Acetabular Labrum tear

[Kiwi]

Jess,
I feel my hip give way to the side and some time toward the back. I is hard to describe it pops out and then my knee buckles. I have now also developed this great new pain in the butt. deep inside if I move the wrong way or take to large of a step it is almost unbearable. I am at my witts end I truely do not know how people can live like this for years. I can hardly walk most days witn out pain. I hope you get relief soon.
Robin

You could be describing me! Though I'm not too bad with the walking unless I over-do it. Thank you for the replies, I look forward to hearing how you go with the specialist.

Jess

[Camel]

Dear Jean M,

Thanks for the advice, have booked in to see Dr O'Sullivan in December. I would also be interested in any feedback from people 12 - 24 months post surgery, especially Dr O'Sullivan patients.

Camel

[Surfchick]

Hi both and anyone else interested!

Forgive me if there are spelling errors, sitting with the whisky and cola to kill the pain in my shoulder labral tear!

Almost 7 months post op redo (2nd) left hip scope. I have posted alot of this info over the 19 months on here but prob worth repeating!

Sept 2004 - lower back pain -> physio
Dec 2004 - acute spasms in lower back -> private physio and trigger point steroid injection around L4+L5 (helped).

Feb 2005 - had discovered I couldn,t lie on stomach + lift leg up behind me in a spinal rehab class (extension), wondered why. Physio said keep practicing!
Sudden loss of use of left leg whilst doing core stability ex for lower back - felt paralysed for 12 hours then use returned!
Admitted to hosp for 2 weeks - 5 days in ortho hosp, MRI T+L spine - normal, MRI brain _- normal!
Sent to neurology for 9 days - no neurological cause found. Made to see psychiatrist - no cause found.

My knee started to buckle/give way but I would hold on to my hip! Couldn't decide if it was hip or knee giving way + docs dismissed it!
April 2005 - steroid injetion to left hip - worse initially then day 10 - cured for 2 months.
Hip surgeon, biased as had seen shrink before said it was psychological that injection had helped and discharged me.

Loads of s**t followed.

March 2006 paid privately for 3rd opinion to pain management specialist who referred me to hip professor!

May 2006 - diagnosed with labral tear following MRa.
June 2006 - consented to have bone resection (shaving) and labral tear fixed.
Surgeon did not however shave bone, just fixed tear and ligamentum teres. Said bone was ok.

Strangely my knee never stopped buckling/giving way post op - so thought it was a knee prob. 7 weeks post op - all same symptoms back and told would need more scans and another scope.

Nov 2006 - MRa and CT - bigger tear and osseous bulge on head of femur on CT. The Alpha angle is what they measure as a guide to FAI. Up to 55 degrees is normal, mine was only 57 degrees. The big question by surgeon - was that extra bone causing the tear?

April 2007 - re do scope on NHS - did not pay - same surgeon. 10 times more work on hip but still key hole. This time - significant bone was shaved. Labrum had re torn and detached from the bone so they used 2 anchors to repair it.

November 2007 - 7 months post op - my knee HAS NOT given way/buckled at all since op. Surgeon is pleased with me but will see me agin in 12 months.

I don't know the exact anotomical/physiological mechanism that causes the hip/knee to give way - but I know for sure that since the bone has been shaved that that problem has gone away. I wish he had shaved it last year! Still paying the loan for that for another 4 years.

My physio tells me that PAIN INHIBITS MUSCLES - whether that is a contributing factor?

(I now have a SLAP lesion labral tear in right shoulder and awaiting that to be scoped! My tendons look normal on scans but there is so much muscle tension/ache/knots/spasms in neck, shoulder blade and upper arm. I asked why? Was told the pain from the shoulder joint inhibits/stops muscles functioning normally and they go in to a protective spasm to try to stabilise the joint. The same can be applied to the hip joint).

I hope this helps a little? Best info I can provide.

Surfchick

[Surfchick]

A lot of us on this site have labral tears, often associated with problems in the movement between the ball and socket. One of the most nagging pains I had pre-op was butt pain. This was probably the first pain to go post-op. No-one has really explained why, but I suspect it's because the muscles there (like elsewhere) haven't been functioning properly for a while and somehow go into spasm. If anyone out there reading this understands this better, maybe you could post something? Lots of people mention butt pain so I think it would be good to get a more medical explanation, perhaps from a physio who is a fellow sufferer?

I think my previous message explains this. Pain inhibits muscles. There are ligaments that attach to the hip joint, then muscles attach to the ligaments, these muscles then insert either around the lower back, glutes/bum, hip and thigh. Muscles such as: iliopsoas, piriformis, TFL (tensorfacialata - I think), glute medius, maximus and minimus, ITB( iliotibial band/tract). All these (sure there are more that I have missed out) help to stabilise the hip/pelvis/thigh.

Anything wrong in the hip joint causing pain and inflammation will stop these muscles working properly - a muscle imbalance. Some tight, weak, under or over active, short or long. The spasms are the body trying to compensate and attempt to stabilise the joint - but yes it also gives us unbearable pain!

Don't quote me on any of this, I am a cardiac physiologist but through my own suffering have gained some info. I think it makes sense?! I will ask my physio if he may look at this site and may be post a more technical answer, but no promises!

I will keep posting - at some point I will be one of the 24 months post op. I think this site is great. Like my passion for surfing, but I can't surf due to my shoulder, I enjoy helping others in the same boat. It helps me to hopefully help others!

I see a rheumatologist on Tues - hoping he can tell me why my joints keep getting labral tears!

Will post again with an update.

Surfchick

[Jean M]

Dear Surfchick,
Thanks so much for all your info. It was great reading, and brought back floods of memories whilst I was enduring the rounds of docs who really couldn't work out the source of all my pain. Like you, my problems "started" to manifest in Nov. 2004, with my proper diagnosis of labral tear in about June, 2006, confimed in August or Sept. after MRI and bone scans. The first surgeons I consulted didn't really want to do any surgery - particularly didn't want to address the FAI. They said they could fix the labral tear and that I would need a hip replacement 10+ years' time. I asked for a referral to someone more experienced in arthroscopic labral repair, and ended up with the best guy in Australia. This guy (Dr. John O'Donnell) not only pinned by labral tear back into the socket, he also shaved a bump off my femur (small on MRI but larger during surgery). I credit most of my pain reduction to the bone shaving. Like you, I think this is the magical procedure that somehow helps the body so all these terrible muscle spasms disappear. In my case I had LOTS of nerve pain, and all this has gone since the surgery. I truly believe that had I gone with the initial surgeons I wouldn't be experiencing the benefits now. Thank god I found Dr. O'Donnell.
Curiously, I've been having problems with my left shoulder. The pain isn't anywhere near as bad as with my hip, but it's starting to impede activity there as well. I've been diagnosed by my chiro as having "supraspinatus tendonitis" with referred pain along my arm, my neck and into side of my back. But I'm having some doubts, and as you mentioned a problem there as well, I'm wondering if there is a pattern there? Maybe I have a labral tear there as well??
By the way, how could a rheumotologist help with these labral tears?

[Surfchick]

Hi Jean,

Glad if the info helped.

Although I am in the UK, in Nov 2006 I had a one off consultation with my surgeon and John O'Donell. They had come over to the UK for Sports hip conference! Should have seen Marc Philipon too who I believe to be the world lead but he had to fly back early to see a patient. John was great. He agreed with my surgeon a surgery plan for me - I was lucky to see him. the clinic was a one off for "difficult hip patients"! Took 1 hour.

( My physio thought my shoulder was shoulder impingement caused by inflamed supraspinatus tendon. each appt I had - I kept saying "I think it's a labral tear". Eventually the physio half thought it was tendon and half labral tear. When I went to clinic I really had to push for an MR arthrogram on shoulder - this confirmed the SLAP labral tear.)

My hip surgeon suggested going to see a rheumatologist as I have lots of tender spots/trigger points all over body, alot round hip, glutes, quads, abdomen, sides, arms and chest. They are symmetrical and the same on both sides of body. I just thought it was me, over weight, un fit and delicate! They tell me I should not be tender. Even if I get an itch - once I have scrathed it, I have intense pain in the muscles for a few mins! Also as I told him about my shoulder he thought I may have polymyalgia. GP thought maybe fibromyalgia. A cardiology friend wonders about a connective tissue disorder - may be why both joints have had labral tears?! I have had blood tests on Fri to check my inflammatory markers. Will get results on Tues. Will let you know the outcome!

Another take on this, although I don't believe it - it's my thought process, attitude to life, stressful events upsetting, eating away and tearing you up inside, make the labrums tear!
I don't buy it!

Glad you are doing well.

Surfchick

[calvin]

hi all, i'd appreciate any information anyone can give. i've suffered groin pain for 2 years, had inguinal hernia repair, gilmore's groin repair, various osteitis pubis treatments with little success. last week i saw Dr Schilders in Bradford, U.K. He took one look at my stork view x-rays and began talking about FAI and hip problems. It was a total shock because all my pain is in my adductor and up into the groin and i'd been referred for an adductor release op. I've seen a good 4 or 5 different consultants in trying to sort this out and not one has ever mentioned anything about my hip joint or FAI so i know little about it.

i've never even looked at posts about anything hip-related until now despite browsing this forum for a good 18 months. so what i'm asking is, do many of you confirmed FAI sufferers experience your symptoms into the adductor primarily? does anyone know the success of hip arthroscopy for a primary groin problem? most of you seem to mention pain elsewhere and i'm interested to know how common it is for groin specific complaints. also would love to hear from anyone who's seen dr schilders.

cheers, calvin

[Kiwi]

Gosh Surfchick, you must be giddy with all the running around you've had to do...and now the shoulder! ARGH! It seems a lot of people with labral tears have other joint issues too or are prone to joint injuries? Just an observation I've made reading through groups and meeting people, myself included lol. I mentioned this to my GP yesterday and he told me it's just bad luck. Hmm...and re: "it's my thought process, attitude to life, stressful events upsetting, eating away and tearing you up inside, make the labrums tear!" WHATTT??? lol I can't believe a doctor said that lol.
The pain inhibiting muscle thing really makes sense, maybe it's some sort of defense mechanism/reflex although not a very useful one lol!
Good luck with your shoulder, hope that is an easier recovery than your hip has been!
Just out of curiosity, how is your right hip?
Jess

[Jean M]

Dear Calvin,
There's a wealth of info on this forum about hip/FAI problems. I usually type in "labral tears" in the search bar at the top of the page and this brings me to all the relevant posts/threads. Your symptoms are not dissimilar to many on this forum. Just read through all the posts (you'll need time for this!) and you'll be put in the right direction, and know which questions to ask.
Good luck

[Jean M]

Dear Surfchick,
We seem to have a lot in common symptoms-wise! We've even seen the same Aussie surgeon and we live on opposite sides of the world! That really is something, and goes to show how global things are getting!.
Can I ask you what kind of pain you get with the shoulder, and how much restriction of movement? To be frank, I was experiencing a POINT of pain in my upper left arm, for the same period of time I was experiencing muscle spasms, nerve pains etc. due to my hip. Of ocurse I ignored the upper arm pain (all of you out there know how bad hip pain can get, so you'll understand why I didn't worry about the arm pain). Anyway, this POINT of pain has gradually worsened. Now I have pain sometimes in my elbow, mid arm, and wrist! Last night, for the first time, the pain in the wrist area kept me awake! I find certain movements (like grabbing anything from the back seat of my car) EXTREMELY painful. But the pain doesn't last. In between painful movements, I'm left with a feeling of some stiffness and a slight ache.
So, Surfchick, any specific info about the shoulder would be good. I suppose an MRI, or MRA would be the way to go????
By the way, I think this shoulder business is so unfair, given everything I've gone through with the hip. My hip is "good", I rarely have any referred pain, but now my shoulder is causing me grievance......................................lif e can be so unfair. You fix one thing, and another pops up.
As for the idiot who said you've brought these labral tears on yourself, I think that's such a cop-out. We could blame all pain on stress, to some degree, couldn't we? When I was experiencing all my hip pain (prior to surgery) I saw a few alternative practitioners who suggested that I had brought on all the pain, and needed to change my life...............same cop-out as you've experienced Surfchick.