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Gluteus minimus tendon tear—update 3/25/2024

Hello, I’m curious if you have gotten the Regenexx? I am from IF and my doctor is one of the Regenexx facilities. I have not been diagnosed with a hip abductor tear yet, I am waiting on an MRI, however I have been seeing Dr. Vlach for what I thought was back pain and she spoke to me about the Regenexx for that however it seems my back pain is actually referred from the hip.
I am trying to read forums to see what others symptoms are and what treatments did and did not work. Any information would be helpful.
Thank you

I am scheduled for Next Tuesday. It seems like it took forever to get all the i’s dotted and t’s crossed :roll_eyes: plus getting care covered for my Mom.

I have had one half-assed PRP treatment here and despite a very low volume of the injection and no guidance, it did help. It took about 5 weeks to kick in. Dr. Vlach said that bodes well.
I have had back pain too. I thought it was an SI problem but I do think that has also been referred from the hip issues.

My connective tissues are just is not very healthy :stuck_out_tongue:. I will let you know how it goes. I have to go over on Monday to be there at 8am Tuesday for the blood draw. I live in Boise so have a 4-5 hr drive and am not leaving here at 3am. Driving home ought to be interesting. Luckily (as far as driving), it is my left side and I will have someone shotgun if anything becomes too painful.

Susan

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Hey that’s great you got some relief with the half -assed (lol) PRP! Here’s hoping for some really solid, lasting results with the Regenexx!

Do you take anything to support your connective tissue? I started Juven before my big hip surgery and have continued it because it’s just such a good collagen etc supplement. It might be worth a shot for you, too?

(Amazon usually has the best price. I prefer the orange flavor, but fruit punch isn’t bad either.)

I started collagen about a month ago. I will look into the Juven. I have had so much tendinopathy. Feet, knee, hips, elbows…. :stuck_out_tongue:.

Susan

Have you seen any improvement? Straight up collagen supplements never did for me what Juven does. It’s kinda $$ but worth it! (And, bonus, it doesn’t smell or taste like dirty socks :nauseated_face:)

Not yet. I have read that it isn’t a short term deal and was planning on trying it for 3-6 months.
Will still look at Juven, at least for the healing period after the injections.

Definitely plan to have someone else drive. You may not need it, but my friend had PRP in her piriformis and was very sore. She wished she had had crutches to get to her car. She also felt nauseated from the trauma of the injections - not to scare you, but just to be prepared. She tolerated it fine but afterwards felt lightheaded and a little sick. They said it was pretty typical, so just be prepared so you don’t have to drive if you don’t feel up to it.

Boise is about a 3 1/2-4 hr drive with no construction or nasty roads. This time a year you never know on the roads. I think it’s supposed to stay cold and no snow for the next week so you should be good.
I had a labrum repair last year in Utah. I understand how hard it is to travel for something big especially when it hurts. My surgeon is the one that sent me to Dr. vlach originally for a hip injection. He said he trusts her and he is a renowned surgeon for labrum repair. I’m curious if he does the abductor tendon repairs as well. If my MRI shows a tear I will send it to him and see what he thinks.
I did see a neurosurgeon for my back after getting my MRI results. I don’t know if you have seen Dr. Vlach but she is not very personable. He said he wasn’t sure how the PRP injections are but he did say he thinks Dr. Vlach is a great doctor. If the injection is anything like the onesI have had in my hip, the injection sucks, and afterwards the fluid puts pressure on the area. However mine have been in the joint so that might be part of it.
I thought my back pain was from the SI as well. My PT says my muscles are so tense that they are pulling on my SI joint. But when he tries to loosen them with stretching, massage and dry needling, it make the pain all over worse.
At this point no body knows what’s wrong. I’m hoping the MRI will shed some light in it. I’m tired of being in pain.

I know what you mean. My issue started early fall of 2021. I moved my horse to a different barn last November and it is on a hillside :grimacing:. Man it was a long winter. It hurt so bad to walk uphill or up stairs. Amazingly, riding has not bothered the issue at all, thank goodness. There is something I can do. I finally went to a local sports medicine guy in March. I think a lot of those guys don’t have much gumption to treat chubby old ladies. I did 2 rounds of PT with different PT’s. It didn’t really hurt anything but it didn’t help anything either. He did steroids a couple times which helped for about a month. After 2 rounds of steroids and the one round of PRP, he finally ordered an MRI. His final…open surgery or just keep doing the steroids. I think that would do in the tendon completely. I did not think there were any tears but haha…I had a telehealth visit with Dr. Vlach. She is pretty direct but I respect someone that knows what they are doing and it more cognizant of the big picture…like getting my mobility back and hopefully pain free. The protocol for Regenexx is so much more strict than what the local guy did. I just showed up, they didn’t draw enough blood and injected what came out of the machine and sent me out the door. No instructions of any kind. I knew it could take a few weeks to work and was surprised when things did get quite a bit better at about 5 weeks…but far from gone.

So I am optimistic. I think I will take my walker with me. It doesn’t cost anything to throw that in the car. I think she was planning on injecting 3 sites although that was before she saw the MRI so I will find out Tuesday.

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I just turned 40 and am fairly active. I did a fun run in July 2021 with my mom and kids. I started having low back and hip pain. I saw a couple back doctors and two physical therapists. When my doctor and PT couldn’t explain why done exercises I physically couldn’t do I went to an orthopedic surgeon. He sent me for a diagnostic injection in my hip joint. It took away most of my pain but not all of it. So he sent me for an MRI of my hip joint that confirmed labrum tear. I had that fixed October 2021.
A week and a half later my daughter was in a horrible account that broke her pelvis in 5 places. I spent the next 3 months taking care of her, so I never went to PT after my surgery. Once she was back to walking I started going to the gym again and started having pain. I have seen 3 PT’s since March of this year. The first one I was just getting worse slowly. The second one had me stretch my hip a lot which made everything worse. I had x-rays and an MRI of my back. My 3rd PT helped a lot with the back issues and I was making good progress until we started strengthening, stretching and massaging my glutes. The pain just got worse again. I had a diagnostic injection in my SI joint which again took most of the pain away but not all of it. I have also been in anti inflammatories for 4-5 months but after a couple weeks they upset my stomach and i have to stop taking them for a couple weeks. I was going to get a steroid injection in my SI joint but since PT was causing more pain the doc wants an MRI of my hip now to try to find out why.
I feel your pain. It’s so discouraging when it hurts all the time. I really hopes it helps you.

Have any of your doctors tested you for an autoimmune connective tissue disease? I know our connective tissue gets stiffer as we age, but your issues sound more serious than regular age related stiffness.

I hope your treatment goes great and gets you the results you are hoping for!

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No they have not. I will look into that. Thank you.

If you were unable to abide by your weight bearing and external rotation restrictions post labral repair, I’d be awfully concerned you ruptured the hip capsule, and the pain you feel now is because you’re unstable due to the capsule defect.

A good MRI should catch that, but you might need contrast. Not every radiologist or surgeon out there can identify that on the imaging, so you might need to be evaluated by one of the few surgeons experienced in capsule reconstruction.

Failure following arthroscopy is very often difficult to figure out. Don’t get discouraged if your local surgeon says nothing is wrong. That really doesn’t necessarily mean nothing is wrong–just that he doesn’t know. Someone out there does.

I have never heard of a ruptured hip capsule. My recovery was a bit rocky. 10 days after my surgery my daughter was in an accident. I ended up doing way more walking than I intended and spent a week in the hospital with her.
I plan on sending my MRI to my hip surgeon as well. My local radiologist didn’t see my impingement but my surgeon did and was able to show me in the MRI.

Whew…it is done. Nothing like spending 10 hrs in the car in 24 hrs (my friend that went with me lives northwest of Boise hence the extra time). I really like Dr. Vlach. She answered all my questions and explained things very well during the procedure. Night and day difference from my first PRP experience. She injected the tendon for both the glute minimus and glute medius and she did the hip joint as I have some small labral tears and arthritis.

We will see how it goes. I am very sore today. The tendon injections were kind of painful despite the local but this will pass. I have my follow-up in a week (thank you internet :wink:) and she said to stay off the horse for 2 weeks…I can do that.

Jlove621, I hope you can get an answer. Chronic pain is so frustrating. I highly recommend Rocky Mtn Spine and Sport.

Susan

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Susan! I am so glad your appointment went well. Injections are no fun. The one in the joints are particularly painful because you are adding a fluid into a small joint space. As the fluid dissipates it gets better.
I really hope these injections work for you.
I am not entirely happy with their office right now. I was told 2 weeks ago (by her PA) that I needed another MRI. I called last week and left a message because I had not heard anything and my insurance normally doesn’t take that long on MRI’s. I got no reply. I emailed yesterday and then decided to call my insurance to make sure they received the auth. They said it didn’t get started until Monday! A whole week and a half since my appointment. Had they sent it right after my appointment I would have had the MRI last week and at least known where to start. They still haven’t responded to either my voicemail or email.

That is too bad. I had all my stuff done locally (in Boise) although it did take an act of Congress (or seemingly so) to get them the MRI. So things did drag out a bit but weather-wise for the the drive, it turns out later was better. The hip injection was (and is) the least painful. Those tendons didn’t like that much fluid for sure

Susan

When they go into the joint to repair the labrum, they have to go through the hip capsule. The hip capsule is then closed, but the repair is fragile and needs to heal. If you were unable to abide by your restrictions, damage to the capsule is a serious risk. Very few surgeons in the country are capable of reconstructing a capsule, so you really might have to work to find someone with familiarity to not only fix the issue, but even diagnose it.

@Kyrabee good luck! I’m so glad you were able to try the Regenexx PRP. I really hope it does amazing things for you!

I read into the capsule injury when you first mentioned it. From what I understand is it’s causes instability and the hip to dislocate. I have not had that.
my pain consists of an overall ache mostly in my right hip some in my left and back when i wake up. It feels like it needs to pop.
I get sharp intense pain from the L3-L4 down on the right side sometimes radiating to the left, usually towards the end of the day or after sitting or moving a lot. The doctors thought it was my back so I had an MRI. I do have some degenerative disks and mold stenosis but nothing to cause the pain I’m having.
We worked on my back in PT and I was doing probably 75% better until we started strengthening my glutes. My glutes medius and piriformis tightened up so much. So at PT they did massage, stretching and even tried dry needling. I once they started that I get pain across my glute medius, down the piriformis, down the side of my hip (not sure what is there) and towards the front and now into the groin like I had with the labrum. Along with the intense pain in my back.

Instability can be a lot less than “dislocate” level and still cause exactly the sort of pain you describe.

Due to iatrogenic damage to the acetabular rim, my hip was massively unstable. I never felt anything I could identify as instability. I saw several experts who were unable to identify the instability. When I finally got to the right guy, and had a dynamic ultrasound to actually quantify the instability, it was “the worst he’d ever seen.”

The restrictions following arthroscopy exist for several reasons. Protecting the capsular repair is a significant one. If you were unable to abide by your restrictions, damage to the capsule is a concern. Diagnosing failure following arthroscopy is often very challenging, but this is one avenue to explore. It’s likely you’ll have to travel to find a surgeon who’s actually got enough experience to really work you up, and you’re very likely to hear “everything looks good” from surgeons who don’t, rather than have them admit they just don’t know.

Good luck.

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