Hip, Hip....Fixed!

I hate to admit this but I am not superwoman. I usually will work through pain and discomfort as I cannot be bothered by taking time off for rest and the aches and pains usually go away at some point. Well, that attitude has finally caught up with me. I have been suffering from hip pain for a long time now and it was getting to the point where my activities were being affected. I was having a hard time with certain moves such as external rotation and flexion of the hip which during dance is quite common.

So, I finally went to see my favorite orthopedic doctor…I swear my family keeps him in business! Emile is fantastic as he understands the mindset of the athletic patient. We started our journey with x-rays of the hip and then injections deep into the hip with the thought that this was bursitis. Bursitis is inflammation of the bursa which are small, jelly-like sacs that are positioned between bones and soft tissue. They act as cushions to help reduce friction during joint movement. After a series of two injections, several weeks apart, with no relief I asked Emile for an MRI.

The results of the MRI came back as a hip labral tear, femoroacetabular impingement (FAI), and a whole lot of tendonosis in the hip musculature. Let’s define each of these terms for a better understanding:

Hip Labrum: Your hip joint is a ball and socket joint. The head of the femur fits securely into the acetabulum or the socket of the hip…think about how a golf ball sits on top of a tee - the rim of the tee holds the golf ball in place. The hip labrum, made up of soft fibrocartilage, holds the ball of the femur in place by acting as a rubber seal. The labrum’s job is to allow for stability, cushioning, and full range of motion of the hip.

Hip Labral Tear: The labrum can tear away from the bone due to a traumatic injury or repetitive pivoting or twisting motions. Excessive wear-and-tear to the hip labrum caused by abnormalities in the hip joint can also lead to a hip labrum tear. The problem with the labrum is that it has a limited blood supply which makes it almost impossible for it to re-attach itself to the bone without surgical intervention.

Femoroacetabular Impingement (FAI): There are several types of FAI, but the type I had is called Pincer impingement. This type of FAI occurs when the front rim of the acetabulum sticks out too far and the head of the femur bumps into during hip flexion causing damage to the labrum. This is typically a congenital condition or may develop during childhood. Repetitive motion may accelerate damage to the labrum.

Tendonosis: This is a chronic condition involving deterioration of collagen (a structural protein) in the tendons. You may be familiar with tendonitis, which is inflammation of the tendon. This condition is short term, usually just a few days. Tendonosis is more serious as the tissues in the tendon are breaking down. It is caused by overuse.

After we received the results, Emile sent me to a hip specialist. Right away the surgeon said that surgery is needed to repair the tear. I nearly broke down in tears in his office as the recovery period is three months before returning to normal sport activity. I went home and discussed my options with Jeff. The only options were to do surgery the following week or wait until January. After writing out pros and cons, I decided to wait until January…. we had a ski trip to Utah planned the second week of January which made the decision easy.

I had the surgery and it went better than expected! The labral tear turned out to be fraying, meaning nothing was detached from the bone but it was jagged. The surgeon did a debridement in which the labrum is trimmed to smooth out the area. This is a much better outcome than a tear in which anchors and stitches are used to reattach the labrum to the socket. In addition to cleaning up the labrum, the surgeon relieved the FAI by trimming the bony rim of the acetabulum and shaving down the bump on the femoral head. Onto recovery!

Recovery has gone smoothly. The pain and swelling have been minimal. I was supposed to be on crutches for two weeks but the surgeon took me off them after six days. I have just start physical therapy and am working through range of motion activities. The strength building phase will start in a few weeks. I have started walking, without the dogs who are really mad at me right now. I am up to about two miles of very slow walking. I am trying to temper my enthusiasm for activity so that the hip will heal as quickly as possible…easier said than done.

One of my biggest worries besides the drastic decline in my activity level was making sure my Garage Girls were still getting in their exercise sessions. Prior to the surgery, I recorded 24 new workouts so that you will still have new monthly workouts while I go through rehab. Our in-person class schedule will change until I can return to dance so look for those changes on the website. I plan on coaching you through your training sessions from a chair, if need be.

My biggest lessons from this ordeal are that sometimes you have to remember that you are not invincible, listen to your body and what it is telling you, seek our medical attention when needed, and be OK with taking the time to recover. That last one is the hardest lesson to learn but I am working on it!