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Daniel asks the Guru about a labral lesion in the hip joint

Jan 13th, 2016

Hi there,

I am an avid runner have been running 30-40miles a week for the past 10 years. I’m 40 years old and experienced mild hip pain 2 years ago. This did not prevent me from running, I was just more of aware of hip pain after a run.

Three months ago the mild pain became more discomforting, so I decided to get my problem diagnosed by a sports physician. A 3T MRI scan revealed I have small labral lesion in the hip joint. I have already had a cortisone injection (Dec 17) and since then I have been able to run short distances (5km, normally run 10-15km) with some discomfort.

It seemed to be fine until I recently returned (Jan 7) from a trip from Australia, whereby I have noticed the pain has intensified when sitting or idle. Not sure if this has anything to do with being in a flight for 24 hours.

My doctor did mention that he wanted to me to undergo intense physio before my follow up appointment in Feb – as we would like to avoid surgery if possible.

Regards Daniel

Jan 13th, 2016

The Guru Responded:

Hi Daniel

 

Sounds pretty fair advice from your Doc BUT you need to make sure you see the right person/physio.

 

There is a growing issue where many in the medical community incorrectly assume that pathology on MRI equals pain and dysfunction, which simply isn’t always the truth of the matter. There are an awful lot of 40 year old runner dudes with labral tears and no pain just as there will be lots out there with pain and no labral tear.

 

You need someone to fully understand what you’ve got and why and then explain to you about how your hip functions (especially when running) – the anatomy may, or may not have any relevance to what you feel, and certainly you/they can’t change it – but you can change what you do with it.

 

It’s very rarely a case of “just getting stronger” with rehab exercises but is about managing load over a good few joints and developing better function, control and endurance of the supporting muscles.

 

Surgery at best, is bad (long term) and anecdotally only 20% need to go under the knife…..surgeons may/would think higher!

 

Fail at really good rehab then progress to surgery and only then if needed, don’t just leap in because intensive stuff didn’t work (and I’m not sure it will as you need time to learn to control…..)

 

The Guru

Six Physio

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