Wednesday, January 18, 2012

FAI/labrum tear does not have to equal surgery!

So I just got a question from a follower from Denmark asking how I'm coping post surgery.  Maybe there's a bit of a language barrier, but maybe not and I haven't been that clear.

So let me clarify the record.

Two years ago I was diagnosed with FAI (cam and pincer type) and was told I may have a small tear in my labrum as well.

Incidentally I learned I had tight hip capsules.

I started seeing a massage therapist while doing exercises to treat the hip on a regular basis to release the hip muscles, and it starts to render me pain free.

Fast forward to August last year and I seemed to make the hip worse in an Olympic lifting competition.

I go get another MRI to see what's going on.  In the report it comments that my femur heads are nice an smooth, nowhere does it mention that there is an impingement.  It seems that my impingement has gone away.

I still have a laberal tear though (which seems to be the root cause of the pain), so I start seeing a Dr Hauser, a prolotherpist, and I seem to be progressing nicely.

Nowhere in there did I get surgery.  For me, surgery is not the answer for a hip impingement.  An impingement is the result of poor mobility, if you fix the impingement it will just come back because you still have the mobility issues.  Moreover, even if the surgery fixes the underlying issues it may not leave you pain free.  I'm willing to bet good money that the large majority of people who have pain and impingement actually have muscular pain and not joint pain.  If you fix the impingement, the muscles are still going to be too tight.  After months or years of learning how to be tight (and painful), the muscle is going to take a lot of attention to make it release and stop hurting.  If you go online and read people's blogs who just have the surgery, it just doesn't seem to workEven if you have multiple surgeries (like five of them).  Surgery is at best an incomplete solution.

First fix the mobility issue, the body will take care of the extra bone growth on its own (mine did).  If you already have a tear in the labrum, then try prolotherpy before surgery.  Prolo seems to be largely dependent on the skill of the administrator.  For example, the "expert" in Alexandria said he couldn't help me, but lo and behold I'm getting help from Dr. Hauser and it seems to be working.

My point with all of this is surgery is not the only answer.  Orthopods think it's the only answer because that's all they know.  They don't know anything about massage therapy or PRP treatments or anything else.  They just do surgery, and that's it.  So if you ask an Orthopedic surgeon for help of course all they are going to recommend is surgery.  But there are other ways, I'm a prime example.

[Edit 7/8/13: I am now seeing a PT who does dry needling, and it is doing wonders for the last remaining bits of pain. I highly recommend you find someone who does dry needling early on in your search for pain relief.]

3 comments:

Emily de Lacy said...

Hi Adam, your blog gives me hope that I can get over my hip impingement without surgery! I just don't see surgery as a viable option given my life and lifestyle.

I'm a runner who had femoral neck stress fractures last year that healed, but then the pain reappeared in the form of a hip impingement. I have been working with a massage therapist, chiropractor and now PT, but improvement is very slow. Did you improve slowly with all the mobility work, what was the time frame? I'm a runner who worked hard to get to the Boston marathon this April, and am wondering if I should continue training on an often sore hip. It is definitely getting better, but at a snails pace.

Also, do you still get twinges of pain? Were you feeling the pain initially when you were sitting?

Thanks for any insight you can offer into your healing process!

Adam said...

I'm not exactly sure how long it took for the FAI to completely go away, given that for me the pain didn't really stem from the FAI itself but from the tight hip capsules. From a hip flexibility stand point, it took a little under three months of seeing a chiro and a massage therapist on a weekly basis to undo all the bad stuff I had done to my hips.

After that I was still experiencing some pain, but it was tons more manageable. ...it has been that last tweak to be completely pain free that has taken a really long time (thanks torn labrum).

I don't still get twinges of pain, and I never felt pain sitting. In fact, I felt more pain standing (and stretching the hip muscles) than when I was sitting.

Have you check out the sections of this blog that point to stretches you can do on your own to help? Here is one post: http://www.youdontknowmefromadam.blogspot.com/2012/12/exercises-to-treat-faitight-hip-capsules.html

marian said...

I am also a runner/ senior athlete (F, 61) who suffered from pain in my hip; it seemed to start about two years ago when I took a fall while walking a "hyper" dog who pulled me off the ground and I fell on my hip. For several months the hip seemed o.k., then I got lymes disease; fast forward two years; the lyme made me very ill, I was on antibiotics off and on for about two years, and I was left with a pain in my groin (which I though initially to be a hip flexor), I kept running through my pain, (as die-hard work-out-a-holics will do), but the pain got so bad that I was hobbling and walking through my runs. I realilzed at some point the running was crippling me, so I stopped; I was even walking with a limp. Then I bought a trainor for my road bicycle and started pedaling. I found I could do that relatively pain free and that I could actually work up a sweat. I have been pedaling every day for 45 minutes a day and I follow up with stretching exercises while my body is really warm. I have also been taking chondroitin and glucolsamine, and I find I can now walk without pain. Two weeks ago I even went on a 5 mile "slog" (slow jog; I hate to admit 11 minute mile average, but it felt great to experience a pain free range of motion albeit slow. I am going to continue on this regimen as it seems to be working. I should also add that I have incorporated some mild upper body weight lifting and inclined situps and leg lifts. If I can continue on this rate of improvement, I figure in another year I might be completely pain free. I think there is hope. -marian