Hip Labrum Tear

[EGDM]

Back again. I had surgery on 3 February 15. From what the doctor told my wife, it essentially looked like a bomb exploded in my hip. So a THR is in my future, sooner rather than later. I have pretty bad OA in the joint. I knew I had OA but I never felt what seemed to be severe pain because of it. So there is no telling how long my shit has been getting mangled.

Good news is that once PT is done, I should enjoy BJJ again. It will be a journey for me. I plan on easing back on bjj for a year or so post recovery and focusing on yoga and improving movement patterns. Once movement is cleaned up a bit I will shift more time to BJJ.

That sucks to hear. Did they end up doing any microfracture to try to get some of the cartilage to regrow? How long are you going to be on crutches for?

If I can offer one piece of advice as someone who's just a few weeks ahead of you in rehab, it's take the restrictions on movement seriously. I was a little cavalier about lifting my leg and engaging the hip flexors and gave myself a nasty case of tendonitis that has been a mother to get rid of. You want to keep the joint mobile for healing, but don't take things too fast.

 

[brendan raedy]

Total Hip Replacement. Sorry for the abbreviation.

All good...should have been able to figure that out. OA=Osteoarthritis, right?

 

[blacjac]

That sucks to hear. Did they end up doing any microfracture to try to get some of the cartilage to regrow? How long are you going to be on crutches for?

If I can offer one piece of advice as someone who's just a few weeks ahead of you in rehab, it's take the restrictions on movement seriously. I was a little cavalier about lifting my leg and engaging the hip flexors and gave myself a nasty case of tendonitis that has been a mother to get rid of. You want to keep the joint mobile for healing, but don't take things too fast.

Thanks for that advice brother! I doubt a micro fracture was performed. I haven't talked to the doc extensively, apparently I was talking about unicorns and dragons when I came to. He gave my wife a general overview of what he saw.

I will have my follow up on Thursday, where he will the give me the lowdown in person. I am 50% weight bearing with crutches. My physical therapist will advise me when I can stop with crutches and the brace. I suspect it will be at the 2-4 wk mark. It is a bear moving a 50lb limb without using my hip flexors. I have been using my pajama pants as a handle to get my leg in the bed and off...lol

 

[blacjac]

All good...should have been able to figure that out. OA=Osteoarthritis, right?

That's correct bro!

 

[EGDM]

Update for interested parties:

I'm now seven months post-op on my right hip (labrum repair, microfracture). I was doing really well until a month ago when I started to get more aggressive with my PT and did a few days of dynamic exercises with deep hip flexion. This set off my tendonitis again and it's taking a few weeks to settle down.

I won't really get to see what the full rehab path looks like, since in two weeks I'm having the same procedure done to my left hip. It is a similar mess to what my right hip was - stage 4 osteoarthritis, torn labrum, and ruptured femoral ligament. I would have liked to fully rehab my right hip before taking this step, but it's getting to the point where I can't even stand up long enough to cook dinner before it starts hurting a lot. I get to do this all over again and, hopefully, by the end of the year rejoin the ranks of the fully ambulatory.

I still have no clue if I'll ever be able to grapple or do anything athletic beyond swimming ever again. I really don't want to have a hip replacement in my 30's. I've seen elderly folks whose protheses have worn out and it's not a pretty picture...

 

[EGDM]

Since @rgr linked to this thread from another discussion, I'll give another update:

I have since had my second labral repair, this time on my left hip. The day after surgery it felt better than it did before the operation and I haven't thought about it since then. My orthopedist says it should last as long as the rest of me. Total win for that one.

The first surgery on my "bad" hip was 10/2014. For most of the first year I was inconvenienced in day-to-day activity and felt some degree of pain all the time. Around 09/2015 I said "fuck it", and, somewhat against the advice of my therapist and surgeon, started bicycling on the road and going back to BJJ. Suprisingly, this actually improved my situation a lot.

I've done a good deal of experimenting, and there's a definite sweet spot for me of regular, moderate activity. I try to bicycle 1-2 miles twice a day (taking my son to preschool). If I skip this for a few days I start to get a slow-building stiffness and soreness in the muscles and tendons around my hip, which goes away if I get back on the bike. Additionally, I've been training BJJ 2-4 times a week. I started slow, but for the last few months I've had no trouble rolling hard and doing standup.

I have no limitations of movement other than some ongoing mild stiffness in my short adductors (think butterfly stretch). I try to avoid high falls, running, and jumping out of an abundance of caution. I don't train two days in a row, because I sweat a ton and my hip is very sensitive to my hydration. If I'm topped off on water I almost don't notice it. If I'm dehydrated it starts to ache. I haven't had to ice or take anti-inflammatories for about a year.

I've had my 18-month follow-up with my orthopedist and the x-rays show no measurable decrease in the joint space since my surgery. The doctor thinks this is a good sign and says that I will probably get 5-10 years without needing to make "additional accomodations" to my activity. After that, who knows?

So far, so good.

 

[CFGroup]

As EGDM said, welcome to the club.

First thing that I recommend that you do is stop training. BJJ is not good for the hips.

I originally tore my labrum, and rolled on it for 3 years, making it worse and worse. Obviously, I did not know that I had a torn labrum until about 3 years later, as the pain was not that bad. It just felt like a pulled muscle that limited my mobility. If you stop now, and stop the damage before it gets worse, you might be able to continue BJJ in the future with out needing a hip replacement in the next 2, 5, or 15 years (it depends on the damage that you do now).

I had 20% of my cartilage removed, they repaired my cartilage in 2 places, performed microfracture to promote more cartilage growth in the removed sections, and they shaved down the bone in 2 places in order to prevent further tearing.

The recovery is much longer than that of a hip replacement, as the the surgery/area is delicate and needs a long time to recover. I could swim after about 6 months, and slowly tried to return to bjj at about one year. I am never supposed to run or jump again (as that will make me need a hip replacement sooner). It was/is an up and down process. I take a lot of natural supplements to help (they maybe placebos, but at this point, who gives a shit, I just want to role!) such as fish oil, glucosimine chondroitin, and tumeric on a daily basis. I tried to return to rolling 2 days a week, but could not do it. Now I role once a week, and have accepted that as my reality. I have fun, stay in ok shape, and tap to people I used to kill.

My best advice for you would be to be PATIENT!!!
Do not return to drilling or rolling until you are really ready.
If you have surgery, rehab well and take your time....it maybe up until 12-18 months. Not being able to run or jump....it really sucks.

If I had known I was fucking up my hip to anything near the level that I did, I would have stopped and gotten the surgery a lot earlier than I did, and potentially would be much more mobile than I am today. I was a 35 year old purple belt when I had the surgery.


I recommend that you check out the post below. I have also p'mailed a lot of these guys in the post below. Once again, be patient and and listen to your surgeon.

I guess that I should also mention that I have had my knees scoped 3 times. That was nothing compared to the hip. My knees feel fine. The hip is a much more complicated joint, henceforth the long recovery time.

Good Luck!!

http://forums.sherdog.com/forums/f12/brazilian-jiu-jitsu-after-hip-replacement-1441739/

Gotta jet now but I'm 5 weeks out of hip resurfacing, on the way to PT right now. I'm 2 days off of my crutches, PT and stretching twice a day a week back ridding my bike 5 miles every other day Ibuprofen 2 times a day after breakfast and dinner.

I'll get full high impact function back.

Gotta go....

 

[rgr]

Long time.......let's hear some updates......here is mine......
I got my hip replaced in June 2018. I was doing great, training on the mats, sometimes 3 times a week. I received my brown belt and was having a blast. At times I would feel more pain in the hip, and take two weeks to a month off.
Then, I went traveling to Europe with my family, and walked a ton......like 17,000 steps a day. My hip pain became unbearable, and I was unable to walk and enjoy the tourist sites with my wife and daughter. A number of days I had to stay in bed. It took about 4-6 weeks of taking it very easy and walking as little as I could to get back to feeling OK. I felt my quality of life had deteriorated too much due to the hip, and decided to get the Total Hip Replacement (THR).

My recovery was tougher than others, and that might have been due to my past hip surgery. About a year out, and after much re-hab (more than usual), I was able to feel normal again. I am now about 17 months post surgery, and feel very good. I walk around 12-14,000 steps a day......but that is one of the only things that I can do. I do not think it would be wise to return to the mats, as the risk does not seem worth the reward. However, I am happy to hear stories of anybody that successfully returned to BJJ after a total hip replacement. Or stories of people that tried to return, how long they were successful, before their hip popped out and it backfired.

Overall, here was my time line:
2009 - Blue belt - started to feel hip pain - kept training and coaching wrestling
2011 - Purple Belt - Hip pain became unbearable - two doctors told me I needed a total hip replacement, but arthroscopic surgery might buy me some time. Retirement #1
June 2012 - Got arthroscopic hip surgery, recovery was brutal. It took about two years to successfully get back on the mats.

2014-2017 - Successfully trained a few times a week, got my brown belt.
July 2017 - Pain in the hip became unbearable - Retirement #2
June 2018 - Got Total Hip Replacement

Hopefully this helps some people for the future. It was a great ride while it lasted. Maybe I will be able to coach a little, but it might be too risky.

 

[Normot]

Woah, there are a lot of us. Labral repair done on my right hip. I now can train a few times a week. Not like I used to or my hip pain becomes unbearable. Surgery drastically reduced the pain, buy I've never reached pain free status and the MMA dreams ended with the surgery, no point being competitive if you can't train hard enough. It sounds like it's the beginning of the end for all of us once you have had a hip surgery. No bone damage, but I also haven't gotten an x-ray since the surgery 3 years ago. Who knows how it is now, really don't want a hip replacement.

 

[5thDimensionMMA]

Woah, there are a lot of us. Labral repair done on my right hip. I now can train a few times a week. Not like I used to or my hip pain becomes unbearable. Surgery drastically reduced the pain, buy I've never reached pain free status and the MMA dreams ended with the surgery, no point being competitive if you can't train hard enough. It sounds like it's the beginning of the end for all of us once you have had a hip surgery. No bone damage, but I also haven't gotten an x-ray since the surgery 3 years ago. Who knows how it is now, really don't want a hip replacement.

Same here man , the hip surgery ended my mma dream too ..How long has it been since you had the surgery ?Doctor said I need one on my left hip as well and I’m pretty hopeless in ever competing in mma let alone train BJJ weekly .I had a Femoroacetabular impingement which is extra bone growth in the femur and the socket , so they shave the bone which leaves the joint to move more freely .I didn’t have any damage in the labrum .Im four months out from the surgery , I’m not sure if I’ll get the left one done since the pain in the hip comes and goes , sometimes it hurts just walking and sometimes there no pain .The only time I feel pain is when I cross my leg over my knee .I also have a slap tear on my right shoulder. It sucks to see these athletes train hard without any major injuries and here we are fucking broken without ever competing or being able to chase a dream that you are passionate about .

 

[CFGroup]

You should check in with your doctor if your THR is that painful.

I'm on a resurfacing so it's a little different, but I know someone who use to do marathons, had THR and is a casual runner, 5 miles 4 times a week with no issues.

Your situation is abnormal from all I've gathered. The only thing I can think of, and I'm sure your surgeon went over this for you. With THR you can't cross your leg over your center line due to risk of dislocation. Maybe constant pressure at those angles in training keeps aggravating the connective tissues with micro dislocations.

I had surgery July of 2017 and I've been back to Judo a year Nov 19th and have had sourness that always clears up in 36 hrs. This club does 25% Ne Waza so I'm getting a lot of the same pressures and can still feel areas were I lack the flexibility of my native hip. I'm still re discovering stretching I'd given up on pre op. All the cross centerline flexibility postures hip resurfacing allows me to return too. When I do a lot of high speed drilling at home I can get a tendon grinding against scar tissue that scared the shit out of me....July 4th 2018 cause we went to the beach and I could feel grinding carrying the cooler...and went in for a checkup. I'm most of the way back to the strength and flexibility to throw Uchi Mata based on my resurfaced hip but would not go to it in a comp as an indication of where I'm at as of last Thursday's training.

Not sure if this will show, but it's a clip of my skill vs rank at my new club getting thrown on my rebuilt side. It was symbolic to wear my white belt at a new club, with a new hip.

 

[EGDM]

I may as well check in, too. I trained for 2015-17 after returning from my hip surgery in 2014. Like rgr, I made it to brown belt before the final retirement. My retirement was not due to my hip but rather my knees, which are a clusterfuck in their own right but a mostly unrelated story.

My "bad" hip, which had the stage 5 arthritis, still pains me mildly from time to time but I'm five years out from the operation and progression appears to have stabilized. The formal finding is "no measurable narrowing of the joint space". My orthopedist expects I should get another 5-10 years before problems resurface - which was what he said 5 years ago. Fingers crossed.

I haven't thought about my "good" hip (also labrum repair and femoroplasty) since the week after surgery. Total win there.

Long time.......let's hear some updates......here is mine......
I got my hip replaced in June 2018.

Bummer, though I'm glad it's an improvement for your ongoing quality of life. A friend of mine had the exact same experience after a European vacation. Felt like he'd been shot in the hip and had a THR the next week.

 

[Normot]

Same here man , the hip surgery ended my mma dream too ..How long has it been since you had the surgery ?Doctor said I need one on my left hip as well and I’m pretty hopeless in ever competing in mma let alone train BJJ weekly .I had a Femoroacetabular impingement which is extra bone growth in the femur and the socket , so they shave the bone which leaves the joint to move more freely .I didn’t have any damage in the labrum .Im four months out from the surgery , I’m not sure if I’ll get the left one done since the pain in the hip comes and goes , sometimes it hurts just walking and sometimes there no pain .The only time I feel pain is when I cross my leg over my knee .I also have a slap tear on my right shoulder. It sucks to see these athletes train hard without any major injuries and here we are fucking broken without ever competing or being able to chase a dream that you are passionate about .

It's been almost 4 years.S training two years post op, but never went back to training 5 days a week. Hip just can't handle it, gets too sore and beat down. No issues while actually practicing. What helped me get over the depression of not living my combat dreams was seeing my friends get to live them. At the time I had a couple of training partners make it into the UFC. They ended up getting beaten up and cut or got more injuries and retired. Combat sports are crazy and even the guys you see passing you by end up with heartbreak. The benefit of the dream dying early is you can advance the rest of your life.

As glorious as it is to get into the UFC it's not fun using your UFC paycheck to make a down payment on a house and than having to fight through injuries just to lose and get cut and be 31 with no work experience and brain damage.

 

[waiguoren]

It's been almost 4 years.S training two years post op, but never went back to training 5 days a week. Hip just can't handle it, gets too sore and beat down. No issues while actually practicing. What helped me get over the depression of not living my combat dreams was seeing my friends get to live them. At the time I had a couple of training partners make it into the UFC. They ended up getting beaten up and cut or got more injuries and retired. Combat sports are crazy and even the guys you see passing you by end up with heartbreak. The benefit of the dream dying early is you can advance the rest of your life.

As glorious as it is to get into the UFC it's not fun using your UFC paycheck to make a down payment on a house and than having to fight through injuries just to lose and get cut and be 31 with no work experience and brain damage.

Beautiful post. Wise man.

 

[5thDimensionMMA]

It's been almost 4 years.S training two years post op, but never went back to training 5 days a week. Hip just can't handle it, gets too sore and beat down. No issues while actually practicing. What helped me get over the depression of not living my combat dreams was seeing my friends get to live them. At the time I had a couple of training partners make it into the UFC. They ended up getting beaten up and cut or got more injuries and retired. Combat sports are crazy and even the guys you see passing you by end up with heartbreak. The benefit of the dream dying early is you can advance the rest of your life.

As glorious as it is to get into the UFC it's not fun using your UFC paycheck to make a down payment on a house and than having to fight through injuries just to lose and get cut and be 31 with no work experience and brain damage.

Damn your hip still gets sore after 4 years.. Dustin Porier apparently has a torn labrum in his hip too,we will see how he does. Sean Omalley had a hip surgery as well,im not sure which type but he is looking good and seems to have recovered.I just turned 31,Ive been training since a teenager,the chances of me pulling a Randy Couture is unlikely.I have meniscus tear on the same side i had hip surgery,right shoulder slap tear,and another tear on the left hip. Im fucking done. The shoulder injury is manageable,i haven't lost strength on it at all. Both of my shoulders click just moving it around. Knee pain is bearable too it just aches.I wish we can get stem cells or some another advanced technology and just get it healed up. I feel your pain man,Im still figthing this depression. I just want to train and get some grappling rounds in but I cant. I go to the gym and hit the weights, do some shadowboxing but its not the same.I guess this is just a part of life and growing up I just have no ambition for anything else.. Another question-Do you get soreness in your glute on side you had hip surgery? Like when you are sitting down or walking etc.

 

[rgr]

You should check in with your doctor if your THR is that painful.
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Are you referring to me or someone else with this quote? My recovery from the Total Hip Replacement was definitely longer than the norm. My Doctor theorizes that my muscles, ligaments, and tendons probably adapted from when I had my hip scoped in 2012, therefore, longer recovery getting them back to "normal." Lots of muscular physical therapy....specifically with the psoas, which is a very hard muscle to get to.

Hip resurfacing.....I know someone who use to do marathons, had THR and is a casual runner, 5 miles 4 times a week with no issues.

Your situation is abnormal from all I've gathered. The only thing I can think of, and I'm sure your surgeon went over this for you. With THR you can't cross your leg over your center line due to risk of dislocation. Maybe constant pressure at those angles in training keeps aggravating the connective tissues with micro dislocations.
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I looked into hip resurfacing (so did the legendary John Danaher, but he chose a THR as well), but I had two doctors not recommend it in my case. Maybe if I would have gotten to this problem earlier, that would have been a reasonable option.

In regards to the person that runs 5 miles a few times a week, that is great, but to my knowledge they will need another THR much sooner, like in 8 years instead of 20 years. That is why doctors say to stay away from running, jumping, combat sports, etc, as you will either:
a. pop out your new artificial hip, and potentially damage it/need it to be replace.
b. wear out the new hip at a much faster pace.
The risk does not seem worth the reward for me. However, if I am wrong, and most younger people with THRs are running and doing BJJ, I would love to know and join them. These people that are doing these things with THR might last for a while, but I think their luck will eventually run out......

Take a look at what happened to Mark Coleman:
2013 - Had hip replaced, and coached on the Ultimate Fighter. Shortly afterwards, his hip started to pop up once a week. His hip got infected.....very dangerous. - and replaced again in 2015. I believe that now he has had his other hip replaced as well. That is 3 hip replacements in 10 year.....brutal!

But, the more information we get, the more we can help people that have similar problems in the future.

 

[EGDM]

specifically with the psoas, which is a very hard muscle to get to.

Man, screw the psoas. Mine still bugs me moderately five years out and I haven't found any kind of therapy that improves it. Things that make it worse (or better) under various conditions: Standing, sitting, lying down, exercise, and not exercising enough. Ugh.

wear out the new hip at a much faster pace

Yeah, I don't quite get this approach to joint replacement. While it's certainly possible to do high-rep or high-stress activity with a prosthetic, I can't see how it's smart. Unlike your original hip, it's simply inanimate mechanical parts that can't self-repair. There is a bank of wear that you start drawing on and then the it fails. Period. And you only get two for the rest of your life before you run out of viable bone in your femur.

 

[Normot]

Just like you, it wasn't just my hip, it's knees,neck and shoulders too. You'll figure it out, my body may not be what it used to be, but after crying myself to sleep for a few years I did eventually come to terms with my body and am thankful for what I can still do. I think accepting that is partially what let me heal enough to get a few good training sessions a week in. Learning to be ok with the pain and not pushing myself too deep into the pain hole while also not doing nothing and wallowing in self pity. Took awhile to figure it out.

Another question-Do you get soreness in your glute on side you had hip surgery? Like when you are sitting down or walking etc.

I did, but I don't anymore. My hip pain is isolated to the front of my hip.

 

[CFGroup]

Don't know guys, My Doc has tons of very active people on these resurfacings. I showed him breakfalls and he still was sure that the modern prosthetic will hold up.

One of his guys is a para fire rescue out here for FDSD another guy now has both hips done who runs marathons at a older slower pace but still 26 miles.

Mine may only last 15 years instead of 20, but I can do 100% of what I use to and by the time it wears out I'll be at an age that I won't want to get thrown on my head any more, plus the science will be that much more advanced.

Maybe not sitting at a desk and waking up at 5 am to do 3 hours standing Chi Kung, Tai Chi, kickboxing footwork drills into striking and Uchikomi solo drills plus a half hour of stretching no alcohol vegetarian 4 days a week has something to do with the success I'm able to return to full activity.

One thing I'll add is I did go back to some PT exercises after chatting with a running coach I work with that reminded me how stable my core was in the 6 months I did the focused PT post op.

Almost time for my 3 mile Turkey trot with my new running shoe's before stuffing myself. There's zero pain or discomfort in my lower body this morning.

 

[EGDM]

Don't know guys, My Doc has tons of very active people on these resurfacings.

Yeah, resurfacing is a different animal from THR. I understand it's a less popular approach due to being a more mechanically difficult operation with outcomes more dependent on the surgeon's skill (and the possibility of heavy metal toxicity down the line) but if it's installed properly it certainly seems to be a categorically better solution for a young active person of the correct patient profile. The mechanics of the large ball compared to THR make it much more robust, and it preserves more bone so you still get 2 THRs if you need them for whatever reason.

When my time comes I will strongly consider it.