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 work.  Even 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.]

First Prolotherapy session finished

Nervous as hell, I showed up to the doc's office at 8:45, 15 minutes ahead of time.  I had already taken my vicodin and xanax, and I was starting to feel a little woozy.  Still lucid, I filled out some sheets and then was taken to a room.  They had me gown up and applied a topical novacaine ointment to my hip/thigh area.  After waiting a while for the drugs to set in Dr. Hauser showed up.  I was handed two squeeze balls laid on my back, and he got to work.  I could feel some of the pricks of the needle, but just barely.  Then he had me lay on my side and started going at it from there.  I don't think the numbing agent had been applied there because I could definitely feel that more, but I just focus on something else, like those stress balls.

But then it was over.  It probably took like 2 minutes, max.  Apparently he gave me 60 injections, but I could have sworn it was like 15 at most.  My hip definitely felt some swelling, but it was discomfort and not pain.  They put a heat pack on me and let me just lay there for a while.  Eventually I got up and dressed.  I was pretty tired and I think the drugs were making me woozy, so shortly after Kristin started driving me home I passed out.  When we got home I laid down on the bed and then slept for six hours.

My hip definitely feels different, it feels swollen and like I'm stretching my glute or something.  There's not really any pain though, and the pain from the psoas being too tight doesn't seem to exist right now.  I don't know if it from the drugs or the swelling has allowed the muscle to relax.  I don't know.  All I know is that I now have to be very careful with what I do, to make sure I don't make my hip click.  If I do, I'm preventing my labrum from knitting together, and that is the last thing I want to do.  It will be tricky, all those little habits like crossing my legs will be tough to not do, but this is definitely worth it.

If I can beat all of this without surgery, I am going to be a very happy man.  The thing that I like most about this prolotherapy is that although I can't really exercise like squats or Pilates, I can walk around and be independent.  This is not like what I would experience if I had surgery, where I would be on crutches and my body would be recovering from the stress of putting my hip in traction.  Surgery really should be an option of last resort, and if this works I am going to be very, very, happy.

Has my FAI gone away???

The fact that Dr. Hauser couldn't detect any impingement has really got me thinking, is it actually gone?  I really need to check with the results from the MRI I had a couple of months ago to see if my cam and pincer impingements are gone.  If this is the case, then I'm proof positive of the importance of mobility work.  I always wondered if the extra bone growth would go away on its own.  I mean, it's no longer needed because the femur is no longer banging into the hip socket, so it could go away.  On the other hand, it would seem odd that the extra bone would realize it's no longer needed and would go away.

...I will call the doctor's office later today and see if they could help me out on this one, since I don't have the images for myself.

Met with Dr. Hauser

The meeting was... interesting, to say the least.  He did a few, quick tests and felt that I really didn't have an impingement of the hip (this would kind of make sense since I've been working on my stretching my hip capsules for almost two years to the day now.), but he definitely felt some instability in the hip joint as well as that laberal tear.  This is almost completely opposite of what the PRP Dr Wager diagnosed like two years ago (no laberal tear, but FAI). Perhaps all the stretching and stuff has made the impingement a non-issue, that would definitely be ideal as well as the hope of getting all those massages. 

He told me that he felt he could help, and if I wanted to he could do a procedure in like 30 minutes.  ...He gave me the option of taking some painkillers before the procedure, as I will get poked by a needle 30+ times.  That is a ridiculous amount of needle, so I felt I would be best served by some vicodin.  However, I have a lot of work to do, and I can't really afford to take today off so instead I scheduled an appointemnt for the 23rd.

There is one thing that really, really bummed me out though, and that's the recovery.  One of the main reasons why I wanted to try prolotherapy before surgery was because of the recovery.  In the clip of Dr. Hauser getting an injection of stem cells (the stem cells come from the marrow in his own tibia) for treating his knee he talks about how he was running three days later.  Well, appearently with a labral tear I would have to be inactive to let the labrum knit together.  I can swim and walk,but anything that causes my hip to snap would be bad (so no more than 20 degree movement), and I wouldn't be able to do any external rotation as well.  ...That last part may mean I might have to hold off on dance lessons (have been learning how to dance with Kristin in preperation for our wedding). 

It's that last part that kills me.  I've really been enjoying dancing with Kristin, and that I would have to hold off on dancing for like eight weeks is sad news.  The recovery time for prolo is almost the same as surgery, so it makes the idea of prolo less appealing.  However, I know that surgery is not always the answer, in various forums there are people who are months post-op and are still expereincing pain just walking.

So I think I've decided to try at least one prolo treatment, but I swear I'm not as near as excited about this as I was when I thought I could immediately get back into squatting and stuff.

I will keep posting about this, as well as some other things.  I apologize for the lack of posts, but since I've become more inactive there hasn't been too much to write about.