Hip labral tear

[Phil1p33]

Played a game at the end of February where I stretched out for a save and noticed something felt off, it wasn't bad in the moment but I woke up the next morning and could barely walk. Ended up getting a MRI and a surgical consult and was told that I have a labral tear in my left hip. Doc was pretty confident I didn't need surgery right now and recommended 6 months of PT and then we'd reevaluate.  I'm about a month in to my PT journey and things have been going fine. I've been 95% pain free up until last week when my hip flared up again, and maybe this is a bit of the pain talking, but I'm having a hard time believing PT is going to actually help me get back to playing in net. I've been cleared to skate out so that's been nice to have but I definitely miss being in net.

Curious to know if anyone here has dealt with any hip labral issues and what, if anything, helped you return to the net, PT, surgery, etc.

[AdamL]

The function of the labrum is to provide stability.  When it tears, that hip now has to rely more heavily on the musculature around it to keep the femoral head centered and the joint happy.

Your best bet will be drills that then work on improving that stability.  Get strong in your end ranges of motion, under control using the actual muscles around the hip and not by turning and twisting at the spine.  I like doing my hip CARS lying on my side, for example.  It prevents you from cheating and hiking up a hip to get extra range of motion.

I would also actually strongly recommend Maria's strategic mobility for goalies program.

https://www.strategicmobilityforgoalies.com/

I went through it a couple times and noticed some really nice improvements in how I felt.  If you're getting any pinching, I would add some banded distractions to create space in the joint before working through some of these end ranges.  

Good luck!

[keeperton]

4 hours ago, Phil1p33 said:

Played a game at the end of February where I stretched out for a save and noticed something felt off, it wasn't bad in the moment but I woke up the next morning and could barely walk. Ended up getting a MRI and a surgical consult and was told that I have a labral tear in my left hip. Doc was pretty confident I didn't need surgery right now and recommended 6 months of PT and then we'd reevaluate.  I'm about a month in to my PT journey and things have been going fine. I've been 95% pain free up until last week when my hip flared up again, and maybe this is a bit of the pain talking, but I'm having a hard time believing PT is going to actually help me get back to playing in net. I've been cleared to skate out so that's been nice to have but I definitely miss being in net.

Curious to know if anyone here has dealt with any hip labral issues and what, if anything, helped you return to the net, PT, surgery, etc.

Yo, that's my queue.

I have a confirmed 4mm labral tear in my left hip (that I probably had fully form in like 2022, frankly). I originally got sent on a 6 week PT stint (by my orthopedic) and then got the okay to test it. Shit still hurt pretty bad oops.

So then I finished the season, and have been on a 3 months PT, no playing (was still coaching but not demoing stuff for the kids) stint. I finally got to test it again this week (Tuesday) and it hurt pretty bad, but I had also just gotten a booster shot and I think that made everything hurt, because oddly enough zero pain the next day (including at PT). I'm testing again tomorrow in the early afternoon, so I'll report back (tomorrow!) with hopefully a better outing. I think I'm going to use my more set of steel.

 

The longer summary is my PT has been entirely strength training. My routine is basically: warm-up on a bike for 8 minutes, get stretched out, single leg bridges, resistance band with fondas and sideways knee spreads, high resistance with side steps and backwards-diagonal steps, squats (I'm up to 175 lbs on the bar) at 3 sets of 6 with two lead up sets at lower weights, 3x10 deadlifts with a trap bar (170 lbs thus far), 2x15 2sec pause weighted (8 kg) split squats, 2x10 kick backs on a shuttle at I think 40 lbs, 3x15 single leg lying press at 120 lbs, weighted (12 kg) 3x10 1 foot step ups, 3x20sec side planks (adductor and abductor), 1x15 reverse deadlift with 16 kg, farmer carry (each hand has 22 kg) followed by single arm with same weight, 3x45sec resistance banded wall sit, and I might be forgetting something else. It's a pretty good workout and has yielded me a certified dumptruck for a posterior.

 

It's been awhile, and sometimes it does feel kind of like it hurts. If your pain is like mine, it's a very specific and pointed burning feeling right in the socket. What sucks for me is that I have rather loose ligaments, so my hips (and shoulders) are totally fine dropping out of socket in certain positions. This is cool and all for being able to do the splits, but awful for the soft tissue. I sometimes go through days/efforts where I wish they'd just rip it up and repair it, even if that means I'll be out for 6 months, but I have to remain hopeful other times too.

Edited April 19 by keeperton

[Phil1p33]

On 4/18/2024 at 7:07 PM, AdamL said:

The function of the labrum is to provide stability.  When it tears, that hip now has to rely more heavily on the musculature around it to keep the femoral head centered and the joint happy.

Your best bet will be drills that then work on improving that stability.  Get strong in your end ranges of motion, under control using the actual muscles around the hip and not by turning and twisting at the spine.  I like doing my hip CARS lying on my side, for example.  It prevents you from cheating and hiking up a hip to get extra range of motion.

I would also actually strongly recommend Maria's strategic mobility for goalies program.

https://www.strategicmobilityforgoalies.com/

I went through it a couple times and noticed some really nice improvements in how I felt.  If you're getting any pinching, I would add some banded distractions to create space in the joint before working through some of these end ranges.  

Good luck!

Oh I just bought this course a couple months before my injury. I'll definitely get started with it now! Thanks! 

[Phil1p33]

On 4/18/2024 at 9:42 PM, keeperton said:

Yo, that's my queue.

I have a confirmed 4mm labral tear in my left hip (that I probably had fully form in like 2022, frankly). I originally got sent on a 6 week PT stint (by my orthopedic) and then got the okay to test it. Shit still hurt pretty bad oops.

So then I finished the season, and have been on a 3 months PT, no playing (was still coaching but not demoing stuff for the kids) stint. I finally got to test it again this week (Tuesday) and it hurt pretty bad, but I had also just gotten a booster shot and I think that made everything hurt, because oddly enough zero pain the next day (including at PT). I'm testing again tomorrow in the early afternoon, so I'll report back (tomorrow!) with hopefully a better outing. I think I'm going to use my more set of steel.

 

The longer summary is my PT has been entirely strength training. My routine is basically: warm-up on a bike for 8 minutes, get stretched out, single leg bridges, resistance band with fondas and sideways knee spreads, high resistance with side steps and backwards-diagonal steps, squats (I'm up to 175 lbs on the bar) at 3 sets of 6 with two lead up sets at lower weights, 3x10 deadlifts with a trap bar (170 lbs thus far), 2x15 2sec pause weighted (8 kg) split squats, 2x10 kick backs on a shuttle at I think 40 lbs, 3x15 single leg lying press at 120 lbs, weighted (12 kg) 3x10 1 foot step ups, 3x20sec side planks (adductor and abductor), 1x15 reverse deadlift with 16 kg, farmer carry (each hand has 22 kg) followed by single arm with same weight, 3x45sec resistance banded wall sit, and I might be forgetting something else. It's a pretty good workout and has yielded me a certified dumptruck for a posterior.

 

It's been awhile, and sometimes it does feel kind of like it hurts. If your pain is like mine, it's a very specific and pointed burning feeling right in the socket. What sucks for me is that I have rather loose ligaments, so my hips (and shoulders) are totally fine dropping out of socket in certain positions. This is cool and all for being able to do the splits, but awful for the soft tissue. I sometimes go through days/efforts where I wish they'd just rip it up and repair it, even if that means I'll be out for 6 months, but I have to remain hopeful other times too.

Thanks for all of this! That strength routine seems pretty great, how often are you doing that? Somewhere over the last couple of years I fell out of going to the gym consistently and I feel like I'm truly paying for it now.

[Chenner29]

On 4/18/2024 at 3:19 PM, Phil1p33 said:

Played a game at the end of February where I stretched out for a save and noticed something felt off, it wasn't bad in the moment but I woke up the next morning and could barely walk. Ended up getting a MRI and a surgical consult and was told that I have a labral tear in my left hip. Doc was pretty confident I didn't need surgery right now and recommended 6 months of PT and then we'd reevaluate.  I'm about a month in to my PT journey and things have been going fine. I've been 95% pain free up until last week when my hip flared up again, and maybe this is a bit of the pain talking, but I'm having a hard time believing PT is going to actually help me get back to playing in net. I've been cleared to skate out so that's been nice to have but I definitely miss being in net.

Curious to know if anyone here has dealt with any hip labral issues and what, if anything, helped you return to the net, PT, surgery, etc.

Went to pick up a pen off the floor back in late June of last year.  Heard a pop and had extreme discomfort for a couple days.  I could barely walk for about a week.

Ended up going through the same process, an MRI found that both my hips have labral tears.

First doc I went to suggested a cortisone injection as a diagnostic (I guess this is common) and advised for surgery.
Asked a couple doctor and PT friends who suggested I get a second opinion.
Second opinion surgeon suggested PT and anti inflammatories.  I ended up taking this route.

I think I started skating again in March.  That time table seems long, but it took six weeks(!) for my health insurance to get their act together and find a surgeon that had experience dealing with my symptoms, and another two weeks to get the second opinion appointment.  I believe I started treatment with the PT end of September/early October.  I was basically pain-free by January, but too busy with work/other commitments that I just didn't have time to skate.

I think I am a little blessed with my physiology - both my PCP and surgeons remarked on how deep-seated my femur is in my pelvic socket; whatever caused the tear (probably goalie-ing) may have been worse otherwise.

[keeperton]

4 hours ago, Phil1p33 said:

Thanks for all of this! That strength routine seems pretty great, how often are you doing that? Somewhere over the last couple of years I fell out of going to the gym consistently and I feel like I'm truly paying for it now.

Twice a week at the PT place, then 2-4 times at home (with what I can do at home, so basically get rid of the squats/deadlifts and decrease some of the weights that use kettlebells). Since I've been testing it on ice for two weeks now, I use those as their own workout period and am trying to take it easier on my strength training so I don't overdo anything. 

[IpaddyTECH]

Never had a hip injury just yet but had my share of shoulder and ankle ones. Everyone here has had some great thoughts so I don't have much to add. All I will chime in is this:

Ligament tissues due just take time, a long time to heal. I had a severe tear in my ankle ligament and thought for sure I'd need surgery. Instead, 3 months in walking boot and 3 months light duty (no hockey at all during this time) and it healed perfectly on its own. It won't stop hurting until it's fully healed, so don't take some pain as a sign nothing is getting better. But obviously trust your docs over us haha. 

Last thing. I had a bicep tendon tear that had to be surgically repaired when I was 23. I got lucky that the repair went well and is holding up mostly now 10 years later, but my current surgeon explained that any surgery, has a shelf life and will eventually lead to further complications. I'm going under this Friday and he's going to take a look at my original surgery and do any touch up that he can. I'll be babying that shoulder the rest of my life. I used to hate the typical "ah just do a bunch of PT and give it time" approach, but really if your doc says there's chance to heal naturally, it's worth completely exhausting that option before going ahead with a surgical intervention. Best of luck to you!