Joining the hip pain club

[Simkie]

@Risuena totally, 100%, agree that we just don’t know how to screen for people who will benefit yet. It’s really tossing darts at a board. Just observational, in talking to people, it seems like those with your standard presentation of groin pain are probably the group that’s most likely to have good outcomes. If the presentation is atypical, all bets are off. The guy I saw here in NYC won’t even touch posterior pain–refers patients that present that way down to Hal Martin. That’s telling, isn’t it?

Do some poking around about traction. For me anyway, understanding what they do to you in surgery is helpful to frame how you feel on the other side.

When is the big day? I am…6? years out on Nov 11!

[academichunterprince]

I’m new, but I specially made an account on this forum because I wanted to join this conversation. I have a diagnosis of a left partially torn labrum, and I did PT (aka pain and torture) for three months early this year, but I didn’t get it diagnosed and basically worked out and everything on a bummed hip until I couldn’t take it anymore. I had a fall with a horse that I’m 99% sure caused my labrum to tear.

My ortho said that I should be ok as long as I didn’t take rigorous classes that involved a lot of studying. I laughed it off because I wasn’t doing much at the time…well I’m in grad school now and the sitting is killing me. I got through this summer with limited hip pain, but I don’t know if its the cooler weather (I just moved to New England) or if its the constant sitting and studying but my hip is absolutely killing me now. I could barely canter tonight and I had to buy a memory foam pillow to sit on when I study. I try to work out 2-3x a week and I don’t run anymore and I’m very careful about what I do on leg day.

I’m turning 26 in a little over a month, and I want to avoid injections or surgery at any cost, and I don’t want to be living off of Advil either. I’m pretty stubborn and will try to work through the pain. I joke around with my other health field friends that I’m going to be the best kinesiology partner next semester because I’m all sorts of messed up, but I wouldn’t mind finding something that might make winter and studying a little more bearable. Any suggestions?

[Laurierace]

Why do you want to avoid injections? They could buy you several pain free months if not forever. My daughter has two different tears in her labrum and was injected last February and is pain free most of the time.

[Simkie]

@academichunterprincess Explore PRP. Pretty sure I’ve posted about my successes with it in this thread of you want to read more. I have a regenerative medicine guy in CT that I can highly recommend, if you’re interested. Additionally, I’ve heard there’s a team at Boston Children’s doing work with shockwave for labral tear pain, and that sounds super interesting.

Also, find the best muscle work person you can, and see them regularly. That might be a massage therapist or a PT who does dry needling or someone who specializes in trigger point or any number of other people/specialities…but just find the best. This comes with SO much muscular imbalance and that’s often a huuuuuuge factor in pain level.

And just one more thing…all injections aren’t equal. All injections aren’t steroid, and all steroid isn’t going to be harmful to the joint.

[academichunterprince]

@Laurierace My ortho said that I should try to avoid injections for as long as I can because in her opinion I’m much too young. I would have to do my own research on that of course, which I’m starting to do.

@Simkie I’m looking into PRP! I would need to see if my insurance will cover it, but I’d much rather do that than steroid injections. I would need to find a doctor up here and discuss it with them, so I might take your recommendation! I most definitely need to find a muscle person! That’s on my list of things to do because I found trigger pointing and dry needling really helped! I’m interested to try shockwave too if I can afford it. Its funny because I’m so willing to shell out money if my horse needs any sort of work but I only do work on myself if I’m dying haha

Thank you both for your recommendations!!

[Simkie]

@academichunterprincess insurance will not cover PRP. Shockwave is also not covered.

But PRP is less than my out of pocket for surgery, and more successful, so 🤷

[Risuena]

@Simkie

@Risuena

When is the big day? I am…6? years out on Nov 11!

@Simkie, we’ll almost be anniversary buddies, mine is Nov 14!

@academichunterprincess - I don’t have much to add, but agree with Simkie that the muscle work can do wonders. While I was doing PT, they were dry needling me, which helped some. Then one day the person who did the dry needling was out, so another person worked on me. I guess it was massage, but I think her elbow was the main instrument…Honestly didn’t feel that great while she was working on me but afterwards I felt much better than I had in a long time. So the right person can really help!

I also resisted injections until I wasn’t able to ride. After I got in injected, I was able to really focus on PT and get stronger, so I think it was a good thing, though I absolutely understand your hesitation.

My only other suggestion is to win the lottery, quit school and work, and go live in some glorious vacation spot. My hip felt amazing the week we spent at the beach this summer - I spent my time walking around or laying on a lounge chair, I barely sat the whole week. There’s the cure!! :lol:

[x-halt-salute]

@Risuena wishing you the best outcome!

@academichunterprincess beware of being stubborn and working through the pain. That seems to be how I went from a labrum issue on the mild end of the spectrum to osteoarthritis on the severe end of the spectrum. Altered biomechanics and inflammation can do quite a lot of damage over even just a couple years, and moderately invasive treatment now might be better than the extremely invasive treatments that could be on the table a couple years down the road if you’re unlucky. Not saying jump to surgery, but consider your options carefully and don’t neglect yourself. IME grad school poverty and academic culture often lead people to overlook self care (been there, done that, have the chronic issues to show for it). Budget carefully and exploit resources available to you through student health insurance (esp. if your uni has a med school), and don’t let the perverse self-deprivation ethos of academia sway your approach to your health. Also, take advantage of @Simkie’s experience and practitioner recommendations in your region if you can. She’s been an incredible help to many of us with hip issues and knows her stuff.

As for me, I sat the trot this week for the first time in 10 months. I’ve been dealing with other acute injuries that have kept me out of the saddle for quite some time (I had the kind of luck to sustain a fracture during an employment and insurance gap, after experiencing my first fracture as an adult only months earlier). I’ve been easing back into riding slowly, with posting trot and a pretty lousy perching seat (obliterated coccyx = months of limited seat aids even after riding became bearable). But the difference in hip joint pain with sitting trot work is remarkable, and very obvious now that I haven’t been doing that for a while! Holy crap was my old orthopedist wrong when he said dressage is low-impact enough to be good for a bum hip. Sitting trot pain > jogging pain for me, hands down.

At the new job I invested in a good sit-stand desk, and adjust every hour or so. That makes a huge difference at work. No more 5+ hours in one position forced by a bad desk and chair! I have a more reclined armchair for reading and have just ordered a better ergonomic desk chair to help with the desk sitting portion of my day (which is the worst of the workday for hip pain, and one I spend minimal time in now that I have the sit/stand option). I also have more short walks interspersed in my work day, with parking, office, and lab all over half a mile from each other, plus other regular excursions. Adding 2-3 miles of somewhat relaxed walking into the workday would be an inconvenience for some, but has been helpful to me (vs. sitting all day and concentrating all activity into more intense workout sessions outside of work). I’m rather stunned to see, over the last couple of months, just how much lifestyle and specific riding activities matter to my hip problems.

Hope everyone else is doing well!

[Laurierace]

To add to the craziness of this thread, I had lingering hip pain following my second labral repair three years ago. I have been in and out of PT, had countless massages and acupuncture etc. Finally they injected my back and instantly the hip/butt/leg pain went away. I have a huge synovial cyst pressing on the right side of my nerve roots from where there is grade 2 spondylethsis in addition to all sorts of other issues. So ironic, my hip problems went undiagnosed for four years until Simkie made the diagnosis for us because my pain was all in my back. Now my back pain took three years to diagnose because it was all in my hip!

[x-halt-salute]

@Laurierace

To add to the craziness of this thread, I had lingering hip pain following my second labral repair three years ago. I have been in and out of PT, had countless massages and acupuncture etc. Finally they injected my back and instantly the hip/butt/leg pain went away. I have a huge synovial cyst pressing on the right side of my nerve roots from where there is grade 2 spondylethsis in addition to all sorts of other issues. So ironic, my hip problems went undiagnosed for four years until Simkie made the diagnosis for us because my pain was all in my back. Now my back pain took three years to diagnose because it was all in my hip!

Wow! That’s crazy.

I’m really glad you discovered the spinal problems after so, so much time with hip pain – fingers crossed that it’s something that can be managed w.r.t. pain in the longer term!

[GucciJumper]

Does anyone have lasting issues after their hip labral surgery? Especially when it’s cooler out? I struggle sleeping on my side and my hip has be turned in to sleep well. I’m almost 5 years out. This turned out to be workers comp so I can’t just as a doctor as most wont touch it without a claim.

[Simkie]

Hips and backs are weird and dumb why does everything have to be so connected in that area?? What a terrible design. I’m sorry you’ve been hurting @Laurierace and I hope this is the LAST THING. Geez!

@GucciJumper a lot of us have continued issues after surgery. Sorry you’re in the same boat

@Risuena I’ll be thinking of you on the 14th!! Best of luck!!!

[Simkie]

@Risuena today is the day, right?! Best of luck!!! Fingers crossed for a great outcome!

[x-halt-salute]

Yeah, good luck @Risuena! We’re all wishing you the best!

[FEI_JR2004]

I read this thread a few years back, and saw it pop up again today. I was first diagnosed with FAI and a labral tear in my left hip in 2014 (and in my right hip in 2016). Both the doctor in NC in 2014 and in CA in 2016 told me that I could choose to ignore it if the pain wasn’t too bad. I moved to San Francisco in May and my left hip started getting a little bit worse, but still very manageable (I’d take Advil after certain activities, but there wasn’t anything I just wouldn’t do because of it). I went to a new doctor at UCSF and told him I just wanted to make sure I could keep ignoring it. Turns out that the FAI was causing early arthritis (narrowing of the joint and cysts on the bone), and my doctor told me I’d need a THR in 5-10 years if I didn’t fix the FAI now, which isn’t a great option because I’m only 29.

I had surgery on October 7th, which was supposed to be a femoroplasty and acetabuloplasty to fix the cam and pincer impingement, plus a labral repair. But, when he got in there, part of the labrum was apparently just destroyed to the point that there was nothing to repair, so the plan changed to a reconstruction with a graft using a donor ankle tendon.

I’m scheduled to get off crutches on Monday and have my 6-week post op appointment on Tuesday. But, aside from being on crutches longer than initially planned, the rehab has been going very smoothly and I’m way ahead of schedule. I’ve been doing PT 4 days a week, with 2 in the office and 2 in the pool where I can walk without crutches. I haven’t really had any pain except the occasional twinge–didn’t even take the narcotics after surgery–but I’m trying not to push too hard to avoid some of the issues it sounds like you guys have had!

My mom had a labral repair 7-8 years ago, and the PA in her doctor’s practice (who is an equestrian herself) cleared her to get on at the walk 6 weeks out and to do posting trot/canter as tolerated 2.5-3 months out, and it went well for her. My PT also has a daughter who rides, and so he’s had me do some sumo squats on the Total Gym to see how my hip feels in a wide stance, and that went well… I just bought a horse this week after not riding consistently for 3 years (because obviously there’s no better time to buy a horse than 5 weeks post-op), so I’m anxious to get in the tack again. I’m going to try to get on and walk the saintly horse in the barn next week, and hoping it won’t be painful!

How did getting back in the saddle go for everyone else? What was easiest/hardest?

[Risuena]

@Simkie & @x-halt-salute, thanks for thinking of me! Surgery went well; I’m glad I decided to go with the reconstruction specialist instead of getting a repair closer to me as he found my labrum was in terrible shape. Just got discharged this afternoon. Pain really hasn’t been bad, but I suspect tomorrow will be worse. Glad to have it behind me, and crossing my fingers that outcomes are good!

@FEI_JR2004, I don’t have any insights but will be interested in other replies about ridding after surgery. My surgeon told me it will be 6 months at a minimum before I’m back on a horse, ugh.

[Simkie]

@Risuena glad you’re doing okay! Are you loving the Game Ready yet?

@FEI_JR2004 I really can’t ride. I do a little, but it’s sure not comfortable. A narrow twist is pretty important. I hope you have better luck!

[GucciJumper]

In order for me to ride, I had to get a new saddle with a narrow twist. I had to wait about 4 months in order to ride without pain.

[x-halt-salute]

I did not have a reconstruction, but I was also out of the saddle for about 4 months and needed a saddle with a narrow twist. I don’t have the same range of motion in both hips and struggle with straightness. And sitting trot has never been quite the same since surgery.

@FEI_JR2004 I’m glad you decided to be proactive. Injury-induced early arthritis is not worth messing around with. I’m sorry you’ve already started down that path and I hope your surgical recovery continues to go smoothly.

[FEI_JR2004]

@x-halt-salute

I did not have a reconstruction, but I was also out of the saddle for about 4 months and needed a saddle with a narrow twist. I don’t have the same range of motion in both hips and struggle with straightness. And sitting trot has never been quite the same since surgery.

@FEI_JR2004 I’m glad you decided to be proactive. Injury-induced early arthritis is not worth messing around with. I’m sorry you’ve already started down that path and I hope your surgical recovery continues to go smoothly.

Thank you! I’m bummed to hear that people have had a hard time going back to riding! Mine was never painful for riding before the surgery, so I’m hoping that bodes well for how it goes now. I sat in a couple saddles on a fitting stand over the weekend and none of it was painful, but I did feel more comfortable in the saddle with the narrow twist for sure!

@Risuena how are you feeling post op?