Resurfacing after Hip Labral Surgery, Post 1
Lots of you have reached out with questions about “best care” practices after hip surgery. There isn’t a whole lot in scientific literature written about rehab, and over many months of fielding questions on my closed HIP LABRAL PHYSIOTHERAPY FB page, I am finally ready to share what Best Care Practices after Hip Labral Surgery may look like.
Today is Post 1 of this series, which will follow me day-by-day, week-by-week, through the highs and lows of my recovery and rehabilitation. Here we go!
First, “What IS Hip Labral Surgery?”
A relatively new term, the surgery is presently called “Hip Preservation.” However I like to call a spade a spade – this surgery is a bona fide hip reconstruction.
This surgery is a major undertaking for surgeon and patient and is constantly charting new territory in surgical techniques and discoveries. A brilliant way to preserve the hip joint, a surgeon is charged with essentially piecing the hip back together and reshaping it to work better than before surgery. It comes with risks AND benefits, many of which I will address in posts to come. It requires serious dedication and a wicked good physical therapist to get you back to fighting shape after surgery. But success begins with choosing a good surgeon who is a specialist in this type of surgery (more on that later).
Not a hip replacement, hip labral surgery rarely ONLY consists of repair of the labrum. Most of the time, a torn hip labrum is an issue secondary to a whole slew of hip disorders that make up a quagmire of highly technical and complex systems that converge during hip reconstruction. Whew, that was a mouthful.
A few of those technical things include hip dysplasia, impingement syndromes (and oh are there lots of different kinds we will be discussing), tendinosis, bursitis, pelvic pain, sexual dysfunction, snapping hip phenomenon (internal and external), anteversion, retroversion, and well, that’s enough to get us started.
Passion for Hip Labral Rehab
Let me tell you that this surgery was everything I thought it was going to be, and a hell (there’s just no other way to put it) of a lot more. I would have LOVED to avoid surgery, and heck, to avoid the injury that led to surgery – because I don’t know a single person who would prefer to gain clinical expertise by actually suffering through the injury or surgery. But alas, adversity is often what makes us better.
As you may guess, I did experience a single traumatic injury – which then proceeded to give birth to a perpetually poorly behaved, havoc-wreaking monster of a chronic condition. The funny thing was before the injury, my area of clinical expertise was ALREADY orthopaedics and women’s health. You can see I was kind of in for a colossal butt-kicking lesson from the universe. Oh the irony…
I did try to prepare myself for the road to recovery though. Read my post on Shutting Down to Move Forward: The Therapist Becomes the Patient.
But trust me, I would rather NOT have gleaned clinical expertise on hip labral and pelvic injury through personal tragedy.
Nonetheless, I knew that my journey from hip reconstructive surgery back to health, was going to help more than just me. I could use it to help so many others who wrestle with that same monster.
But yea, there are a few challenges to recovery:
- I am mother. Of three boys. Ranging in age from 3-9.
- I was/still am trying to finish my doctorate.
- I completed a book chapter for a colleague’s new text on Fostering Creativity in Rehabilitation and a research manuscript during early post-op.
- I had to maintain a full teaching schedule that required walking and stair climbing (which I couldn’t do) and lots of standing (which I also could not do).
- The final straw was, midway through rehab, my oldest son received a special needs diagnosis.
Nevermind having clean laundry and healthy meals to foster healing (and maintain sanity).
I mean, a human can only do so much.
The point is – I didn’t live tweet or post about my recovery in real time.
The Bright Side
The good side though – is my delay in posting has given me much needed time to reflect on what variables are most critical to the recovery process.
If you are considering hip labral surgery, please read Top Five Must Have Hip Labral Surgery Tips to help you prepare.
Other colleagues I know have released blog series in real time, a chronicle to their injury and recovery. Shelly Prosko and her traumatic Achilles Tendon rupture, is one of those colleagues. Also a physioyogi, I highly recommend Shelly’s series on her recovery. Read here or cut and paste: http://www.gingergarner.com/2014/10/28/medical-therapeutic-yoga-achilles-tendon-rupture-missing-link-rehabilitation/
Now onward and forward, I am (finally) sitting down to write, 5 and a half months AFTER my surgery.
I hope you’ll join me on my journey through Hip Preservation, er, Reconstruction Surgery and that, most of all, you’ll find something that will inspire you to more complete healing and recovery.
Resources
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This page is private and CLOSED. You will have to request membership, which I have to approve. I have been fielding questions and growing a network of international HIP LABRAL physical and physiotherapists experts who can help direct you to the who’s who of hip preservation so you have the best chance for recovery. Join the HIP LABRAL PHYSIOTHERAPY & PHYSICAL THERAPY NETWORK
Hi Ginger, I have developed severe pain in my hips in the last 3 months. I am a yoga instructor for 9 years and practitioner for 13. MRI has confirmed trochanter bursitis in both hips, tendonitis in both hamstring attachments with partial tear in left hamstring. A labral tear in the left socket at 2:00 point. I also have pain in both groins and moderate degenerative changes of the pubic symphysis versus osteitis pubis…not sure what that is.
I am not particularly open in my hips and have never forced this area, however, I am an athletic type and I swim, run, bike, and participate in aerobic classes. I love to hike and bike outside. Suddenly my life is drastically different. I am not considering surgery yet. I also have pelvic floor issues from two child births. Several surgeries have left me with lots of scar tissue in my pelvic floor. I also have degenerative disk disease and bone spurs at L-4. The x-ray also confirmed some scoliosis in my thoracic spine. I have lived fairly pain free and had a very active life until these last 3 months. I am 58 years old and learned of this since the pain became pretty debilitating. I would like to follow your blog.
Hello Karen,
First, I am so sorry you are experiencing such pain and debility as a result of pelvic and hip issues. Second, I am glad you found me. As you probably have learned by now, I am a physical therapist who specializes in women’s health and orthopaedic issues – particularly concerning the pelvis and hip. My first recommendation would be to ask about the type of therapy you have received so far. I would highly recommend finding a women’s health therapist in your area who also specializes in hip issues. Second, I would recommend that you follow my blog. You can sign up for my newsletter on my front page: http://www.gingergarner.com. Third, if you have any questions you can certainly contact me through my site as well. Many thanks and best wishes for your recovery, Ginger
Hi hi Ginger, I have suffered with hip related problems for many many years,I was 17 years old. It was 1960 I presented with pain down my (R) buttock and was referred to ortho consultant and after exrays was told I had to have a plaster cast fitted which I would wear for six months. In those days patients were not encouraged to ask questions so I just accepted that I would be going into plaster. The consultant did’nt proffer as to why I should have this. I had the full plaster of Paris fitted from below neck to over my hips. After 6 months I had review and was told I had to have a further plaster fitted, no explanation again so I had the same again. I should mention that even before the 1st plaster was fitted I was experiencing pain and fatigue in my (L) hip which I pointed out to the plaster tech appeared larger than my (R) hip. During and following all this I had no relief from Sciatic pain predominant to my (R) side. I guess you know from what I have said here (with your experience and knowledge that I was hatching a scoliosis to my left side. I am now 73 years and I have never ever had any relief from pain despite two laminectomiesand a case file 2inches. I have without question bee completely mismanaged by the British health service my general health is good for which I am grateful. My hips are a thougher mess I have nil abduction to my (L) hip upon Patrick’s test and very limited abduction in my (R) hip with painfull internal and external rotation especially to my right hip. I have related this to you purely to make you aware of the treatment people received in the UK even to this day due to such poor understanding of the Psoas muscle by the laziness and ignorance of the medical here. I have found your articles very progressive, and informative. Barry Mcgowran.
Hello Barry,
I am so sorry you received such treatment – and disregard for your own choices and rights with respect to control of your own healthcare. Thank you for making me aware of your struggles and for sharing your story. You are courageous for doing so – and I hope you have found some type of relief or assistance now? I would hope so! I do come to the UK to teach – and have often discussed the possibility of teaching coursework to health care professionals about better care of hip injuries. Hopefully better hip care will become a reality – as PT’s have much to offer to assist in improving hip health outcomes.
Hi Ginger
I believe I have made a mistake. I had a total hip replacement on June 16, 2016. I did the physical therapy at home but I did not do the therapy out side of my home. It has been a year and my hip is still in pain. I walk with a limp. I can barely climb stairs. I can hardly walk. It have made me so depressed. Is it to late to do something about my situation. I cannot do the things I use to do and it is effecting my job. I am a peace officer in the jail. I just cannot do the things I use to do and I feel like a failure. Please help me on what should I do. Thanking you in advance.
Cynthia
Hello Cynthia,
Thank you for reaching out and for sharing your story, as well as your insightful questions. The first and most immediate recommendation I would make is to seek physical therapy care as soon as possible. Early intervention is best, but in absence of that, I want you to know that you are NOT a failure. This lack of progress after your hip replacement is not your fault. Your healthcare providers should have emphasized the importance of both at-home and in-clinic physical therapy – and honestly, the message rarely gets delivered or delivered well. Our healthcare system has failed you in this aspect, and at no time should you ever feel like a failure. That said, you still can make a full recovery and feel good about your total hip replacement. Most states have direct access to physical therapy, which means you do NOT need a referral in those states. I would also look up your insurance coverage for physical therapy and see what kind of access you have, financially and logistically. Remember, it’s never too late – and it has not been that long since your hip replacement. You have every chance to make a stellar recovery!
All the best, and hope this helps,
Dr. G
Hi Ginger,
My name is Irene and I live in Chapel Hill. I have recently been diagnosed with a large labral tear of the left hip. I have had symptoms of hip pain for over a year. I am now looking at surgery options to repair the tear. I am hoping to see Dr. Brian White at Western Orthopaedics in Denver, CO. I would like to find a great hip PT locally however. I thought you might be able to recommend one or more people who could help me with PT either before and especially after surgery.
Sincerely,
Irene
Hello Irene,
Good luck with your surgery. I’ve heard good things about Dr. White. You do need a good hip PT locally, yes, and will for at least 1 year post-op, in order to get the best outcomes. I would recommend looking at this list of folks I’ve trained first: https://proyogatherapy.org/for-patients/find-a-therapist/ Dr. Sarah Talley, DPT is in Raleigh and may be able to help you. She is on the list.
Hope this helps,
Dr. G