Joining the hip pain club

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Hey CoTHers,

I owe some of you thanks for sharing your hip pain/injury stories on this forum. Reading your stories has been informative and oddly comforting (I’m not alone!) as I deal with my own hip issue.

I’m posting to get out some nervous energy between tests and doctor appointment – I have a feeling I may be in the torn labrum or FAI club, but am awaiting diagnosis. Yesterday I had an MRI of my right hip. Monday I see an ortho doc for a “hip pain consult”, at which said MRI will be interpreted.

I’ve had tight hips for years, and ~5 years ago was told by both a dressage clinician and a personal trainer that they’ve never seen anyone as asymmetrical as me without a history of serious injury. Which I laughed off and attributed to weakness and lack of discipline in strength training…

Last spring/summer I started getting seriously achy hips (bilateral, but worse on the right) after every ride, every run, every hike. I took a pretty rough fall last autumn and sometime after that started developing sharp pain deep in the hip joint when riding (feels like the anterior/lateral part of the joint, but it’s hard to totally pin down). My hip will ache like crazy if I walk more than a mile or so, sit for more than a couple of hours straight in a desk chair, or so much as ride a 20m circle at the walk. Running my favorite short trail or really riding causes sharp pain that gives way afterward to aching that persists long enough to keep me awake at night. Not to mention that I simply can’t ride well – the other day I was trying to ride through the stabby pain but my hip kept locking at the canter and I kept having to shift my weight to unlock it (alas, we’re not ready for tempis, but it’s nice to know my horse will offer flying changes in as few strides as it takes for my hip to lock up!).

This winter/spring my horse was off for a minor lameness for a few weeks, after which I turned her over to my trainer to bring back into work (a convenient mix of giving my hip time to rest from any overuse and getting my horse whipped into shape by a pro). My very first ride back started the stabbing hip pain all over again.

I’ve had a few visits with my primary care doc and a couple of rounds of physical therapy over the last ~6 months which have basically had zero impact on it. I’ve finally convinced my p.c. doctor that I need more than just advil, a few weeks of rest, some PT exercises, and a cursory range of motion test to solve this. So now I wait and see what the MRI shows. I don’t even know what I’m hoping for.

Until then, thanks for all of the equestrian-specific hip pain info you’ve all provided on this forum and wish me luck!

[Laurierace]

I had torn labrums in both my hips but never had any hip pain so I can’t really tell if your experience is the norm or not. My pain was all in my back, mainly my SI. Now that both hips are fixed my back pain is much better but I have pain elsewhere. It was worth it but not the perfect fix I was hoping for. Jingles for a quick fix for you.

[GallopHer]

6 years ago, I had torn labrum and severe FAI. Initially, I opted for arthroscopic surgery, which helped a tad, but did not totally revolve my problem. 4 years later, I had THR and WOW - do I wish I had done that in the first place.

Good luck - let us know what you learn from your MRI.

[GallopHer]

ps - you really don’t want to join the hip pain club.

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[QUOTE=GallopHer;8220122]
ps - you really don’t want to join the hip pain club. :([/QUOTE]

I know! But alas I’ve been tapped to join this elite society. I appreciate your stories and your support, GallopHer and Laurierace! I know I’ll need a bit more of that when I get the MRI results.

[Simkie]

If I were to do it all over again, I would have pursued non surgical treatment modalities for as long as possible before going to surgery, and then I might have gone directly to a total hip replacement. My recovery has been miserable and I still have pain, a year and a half later.

Evaluate your options critically. Consider steroid injections (or HA or stem cell or PRP) before jumping to surgery. Find a really, really (really, really) good PT–with or without surgery. That person will be pivotal regardless of the path you take.

[Jexa]

For what it’s worth, I had surgery 5 years ago to repair a labral tear…a significant amount of the pain is gone, but it ain’t fixed. If I sit in one position too long, I have a severe limp when I get up. Running? Pft, nope! And I still haven’t figured out how to ride properly again. And I won’t go through that surgery again unless the doc thinks this time will be the cure all. It sucked. But my other hip is starting to show the same symptoms…

Even worse, I believe the imbalance in my hips has caused the ridiculous amount of back problems I’ve had come up in the last 5 years. Hip pain = ick. Back pain = I will sacrifice any number of small children to heathen gods to end this!

Sorry to be a cautionary tale, I know it’s not what you wanted to hear. I hope yours will be an easy fix. This is one club you want to leave immediately :no:

[tollertwins]

Frankly, every PT I ever visited for a labral tear ended up making the pain worse!!! None of them believe that the damned things don’t ‘heal’ on their own or with enough PT. All the exercises I was given were pretty much contra-indicated by people who actually understand the injury.

I also wish I had gone straight to THR…since I got to be one of the lucky few percent who had the hip cartilage totally dissolve after the surgery.

There is a doc near where I live now who fellowed w/ Phillipon (one of the guys who started the whole labral repair ‘thing’).

They apparently no longer do the surgery for people much over 40, and he, at least, wants to take a gander at what the cartilage in the joint looks like on MRI, as they have found that cartilage damage in the joint itself leads to worse outcomes.

My non-bionic hip, unfortunately, is, in his words, too bad for the labral repair (not that he would do it on somebody my age anyhow…), but not bad enough for a THR.

FWIW - things that help me…

-I get cortione shots in that hip every 5 - 6 months.
-I’m taking Cosequin ASU, fish oil, and the human version of Cortaflex (celebrex helps a lot - but my stomach can’t take it).

• NO TURNING THE LEG IN!!! I can turn out all I want, but if I turn in it squishes the damaged cartilage.
• Lots of work that requires the glutes to work. I have a pilates reformer, and do piles, and piles of leg work.
• I can’t run, and to go for even long walks I take hiking poles.
• Also can’t ride wide horses anymore…
• No heels. I have to wear the flattest shoes that I can find. If you have to walk on hard surfaces, really squishy shoes help. Thinline insoles are AWESOME!
• If sleeping on that side, I have to have a pillow between the knees so that the hip doesn’t accidentally fall so that the leg is turned in.

[Laurierace]

My hips are doing pretty good and my back pain is much better. I have had piraformus syndrome and bursitis and currently have gluteal tendinitis on both sides. All of that is just part of getting back to normal I guess. I pretty much sat on the couch for four years before the surgeries due to pain so I was very out of shape. I am riding, walking dogs and joined a gym all of which requires a fine line be walked which I didn’t do a very good job of.

[GallopHer]

I agree with tollertwins. If you have a labral tear, in my opinion, PT only aggravates it and does nothing to repair the torn labrum. I also had to ride my more narrow gelding, as my wide-backed mare made the pain worse. I also switched from a western saddle to an all purpose english saddle. I needed to keep the spread between my legs as narrow as possible.

I tried cortisone injections but they did little to ease my pain.

I tried cortisone injections but they did little to ease my pain.
I should have never had the arthroscopic surgery at my age. (Well over 40). In fact my surgeon told me that the results would not be great at my age, but I wanted to avoid a THR. (Bad idea)

I still don’t have great range of motion, but I have ZERO pain when I ride now.

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Wow, thanks for sharing your experiences! Although I must admit that now my nervousness is closer to terror.

At least now I know what to hope for on Monday – something that can be treated with a steroid injection!

I’m sad to hear that PT has played a big role in recovery for many of you. The PT group that my health insurance will cover have not impressed me so far. They had me doing ineffectual activities for months with basically no input from them or change in the program. I ended up getting extremely sore achilles tendons during the PT and every time I mentioned it to them the response was “See, things are changing. It’s a sign that we’re on the right track”. But I was hobbling around with a sore hip and sore ankles until the PT ended, at which point I went back to being hobbled just by a sore-as-ever hip. I have zero faith in them, but also can’t afford to pay out of pocket for PT.

There’s also a pretty good chance I’ll be relocating/changing jobs in a few months, so maybe I’ll have access to better PT on the other side of that.

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[QUOTE=GallopHer;8221288]
I also had to ride my more narrow gelding, as my wide-backed mare made the pain worse. I also switched from a western saddle to an all purpose english saddle. I needed to keep the spread between my legs as narrow as possible.[/QUOTE]

Well that is the one place where I am winning! My mare is narrow and a bit slab-sided, which I used to consider a downside but has DEFINITELY become a perk since this hip pain started! Unfortunately I can no longer tolerate my saddle (a dressage saddle with a moderate twist) so I’m on a rather frustrating search for something that, as you say, keeps the spread between my legs as narrow as possible.

I’m in my early 30s, so I don’t know what that means for chances of success with arthroscopic surgery – it sounds like there are successes and regrets alike from people on both sides of 40 on this board. Wanting to avoid THR sounds like an entirely reasonable thing, but maybe as Simkie suggested, the goal should be to keep the hip going as long as possible without surgery, and then go straight to THR. I’m getting ahead of myself, but it’s probably better to start mulling this over.

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[QUOTE=Jexa;8220793]

Even worse, I believe the imbalance in my hips has caused the ridiculous amount of back problems I’ve had come up in the last 5 years. Hip pain = ick. Back pain = I will sacrifice any number of small children to heathen gods to end this![/QUOTE]

Well, you win for most terrifying comments this morning!

I hear you on the back pain. I’ve had plenty of it, which I never associated with the hip because it started before the hip symptoms and is more intermittent. I hope you can get some relief!!

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[QUOTE=tollertwins;8220906]

• NO TURNING THE LEG IN!!! I can turn out all I want, but if I turn in it squishes the damaged cartilage.
  …
• If sleeping on that side, I have to have a pillow between the knees so that the hip doesn’t accidentally fall so that the leg is turned in.[/QUOTE]

Inward rotation is a sure way to make my hip sharply painful too! But how does one ride without inward rotation?

I will try that pillow trick, though! I haven’t had a good night’s sleep in months thanks to this stupid hip, so it would be nice to have some relief there.

[stryder]

I’ve had both hips replaced. (Bone-on-bone and bone spurs) Before the first one, everything hurt: both hips, both knees, my back. My lower back and the other hip were in spasm trying to protect the worse-off hip. Just bumping my knee on the steering column getting into the car was enough to make me want to cry. I was flat-out miserable. After THR, everything stopped hurting. The muscles let go.

Leading up to my second THR, really only that hip hurt because I didn’t let it go so far. Had the second THR on March 2. Started riding 8 weeks later. I irritated the bursa so have had some discomfort, but have been blessed with a genius PT. Good PT may be hard to find, but makes a profound difference.

So sorry you’re going through this, and hope you improve.

[tollertwins]

And frankly, the recovery from the THR was a cakewalk compared to the 'scope aftermath…

Riding w/o turning the leg in…I kinda look like a duck. I might be more effective w/ the leg turned in, but am in so much pain if I do that that I can accept less effective. I ride a little off the rear part of the calf on that side.

I also had SI pain on the left side that miraculously disappeared after the THR.

[MustangSavvy]

I have pretty severe hip pain, a lot of that though is related to scoliosis sand arthritis of my spine. But I also always subluxations of my hips and other issues. It is hard to ride/hike like I used to. I am only 21, btw. I am being evaluated for other chronic issues as well.

[Simkie]

FWIW, I thought I did everything “right”:

I went to a surgeon who fellowed with Philippon

I got a second opinion from the Steadman-Philippon clinic, and they told me to proceed to surgery with the guy I initially saw, and called him the best to come through the clinic. (You do not actually get to see Philippon until you’re famous, but I saw one of his partners.)

I was diligent with my PT

…and I am still very regretful.

I had about six awesome months where things felt really good after surgery. Perhaps if I’d had better PT right away, I would have had better results, but they guy the surgeon sent me to was really NOT a good fit and I just wound up really pissing off my flexor tendons. The guy I’m seeing now is really ALL ABOUT getting the glutes on, getting the lower core on, and correct movement. He’s the first one I’ve seen to put the whole thing together, and we do a lot of kinesio taping, dry needling, electro stim, trigger point release…all sort of stuff to get pissed off muscle groups to LET GO and do their job, and to strengthen the stuff that allows the hip to work properly. But it’s still two steps forward, one back, because all of this has been going on so long.

I no longer have any confidence that the docs can do anything for my pain and am just So. Tired. of seeing them.

Recovery from the surgery itself was also the most incredibly brutal thing I’ve ever gone through. No way in hell am I ever doing that again.

[tollertwins]

Simike…if you can find somebody who does active release therapy (ART) it might help. HSS in New York seems to suggest it for a lot of patients.

The psoas tendonitis seems common. Had it before surgery, worse after surgery, and even worse after an anterior hip replacement.

ART guy said that everything in there was gummed up. I only had 8 sessions (moved and there isn’t anybody around here) but it helped a lot.

But - the first few sessions hurt so damned bad my husband had to drive me home…

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[QUOTE=Simkie;8222145]
I no longer have any confidence that the docs can do anything for my pain and am just So. Tired. of seeing them.

Recovery from the surgery itself was also the most incredibly brutal thing I’ve ever gone through. No way in hell am I ever doing that again.[/QUOTE]

And the latest winner of the hip pain terror trophy goes to Simkie!

What are the odds I walk in on Monday and the bone and joint specialist just injects some steroids and fixes it on the spot? Cause the alternatives are starting to sound really terrible!