Toadmeister

Not a sympathy thread. Checking to see if anyone else has had this injury in the hip, surgery, what recovery was like, and how soon you got back cycling again?

I’ve had the injury over a year now, finally had an MRI done to confirm it. I limped and struggled thru a year of cycling doing OK for the most part if I didn’t push too hard. Light cycling is OK. I did RAGBRAI last year regardless but would have done more gravel and bikepacking were My hip feeling better.

Thinking delaying surgery till fall and trying cortezone shots to get me thru this spring and summer. I’m not happy taking Ibuprofen all the time.

please share your experiences. Thanks.

rosefarts

Who is suggesting arthroscopic surgery?

I don’t know your age. I usually see it done on women between 16 and 30, never over 50. Almost never on men, again, only on young ones.

Painful sex for women is the most common reason for surgery. Or cheerleading and gymnastics.

I’d get a second opinion. It’s semi rare and I doubt it’ll help cycling. Cortisone? Rest? PT? You have options.

Toadmeister

Almost 50 here. I’m a 6’4” 270# Clydesdale if that puts things in perspective.

I did PT last year for about 4 months. It helped with the secondary issues of tight muscles on that side but it never gets to the root of the problem. I do yoga now which seems to work better than PT for that.

I see a surgeon next week to discuss arthroscopic surgery. I’m concerned if I don’t fix the root of the problem, I will continue to needlessly suffer and not enjoy my full cycling potential this year. Ibuprofen, ice, and rest (not biking) suck.

Seat height on my bicycle is critical for not aggravating the problem. Sex with wife has been no problemo in context of this issue

rosefarts

If I had to bet, I’d say the surgeon is going to try to dissuade you from a hip scope. He may discuss other surgical procedures (total hip) but that depends on the mri.

Lots and lots of people, even athletes, are walking around with a torn labrum and are pretty much fine. The pain is the concern here. I’m curious what the surgeon is going to say about that.

Toadmeister

Actually injured it as a result of too much biking (repetitive motion) and not enough other stuff (basketball, hiking, cross training) during COVID because gyms were closed. Happened during the end of a long cross-country Fat bike race, the Triple D Winter Fat Bike Race, Dubuque Iowa. I was actually doing the DD 28ish miler and stopped for a quick rest like 1 mile from the finish. Stood up on the pedal to take off again and WHAMMY felt like I got shot in the hip/upper quad/groin. Peddled one legged to the finish.

leg hasn’t been the same since in over a year. Easily aggravated by driving or sitting badly too long also, not just biking. I might argue light biking is good PT on its own with Yoga to keep things flexible. Pedaling hard on hills can aggravate it.

Toadmeister

The rest of the hip joint appears fine via MRI and X-ray according to my Orthopedic doctor. Absolutely no need for a total hip surgery. Cartilage is torn and probably needs sewing back together. I guess I’ll find out what the surgeon recommends.

Fredo76

Gobbling ibuprofen can give one a life-threatening bleeding ulcer (ask my wife). Or kidney disease (ask my kidney doc). Relying on ibuprofen long-term is not a solution, seriously.

Good luck with your hip. I've had hip replacements, but know nothing about a labrum tear.

Pratt

First, I have no idea; never even heard of the procedure. But surgical skill is not distributed like a nice bell curve. Surgery has, just like cycling ability, a lot of mediocre practitioners and a very few really really good ones, way off on the righthand tail.
If I were in your situation, I would research who the University of Iowa uses for their football, and other, teams. He will be good and will have a strong bias toward restoring/maintaining function. If you were elsewhere, I would recommend professional sports teams, but I'm not aware of any in Iowa.
Good luck.

Toadmeister

Thanks for this feedback, exactly what I was looking for! Yes, it will be at the University of Iowa hospital.

https://uihc.org/health-topics/hip-labral-tear

KerryIrons

I have zero insight on your issue except to say that there are many things that can be surgically repaired that can also be dealt with non-invasively. Two personal examples: I damaged (tore) my rotator cuff three times and finally it was suggested I do some specific exercises designed to strengthen the shoulder. I have been doing them religiously for decades (literally 30 + years) and zero issues since. I was warned by a doctor "Don't let them cut you!" More than a decade ago I was told (via x-ray) that I had terrible arthritis in one knee. I was given PT and told that a knee replacement was not far off. I have been doing those exercises daily since the diagnosis and my knee actually feels noticeably better than when I was diagnosed. I think doctors have become accustomed to their patients demanding quick fixes and knowing that patients won't do the needed self-work to deal with chronic conditions. Most people do PT for as long as the prescription lasts (or less), feel a bit better, and then quit. Things like this sometimes should be lifestyle changes rather than short term fixes.

Toadmeister

Very good point actually. We are sometimes conditioned to believe that a surgical fix is needed when it always isn’t.

I did do PT for 2-3 months. Certainly helped some but never got to the root of the problem. I’m turning to surgery now after a year of suffering thru it. Many ups and downs where things got better for a while but than get worse again. I need a permanent fix and not a band-aid.

Ubie

Ugh, thank you for this post. Now i now what I need to discuss with my doctor at my next physical. Your post led me in to a deeper dive of my issues. Deep 'popping' in my hip, clicking sound/feel when rotating my kneecap inward, general tightness and loss of range of motion.

MinnMan

I strongly suggest a second opinion. More specifically, come on up to the Twin Cities and see Dr. Chris Larson at Twin Cities Orthopedics. He's one of the most experienced hip surgeons anywhere and does most of the orthopedic surgery for local teams (Vikings, Wild, etc.). (When you go to his office, you'll also see a signed poster from Greg Lemond, thanking Chris for the great work.)

If you go into the peer-reviewed medical literature on arthroscopic hip surgery, you'll find he wrote some of the most highly cited papers in the field.

I was told by an orthopedist that I had a labral tear. Larson looked at all the imaging and said, well yeah, you do but surgery isn't going to help and has more risks than benefits in your case. He won't cut you up unless you really need it and will benefit.

But if you do actually need the surgery, he's probably the one to do it.

An appointment will take time - he's in gigantic demand.

msu2001la

I have experience with this. I developed labrum tears on both sides due to FAI as a distance runner. I started experiencing really severe pain in my left hip while standing/walking (oddly not while actively running, which of course resulted in me ignoring this for a while). After many months of PT/strength, NAISDs and Cortisone shots, I had arthroscopic surgery on my left hip in 2014. I went through the same procedure on my right hip in 2016.

I had mine done at Midwest Orthopedics at Rush in Chicago, if you're interested in a second opinion: https://www.rushortho.com/doctors/shane-nho

To answer your cycling question directly, I used cycling as a major part of my rehab. I was on a stationary bike within a few days of surgery (just for range of motion) when I was otherwise non-weight bearing. I was biking 20-30 mins a day after a week or two, and was biking almost daily on the trainer throughout my recovery.

My recovery was different between both surgeries. In addition to labral tears, my left hip had extensive cartilage damage, and in both cases due to FAI there was some bone re-shaping done to both the femur and hip socket. I had microfracture done on my left femur to help regenerate some new cartilage growth. Due to the microfracture I was non-weight bearing for 8 weeks after my first (left) hip was done. My right side was far easier and I was working my way off the crutches after 2-3 weeks.

In both cases, my total recovery was in the neighborhood of 4-6 months, but really the first 4-8 weeks was the most limiting and intense. After that I was doing PT 2-3x a week and just a ton of core/glute strength stuff and stretching. I had a post-op flare up about 18 months after my right side surgery - I was convinced I had re-torn my labrum. MRI and xray confirmed there was no damage, just inflamation so I did another Cortisone shot and 8 more weeks of PT and that totally solved it. No issues since.

My advice:
It sounds like you've done this, but for anyone else reading - find an ortho doctor that specializes in hips. There are a lot of knee doctors out there doing hip scopes, and they aren't the same thing.

Find a PT that specializes in post-op ortho recovery. This makes a huge difference in recovery time and success, and I met a number of patients during my recovery that started with crappy PT's and had major setbacks during post-op.

Do as much core/glute/leg strength training as you can pre-op. The stronger you are, the faster you'll recover.

Good luck. Feel free to DM me if you have more specific questions.