "snap", and it's taken 8 1/2 years to get a correct diagnosis with a new surgeon I visited last August. He knew straight away what it was because of my symptoms and an MRI confirmed it) -
I'm keen to get some relief at long last, but now having second thoughts if the surgery won't be long term relief from the pain.
Can anyone give me peace of mind I'm doing the right thing going ahead with the surgery, as it's not too late to pull out.
My surgeon is very hard to get hold of and is only here once a week.
Labral Tear-Hip Arthroscopy
I am 7 days post Hip arthroscopy to repair/"clean" out the labral tear I had as well as remove some cysts. I had Perthis Disease as a child (causing avascular necrosis) which caused my left hip joint to be flattened thus causing a tear of the acetabular labrum.
So far the pain that I had in the groin and the buttocks region has been resolved. I have had no pain since the surgery which so far seems to good to be true.
My first day of therapy was on the fourth day and was placed in the bike to do some cycling and leg lifts. Yesterday was my second day of therapy and they had me do some strengthening exercises after cycling for about 15 minutes. By the way, the first five minutes of cycling yesterday were painful as I felt my hip get "stuck". I was told it was probably from adhesions that were forming. After the initial onset, the pain went away and the hip was doing good.
I started having some pain today in the buttock region; however, it is probably from being on my feet for about two to three consecutive hours. My ortho specialist did tell me to take it easy for a week or two.
For those who are having the surgery, My BEST TO YOU...For me it was the best decision I could have made... The ortho said I was too young for a hip replacement (I'm 36 yrs old) and that this would at least lengthen the time before I need one.
Labral tear - hip arthroscopy
Title of previous posts incorrect - should have been as above.
Labral tears and pistol grip deformity
I'm glad to have found this forum to check out the experiences of others and share those of my own. I'm a 42 y.o. fairly avid cyclist who experienced my first hip pain in Jan. 2004 while doing plyometric exercises (giant skipping, explosive sprints, etc.) during a "boot camp" workout program. My initial symptoms were a dull ache and pressure when taking long strides and pain when running. I saw a PT and had some deep muscle work soon after the injury but without any real improvement. I was able to ride strenuously that cycling season but still unable to run so I visited a local orthopedist and after an MRI discovered I had a labral tear.
The ortho also diagnosed "pistol grip" deformity - referred to as femoroacetabular impingement (FAI) ? and recommended an open surgical dislocation procedure to reshape the head of my femur. Since I had never experienced hip problems before, the thought of undergoing this fairly major surgery seemed excessive. The ortho also said he could simply arthroscopically remove the torn labrum but that it wouldn?t address the underlying impingement issue.
Thinking I was being conservative, I opted for arthroscopy and in early Dec. 2004 had the surgery without incident and with really good results ? at least initially. I was off crutches and pain meds in 2 days, back at the gym riding a stationary bike in 2 weeks and out riding my bicycle in early Jan 2005 (on an unusually warm Maine winter day). By mid-Jan I was weight training with no apparent ill effects.
Unfortunately, in early Feb 2005 I had a cycling accident where my bike slid out from under me and I ended up doing a split on my recovering hip. The pain was intense and I knew immediately that I had really messed it up again. Upon my visit to the local ortho a couple weeks later, I was informed that even if I had re-torn my labrum the underlying pistol grip had to be addressed in the course of repairing the tear. I still wanted to avoid the open surgical dislocation and sought out a second opinion with one of the most prominent hip arthroscopists in the US.
In July 2005, I had another MRI and CT scan done and the ?expert? wasn?t able to find any obvious signs of labral tears. He also wasn?t a big proponent of the impingement theory for explaining why tears often occur in the first place. So I had my local orthopedist recommending open surgical dislocation and the ?expert? telling me I was fine and not to worry. The trouble was (and continues to be), my hip still hurts and I can?t strenuously ride my bike, run, hike or ski.
After the fair amount of research I?ve done on FAI I?m now convinced I should?ve taken the initial advice offered by my local orthopedist (address the impingement with the open procedure) and that the ?expert? probably misjudged my case. In fact, there seems to be a growing body of literature that supports the idea of FAI as a significant underlying cause of labral tears. Much of this literature also suggests that if left untreated, FAI will almost inevitably develop into degenerative arthritis and that reshaping the femoral head can slow or halt this process.
Consequently, I?ve got an appointment in a few weeks with my local ortho to finally accept that I need to have the open surgical dislocation. I can?t bear the thought of being consigned to a life of inactivity and hope to regain some of my previous physical capabilities and remain active well into my later years. I?m too young to have an old worn out hip! And it sounds like all of you are, too!
Thanks for the opportunity to share my story and I?ll check back frequently to see how you?re all doing. Also, if any of you would like links or PDFs of the documents I?ve found in my research just send me an email (firstname.lastname@example.org) and I?ll send them to you. (You could also do a Google search for ?femoroacectabular impingement? or ?pistol grip deformity.?)
Portland, Maine (USA)
Article on Acetabular labral tears
Great article from the journal Physical Therapy
Lewis CL, Sahrmann SA. Acetabular labral tears. Phys Ther. 2006;86:110 ?121.
Acetabular Labral Tear + Arthroscopy/Labral Debridement
I am a 20 year old female who has a history of joint problems. I had a capsular shift performed on my shoulder at the age of 17.
After 5.5 months of frustration and misdiagnosis I am 7 days post op from Hip Arthroscopy + Labral Debridement.
I presented with severe pain in groin for no apparent reason. I am an active cyclist and whilst I had had a fall some months prior to the onset of pain, the sudden onset meant that there was no link to the fall.
Xray, CT and MRI investigations showed an Acetabular Labral Tear and moderate non-specific synovitis. Lesions on the Femoral Head were also shown which were possibly an indication of an Osteoid Osteoma (a benign bone tumor which causes night pain). This was later ruled out after they scared me by telling me that it might be a malignant tumor! The injury was so severe that I was basically on crutches for 5 months.
I was treated with 2 cortisone injections to no avail.
I have heard a lot about arthroscopy patients having little success after surgery and was fairly sceptical about the procedure but I have to say one week out I have no pre-op pain at all.
I was in hospital for three days (usually this is a day procedure but I had quite a lot of debride taken out).
A little about the procedure: it takes about 2.5 hours. Both legs were placed into vascular stockings and the leg that was to be operated on was placed into traction.Two small incisions are made on the outer thigh region where probes are inserted.
I walked out of hospital aided by crutches and continue to use them now one week later.
I had physio two days ago - passive movement is fantastic. I am still very sore and sorry but it is only going to get better from here in. My physio expects that I will be able to walk unaided in another week (slower than what other people have posted but we all heal differently!). The main thing that the groin pain is gone.
After months of chronic pain I now have relief and can get on with life.
To people who feel that there are no non-evasive treatment options left - I say "GO FOR IT". What have you got to loose?
Acetabular labrum tear-Arthroscope
:confused: Anyone interested in post-op recovery.
It is now 3 weeks, + 3 days since procedure. I've had a couple of physio sessions, including weight bearing exercises.
Still experiencing pain while sitting, with hip not taking any weight. Any change in direction, or sudden rotation of the hip causes it to "catch", resulting in sharp pain. Hopefully ongoing physio will strengthen muscles around joint, aiding recovery.
Anyone experienced similar symptoms?
Post-op recovery (hip athroscopy + labral debridement)
I know what you mean. I have had other joint surgery in the past (shoulder capsular shift - very invasive) and the body takes time to heal. It took around 6 weeks with my shoulder before I stopped getting the "catch" sensation.
I am sure that once you have regained muscle stability in and around the joing that you will no longer experience that "catch" sensation.
I am finding at the moment that I am compensating for pain by overusing my glutes at the moment and as such I am unbalanced. Did you have this problem? My physio keeps telling me off for walking with a stiff leg!
All the best.
Acetabular labrum tear - Arthroscope
:D Hey Jeff, PT, Claire & others,
Thanks for the replies fellow painsters. Jeff, this discussion has expanded somewhat from your original post and based on the global responses, this is the only forum on the subject. Shame it was not available when many of us were being misdiagnosed.
I have been undertaking physio, including light stationary bike work etc for the past couple of weeks. Originally advised my recovery would take 3 months to return to pre-injury status. Based on previous posts, I will need to discuss with surgeon and re-evaluate. My age may also be a factor in recovery, as I'm 44.
Acetabular labrum tear - Arthroscope
My appoligies James. That will teach me for attempting to reply to two forms of media at the same time.
The role of femoroacetabular impingement on labral tears
I've been following these posts with interest and some perplexity in that none really seem to address what may be the underlying cause of labral tears in many cases, namely femoroacetabular impingement (FAI). I appreciated Thihan?s observations that hip pathologies can be very complex and not very well understood, but in the case of FAI it would seem to be a relatively straightforward mechanical issue. As I mentioned in my Feb 13th posting, there seems to be a growing body of literature that supports the idea of FAI as a significant underlying cause of labral tears. Much of this literature also suggests that if left untreated, FAI will almost inevitably develop into degenerative arthritis and that reshaping the femoral head can slow or halt this process. Have any of you other folks posting to this thread had any experience with surgical procedures to address FAI?
Any assistance / feedback would be greatly appreciated.
Fred Dillon, Maine, USA
Below are excerpts from an article by Dr. Tom Sampson from San Francisco.
Hip pain in younger individuals has been associated with abnormal morphology of the hip joint itself. In recent times, there?s been more attention paid to acetabular and femoral morphology and its association with femoroacetabular impingement syndrome. Femoroacetabular impingement may reduce motion due to pain typically in flexion and internal rotation. This is due to the impinging bump of femoral head neck bone either overloading the articular cartilage causing chondral injury or delamination defects of the anterior acetabulum with separation and tearing of the adjacent labrum. There are two types of FAI; 1) Cam impingement in which there is an increase in the anteriolateral radius of the femoral head mismatching with the radius of the acetabulum 2) Pincer impingement in which there is a short offset between the head and the neck allowing the neck to abut against the rim of the acetabulum and labrum...
Femoroacetabular impingement occurs in late adolescents and young adults and may be a precursor to early hip arthritis. Reinhold Ganz and his Bern Hip Group and Jeff Mast have made significant contributions to our understanding of femoroacetabular impingement. They have demonstrated that its early correction may alleviate pain and prevent the progression of arthritis of the hip. An arthroscopic equivalent to the open surgical dislocation has been presented. Our experience has shown it can be done safely and effectively with favorable early results. Patients are off crutches quickly and no hardware is left behind as with the trochanteric osteotomy done in the open procedure. Only after a thorough study will we be able to compare the long term outcome with those of the open procedure, however the early results are very favorable and is a less invasive procedure is more desirable...
For the full article, see the following link: