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Hip labral tears, shoulder labral tears, herniated disk. Yep, I wouldn't pass vet.

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  • Hip labral tears, shoulder labral tears, herniated disk. Yep, I wouldn't pass vet.

    Help me, I'm lame! Hahaha

    I did a search for people that have had FAI and hip labral tears, but most were from a few years ago and I know it has become more popular. I'm a collegiate athlete, not the equestrian team. I have FAI labral tears in both hips as well as labral tears in both shoulders and a herniated disk in my back. I've been muscling through the pain at practice, competing, riding, living etc for a few years now. for those of you who have had it, you know how especially uncomfortable FAI can be. I have the typical symptoms, back pain, glute pain, groin pain and quad/knee pain. The shoulders have been torn for more than a year now and are "as tolerated" by the doctor. He wasn't in a hurry to rush into fixing them and I'm not interested anyway. The herniated disk in my back isn't much of a concern either to the doctor right now as I don't have numbness. , The hips are new, and concern me and doctors. I know there are consequences for not fixing it, but I don't know much about the surgery since it isn't popular.

    I'm looking for success stories with repairs when it comes to FAI especially. I don't really want to get surgery, but my coaches have been limiting me lately, and I just want to do my job. I can handle the pain, but they're worried about how I will hold up during seasons, as the hip tears are fairly new. I've been okay so far, but I'm not really interested in getting surgery right now and I'm sick of being babied. I just want to keep on pushing through it.

    Basically, id love to hear your stories and successes as I have no idea what to do. I am not really interested in sitting out. I meet with a hip specialist to go into further details about my MRI next week.

    Thanks!

  • #2
    I work with a doc that does hip scopes and repairs. From what I understand, it's a relatively new thing to do, and many docs don't or won't do them. However, I've heard that they can be very successful. My advice, get it done now, while your tissue is still alive and can repair itself, but find a doc who does them frequently.
    What I lack in preparedness I make up for in enthusiasm

    Comment


    • #3
      Originally posted by InjuredAlter View Post
      ...... I have FAI labral tears in both hips as well as labral tears in both shoulders and a herniated disk in my back. I've been muscling through the pain at practice, competing, riding, living etc for a few years now. ........
      Thanks!
      How about trying rest for a while?
      Do not confuse motion and progress. A rocking horse keeps moving but does not make any progress.
      Alfred A. Montapert

      Comment


      • #4
        While I realize that the general culture in both HS and College (as well as pro) athletics is to muscle through as kind of a badge of honor, down the road (like when you're 30, 40, 50+) you may really regret not taking some time to rest and recover, do appropriate surgery/therapy, etc. Constant inflammation can set you up for arthritic issues and if you continue damaging things, it may not be as easily repaired later.

        For now, if I were in your shoes, I'd get to a sports medicine doc who is up to speed on the latest and greatest. Preferably a doctor who is already being used to treat college athletes at big schools, pro athletes if possible, etc. Not all orthopedic doctors are necessarily interested in getting you back to fighting fit--average function for the "normal" person may be all they're after. I had very different experiences with my 4 knee and 2 hand surgeries depending on the doctor and therapist's ideas about what constituted "normal function".

        I don't have first hand experience with your particular injuries, but I was a HS and college athlete and wish wish wish I had not pushed so hard when rest probably would've been wise and likely saved me from having to have so many surgeries and chronic pain now...15+ years later. The kind of stuff that affects my ability to ride without pain, hold reins, jog, sleep well, ski, hold a pen, carry a bucket, etc etc.


        Best wishes.
        A good horseman doesn't have to tell anyone...the horse already knows.

        Might be a reason, never an excuse...

        Comment


        • #5
          Originally posted by BuddyRoo View Post
          While I realize that the general culture in both HS and College (as well as pro) athletics is to muscle through as kind of a badge of honor, down the road (like when you're 30, 40, 50+) you may really regret not taking some time to rest and recover, do appropriate surgery/therapy, etc. Constant inflammation can set you up for arthritic issues and if you continue damaging things, it may not be as easily repaired later.

          For now, if I were in your shoes, I'd get to a sports medicine doc who is up to speed on the latest and greatest. Preferably a doctor who is already being used to treat college athletes at big schools, pro athletes if possible, etc. Not all orthopedic doctors are necessarily interested in getting you back to fighting fit--average function for the "normal" person may be all they're after. I had very different experiences with my 4 knee and 2 hand surgeries depending on the doctor and therapist's ideas about what constituted "normal function".

          I don't have first hand experience with your particular injuries, but I was a HS and college athlete and wish wish wish I had not pushed so hard when rest probably would've been wise and likely saved me from having to have so many surgeries and chronic pain now...15+ years later. The kind of stuff that affects my ability to ride without pain, hold reins, jog, sleep well, ski, hold a pen, carry a bucket, etc etc.

          Best wishes.
          ^^^^^ THIS^^^^^

          Your body is telling you to back off and slow down. Its probably telling you that you have pushed it too far. If you were a horse, you would be put out to pasture rest for at least a year or more.

          FAI....aka Femoral Acetabular Impingement are the beginnings of arthritis. If you are in your 20's you need to learn to start taking care of your body or when you hit 50 you will be a cripple.

          Surgical treatment should only be considered as a last resort...and only if you can't do the normal things in life....like walking, bathing, eating......not to continue sports.

          Rest and conservative treatments should be first. Any and all surgeries exposes the patient to potential for blood clots/embolisms, infection, in this case, potential hip instabilities, femoral neck fracture, necrosis of the femoral head, and scarring.

          If you don't back off, you're probably looking at bilateral hip and shoulder replacements before you're 40.

          This is a nice summary that basically says that this condition is a result of trauma.....and repetitive motion or sports are right up there.
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697339/
          Do not confuse motion and progress. A rocking horse keeps moving but does not make any progress.
          Alfred A. Montapert

          Comment

          • Original Poster

            #6
            Thanks for the replies. I'm hard headed and tenacious and tenacious and have a hard time accepting that I need to let my body rest. I'll definitely listen to the hip specialist next week. He has preformed this surgery on multiple teammates of mine. Since I'm part of a D1 program, I receive excellent care and doctors, and I wish there was a way around surgery for FAI but it doesn't seem so. The surgery worries me because some of my teammates still experience pain, so I'm worried that since I can handle the pain now, that surgery will make it worse or something.

            Comment


            • #7
              I fractured a leg, dislocated and crushed an ankle, playing football in 1963 (naked bootleg, linebackers that lost their jocks high/lowed me). doctor said not only would I never play football again, but I'd never walk straight. Screw him, 7 varsity letters (baseball, football, track - played basketball but I'm small, white, and slow) later.

              Busted a right knee, 1964, had to remove fluid frequently.

              Hyperextended right elbow (e.g., bent it the wrong way when blocked while arm tackling a guy - probably my fault for arm tackling) and dislocated right shoulder, 1966.

              1978 - physical exam, chest X-ray, dr said my chest was perfect but did I know that I had 2 chronically separated shoulders he could see on the chest x-ray? Yeah, I knew - I live with them every day. When my shoulder hurts, my leg feels really good. Shoulder pain is the worst.

              2012 - back pain moved into hip and down to knee, obviously a hip going bad. Some good days, some bad. but it still works, and I'm still going.

              2013 - leaned over to pick up a water bucket in 10 degree weather, popped a hamstring. Embarrassing thing, the bucket was empty.

              For the first time in 50 years, I'm balanced and not favoring one side or the other - I'm lame both ways. Must be a walking horse (I grew up in the 1960's with big lick walking horses, and am proud of it).

              I'd worry about the disc.

              Comment


              • #8
                RE: FAI...

                If you are looking to get the tear fixed and your hip remodeled, make sure you go to somebody who does PILES of them! Don't know where you are, but I would try to find one of the guys who fellowed w/ Phillipon. I know of 1 in Chicago (name escapes me right now - starts w/ a D), Bryan Kelley at HSS in NY, Mark Adickes in Houston. There are others - do your research!

                There are more and more articles about 'don't do casual labral repair'.

                Additionally - by the time that the surgery is over (even if successful) a number of people have really wonky tendons and muscles. I believe that Dr. Kelley recommends ART (active release) to get them over that part.

                There are some places now requiring a 'delayed gadolinium' MRI prior to surgery, as they found the hard way that the presence of extensive cartilage damage in the joint will cause the surgery to fail (ask me how I know....sigh).

                ETA: Impingement isn't arthritis - it CAUSES arthritis....

                Good luck - NOT a fun surgery, and can have pretty long recovery. There are a couple yahoo groups dedicated to FAI and hip scopes.

                Additional info - your hip x-rays are totally and completely meaningless as far as whether you have cartilage damage or not. When I went in for surgery there was only an itty bitty amount of bone remodeling showing on x-ray or CT. When the doc got in there he said that the articular cartilage was really beat up, with some full thickness tears in it.

                Comment


                • #9
                  fwiw, I know of a college baseball player (catcher, so hard on the hips) with FAI who DID have noticeable improvement with PT and avoided surgery. But he diligently stretches and does his exercises for 2 hours, every day.

                  Comment


                  • #10
                    In 2009 I had arthroscopic surgery to shave off a bone spur that caused labral tears (riding those dang wide mares), clean up the tears and a "rim resection". I went to the surgeon for the Vikings and the TImberwolves that performs 15 of these surgeries a week. He was great. It was 3 months no running or riding, PT 2x a week. Although my PT had me sit on a horse after about 6 weeks just to stretch out the area. It was a sacrifice, expensive and it's never been 100%, but it's not getting worse and it will hopefully prevent a total hip replacement in the future (I was 33 at the time of surgery). In my case surgery was the only permanently effective solution, I'm glad I did it and glad I went to a hip scope specialist.

                    Comment

                    • Original Poster

                      #11
                      Originally posted by tollertwins View Post
                      RE: FAI...

                      If you are looking to get the tear fixed and your hip remodeled, make sure you go to somebody who does PILES of them! Don't know where you are, but I would try to find one of the guys who fellowed w/ Phillipon. I know of 1 in Chicago (name escapes me right now - starts w/ a D), Bryan Kelley at HSS in NY, Mark Adickes in Houston. There are others - do your research!

                      There are more and more articles about 'don't do casual labral repair'.

                      Additionally - by the time that the surgery is over (even if successful) a number of people have really wonky tendons and muscles. I believe that Dr. Kelley recommends ART (active release) to get them over that part.

                      There are some places now requiring a 'delayed gadolinium' MRI prior to surgery, as they found the hard way that the presence of extensive cartilage damage in the joint will cause the surgery to fail (ask me how I know....sigh).

                      ETA: Impingement isn't arthritis - it CAUSES arthritis....

                      Good luck - NOT a fun surgery, and can have pretty long recovery. There are a couple yahoo groups dedicated to FAI and hip scopes.

                      Additional info - your hip x-rays are totally and completely meaningless as far as whether you have cartilage damage or not. When I went in for surgery there was only an itty bitty amount of bone remodeling showing on x-ray or CT. When the doc got in there he said that the articular cartilage was really beat up, with some full thickness tears in it.
                      Thank you everyone for the replies.....it'd be impossible to get in with Dr. Phillipon, although you named one of his fellowships that is sort of close to me.
                      7 of my teammates have received the FAI hip labral tear surgery in the past 4 years, most on both hips, and most still experience pain. Is that something I'm just going to have to deal with? I don't want to get them fixed, and then end up being in more pain after... Especially since I think I can handle it right now.
                      Last edited by InjuredAlter; Jan. 28, 2013, 12:34 AM.

                      Comment


                      • #12
                        Originally posted by InjuredAlter View Post
                        Thank you everyone for the replies.....it'd be impossible to get in with Dr. Phillipon, although you named one of his fellowships that is sort of close to me.
                        7 of my teammates have received the FAI hip labral tear surgery in the past 4 years, most on both hips, and most still experience pain. Is that something I'm just going to have to deal with? I don't want to get them fixed, and then end up being in more pain after... Especially since I think I can handle it right now.
                        Ok....'splain to me why you want to get surgery rather than FIRST trying conservative treatments and backing off sports to let the body heal?

                        Also a point to ponder is why 7 teammates have had this surgery? What sport and what training ethic leads to this?

                        I suggest you read the book, "Unaccountable" by Marty Makary.

                        Phillipon is good but not god. Suggest you wait and try other modalities of treatment first. It is a fallacy that any medical intervention will make you "good as new." Medical procedures help injuries, but any time you slice and dice into the human body, it leaves behind effects.....scarring for one. Usually the recommendation for patients is that your body will tell you when it is time...eg., when the pain of the current state is worse than any pain after treatment, then go for treatment.

                        But hey....do what you want.
                        Do not confuse motion and progress. A rocking horse keeps moving but does not make any progress.
                        Alfred A. Montapert

                        Comment

                        • Original Poster

                          #13
                          Originally posted by pluvinel View Post
                          Ok....'splain to me why you want to get surgery rather than FIRST trying conservative treatments and backing off sports to let the body heal?

                          Also a point to ponder is why 7 teammates have had this surgery? What sport and what training ethic leads to this?

                          I suggest you read the book, "Unaccountable" by Marty Makary.

                          Phillipon is good but not god. Suggest you wait and try other modalities of treatment first. It is a fallacy that any medical intervention will make you "good as new." Medical procedures help injuries, but any time you slice and dice into the human body, it leaves behind effects.....scarring for one. Usually the recommendation for patients is that your body will tell you when it is time...eg., when the pain of the current state is worse than any pain after treatment, then go for treatment.

                          But hey....do what you want.
                          Trust me, I wonder as well. The sport is rowing. It tears your body apart. As far as surgery, it is my understanding that FAI does not treat itself. I understand that you can do things to strengthen your muscles and support the labral tear, however since FAI is a bone deformality, it does not go away by itself. Trust me, I do NOT want to miss a second of rowing and I am anti doctor in every way shape and form, so surgery is not appealing to me. I had many surgeries as a child due to illness and I'm not a fan. However, if I am going to have serious consequences for ,y actions by the time I'm 30, then surgery would be an appropriate option.

                          Comment


                          • #14
                            While I can understand your avoidance of doctors and surgery, I would strongly advise you to take a step back for a moment and think about the REST of your life. Which, btw, if all goes well, will be a LOT LONGER than your collegiate rowing career or horse back riding career or any other career.

                            My husband asked me yesterday if I thought I could do the Marine marathon with him this next fall. I would love to. I cannot. Physically cannot do it. Very little cartilage left in my knees. I used to run a lot. I would love to train w/ my husband and have that be something we did together. But I can't. Heck, my knees hurt (soccer injuries--meniscus and MCL--4 times) if I have to drive more than about 30 min without cruise control. Just driving to the barn is painful.

                            They hurt when I ride.

                            They hurt when I do pretty much anything other than swimming or walking.

                            Do you want to be limited when YOU are 34 years old? Just to play another game, make it to another race?

                            I started having knee surgeries in HS. I wish someone would've just told me then to knock it off.
                            A good horseman doesn't have to tell anyone...the horse already knows.

                            Might be a reason, never an excuse...

                            Comment

                            • Original Poster

                              #15
                              I understand BuddyRoo that this is for the rest of my life. That aspect terrifies me. Thinking long term is so difficult. I don't want to have to pay for this when I'm 50, and I also don't want to give up my rowing career. I plan on continuing both riding and rowing after college. I have so many questions to ask the surgeon tomorrow. I want to make sure that everything is done right, and that only the necessary and most conservative approaches possible for my injury are taken. I'll be getting a second, and probably a third opinion.

                              Rowing is my passion. I'm obsessed. I really haven't taken more than a week off from it in three years. I really want to find a way to continue without limiting myself in the future.

                              Comment


                              • #16
                                Your passion won't go away. And neither will your sport. And there are other rowing type opportunities as an adult for fun--like kayaking (I LOVE IT!!!).

                                After my 4th knee surgery in college, I quit playing soccer and started coaching kids. It was so fun. ALMOST as fun as doing it myself. LOL. Consider how you can stay in the sport without harming yourself.

                                I truly admire your spirit and I feel your pain (to the extent I can empathize as I've not had the same injuries obviously). But there is so much more life out there!!! You want to be able to enjoy it!
                                A good horseman doesn't have to tell anyone...the horse already knows.

                                Might be a reason, never an excuse...

                                Comment


                                • #17
                                  I had arthroscopic surgery 4 years ago for FAI and torn labrum in my right hip. I waited too long and the FAI caused serious arthritis. The arthroscopic surgery greatly reduced my discomfort in the saddle. I'm a candidate for full hip replacement, but the previous surgery has bought me some time.

                                  OP - where are you located? I can recommend an awesome surgeon in NC, if that is close enough to you.

                                  The recovery process is not fun at all, but the outcome was worth it.

                                  Comment

                                  • Original Poster

                                    #18
                                    Unfortunately, I'm no where near NC
                                    GallopHer, do you mind me asking how old you were at the time of surgery??

                                    Comment


                                    • #19
                                      My understanding - the more successful surgeries are on people who have little to no articular damage, AND have a hip that can be remodeled to 'physiologic norms'. That includes repair of the labrum itself and remodeling the bony sturctures to get rid of the impingements.

                                      AND don't have any bizarro reactions to the surgery. Like psoas tendinitis is a REALLY common side effect of the surgery (again - ask me how I know) and there can be nerve damage as well.

                                      You are correct - it doesn't treat itself - and the surgery is really a 'buy time' surgery. The tear will cause the joint fluid to leak over time, and that can accelerate the formation of arthritis.


                                      Have you spoken to one of the docs re: trying a combination of cortisone/HA injections and PT to see if you improve? If the tear is mild you may be able to manage for quite some time that way.

                                      It's not a surgery to rush into. And it kinda depends on how much pain you are in - and for sure where it is coming from. I have a LOT of pain at times that isn't from the tear..its from all the muscles compensating for instability. Something like ART is good for that as well, and seems to be where some of the lingering post surgical pain can come from.

                                      Comment

                                      • Original Poster

                                        #20
                                        Originally posted by tollertwins View Post
                                        My understanding - the more successful surgeries are on people who have little to no articular damage, AND have a hip that can be remodeled to 'physiologic norms'. That includes repair of the labrum itself and remodeling the bony sturctures to get rid of the impingements.

                                        AND don't have any bizarro reactions to the surgery. Like psoas tendinitis is a REALLY common side effect of the surgery (again - ask me how I know) and there can be nerve damage as well.

                                        You are correct - it doesn't treat itself - and the surgery is really a 'buy time' surgery. The tear will cause the joint fluid to leak over time, and that can accelerate the formation of arthritis.


                                        Have you spoken to one of the docs re: trying a combination of cortisone/HA injections and PT to see if you improve? If the tear is mild you may be able to manage for quite some time that way.

                                        It's not a surgery to rush into. And it kinda depends on how much pain you are in - and for sure where it is coming from. I have a LOT of pain at times that isn't from the tear..its from all the muscles compensating for instability. Something like ART is good for that as well, and seems to be where some of the lingering post surgical pain can come from.
                                        Your posts have been incredibly helpful, so I thank you for that. One of the doctors you listed that fellowshiped with Phillipon is near me, so I'm definitely going to be traveling to him to get a second opinion. I've researched so much on this in the past week and the posts here have been incredibly helpful as well. I'm going to ask our team hip doctor about the delayed gandolinium MRI, and my parents are willing to do whatever to make sure I receive the best care. I think that'll be the next step so I can figure out the extent of cartilage damage and how much I will continue to damage my joints by not getting surgery. I also learned through research that just because you have FAI doesn't mean that it is actually impinging. Many doctors do a x ray where they have you actually move and take a series of pictures as the joint is in motion. One woman had a cam growth, however no impingement was occurring. There was still plenty of joint space.

                                        I want to be damn certain that this is the cause of my pain before I let the surgeon of my choice operate on me. It's a fine line between me toughing it out and me not hurting myself for the future. I know that they'll inject your SI joint, the muscles on the side of your butt (where a lot of people have hip pain) and the hip joint itself to make sure that the pain is actually coming from the hip. Kind of like blocking a horse, I guess. I just want to be VERY certain that this is the problem.

                                        I am willing to try cortisone and physical therapy, and was planning on using cortisone to get me through our spring racing season, but it still isn't a guarantee. I will be getting multiple opinions for sure and will exhaust all options before surgery because I'm not willing to give up a year of rowing to repair my hips quite yet.


                                        Thanks again for the replies everyone.

                                        Comment

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