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The Corner


Joined: 06/13/2009 Posts: 400
Likes: 82

As a PT, this and some of the responses below are concerning.

Charleston is right, in a way. PT isn't "fixing" a labral tear. The labrum in a hip or a shoulder just isn't going to heal itself. That said, trying therapy first wasn't a terrible idea. Depending on size, location, and activities of choice, some people are able to develop the strength and flexibility to function normally with a tear, and thereby avoid surgery. However, dry needling, cupping, and massage are all meant to affect the soft tissues (muscle, fascia, tendons). Maybe she is having some associated soft tissue restrictions, but these are not affecting the labrum itself.

Also, chef, I just shake my head at any PT that keeps this patient coming for 6 months. If this is my patient we'll give it a month, and at that point either they are improving and we are going to make a plan for them to continue to work on this on their own, or they aren't and it's time to start the MRI/surgical progression. (Of note, I'm fortunate to work in a busy sports medicine clinic where I don't have any pressure to keep numbers up or keep patients coming for longer than is necessary)

The recovery from surgery sucks. Not because it's all that painful, but because its fairly restrictive. Typically you are looking at a hinged hip brace that will stop hip motion at 90 degrees for about 4 weeks. No weight through the leg for about 2 weeks, slow progression of weight bearing after that. What patients complain about most is the foam wedge they sleep with between their knees, that keeps them from crossing their legs or rolling in bed. It sucks, but it's pretty easy to undo a labral repair early on, so it is what it is.

That said, if it is limiting her lifestyle, there likely aren't many options. You could inject it an see what happens, but again, that would be just to see if decreasing the inflammation in the hip will get below the pain threshold, its not a true fix. Returning to heavy activity is probably going to lead to the same symptoms again eventually.

If she reaches that point, choose your surgeon carefully. The hip is something that the surgeons that do it best tend to specialize in. You might even be able to find somebody that could do it arthroscopically. That isn't a requirement for a good surgeon or repair, but a few holes to deal with are less worrisome.

Happy to try to answer any questions. Good luck.

(In response to this post by SPYCAV)

Posted: 01/06/2019 at 10:16PM


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Current Thread:
Torn Labrum in Hip Advice/Experience -- SPYCAV 01/06/2019 2:32PM
  I went with PT -- VignetteHoo 01/06/2019 3:36PM
  I'm surprised she can cycle -- VignetteHoo 01/06/2019 5:31PM