I have finally had some readers reach out with questions about hip pain, surgery, and FAI which was my whole goal of sharing my experience. I thought I would write a small post about pre-surgery, my symptoms, and what I considered my "essentials" for recovery. I really haven't written the nitty-gritty truth or lamented each day of the process because for me, that would hinder my healing mentally. All in all, for me this was a positive (yet not easy) choice and I would rather not focus on the negatives of an elective surgery. Yes it sucked that my labrum tore, but it was my choice to do the surgery. Know what I mean, peeps?
However, it is helpful to know and understand what you're in for if you do go through with this surgery. I have a few earlier posts with a great picture of my actual torn labrum found here as well as some thoughts before the surgery itself in this post! As I have mentioned previously, if you have a torn hip labrum (like I did) as well as FAI like I did/and still do in my left hip (a structural impingement of the pelvis and head of the femur) you will find it hard, if not impossible, to read positive blogs and sites about the surgery; for one main reason; IT HURTS and it's a long recovery.
Initially, the only blogs I found were so upsetting it almost terrified me and my family to even consider the surgery. I was so lucky, as I have written before, to find Ashley at Fitness is Delicious to see a fellow runner and triathlete be so positive in her recovery. She is my long-distance hip home girl! However, if and when you decide to go through with a repair or FAI correction, there are some things I would consider buying or having around and my list is below.
If you think you might have a torn labrum or are having hip pain, my journey is below. It is not meant to diagnose you, but I do think it's helpful to hear someone's perspective and then consider your options. I was pro-active in finding a top surgeon and physical therapist. So you have to take control of your body and recovery-not settling for anything less than the best.
Pain & Misdiagnosis
While everyone's symptoms are different, torn labrum pain and FAI can be commonly misdiagnosed as a psoas strain, tear, or groin pull...as mine was. It began as a deep ache and throbbing in my groin and spread around to the glute. When I still couldn't walk three weeks later after onset, I was absolutely not believing it was my psoas as some practitioners told me. I did countless hours of research, meeting with surgeons, and finally got a hip MRI (they do place a needle into your joint capsule to inject dye.) showing I had a torn labrum and FAI in my right hip, as well as glut medius tendonitis, and a stress reaction in the head of my femur. Whew! It felt so good to have a concrete diagnosis. No more guessing. So please ensure if you suspect you have these similar symptoms, go get checked out and obtain imaging to be positive, trust your instincts if you think it's more serious.
I first began to feel pain when I was training very hard and trail racing frequently last summer of 2013. I was doing hard trail half marathons almost each weekend, and part of my training plan included steep hill repeats that required sprinting up a steep grade with a constant lifting of my knees and hips, and I am talking about running hills that are hard to simply walk! So it was very vigorous. I was also doing high level Pilates and strength training with repetitive deep hip flexion, thus, I don't believe one thing in general was the culprit, rather all the things I did exacerbated an already existing deformity in my pelvis-and weak hip muscles also contributed.
The pain began as a deep hip/groin ache and radiated to my low back and outer bum cheek. Since I am an athlete, runner, former gymnast, I simply accept the fact that there is pain in pushing your limits. So, I indeed kept training on it, ignoring the fact that the throbbing pain was not really going away. With a goal race in mind, my annual half marathon in Oregon, I was in a moderate amount of pain but decided to still race it anyways.
Race & Finish Line
Once I got to the race, I went ahead and warmed up with an easy mile, definitely a little limp, but decided it would most likely shake out and my drive/mental strength could push me through! And boy oh, boy did it ever. I just wasn't ready to give up after the hard work, travel, and hours of time running. At about mile 6, in what was later named the hilliest course in America for 2013, I had searing fire deep in my joint that made me almost throw up just out of raw pain. At that moment, I knew there was deep damage and something was wrong. My surgeon later told me most likely my hip cartilage was already torn before the race, so the 13.1 miles definitely did the final trick. I look back at photos of my face in in excruciating pain, but I ran all 13.1 miles and crossed the finish line-I am shocked I could push through. I was hardly able to walk as I crossed the finish. Sometimes you simply cannot give up a hard earned goal and my husband totally understood. To this day he and I both agree that I would have felt worse not racing and not trying as opposed to just giving it a shot. Many of you might consider it crazy or reckless-however, I have stopped defending this athletic brain of mine. Yes, I ran on torn hip cartilage but I also have learned lessons only known to myself and I do believe it was a matter of time until it happened; surgeon also agreed.
Post race I was unable to walk or put weight on my right leg but the fact that there was a little wine after the race assisted in easing the pain for the duration of the day! The limping, deep and sharp throbbing, and groin pain continued for three weeks until I decided to get imaging which of course, showed all the aforementioned items. With rest it subsided slightly, but with activity it worsened. With all my research and reaching out to others; I quickly realized that a torn labrum or FAI does not heal on it's own. I also have a BS in Exercise Science and know the properties of cartilage. If you don't do a repair, you will simply manage the symptoms of the tear- which I hear some people can do quite well. For me, however, I think managing the symptoms would have felt like a Band-Aid, just masking it and not really trying to fix what is wrong. Not only that, I couldn't live a life where the more I tried to do, the more it hurt. That is just not me. I did my hours and hours of research and found that the top doc for this surgery is Dr. Marc Phillippon out of Vail, Colorado.
Since he was the leading in the nation, what did I do...? E-mailed him of course. Silly you would even ask.
I asked him if there was anyone in Wa. he recommended, which ended up being Dr. Doug Nowak out of Everett Bone & Joint. Dr. Nowak studied under Dr. Phillippon, he is an athlete himself, and is highly adept and trained in hip arthroscopy. It is not a minor surgery and you want someone with solid credentials. I did meet with a couple other surgeons but once I met with Dr. Nowak-I knew he was the right surgeon for me. He listened, didn't act quickly, understood my goals, and never rushed me and his patient reviews were solid. He even told me to think about surgery for a few weeks and see if the torn labrum was something I could live with-how great is that? A surgeon that was encouraging me to NOT jump on the table like other surgeons I met with. He understood the magnitude of surgery and wanted me to think about it as well. I quickly decided it wasn't something I wanted to deal with, and so I scheduled surgery with him three months after my diagnoses.
I was in surgery for about two hours where Dr. Nowak expertly reattached my labrum, shaved off and re-shaped the surface of my femur and pelvis, and lengthened my psoas tendon in the front of my hip. In order to access the deep joint capsule, the patient is required to be in distraction (aka in a boot that slightly dislocates your hip for instrument access). I recall waking up and being so thrilled I went through with it, considering the night before I could hardly eat I was so nervous. It is a surreal feeling to drive to surgery in your given body knowing you will wake up not how you went in!
The immediate days after surgery are a bit blurry since I was taking medication on a rotating schedule and just trying to cope. If you are getting the surgery, make sure you have loved ones around you to help you maneuver around for the essentials. My husband was my primary source of physical help, lifting me up and down off the bed, onto the toilet, and in bathing and my Mommy was my cook, housekeeper and leg adjuster. When you have the labrum repair it is a bit different protocol from just FAI surgery. So please note that mine included both procedures. What I think people didn't understand and still don't is that I was non-weight bearing for 4 weeks, then partial weight bearing after that, with full walking 8+ weeks after so you are off your leg and joint for weeks. You do have to re-learn to walk. Not only are you using crutches to protect the surgery, you are also not allowed to lift your actual leg to avoid psoas tendonitis. Once I began walking, my muscles were totally atrophied, my neuromuscular connections were gone, and all my muscles around my hip were painful and weak.
Depending on your surgeons protocol (I appreciated Dr. Nowak's as he was cautious with strength and assertive with range of motion), physical therapist, and surgery, your movement will be minimal to begin and then you can add on more and more. Another reason it's essential to have people you trust around you is because you will rely on them to do your exercises for you passively. A few other things my friend Ashley mentioned is the pain meds will indeed goof up your digestion so please make sure you take fiber! It's a very painful side effect when that area is already in so much pain and swollen. My friend Shawn suggested a reaching device to help because you cannot bend down at an angle for quite some time which was also helpful.
Be aware that when you remove the bandages there is lots of blood, fluid, and swelling. So it will look much worse, and it's helpful to have someone there with you to absorb the shock of seeing your hip in that way.
I have been asked continually how bad it hurt and to be honest-I was surprised at how deep it hurt in the first weeks after and how often moving it wrong way jolted it with pain; but you have to remember that just because it is an arthroscopic procedure doesn't mean it's minor! You have layers of tissue, fascia, and bone that they need to access, so know that. When I look back sometimes I think that running the half while it was torn was more painful that surgery itself though!
Essentials & Things to Remember
1.) Loved ones: for movement assistance, bathing, food, and ice. Most importantly for support, love, and comfort!
2.) Crutches: my mom got me extra cushions for my underarms because your ribcage, etc. get over rubbed and pressed by the crutch.
3.) A surgeon you can call: When I slipped and was terrified I ruined the surgery, Dr. Nowak was so great to access and he even called to check in on me. Great for a piece of mind.
4.) Shower chair: my mom brought one with her and it was a LIFE SAVER. I was very unstable and could have slipped in the shower. Not to mention, recovery is exhausting. Sometimes just crutching around up and down stairs was so taxing. It was great to sit and get clean. You typically won't/can't lower yourself into a tub (or submerge your sutures) for weeks.
5.) A good book.
6.) Lighthearted magazines.
7.) Funny shows & movies.
8.) Recovery Ice Compressor/Ice Man Wrap: This is a big one. This machine wraps around your whole hip and pumps ice water over the joint to it's seamless, smooth, and you can rest with hit on because it is secure. I actually slept with it on the first few nights. Wear layers because you get cold, and have a good cup of tea near you. The compression helps tremendously with inflammation-I will still use it after harder and harder exercise.
9.) Warm socks/larger pants: when you are not moving as much your circulation is poor, so I found my feet always cold. Not only do you need larger pants to fit over the dressing, you have to be comfortable! I found the tighter the pants the more it pressed my stitch thread into my skin, ouchy.
10.) CPM Machine: I know some people who have only had FAI and not a labrum tear did not require this. If it's suggested, GET IT. Continuous Passive Motion Machine will manually move your leg for your from about 30 to 70 degrees. My friend Shawn who got the same surgery, also highly recommended it! It feels great to move in some way, even if it's not you doing the moving. It's also been proven to reduce scar tissue in the joint and while the labrum is healing.
11.) I recommend a spin bike for home or somewhere near you if possible. My husband got me a spin bike in great condition and I used it two days after surgery to get my hip moving. It was terrifying and excruciating, but necessary.
12.) Massage. I began lymphatic massage less than a week after surgery. My close friend was kind enough to drive out to me weekly to care for my hip...and emotions to be honest. Lymphatic is specifically for enhancing the lymph system and assisting in reducing swelling. As weeks went on, she began to work muscles and eventually the scars/incisions. I still see her once a week for scar tissue and recovery.
All in all if you find out you have a torn labrum, I feel like these are some of the take home things to think about and have ready to go. If you have FAI and no torn labrum, I would encourage you to speak with a surgeon and look at correcting the impingement if it's symptomatic or your labrum is in danger so you don't have the potential of further joint damage. The most important thing you need, remember...is lots of inner strength and focus. I am 5 months post op and am back to so many things I enjoy and hope to return to 100% at my 1 year mark-right on track.
XO In happy hip health.