Hip Labral Tear and Impingement
Apparently the hip is a very complicated part of the body, and apparently you can see several different kinds of medical professionals who specialize in treating the different parts of the hip. While this may not be news to you, it certainly was to me, and as I sit here on my couch recovering from surgery, I am looking back on all of the different experiences that I’ve had getting to this point.
The Beginning
It started with a dull and tight pain deep in my pelvis that presented itself the first time I ran after my son was born in August of 2016. I was fortunate enough to be able to exercise, and exercise well, the whole of my pregnancy with Benson, and I felt strong and ready to get back into shape after he was born. This pain that I mentioned didn’t go away, and the more I exercised, the more painful it was. It started out feeling like the muscles deep in my pelvic floor, on the right side only, were tightening. Kind of like a Braxton-hick’s contraction. I just figured that my body was still sorting itself out and that it would soon resolve itself. The pain didn’t go away, and as it got worse, it started to feel sharper and more intense. I started feeling it more often, more than when I would exercise. Other things that aggravated it were: walking long distances, sleeping, and holding it in certain positions, such as the butterfly stretch.
The pain got to the point where I had a hard time getting out of bed, and then I had to limp and hold onto things to get myself going after I did get out of bed. The pain would subside after walking around a little bit, but it would present itself throughout the day as I was running around town with my kids, or chasing them around at home, or trying to play with them on the floor. I also mistakenly played soccer one evening, and had to stop about an hour after playing (I thought I could just play through the pain, but that was a terrible idea), and I could hardly walk the whole next day.
First Appointment
When Benson was almost 10 months old, I finally decided to get my hip checked out. We were on our first internship in Florida at the time, so I found an OB/GYN to make an appointment with down there. She was very thorough in her examination, and even did an ultrasound to make sure everything was okay with my uterus, ovaries, etc. She referred me to a physical therapist that specialized in treating the pelvic floor. After about a month of visits and no difference in pain, she told me that I could have tendinitis in my hip. I decided at that point that I had to stop exercising and let my hip rest. By this time, our internship was almost over, so I waited to see anyone else until we got back to Indiana.
Back in Indiana
The next medical professional that I saw was another physical therapist here in Indiana, and after some testing, they believed that my hips were out of alignment and my muscles were in pain from overcompensating. They used different methods to realign my hips and heal my muscles, but still nothing changed.
After talking to a friend, I decided to try a chiropractor. They tried doing some things to help realign my pelvic bone, and thought that I had some strained muscles in my lower back that were referring pain to my hip. After some adjustments and a deep tissue massage, I didn’t think that this was the correct route, and stopped going.
I finally went to my OB/GYN here in town, (who I adore BTW!), and she sent me to a different physical therapist in the same building, who she sends almost all of her women to. After an initial evaluation, she gave me some exercises to do to strengthen my hip.
Miracle #1
By this time, my son was about 14 months old, and I was feeling as if we were still not any closer to finding a diagnosis. Now, I’m not sure what you believe in, but I truly believe that God was in all of the details of this experience. I have been learning patience, have needed to take a step back and slow down, have been blessed more than I deserve, and I believe that God certainly has had some lessons for me to learn. At this point in the journey of healing my hip, I had an experience where I woke up very early one morning- and FYI I am totally not a morning person. It was about 5am; I woke up abruptly and couldn’t fall asleep, so I went out to the living room to read. I started browsing the internet, and then began searching for more information about hip pain. I had done this many times, but had never come across the new information that I found this particular morning. There was a blog that I read about a girl who had had hip pain and had a very hard time finding a diagnosis as well. She wrote about the problem that she had, and her diagnosis ended up being a hip labral tear. A hip labral tear is a tear in the cartilage of the hip joint. The only way she was able to find this problem was to receive an MRI. This girl also mentioned that she had to have surgery, but was able to fully recover. I felt like this was the answer I was looking for! My emotions overcame me, and I started crying, even though it wasn’t even sure if this was the same problem I had or not.
At my next physical therapy appointment, I mentioned a hip labral tear, so the physical therapist tried a couple of different motions that might trigger the pain of a hip labral tear. Well, the motions that she did didn’t cause me any pain, so she didn’t think that that was the problem. Aggghhh, I was so disappointed. Not because I wanted to have surgery, but because I was SURE that I had a hip labral tear. Another couple of weeks went by before my next appointment, and while I believed that the physical therapist did her best and was thorough in her examination, I still had a small feeling inside of me that knew that it was a hip labral tear. At the next appointment, I brought up the tear again, and my physical therapist was kind and did a couple of different hip motions to trigger the pain again. All I have to say is O.U.C.H. Yup, the pain was triggered, and she said that I should get an MRI to know for sure.
After this appointment it took 2 MONTHS to get my MRI. Reasons for this: Waiting for a call to schedule. Wasn’t happening. Calling them to see if it could get scheduled. Needing to wait for them to send the referral. Calling them some more to see what was going on. Still waiting for the referral. Got a call to schedule, but I asked if I could get an arthrogram with it (see below). Needing a different referral for the arthrogram. Waiting. Finally getting a response after sending an email. Scheduled the MRI. Had to reschedule two days before the MRI, because they took too long trying to get the authorization from my insurance. All of these things were very frustrating, but there was an amazing blessing during this waiting time.
Miracle #2
Our next-door neighbor was helping us move a large piece of furniture that I had made into our house, during the waiting time of scheduling my MRI, and we chatted with him a little bit about how his job was going. He works for the Purdue football team doing sports medicine. He mentioned that there were several injuries that season, and mentioned that one guy was having surgery for a labral tear in his shoulder. Oh my, YES! (sad for the football player, of course) I was so excited to talk to someone, in person, who had experience with these types of injuries. Our neighbor gave us a lot of useful information as we told him about my problem, and the best advice that he gave us was to get an arthrogram with the MRI. An arthrogram is when they inject a dye into your joint so that certain things will be highlighted on the MRI. When I read the blog about the girl with the hip labral tear, she mentioned that the tear didn’t show up on her first MRI, but didn’t say anything about an arthrogram. The orthopedic surgeon said that it was great that I got the arthrogram, because it helped them see the tear, that they might not have seen otherwise. Divine intervention, people.
MRI » Orthopedic Surgeon
Fast forward to the MRI. I will go a little quicker here, so that we can get to the surgery.
- The arthrogram was decently painful, but I’m not a person who gets queasy about needles.
- I got a little bit claustrophobic during the MRI scan, but nothing too crazy.
- A doctor at the hospital where the MRI was done did a quick scan of the MRI and saw a small tear in the cartilage.
- I scheduled an appointment with an orthopedic in town.
- Went to this appointment where the orthopedic looked more deeply into the MRI, and determined that I did indeed have a small tear, and that my femur bone had overgrown (impingement) which put a lot of pressure on the labrum and caused it to tear (probably during childbirth).
- Side note: the ball of the femur bone can overgrow, which can occur from a lot of jarring to the joint. They are seeing this problem commonly among runners and soccer players, and seeing that I grew up doing both, it all made sense.
- As it turned out, that first orthopedic that I saw stopped doing the hip surgery that I needed a couple of years ago. Face palm.
- Scheduled another appointment with a different orthopedic at the same practice, and talked over how surgery and recovery would go.
- The surgery is arthroscopic
- They needed to shave down the overgrown bone
- They would probably need to stitch up the torn labrum
- Crutches for the first month, wean off after that
- Total 4-6 month recovery with lots of physical therapy thrown in there
- Took a couple of weeks to schedule this surgery, because it took the office a while to send the referral. Is this a common problem that other people have? Everyone that I talked to during this whole process didn’t think so. Oh well.
Surgery Day
Even though it seemed to take a long time to get to this point, the surgery seemed to sneak up on me. It was done Friday, February 16th, and my husband took the day off of work/school to take me to Indianapolis for the surgery. My dad came into town to watch our kids, and we are so grateful to him for that!
We were told to show up at the hospital two hours before the surgery, so we got there at noon. After filling out all of the paperwork, they took us back so that I could change into my hospital gown, and soon after I met the anesthesiologist. Nick had left for the waiting room at this point. A nurse put the IV in my arm and hooked me up with some fluids. The anesthesiologist gave me a nerve block in my hip, which basically numbed the lower right side of my body, and was meant to last for about 24 hours.
The nerve block made me very tired, and I just remember mumbling to myself and almost falling asleep a few times. The hospital was a little behind schedule that day, and my surgery kept getting pushed back. For some reason, no one came to see me after my nerve block for 2 hours! I couldn’t believe it. I was a little confused because of the nerve block, but I was sure that someone was supposed to at least check on me to see if I was doing okay. I didn’t have any kind of button or phone to call a nurse. No one was around by my little open-curtain room, and once in a while someone would walk by, but they were too far away to talk to. In my mind I set a deadline that if they didn’t come and talk to me by a certain time that I would call to the next person that I saw and ask them to send someone to me. Fortunately I didn’t have to do that, because the anesthesiologist walked by soon after, almost walked past me, but upon noticing my look of concern, came to talk to me. Hallelujah.
Not long after that, they wheeled me to the operating room. I don’t remember much after that, but I know that I said “hi” to a few people, and one of the nurse’s names was also Whitney.
Waking Up
The surgery lasted about 3 hours. I probably stayed asleep for about an hour after the surgery, and when I woke up, it was a little after 7pm. It felt like waking up from a very deep sleep, and I almost started to go into shock, because I thought I was at home waking up in my bed. I felt super emotional, but was somehow able to hold back my tears. All I knew at that point was that I wanted Nick to be there, and that he needed to be there immediately. I’m so glad that he got there quickly, and I felt so much better! Another weird thing about waking up was that I could not stop shivering. I didn’t really feel cold, but the nurse said that that’s a normal reaction to waking up from surgery. True to form, waking up and going home from the hospital wasn’t quite a pleasant experience. A few weeks before having this surgery, I was told that I would be at the hospital for a couple of hours after I woke up to make sure I was well enough to go home. Well, that didn’t happen, as they had us leave about a half hour after I woke up. Yup, I was still barely able to keep my eyes open. Nope, I hadn’t gone to the bathroom yet, despite being on fluids for about 6 hours. And nope, we didn’t meet with the orthopedic surgeon after I woke up like they said we would.
We set up our car with lots of pillows and blankets, since we had just over an hour drive home. The nurse and Nick somehow slid me into the backseat, and we left. Since I hadn’t eaten all day, we went to the nearest drive through to get some food. As time went on, I noticed that I needed to use the bathroom more and more, and that it was getting quite urgent. Like to the point of being in lots of pain, and urging Nick to take us back to the hospital FAST because there was absolutely no way we would make it back to our house.
I hope you enjoy the extremely flattering post-surgery-still-out-of-it pictures.
Miracle #3
Nick hurried back to the hospital, we pulled up to the same door we came out of, and Nick hopped out of the car to find some help. Again, by divine intervention, a nurse was leaving the hospital out that same door when Nick ran inside. She was on her way home after finishing her shift, but she was super kind and helped me out of the car into a wheelchair, and helped me use the bathroom. She also said that we were lucky she was there, because those doors lock. We asked her if I was supposed to use the bathroom before we left, and she said that for some surgeries it is required, but not for all of them. Another thing that she said was that our nurse was probably at the end of her shift, was wanting to go home instead of transfer us over to another nurse, and had us leave too quickly. Great.
After this little experience, we were finally on our way home and made it back fairly comfortably.
First Two Weeks
The nerve block lasted a little longer than 24 hours, and I am so glad it did, because it allowed me to use my crutches to get around a little bit. Once it wore off, the pain wasn’t too terribly bad, but bad enough to take my painkillers a few times a day. I am so glad I am done taking those, because they made me very drowsy and slightly nauseous. I also took a blood thinner the first two weeks, to prevent blood clots, and just finished those today.
At first, the pain was also bad enough to where I was in too much pain to walk with my crutches. Nick had to start moving my right foot for me, and it took about a half hour just to go to and use the bathroom, which was the only time I got up off the couch. Eventually we gave up the crutches, and I was pushed around in our office chair if I had to get anywhere.
My younger sister was able to come and stay with us for a week, and she helped so so so so much! She took care of our kids while Nick was at work, made dinners, pushed me around in the chair, cleaned, and picked up groceries. Everyone needs a little sister like mine! On one of the last days she was here, I was able to start using my crutches again, and it was so nice to have a little bit more independence! For the first week, I was literally on our couch 24/7, getting up 3 times a day to use the bathroom. That’s right, I even slept on our couch! I am usually a stomach and side sleeper, and I never ever sleep on my back. I was able to a little bit while I was pregnant with my kiddos, but my body goes into total freak out mode trying to get me to turn over. It has been a nightmare trying to sleep the last two weeks. For me, it may be the hardest part of this whole thing. This morning I had a little bit of a break though, and I was able to sleep on my left side, the uninjured side, for a little bit without any pain. There is a light at the end of this tunnel!
The kids have loved reading books with me on the couch. Benson will finally sit through a whole book- or 5!
I am so grateful for all of the help we have received in the past two weeks. My mom is a nurse and has been unable to come until next week, and we are so looking forward to having her here! But since I’m pretty immobile and can barely hold myself up for longer than a few minutes; it isn’t safe for me to be alone with our kids. It has been really hard to not be able to help them. We have had so many friends either take our kids for the day or come over and hangout during the day while Nick’s at work. We have also received meals and lots of love and support. It takes a village, and we have the best one!
For now, I am off of painkillers, am able to get up and down from the couch, bed, and chairs, and have my first follow-up appointment next week. They will evaluate how things are going and we will start to plan out the rest of recovery with physical therapy and such. Despite the difficulties, I am really at peace with life and am so glad that I am on the path to overcoming this injury! I am excited to get my body back into shape, to eventually be pain-free, to get back into the shop, and of course to be able to take care of my family again.
Thank you for all of the kindness that you’ve shared with me as I’ve been going through this difficult journey! Whether it has been allowing me to cry when I need to, offering words of encouragement, giving of your time, or bringing meals or gifts; none of it has gone unnoticed.
Have a fabulous week!
-Whitney
PS. If you or anyone you know has had any nagging hip pain, don’t wait to get it checked out! It could take several months to just diagnose the problem, and then potentially much longer to fix it. They are finding this problem, hip labral tear/impingement, more commonly among athletes, and if it goes unfixed, it could cause arthritis, and most likely a hip replacement at an early age. I had a super hard time finding any quality information on this specific issue, so feel free to share this post with anyone you know that has hip pain!
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