"Dear Runner (LT) Chick"- Response (original msg in post below)

Here's my response to a fellow runner chick from Austin, TX (see original message in post below)...

Hi Leslie,

I often think about my abandoned blog and it makes me so sad, like i left my baby in a dumpster or something...sigh... (sorry, inappropriate reference). Sorry that I haven't posted any updates on my recovery in what seems like ages. I guess you could say that I've pretty down about things. Running is our lifeblood and it gets tricky sometimes without that regular outlet... very tricky.

So, here I am 5 months post op, wondering if the tear in my labrum was actually really the cause of my pain. I'm back to full strength and am getting around town just as well as I did prior to surgery, but as for running, I haven't really been making the progress I'd like to. For instance I ran outside for 20mins last night and it was like the highlight of my week. My chest was burning since I'm royally out of running shape at the moment, but every step gives me hope of getting back to where I once was.

It sounds as though, like me, you have quite a few different things going on. Without looking back to see what I wrote on my blog, I can tell you that I've come to find out (after surgery) that I have some pretty serious hamstring tendinitis. The whole idea with going in the direction of surgery was to fix my labral tear in order to then properly treat the tendinitis (with PT). However, we're still in a touch and go phase and I still haven't found anyone who will talk to me in more than generalities. SO FRUSTRATING! But for the most part, my PT and physician (who are working together on this) have remained positive, but seemed stumped on the day to day - up & down of my progress. One day, I feel fantastic (meaning, I can walk and sit comfortably with no pain or tightness) and then I push a little further with running or some other form of exercise and then the next thing I know the throbbing, achy pain is back. I've come to terms with fact that there are quite a few things going on in there... and unfortunately, I didn't get the right help/treatment five or six years ago when the first signs of this started. I did have a labral tear, but I also have hamstring tendinitis and I think there's some piriformis (nerve) stuff going on in there too. So, I know it's still a long road of treatment and patience ahead.

So, (much like my doctor) I don't have a clear answer for you, but definitely go for an MRI and skip the regular MRI and go for the MRI arthrogram where they inject you with dye. This will better show what's going on in there (my tear didn't show on a regular MRI). As I mentioned before in my blog, some people have labral tears and are completely asymptomatic. So, definitely do your research and find someone who is well studied in this injury. I found the Runners World Discussion Board on Injuries and specifically the LONG thread on Labral tears to be very helpful. You'll also probably see me on there if you go through this past year's posts. You'll come to see that there are many of us out there with similar symptoms. It's a very poorly diagnosed injury and there are many people out there grasping at straws to find out what is going on.

Hit me up when ever you want to vent or trade symptoms. I could talk about this for hours (while I'm not out running).

But don't get me wrong, I still have hope and WILL get back out there... hopefully soon!

Take care and best of luck to you!!

Denise

Dear Runner (Labral Tear) Chick

A message I received @ about five months post op...


Hey there!

I found your blog googling for "labral tears and runners" or something like that.

First, how is your recovery from surgery going?

Second, thank you SO much for your blog. I cried and cried while reading it. I am still in the diagnosis phase of my injury, but I started having issues in September 2008. I'm also a long distance runner, and was training for my 7th marathon and hoping to (finally) BQ, which didn't happen since I couldn't do my race. I had some hip clicking before that, but I could still run, no problem. Then I was doing speed work one night, and all of a sudden I couldn't raise my left leg up like I wanted to. It just felt impossible. From there, I have been to (so far) two doctors, one physician's assistant, a chiropractor and a PT. I have had an MRI of my hip, pelvis and back (all came back completely clean). I was on steroids for a week (nothing). Currently I'm taking Lyrica which is meant to help with my neural pathways because one doctor thinks I have meralgia paresthetica. I've tried running, not running, yoga, core work, tons of PT, etc.

Then last week my chiropractor said, I think you may have a torn labrum. I hadn't seen the chiro since January, so he was taking a fresh look at things (i.e., he had said completely different things in the past). I went to my PT, and he was like nope, that's not it. He wanted me to do a nerve test b/c they think something's affecting my femoral nerve. Then I went back to the chiro today, and he said the same thing about the labrum.

So I went back to work and started my googling. When I found your blog, it was like the biggest "aha!" The first post I read was after you had already had your surgery, so I went backwards to see how you were diagnosed. It all sounded SO familiar. All of the appointments, all of the treatment, all the different diagnoses. All of the frustration. With all the different diagnoses I've received, I've always thought, "That might just very well be what I have." When I read your blog I was like, that's me! That's exactly what I have. My pain does not present in my hamstring like yours (it's more directly in the hip and will radiate down my quad).

So now I've written this incredibly long email to a stranger, but I just wanted to tell you thank you so very much for your blog. I am more convinced than ever that this is what I'm dealing with, and now I feel like I can be more insistent on getting to the bottom of this. And as much as I hate to know that anyone has gone through what I've been through (and yes I agree with you, things can be worse), it's so reassuring to hear from someone else who really knows what this whole thing is like. At times, I think people have even questioned if anything is wrong with me at all.

Please let me know how you are doing. Recovering from the surgery makes me nervous. And I, like you, already feel like I've had to sit a fair amount of time out. I missed my marathon in December and was hoping to do some trail runs this summer, but if I require surgery then that will probably be out. I'm curious to know what all you can do, when you can't run. I've been doing yoga (since earlier this year when my mileage became too pathetic to feel like I was still a runner). It sounded like you've done yoga too, so I'm hoping I can at least get back to that somewhat quickly.

Anyhow, if you've read this much, you're amazing. If I do hear back from you, once I get my diagnosis for certain, I will let you know. There's a pessimistic side of me (from all of this) that still worries maybe this isn't it, but my mind is probably 99% made up, and that's saying a lot at this point.

Thanks again,
Leslie (Austin, TX)

Rain drops keep falling on my head!

Since I'm still on my crutches, I certainly could have used one of these today! This guy looks like a total dork. My hat umbrella would most definitely need to have been much bigger. This one doesn't even look like it would keep his shoulders dry. My question is, when you close it, wouldn't it cover your face?

Yesterday, I had my second PT visit in the morning and first post-op appt. with Dr. Bharam in the afternoon. Both seemed to go smoothly. Bharam seemed to think I was making great progress. He reminded me that since I'm not the "typical" patient for this procedure, that he and my PT would be keeping a "close eye" on me. I had already gotten scolded (at PT) for showing up with only one crutch (whoops!). What can I say? I was feeling stronger and thought it would be more manageable to have one arm free. ugh... oh well, back to two it is (at least for one more week).

.

I can stand and walk a bit on my leg pain free, but aches and pains seem to be popping up in other places (apart from my left hip). I'm so happy with the progress that I've made so far (and please don't get me wrong), but yesterday I just felt so sad about it all. I was just so overwhelmed with sadness last night as I crutched home in the dark. I started to feel the dreaded hamstring pain which is what got me to where I am right now. And that combined with all the other pain (from compensating) just started to get to me. Both PT and Dr. Bharam's packed with patients (I suppose due to the holiday coming up) and not that I felt rushed, but I just began to feel a bit like a guinea pig or a lab rat in that some things about this whole procedure/recovery are still so vague. I know I have to stay positive, it's just been difficult to do. I don't like being in such a vulnerable position; having to have people help me with things and tell me what I can and can't do. It just doesn't suit me. I guess it's good in a way because it's definitely slowed me down for a bit, but I just wish that my anticipated outcome was a bit more clear. At least then, it would be easier to keep my chin up.

.

Maybe I just need to go back and read my posts on postiive thinking. ;)

What causes a Labral Tear?

Because so many people have been asking me this question, I thought I'd post it. The following is information on Labral Tears courtesy of www.hiplabraltear.com:

What Causes the Hip Labral Tear?

Almost 80% cases of hip labral tear have no known direct cause. Tears may occur with a slow progression in human life. The known caused factors include degeneration, injuries, osteoarthritis and problematic recurring activities and movements on hip joint, may cause hip labral tear. Many osteoarthritis patients suffer from hip labral tears (acetabular labral tear). Because hip fractures may tear their labrum. However the contribution osteoarthritis to the development of the hip labral tear is still a controversial issue within the medical society. On the other hand, majority of the physicians in this field believe that there is a close relationship between osteoarthritis and labral tears.

The cause of hip labrar tears (acetabular labral tears) are

• Capsular laxity
• Femoral acetabular (acetabulum: concave surface of the pelvis, it is the socket of the hip joint) impingement (impingement syndrome that affects the hip joint)
• Dysplasia (pathologic abnormality in maturation of cells within a tissue)
• Trauma
• Degeneration
• Bony pinching
  

There is a theory that supports the idea that the cause of hip labral tear is because of femoroacetabular impingement (FAI) which generally occurs two forms; pincer and cam. FAI is a disease where the bones of your hip joint come too close and touch tissue or cause too much friction. Thus femoroacetabular impingement is associated with articular cartilage damage and labral tears and as a consequence a hip arthritis may arise at a younger age than usually takes place.

Physical activities that involve force adduction of the hip joint in association with rotation in either direction be likely to worsen the pain.

The length of the leg is also an issue. If one leg is shorter than other leg, this may affect your walking and may put pressure on your labrum. There are specially designed pads
in your shoes to support you for a proper walking.

Recovery is still going well and I can bare weight on the leg, but I'm trying not to as much as possible. I'm up to 80 degrees on the CPM machine (started at 40 degrees), so I'm at my max already with no pain! I have my post-op appt tomorrow at 2pm, so I'm excited to get feedback from my doctor on my progress. My PT homework is going well and I've also been able to ride the upright bike again for 20mins pain free. I'm excited about the progress I've made so quickly and hope it still keeps moving forward at that pace. :)

I'm too sexy for my crutches!

Good morning, party people!

Here is a picture of me before my first outdoor crutch-about on Wednesday night
(day after surgery).
PS: I look kind of crazy.

Recovery is going well so far and now that I'm an "old pro" at my daily post-op routine, I'm kicking it up a notch to add some new homework (courtesy of my PT duo of Ben Gelfand and Rebecca Kalb at STAR Physical Therapy). My first session of PT was last night and I was able to do the upright bike for 20mins (very very slowly)!

I'm amazed at how much stronger I feel every day. I was crutchin' around like a fool yesterday (to/from PT) and am paying for it a bit this morning. My leg is a bit sore and so are my arms. Oddly, my right glute (opposite leg) is super tight. I think because I've been using my right leg so much more for stability. So, I have to be careful not to hurt anything else while compensating the next few weeks.

I just want to thank all my friends and family for their thoughts and well-wishes this week. It's meant a great deal to me to have so many friends and fellow runners so concerned with my recovery. From the bottom of my heart, thank you!

And so the come back mission is on, baby! Stay tuned!

Oh, that's hot!

So, it's four days until surgery and I really wanted to show off all of my flashy (post-op) accessories!

READY OR NOT....


Accessory # 1: The (deluxe) Bledsoe Philippon- Post-Op Hip Brace:




Oh yea, baby! You know you want one!





Accessory #2: The (incredibly comfy looking) foot positioning brace

As "Vivian" from the medical supply company told me (in her life long smoker sounding/native new yorker accent) ,

"if you have any friends with crazy fetishes, now's the time to invite them ov-ah"

Wow! lol!




Accessory #3: The Knee Continuous Passive Motion (CPM) Machine


I'll be riding this baby (the CPM machine) four hours a day!

Sorry boys, I don't think the chick's included. :)








Oh, and there's so much more! Just wait until you see my ice machine! wooooowhoooo!

I'd show you, but I just wouldn't want to make you too jealous! :)