It took a long time to decide go to a doctor about my hip, but I had some deep suspicions about what is wrong with it and after everything I have tried it has suddenly become worse. I got an x-ray of the hip last Friday. It turned up negative, but I saw an orthopedist this this week. After a short time, he said the words that I expected. He thinks it may be Labral Tear and want me to get an MRI to confirm it. I have read about labral tears for the past couple of years, and many things about it seem to fit my hip, however, I wasn't ready to look into seeing if I had that without trying all the available options, particularly when I could still run (even with my constant imbalance, stability issues, and loss of coordination in the hips).
Over the past couple of months, the muscles around my hip have been bracing (or splinting) making them very tight as they seem to want to "protect" my hip. I have tried to run through it and this summer threw everything I could at it, but it just never seemed to resolve. A couple of weeks ago I started taking anti-inflammatories before runs and that seemed to help some, but I wasn't consistent with it.
Last Thursday, I finished up a very active series of races with a track 5000 meters at the Loco 5000 in Dover. I was very hopeful that I could run an "elusive" decent time. Two days earlier I ran 19:13 for a season PR at the Lowell race, but the twists and turns of that course are not to my liking. I thought a flat track race would be the ticket, particularly since my track workouts this summer have been better efforts than my races. I had not run a track 5000 meters in 30 years and set a goal of finishing within 3 minutes of the time I had last run on the track in 1980 which was 16:02. Honestly, I thought I would do a whole lot better than 19:02 and was looking to get under 6 minute pace. I started the race with a 6 minute first mile, but then my muscles around my hip started tightening up again. I got slower and people passed that I should have been able to hang with, but the hip got worse with each mile and I finished last in my heat with a 19:42. After the race, I could only sit down because my hip hurt. When I got up, I was limping again and had a hard time walking, let alone running, and I think it was at that moment when I "knew" it was time to get the hip checked out by a doctor, so I made the call the next day.
Friday, the doctor had the x-rays taken and he told me to take the inflammatories full-time. I have, but for some reason, running hurts more. Maybe, the inflammation is being removed making the hip hurt more. I struggled through 8 miles on Saturday and then again on Sunday. Now, I am limping almost full-time. I tried running Tuesday and after a couple of miles, I had to stop, as the hip got really bad. I even had a hard time walking home. A group of three older walkers even passed me. That was humbling.
I don't know if it really is a labral tear, but it sounds right, and I am not sure of the degree of it, if there is an impingement, or if there is athritis in there. The diagnosis and treatment of labral tears is a new science in the past 10 years or so. If I need surgery, it seems like it might take 6 months before you can return to running, and a year until you are back in form. I guess I am finally ready to go through with that, if that is what I need to do. I have tried everything else and I don't think there is anything else I can do to make my hip better on its own, particulalry now that the pain is getting pretty constant.
Long coolrunning forum thread, but it ends in 2007
Long Runner's World forum thread
Long Letsrun thread "Loss of coordination in leg" thread that I have been following and contributing to since 2006 (introduced me to labral tears-but it is not only about labral tears)
Great information on labral tears from one of the best surgeons for this injury
Video explaing FAI-Femoro Acetabular Impingement- a reason for labral tears and show how surgery is performed
Anyhow I got a lot of staisfaction out of my summer running (even though it was slower than I'd like and not pain-free). I know I still have the abillity to do 70-80 mile weeks. I hit 85 miles one week with 52 miles of it in three days of running. I can still race a lot (although not at the speed I feel capable of running). I do know this. I enjoy running a lot, even when it does not feel well. The challenge I have is to fix this. Although a labral tear is not confirmed, my suspicions are that it might be my problem and I bet they find an FAI-Femoro Acetabular Impingement that has caused my hip problems through the years. I recall knowing something was wrong with my hip even back in high school. My suspicion is that my femur does not settle into the hip properly-it is precisely what I have been feeling for years with all the instability. I only hope I haven't worn things down too much with all the running I have done.
With all my hip and leg problems on the left side, I think it has come down to three problems: the Functional Hallux Limitis which I have been using insoles to correct the past two months. FHL caused my left leg to collapse at the arch and pronate out throwing my left leg into a weird stride. I am starting to think that the insoles have started to correct the angle at my hip, which may be what made my hip feel worse over the summer. Maybe that is where the tear is felt most-when the hip is in a more proper running position. I also have a tibial torsion of the left foot and it angles out to the side. Both the FHLand tibial torsion could have caused a labral tear as they altered the mechanics of the hip joint over time. That is just my reasoning of the situation. I like the way the insoles have kept my feet from collapsing and they have truly been helpful in many ways. I am supposed to have Dr. Dannenberg make a more permanent orthotic for me later this month. I can't solve the tibial torsion. Now if my hip can be fixed and get me back to running, then 2 out of 3 problems will be fixed and maybe I will be able to run in a more balanced, effortless, and pain-free way.
I look forward to getting the MRI to see what it says. I also wonder whether I may get a cortisone shot.I have read that sometimes this actually helps the condition. Sometimes it allows for a week or a few months of pain-free running, and sometimes it doesn't work at all or creates more pain. Depending on the MRI, I may find out I have shredding the labrum or have arthritis that makes a surgery or a return to running doubtful or I may find I need the surgery. I certainly don't look forward to any surgery and it looks like it is usually 6 months until a return to running and one year until full training if things go well.
Nick Willis, the Olympic silver medallist in the 1500 meters in Beijing has had this surgery and has returned to running sub 4 minute miles. Adam Goucher is considering retirement from elite level running because of his hip. "The doctors diagnosed an impingement in the hip joint that is causing bone buildup in the area. There’s also a possible labral tear. Surgery will be required to fix it, and then six months of recovery and rehabilitation will follow." Alex Rodriquez had surgery for a torn labrum.
I haven't been able to run since the aborted run on Tuesday. I have been able to eat extra ice cream to compensate (this won't be good). I also tried mountain biking today and that was fine, so it looks like I am back to biking for awhile.
This new book from the author of The Entrepreneurial Patient blog is a must read book for anyone with hip problems and is thinking about about arthroscopic hip surgery or has had arthroscopic hip surgery for a labral tear or FAI.