In this post I am sharing my story with chronic hip pain, being diagnosed with a labral tear and femoroacetabular impingement (FAI) and how I’ve successfully reduced pain levels and avoided surgery for nearly a year post-diagnosis.
THE BACKSTORY + ONSET
My right hip started hurting at mile 16 of the Marine Corps Marathon in 2010. Fast-forward to 2020 and I have now been dealing with varying degrees of chronic pain in that hip for 10 years. Prior to the onset of the pain during the MCM, I had no history of hip pain or injuries although I had experienced a few running injuries such as knee bursitis and achilles tendonitis.
At the time of the initial injury I was marathon training (running 25-35 miles a week), practicing power and ashtanga yoga 4-5 times a week and teaching BodyPump and group strength classes 2-3 times a week. My yoga practice was such that I was commonly getting very deep assists in hip opening poses like foot behind the head. I also had a fairly aggressive back bending practice. Looking back, I was definitely pushing my body to its limits physically but I was also 26-27 years old and mostly unaware of the amount of stress that I was putting my body under.
I spent years seeing various doctors, chiropractors, massage therapists, acupuncturists and body workers seeking answers and relief. I was always told it was muscular which was good news but also frustrating because nothing really seemed to help long-term. The pain was bothersome and constant but I learned how to live with it. My hip pain never prevented me from running, practicing yoga or lifting weights although I did experience varying degrees of discomfort while doing some of those activities. Yoga always seemed to exacerbate it more than anything else.
The only time in 10 years that I experienced consistent relief from the pain was during pregnancy in 2017-2018. It was the craziest thing but my hip pain all but disappeared. This has perplexed some of my doctors but I attribute it to the hormone relaxin that is increased in pregnant women. I also wonder if maybe something about carrying a baby slightly shifted my pelvic alignment or something like that.
It was not a surprise that as I recovered from childbirth and began to increase my activity levels that my hip pain came back. This is also a good time to note that my activity levels these days are NOTHING close to what they were in my 20s and early 30s. I have greatly reduced the load and stress that I put my body under over the last few years.
GETTING A DIAGNOSIS
In 2019 I had to have emergency toe surgery due to a freak accident. This meant that I met the deductible on my insurance (which was quite high) so I decided to take advantage of that and finally get an answer on my hip. I was committed to seeing whatever specialists that I needed to and doing whatever testing necessary in order to get a diagnosis.
My first step was seeing a sports medicine doctor. I made an appointment with Dr. Keith Anderson at the suggestion of a friend. He did an examination and took an x-ray of my hip. He predicted that I had a femoroacetabular impingement (FAI) and the x-ray supported that. Dr. Anderson said the next step would be an MRI to get more information on the joint and the state of my labrum and cartilage. Dr. Anderson ordered an MRI arthrogram and referred me to Dr. Kenneth Weeks at OrthoCarolina.
The MRI process was more difficult than anticipated. I had it done at Novant Health Charlotte Orthopedic Hospital. With an MRI arthrogram, you receive an injection of fluid directly into the joint before the MRI. This allows the radiologist to get a lot of information about the lining of the joint and the labrum because they can see it so much more clearly. Let me just tell you that it is not comfortable to have fluid injected directly into your joint via a long needle. Getting prepped for the MRI and receiving the fluid injection was pretty quick. I’d say I was in the prep room for under 10 minutes. The actual MRI took about 45 minutes.
I was not prepared for the amount of pain I had after the fluid injection. It woke me up in the middle of the night and I had to get up and take ibuprofen. I was later told that this is super common because the fluid irritates and inflames the already irritated and inflamed joint so much. Some doctors won’t order these types of MRIs because they can be so uncomfortable.
The MRI results were returned quickly and these were the findings.
- The superior and anterior acetabular labrum are diffusely degenerated and torn. There is a small focal region of linear fissuring of the articular cartilage of the anterior superior lateral margin of the acetabulum adjacent to the base of the labrum.
- Morphology of the right femoral neck which predisposes to cam impingement.
- Large amount of tendinopathy of the right hamstring tendon origin with adjacent stress reaction within the right ischial tuberosity.
I read the results in my online chart and felt a lot of fear and uncertainty. I tried not to freak out before I met with Dr. Weeks but it was hard not to go down the doctor Google rabbit hole and to stay out of worst-case scenario thinking. I did reach out to a yoga teacher/physical therapist friend of mine to talk through the results and she had encouraging things to say. She also suggested I schedule a consult with another hip specialist in Winston-Salem at Wake Forest Baptist, Dr. Alston Stubbs.
WHAT IS FEMOROACETABULAR IMPINGEMENT (FAI)?
(source) In FAI, bone overgrowth (basically these are bone spurs) develop around the femoral head and/or along the acetabulum. This extra bone causes abnormal contact between the hip bones, and prevents them from moving smoothly during activity. Over time, this can result in tears of the labrum and the breakdown of articular cartilage (osteoarthritis).
Here’s a photo of a healthy hip where the femur fits nicely into the acetabulum.
And here’s a photo of impinged hips. I have the cam type of impingement, which you see in the middle photo.
WHAT IS A HIP LABRAL TEAR?
(source) A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of your hip joint socket. Besides cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely within your hip socket.
Athletes who participate in sports such as ice hockey, soccer, football, golf and ballet are at higher risk of developing hip labral tears. Structural abnormalities of the hip also can lead to a hip labral tear.
Now, the fascinating thing about labral tears is that they are very prevalent and often asymptomatic so it’s important to determine if your pain is actually being caused by the labral tear or if it’s other factors. I was told by both specialists that I saw that you can do an MRI of a lot of 30+ year old hips and find labral tears. It’s frequently not the cause of hip pain but unfortunately it can be hard to know if it is unless you try fixing it, especially in cases of chronic pain where PT and activity modification haven’t had great results.
SPECIALIST/SURGICAL CONSULTS
I met with two different hip specialists/surgeons after my MRI. Both seemed to be great doctors and I was impressed by the amount of time that each spent with me but I emerged from those two consults feeling very confused and conflicted. Each doctor painted a different picture of my condition, the surgical process and the recovery journey. I had a hard time reconciling the two in my head because they were so different. I almost felt like I needed a THIRD opinion.
Dr. Weeks at OrthoCarolina told me that I had no signs of osteoarthritis (Tonnis grade 0) and that the surgical process would be hip arthroscopy where he would repair my torn labrum and smooth the head of my femur to correct my FAI. Recovery would look like a few weeks on crutches, biking by 4 weeks, elliptical by 6 weeks and a jogging program by 8-12 weeks (of course with tons of PT in there). He was very honest about surgery not being a guarantee to “fix” my hip but assured me that I was a good candidate for surgery. He didn’t push it and I left that appointment with a plan to pursue activity modification and to revisit surgery at a later date. He told me to avoid deep squatting and lunging and I was fine to keep running.
Dr. Stubbs at Wake Forest Baptist had a different take on things. First, I have to say that he spent at least an hour with me doing an examination, reviewing x-rays and my MRI and talking through various scenarios. During the course of the appointment he told me that he wants to write a book about yoga and hips because he’s seen so many yogis in his office in recent years.
One thing that brought me some level of comfort was that he told me it’s not my fault that I’m in this situation. He said there’s a reason why these injuries are so common in gymnasts, cheerleaders, dancers and yogis. We naturally gravitate towards these activities because our bodies are structured in a way that the range of motion that they require comes more easily to us. Dr. Stubbs said that my hip condition isn’t due to one thing that I did but likely a combination of my natural body anatomy and the way the ways that I’ve been moving my body for so many years.
Dr. Stubbs said that I had beginning signs of osteoarthritis (Tonnis grade 0-1). He was super honest about surgical outcomes. He told me I had a 2 in 3 chance of having a positive outcome and that the recovery process would be very long. He told me I would be on a traction machine for about a month and non-weight bearing for a couple of months. Additionally, I couldn’t lift anything over 10 pounds for four months. He said not to think about resuming anything close to normal activity levels for six months.
His surgical plan was MUCH more involved than Dr. Weeks. I took a screenshot for you because it’s so shocking. IT band graft and reconstruction!? Psoas release!? Glute tendon repair!?
While Dr. Weeks gave me a lot of freedom around making a surgical decision, I felt very pushed to schedule surgery while at my consult with Dr. Stubbs. They had me meet with a surgical scheduler who tried to get me to commit to dates in the coming month and also with his research team to do a pre-surgical survey. I did not schedule surgery because obviously I had a lot to consider and digest.
MAKING A DECISION ON NEXT STEPS
I was not in a great place after these consults. I was feeling so confused and really down. There was no way that I could rush into surgery given that a) I am a single parent to a small child and b) the way I earn a living involves the ability to move my body.
I decided to press pause on everything and to gather more information and opinions. In the coming months I had conversations with two physical therapists (Kari Shenck and Libby Hinsley), my chiropractor and a friend who is an orthopedic PA.
I identified two main goals.
- Preserve the integrity of my hip joint to avoid a total hip replacement for as long as possible.
- Not be in pain all the time.
I decided that given where I am in motherhood and with my career, there was no realistic way that surgery could happen in 2020 so I’ve been doing everything possible to take care of my hip and accommodate my impingement in the meantime.
MANAGING MY FAI NON-SURGICALLY
I am about 10 months out of the MRI and surgical consults and I honestly cannot believe how good my hip is feeling all things considered. The number one most helpful thing that I’ve done is to see my chiropractor regularly. I see Dr. Douglas Bradberry at Greenapple Sports and Wellness.
At the start of the year I went every single week and I’ve now worked my way up to bi-weekly appointments. He does a manual adjustment to release my impingement (this was recommended by my physical therapist, FYI) as well as active release therapy on tensor fasciae latae (TFL), psoas and glute medius. This combination of treatments has seriously changed my life. I’ve had a couple of flares where I’ve thought to myself, “this is it….I’ve done it….I’m going to have to have surgery” but Dr. Bradberry gets me back on track. I tell him every time that I see him that it’s magic (and he is magic!).
In addition to regular chiropractic care, I have also accepted activity modification as a necessary means to avoiding surgery. This includes:
- Reducing running frequency and mileage. I would rather be able to run 3-5 miles a couple times per week than push it and not be able to run at all. I am at peace with the fact that I may never run a long distance race again.
- Tons more walking. 99% of the time walking makes my hip feel better, even if I’m experiencing a flare).
- Modifying my yoga practice to avoid extreme internal and external rotations of the hip as well as avoiding things like deep side lunges and malasana squats.
- Avoiding deep knee into chest movements like mountain climber or stork pose (especially when experiencing a flare).
- Avoiding straight leg boat and leg lifts.
- No squatting below parallel when strength training. Also reducing the depth of lunges and shortening my stance a bit.
- Listening to my body and truly following “if it hurts, don’t do it.”
- Focusing my own work on glute activation. My PT recommends lots of two leg RDLs and alllllll the glute bridges. She also has me doing lots of locust variations for spinal strength/integrity.
So far the combination of regular chiropractic care and activity modifications have resulted in a significant reduction in daily pain as well as improved function of my hip. While I still have “background pain” most of the time, it’s extremely manageable and something I can live with for now.
WHAT DOES THE FUTURE HOLD?
I’m not sure. I think I’ll probably end up having surgery at some point in the next few years but I am also open to non-surgical management of my condition if it continues to go well. In the meantime, I have been reading and researching things about labral tears, femoroacetabular impingement, hip arthroscopy, hip preservation surgery and more. I’ve also followed the surgical process for a few friends/acquaintances and found that to be super interesting. And now that I’m starting to share my story online and on social media, I look forward to connecting with others who have had similar conditions and hearing about their outcomes.
Surgery is a big deal and not something that I want to do unless it’s 100% the best choice for me. Both my physical therapist and chiropractor support surgery when I reach the point where it’s worth it from a pain and function standpoint but I’m just not there yet. I feel like I know what I’ve got now with my hip and it’s manageable…but I also know that it can (and likely will) change. Again, my number one goal is to preserve my hip joint and avoid needing a total hip replacement for as long as possible but both of my doctors assure me that I’m not on that path anytime soon.
Okay, that was over 2,500 words and I could keep going for another 2,500 more. I will continue to share on this topic. Let me know if you guys have any specific questions or things you’d like for me to address.
QUESTIONS
Have you dealt with a long-term, chronic injury or condition?
Any others with labral tears and/or FAI?
How do you do with activity modification?
I basically had the exact same injury except I think my tear must have been worse because I had pain with any activity, even walking. I tried doing PT for several months and then my PT said I really needed to see a surgeon. Part of my issue was that the ball joint of my hip joint was misshapen so that was making the tear worse and it make it unlikely to resolve without surgery. So I had surgery in May of 2016. It was VERY hard and I can not imagine going through it with a young child, and especially as a single parent. So I think avoiding surgery for as long as you can is a good idea. My recovery wasn’t as intense as that one doctor described. Like I did not have to be in traction. I was on crutches for 3 weeks – the first 2 weeks were non-weight bearing on the surgical side, the 3rd week I used them to walk to take some pressure off the surgical side. And then I did PT for months and was not cleared to run until October – right in time for cold weather to hit in Minnesota!! So that was a brutal summer. I also moved in with my boyfriend (now husband) on a Friday and had surgery on Monday. So that was a bit, um, intense! But it showed me we could get through anything. When/if you have surgery, I would definitely have your mom come and stay with you for the first couple of weeks, or at least the first week. I needed a lot of help, and I didn’t have a child at home with me!
All in all, the surgery was successful. But I haven’t really ‘tested’ that hip much because I got pregnant the next summer after that surgery and never was able to fit running into life with a baby/demanding career. I do hope to get back to running after we have this 2nd child but I will never run a marathon again. I think I’ll stick to the 10k/10 mile distance as that’s plenty challenging. And I know that the anatomical ball joint issue is present on both hips so I don’t want to do anything that would cause a tear on the other hip because I just can’t see myself going through that surgery again!!!
What kind of surgery did you get? The arthoscopic?
My friend had surgery for this exactly a year ago this week. She was a pretty avid runner (didn’t do marathons much though). She’s pretty petite and in good shape. She started having problems about 14yrs ago, when she had her 2nd child. She thought it was her back and that her difficult labor messed her up. She would have episodes that had her unable to get out of bed. She got some shots in her back/hip about 10yrs ago that really helped, but about 2yrs ago, it started bothering her again. She had some MRIs and found out she actually had the same problem you have. They said she had to have surgery so she did. She was pretty upset. At the time, they said it was due to running. She said she had pain but also she had a hard time doing leg lifts, like she didn’t have a lot of strength on that side. The surgery went well, she was home in a few days. That was end of August. They said she wouldn’t drive till Dec. She was pretty immobile at first but was getting around on crutches before week 2. She did have to spend a lot of time each day in bed with this machine that moved her leg around. It was really hard. Luckily her kids are teenagers and her parents and husband helped her. She did regular PT. Her recovery went faster than they said. She was driving by end of Oct, I think. She got rid of the crutches before then. She said it was really hard. And right when she was starting to feel normal, like in Jan, her other hip started bothering her. And sure enough, she has to get that one done. She was so upset bc the whole process is rough. She put it off for now, maybe in 2021. She said it was super hard and just isolating bc you have to spend so much time using that machine in bed. Plus the first 2wks you can’t even go to the bathroom without help. Her hip is all better though. And they said it wasn’t all from running after all. She has a congenital hip abnormality which is why it affected both sides. The hip socket bone is shaped weird. They wouldn’t have known if this hadn’t happened. So, the surgery is a big deal. I might try to put it off as long as possible till Finn is more self sufficient. My friend started having problems when she was 26 and had surgery right before turning 40.
Hi Jen! I’m a long time reader but this is my first comment. I thought like I was reading my story, I had a very similar process (although I’ve never done yoga) and the exact same diagnosis. I had the surgery 18 months ago, and from my experience since then, I don’t know if I’d recommend it. Let me know if you want to talk more about it!
I am almost 4 months post-op on this exact diagnosis. I am 38 years old and have been an avid runner/marathoner for the past 12 years or so. I have now completed approximately 16 marathons. For a period of time, I was also doing Hot Yoga approximately 2-3 times a week for 2 years. I regularly strength train and also did Body Pump around 2-3 times a week when I lived in an area that had that class. My surgeon’s post op directions seemed very SLOW compared to what I read online. I was non-weight bearing for 6 weeks. Then I went to partial weight bearing for an additional 2 weeks….and then moved quickly to 1 crutch and none. I had to have round the clock help for almost 4 weeks. Now I could have managed after say 2 weeks, but it would have been extremely hard . Just having someone walk my dog, feed by dog etc. About 4 weeks post op–I broke down and said WHY did I do this. Maybe I could have managed this pain. Long story, I am not almost 4 months out and at that point I can being a walk/jog program and gradually and very slowly work back up to where I would like to be. I would like to think I have a few more marathons in me, but I am not sure I want to test the boundaries. Regardless today, I am 100% glad I made the choice to get this surgery. I have 0 pain. I can walk, swim, elliptical and nothing has bothered the hip at this point. I have been very careful and not done anything aggressive, I really want to give the hip and bone time to heal. But if you can get some help…because you will need it. Crutches are brutal, you should do it. You are too active and too young to give up things you love. Just my two cents =) Good luck in whatever decision you choose.
I went through a very similar journey about 10 years ago and saw many specialists before finally getting my FAI diagnosis at the age of 28! After several years of physical therapy, activity modification, cortisone shots and chiropractic, I elected to have an arthroscopic surgery. Like yours, the surgery was to resurface the femur head and clean out the joint of loose and torn cartilage. I healed relatively quickly, but unfortunately the relief was temporary, and once I returned to lightly modified activity, the same pain returned.
About a year after this surgery I saw a different specialist, one who did an experimental FAI procedure. In the second surgery they actually transplanted stem cells into a mesh pouch in the joint. After 2 months of no weight bearing (!) the stem cells re-grew new cartilage. They also more aggressively re-shaped the femur head. This surgery was much more invasive and the recovery was brutal. However, it’s been 6 years, and I almost never notice my hip! This has certainly saved me from having a hip replacement in my 30’s. I don’t know if any of your specialists would offer this same surgery, but I was really pleased with how it worked.
Good luck with your journey- I know how emotionally and physically painful it can be to struggle with a chronic condition which is aggravated by things that you love!
Take it from someone who has had this surgery, from a well-respected surgeon that specializes in these FAI/Labral-Tear repairs, you should think long and hard about whether you want to do this and most importantly if it is even necessary.
I won’t go so far as say I regret my surgery, but i do think it was not needed in my case and other things were going on that were causing my pain. Case in point, I had the same “genetic abnormality” in my other non-operated hip and had similar symptoms there too prior to surgery, but was told I had to wait until fully recovering from the first surgery to get that one fixed. Well lo and behold, after I fixed some of the issues that were causing me pain, that hip is perfectly fine now. The reasons I won’t say I regret the surgery is that I think without it I wouldn’t have had the definitive proof that other issues were at play, I would’ve always wondered if surgery was the fix afterall. Hopefully that makes sense.
I’m a distance runner that was doing ultra-marathons and BQ marathons etc prior to my diagnosis and I am back to doing those things now. But I don’t owe my success to the surgery. I’d suggest you do a search on a few terms and see if that leads you to the same destination it did me. “Dr John Sarno” and “TMS” and “Dr Harold Schubiner” and “Steve Ozanich” would be a good start.
Best of luck!
I’m a 46 year-old professional cook and food stylist. I’ve experienced abdominal/groin/hip pain for almost 7 years. It’s constant, keeps me up and night and interferes with my work. I was recently diagnosed with FAI and labral tear (and hamstring damage) of the left hip and surgery is suggested. I’m in the very confused and overwhelmed stage. I have to stand, bend, carry boxes, bend, twist every day for work. I’ve been to PT, pilates, massage therapists and do exercises but nothing brings relief. I’m contemplating a second opinion, but my scans and tests were very clear. I’ve had knee surgery…so I know the road ahead, if choosing surgery, is tough. I’m most concerned with hip preservation. I’ll keep following! Thanks for sharing.
Wow what a journey! Good for you for being so thorough and thoughtful, it’s a long frustrating path sometimes. Thank you for sharing this with your virtual friends, sending you healing thoughts!
I have had IT band flare ups from running that have caused knee pain. I saw a sports medicine physical therapist who suggested a diagnostic ultrasound — and it was discovered that I have a small tear in the cartilage of my knee. Similar to your situation is it actually the cartilage tear causing the knee pain or they just happened to find the tear when I was having pain from IT band issues?
https://rosm.org/what-make-us-unique/
This was suggested to me as an option for repairing the tear. I have been able to manage the knee pain through PT, running gait analysis/adjustments, and just running less overall than I used to. I’ve accepted being active in different ways over high running mileage. I did think this type of procedure was really interesting though versus invasive surgery.
Also I love barre3 so much as a workout because the workouts were developed by physical therapists and working through pain is never encouraged. Modifications are always offered. So now I do barre3 consistently and run sometimes.
I know this doesn’t provide much insight into your situation, but this has been my own journey dealing with chronic pain in my 30’s and finding happiness and ways to be active that do not cause pain.
Glad you have found solutions that are working currently <3
Thank you for sharing your journey with chronic pain Jen. I’ve had a similar experience but with my right knee and now it’s a waiting game to see how much longer I can go in that tolerable phase. I hate having sx (4 on right knee alone) and with 2 young kids it’s almost impossible to even consider. Thank you for going into detail about how you’ve managed your condition. It helps a lot to know others are ogling through similar experiences.
Thanks for the update! Glad your hip is doing well…all things considering & im just so happy you know what your options are now. I know what it feels like to live with a chronic condition and it’s never “not” on your mind…ebbs and flows and good days & bad days but let’s just keep hoping for more good days!
Agree w/ the comment about looking up Dr. John Sarno’s books (“The Mindbody Prescription”, etc) before considering surgery. I had back pain (for almost 15 years!) so bad sometimes that I could not get out of bed (I’m 38). MRI showed “disk bulging” so I thought the pain was obviously from a physical cause. Did lots of PT which only helped temporarily, but once I read his book my pain disappeared within days! Your issue could be different, but it might be worth just looking into! Hope you get some relief and feel much better soon ❤️
Also meant to add Dr. Nicole Sachs’ podcast “The Cure for Chronic is Pain” is also great:
https://podcasts.apple.com/us/podcast/the-cure-for-chronic-pain-with-nicole-sachs-lcsw/id1439580309
I feel this on so many levels! I ran a marathon in 2008 and my right low back/glute has never been the same. I’ve seen different doctors but never gotten a definitive answer on what is causing my pain. Chiropractic care, weekly deep massage (which is not available right now in CA) and my at home TENS machine alleviate the pain some but it is constant. I have good days and bad days. This post really inspires me to dig a little deeper and get to the bottom of it!
Edit to add that my usual massage place is not open right now but I guess I can’t speak for all of CA. ?
So I think I mentioned this in another comment, but my brother had something very similar, however, his pain was much worse. He used to work in the office and switched roles so that he could work from home. He couldn’t stand or sit long and definitely couldn’t do any exercise. He saw a few doctors in St. Louis and actually had surgery on his right hip 4 times and his left once before finally finding a doctor that has been able to help him. He got his injury from getting into endurance biking. He had his right side done almost a year ago, (late September) and then just did his left side 3 weeks ago. I would say definitely research your doctors. My brother had gone to many doctors who did not actually do anything to help. He was finally recommend to Dr Marc Philippon out in Vail, CO. He’s part of the Team USA staff and has worked on a ton of athletes who’ve returned to sports afterwards. I can’t say good enough things about him and my brother’s experience. It’s breathed new life into my brother as he’d been dealing with it for the past 6 years and countless surgeries and had become quite depressed. I will say he could pick my daughter but not carry her around, so it would be hard to also take care of a toddler. My brother did he say that he could already start to feel relief the day after surgery!! I hope that you are able to push off surgery though and still feel good! I’m glad that you have been able to find some relief! I just started seeing a Chiropractor for some neck issues for close to a year now and it has helped SOOO much!! I wonder if it would’ve helped my brother looking back! Good luck!!
I had a labral tear repaired surgically, and while it did help with the pain, the recovery was just a waiting game. My kids were in high school though. Afterward, I was able to back and run a half and do some triathlons (spring and 1 olympic), but the hip was never the same. In yoga, I could feel it was weaker, especially in one legged things like half moon and Warrior 3. I could not get it stronger. It is painful again, this time just bursitis and tendonopathy, but I can’t get the pain to go away. I can’t even walk or sit without pretty bad pain.
Earlier this year I had PRP (Platelet Rich Plasma) shots in my back to deal with facet joints that were overgrowing and pinching things. They worked! Kind of like stem cell theory, they take your blood, centrifuge it down so that it Platelet Rich. If I can’t get my hip to calm down through PT and Chiropractor, I will be going that route to see if my body can heal itself. I also want to do PRP on my low back to deal with degenerative discs. The bad thing is that it is all out of pocket. Insurance does not cover it (at least mine doesnt and they said that was normally the case). My back was $1550 and I think they quoted my hip in the $800 range. Obviously, I would rather not pay out of pocket, but I think eventually I should because maybe it could prevent an entire replacement down the line if the joint can heal. BTW I am 54. I don’t run anymore unless I’m in a pool, but I love to bike, hike and walk, lift and yoga. I’ve been doing a lot of pilates lately too to strengthen my core and try to rehab my hip. Hope this is helpful.
Oof, I am sorry you are going through this! I am 39, a casual runner and yogi, and also have FAI and a labral tear, and I have hip dysplasia. I’m having arthroscopic surgery next month to repair the labrum and subchondroplasty to address a bone cyst (early osteoarthritis). The surgeon doesn’t want to repair my FAI because I already have significant arthritic degeneration in the joint. He said FAI repair is often too aggressive once arthritis hits a certain point, so that may be something to consider — it might be good to have the FAI repair while you still can. (I am 100% not a doctor, though!)
I really debated surgery, but I also have pretty serious chronic low back pain and I think it may be aggravated by my hip instability. I’ve done three rounds of PT and have had a cortisone injection in my hip. The surgeon told me that there are no guarantees that I will get significant relief from the surgery, but my other option is to keep getting cortisone injections until my hip joint degenerates enough to warrant total replacement. I at least want to try something preventive!
I am sorry you are going through this. Being a single mom and a career in fitness are two hard things to negotiate with surgery and chronic pain. Take care of yourself and thank you for writing about this!
Wow, thank you for sharing this. It’s nice for you to have some answers, but that is tough when your livelihood depends on it. I hope your success in managing it continues. I, too, have right hip pain, although it is mild at this point. I had the same experience that you mentioned where it completely went away when I was pregnant. The only thing I have done for it is PT, which I didn’t have the best success with. I find that when I walk or run on roads with a camber, I am in much more pain afterwards!
I am 33 and have almost the exact same story. Long time runner with hip pain, difficulty with certain hip poses in yoga etc. I got diagnosed this past year with FAI after watching my mom go through degeneration and replacement of her hip joints in her 50s. After a lot of research I decided to go with activity modification and PT focusing on glute strength rather than surgery. The success of the surgery seems very hit or miss, my neighbor did it and had bad results and it looks like the jury is still out on whether the surgery is better long term than PT. I also went through a very similar birth with a c section as you at almost the exact same time ( I really related to all of your posts about that!) and am very hesitant to put my body through any more surgery.
Hi Jen,
My wife subscribes to your blog and she told me about your hip issue, and forwarded me this article to read. I think I may be able to help you.
I’m a regenerative medicine physician in the south Charlotte area (board certified in Rehabilitation Medicine and Fellowshp trained in Women’s Sports Medicine) and I see issues like this a lot. I also have similar issues with my right hip after being a gymnast, college cheerleader and 40+ years in the martial arts. Regenerative medicine has done amazing things for me and allowed me to avoid surgery and stay off of pain medication. This is a passion of mine, not just a job.
Here’s our website and phone number: http://www.heritageregen.com
(704) 610-2601. Please call ans ask for Joanna (my wife/practice manger). Hope to talk soon!
John S.
I went to a PT 3+ years ago to try and figure out what was causing my chronic groin pain – turns out it was hip impingement. I am so thankful that (at least for now) I have been able to manage my pain with physical therapy, although every time I have flare up I do wonder if it will mean surgery
I’m so glad you shared this. I was diagnosed with the same exact issues (FAI and labral tear) about 8 years ago. Mine was likely brought on by (stupidly) ramping up my running much too quickly. When I was diagnosed I was 30 and surgery just didn’t feel right for me. Running was the only thing that exacerbated it, so I dialed back. One of my bucket list items is to run a marathon, and I tried to ramp up a few times and train for one, but increased running always led to a painful flare. I was always lucky that I was almost only in pain while I was running, as soon as I would stop, I would be pain free (unless it was a really, really bad flare). I started teaching spin and dialed back the running and was pain free. I then had two children and had zero interest in running anyway. I’ve tried a couple of times to get back into it, but it has either led to hip pain or a nasty case of plantar fascitiis. Interestingly, a physical therapist and chiropractor suggested that the PF might have been caused by the hip issues affecting my gait. I was unsure about this until I broke my foot a couple of weeks ago and am in a walking boot, obviously, that has significantly changed my gait. My PF pain has virtually disappeared. This post gives me hope that I may be able to run again someday, and I’m going to share with my chiropractor what yours does, in hope she may think some of it may be helpful for me. Thank you for sharing!
I have a torn labrum too. It was discovered when I had that MR arthroscope ( agreed! Not fun!) with which we also learned I had a hip stress fracture (femoral neck). I had a crazy alignment issue from a car accident when I was 15. I would suggest that you consider Rolfing. If you’re having to have the same chiro adjustment all the time (which I was too), you’re indicated for Rolfing. Your misalignment may be locked in by your fascia. I have run 5 or 6 more half marathons since recovering from the stress fracture and have never had surgery on my torn labrum. I also don’t have to do Rolfing or chiro anymore, for quite a few years now. Good vibes sent!
Thank you for sharing! So interesting to read your story!
-Kate
https://daysofkate.com/
Thank you for sharing your experience with this injury. I’m sorry to hear that you’ve been dealing with it for so long. I had a different hip injury last year – a tear in my iliopsoas, but honestly I didn’t get a lot of specific info from my doctor. I had an MRI, an X-ray and did a bunch of PT. In the end, it kind of healed on its own with a crap ton of rest. I didn’t do any lower body strength work, running, biking, etc. for months. It was awful. When I healed, I vowed to do whatever it took to prevent re-injury. So I reprioritized strength work, especially in my hips and glutes. (Love all of your glute activation stuff!) I’m pretty much back to all activity now, but I do have a lot of fear about re-injury. And like recently I am feeling a strain in my left glute (different leg than my hip) and now I’m worried I did something there. Getting older is something, isn’t it?
Keep us posted on how your hip is doing! Thanks again for this post. I’m also glad to hear which chiros and docs you visited. I will put them on my list.
Thank you for sharing! You and I have the same thing, both the right side. I think I may be a couple of years ahead of you. My 1st memory of pain, (mine was in my back) was when I was pregnant with my 2nd child (he is 18 now). I have gone to acupuncture, physical therapists, countless Dr.’s. No one ever saw anything on X-Rays or MRI until this week. I traveled to the Andrews Clinic and they saw the tear and Impingement. I am so tired of thinking about my hip pain. I took the last 7 months off to rest and repair and It has not helped. I was an avid runner for years and teach and practice yoga for the last 6. From everything I have read a tear does not fix itself? I will be 50 in January and I want to be able to move again before then. ?
I had cam-and-pincer impingement secondary to scoliosis with bilateral labral tears. It went misdiagnosed for about 18 months, and by the time I saw a hip specialist, I couldn’t do basic ADLs like tying my shoes or getting out of a car unassisted. I had surgery on both hips and it changed my life. Every single PR I’ve run has been post-surgery, and as the years pass, hip flares become more and more rare. I run 50-70 mpw pain-free and I’d recommend surgery to anyone. Having said that, the recovery was indeed long. It wasn’t painful, especially compared to the pain I was in before surgery, but I was on crutches for 4-6 weeks and in a body brace for about as long. I couldn’t run for 12 weeks. My job involves walking and standing, and it was a challenge.
If you’re hesitating to have surgery, I suggest discussing a PRP injection into the joint. I had PRP into the joint during surgery, but it could have been an option by itself, too. Some doctors doubt the labrum can regenerate, but others think it can – just very slowly – and PRP takes the place of the blood flow that isn’t there (the labrum is poorly perfused).
Thank you for sharing your results! I’ve ran 10 marathons, an ultra, and countless half marathons before getting sidelined with pain in 2018. I had numerous injuries before that (IT band, knee issues, ankle issues, etc) all on the same leg. This pain was definitely different. I had a confirmed tear via MRA but have been putting off surgery. I run when I can but now I’m to the point that anything where I pivot like working at the kitchen counter or vacuuming really cause a flare up. I really want to get back to long distance and also know that at 40 my chances are increasing if developing arthritis. So my plan is to discuss PRP and possibly surgery. I have been hesitant because there are so many negative stories out there that it’s nice to come across someone with great results! Thank you for the encouragement and enjoy your miles!
Would you consider posting a video with the hip exercises you do for PT? I don’t know what locust poses are (although I have head of glue bridges haha). Your tips for managing hip pain are really interesting to me, especially the comment on squats and lunges, thanks for sharing.
Very inspirational story Jen. Wishing you success in beating this pain.
I’ve been worried I might have hip impingement myself and have been nervous about starting off my career with pain. Currently I’m in the Academy about to graduate and I started to have hip pain for the first time about 1 month into the training. Your post motivates me to push through and see if I can manage it as best as I can myself.
My daughter was originally diagnosed with hip impingement. After 3 months of PT and increasing pain, a second opinion revealed a torn labrum. She had the surgery. She was a collegiate athlete so she had the requisite PT and lots of time with the trainers. Hip pain continued. Had a second surgery due to chronic pain and possible retorn labrum and capsule. Intense PT and training for almost a year now-her doctor “released” her as his job was done. Got a second opinion-she was too weak. Got a third opinion and a 3rd painful contrast dye MRI that you described…there is more that happened but she is facing a 3rd surgery from a well known respected specialist-it will be hip reconstruction. The kicker is she is 21 years old. It hurts to walk. She had to medically retire from her sport. I commend you for doing what you can non-surgically.
I just ordered her Dr. Sarno’s book.
Thank you so much for sharing. I’ve got a labral tear that is likely caused by a significant leg-length discrepancy (had an xray of bone lengths, I’m pretty off-kilter) and hypermobility. I’ve been really unsure what to do about it, and I found your post in an act of desperation googling “can labral tear be managed without surgery?” Prior to hip pain showing up out of nowhere 10 months ago, I had been a very light jogger, and I stopped running, backpacking, etc. when it showed up out of fear it would make it worse. The pain is manageable with restricted activity and lots of PT. But I feel stalled out with my recovery at this point, and wanting to get back to jogging, cycling, x-country skiing, more rigorous hiking. I’ve seen such wildly different results discussed with the surgery I’ve been really reticent to even meet with an orthopedist. It helped me a lot to read about your journey and your approach– I think that’s where I’m at too. (It especially helped me to read that labral tears are common and can exist without causing pain…!!)
Hi Jen, thank you for your story. I to have be diagnosed with hip impingements. Can I ask what was your Impingement labelled at mild? I hope your getting on ok. Sinead
Hi! I stumbled across your blog post as I’m laying here icing my hip. I’ve been in some intense pain for 3 weeks and have all the symptoms of a labral tear, but my PT doesn’t think I need imaging yet. ? I noticed you had said your injuries didn’t prevent you from running? Why do you think that is? I can barely walk at the moment. So frustrated!
There is a lot of good information here! Thanks so much. I just went through a week of a lot of left hip pain (for no apparent reason, no stressful sports or yoga) and got an x-ray last Monday, with a visit to the chiropractor Tuesday. I figured between the two visits I might find out what’s going on. The chiropracter said i had my sacrum out on the left side, which he adjusted. That felt much better, nearly back to normal. The x-ray report said I have mild arthritis, narrowing of the medial hip joints, ovoid femoral heads which can be associated with FAI. It stopped short of saying there was FAI (which I assume can be seen on x-ray?) and noted that “soft tissues are unremarkable” which I hope means no tearing of the labrum. I am used to walking for exercise, not a runner, so I think I will ease back into that, and may buy that visit package from the chiropracter!
I think it makes perfect sense your pregnancy released the pressure in your pelvic connections. In my case moving the sacrum into alignment seems to be at least a great temporary fix, if not longer.