donderdag 25 januari 2018

Diagnosis – Labral Tear

I saw the new orthopedist yesterday, and he confirmed what I have suspected for the past few weeks – I have a labral tear in my left hip.  Thankfully it is a very small one, but it’s there, right where I thought it was.

To quote WebMD, the labrum is a ring of cartilage that follows the outside rim of the socket of your hip joint. In addition to cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely within your hip socket.

Labral tears are pretty common and lots of people have them without knowing.  If I weren’t athletic, I probably wouldn’t know either.  Walking isn’t a problem.

The downside to this diagnosis is that it’s not going to heal.  Ever.  It’s cartilage, so once it’s torn, it’s torn unless I get it repaired with surgery.  Which is not in my plans.  But the upside to this diagnosis is that I have a path forward.  And that is a huge relief.

Getting to this point has felt like such a process.  The first doctor I saw (based on recommendation) didn’t leave me feeling great.  While he was very nice, I didn’t love his bedside manner, he talked incredibly fast (and if you know me, I talk fast, so for me to call this guy speedy means he was moving at rapid-fire pace) and he was immediately recommending some major treatments (of the invasive type) without having a complete diagnosis.  He told me I was fine to start running again and I said “Okay, so you don’t think it’s a stress fracture then.”  No, he thought it still might be.  And running would be bad in that case.  So that wasn’t reassuring.  He also was insanely busy and very hard to get a followup with.

However, he did give me an order for x-rays and an MRI, which worked in my favor.  On a friend’s recommendation, I booked an appointment with a different practice the following week and got the scans done so I could bring them in.  That would put me a step ahead.

Immediately, I was much happier with this new doctor.  His bedside manner was much more reassuring, and he was saying things that made sense based on everything I had heard from others who have been through this issue.  He took a look at my scans and confirmed that I do have a small labral tear.  He pointed it out to me on the MRI and it is very tiny, but it’s clearly there.  He also took the time to really explain how the labrum works, which I appreciated.

He gave me a few steps moving forward.

  1. Physical therapy 2-3 times a week for 4 weeks, with specific work to strengthen and balance my hips.
  2. Wear running shoes with specific inserts (which he handed me at the appointment)  ALWAYS for the next few weeks.  No being barefoot at home, no dress shoes at work.  Thankfully, my office is awesome and this isn’t a problem.
  3. 10 day course of steroids to reduce inflammation.
  4. No running for 2 more weeks, then ease back in.  Swimming and biking are fine.
  5. Come back in 3 weeks to follow-up.

All of this makes perfect sense to me, and thinking it was a labral tear, it’s what I wanted.  Well, the physical therapy part, anyway.  The rest is just more good things for healing.

And the best part?  The follow-up appointment, by which point I anticipate having made significant progress is scheduled for the day after my original second appointment with the first doctor.  That means that by seeing this new doc, I could have the problem well on its way to being resolved by the time that original doc would be giving me a treatment plan.

So while there’s no quick fix, I’m hopeful that I’m on track for some reduced pain and will be back to regular training in the next few weeks.

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