Activity, Lifestyle, Pain Relief

Hip Labral repair – the new “HOT” surgery

Fads aren’t just popular in the fashion world, but they are just as prevalent in the medical world. Hip labrum repairs seems to be the new popular surgery, especially for the younger to middle age crowd. But why the sudden influx? Let’s delve in.

Think of the labrum as a suction cup. It allows the joint to move around, but also keeps it from moving too much and dislocating. It literally keeps the “ball in the socket.” We have labrums in the hip and the shoulder.

The hip moves in two different ways. The femur (ball) moves on the acetabulum (socket) and the acetabulum (pelvis) moves on the femur. You need to have available motion in both ways in order to maintain proper hip mobility.

I find with *most* of my patients with hip pain, they have good femur motion, but very poor pelvis mobility. Increased anterior tilt on the pelvis (increased back extension) significantly limits it’s movement, especially flexion and rotation. This limited mobility at the pelvis causes too much femur motion, and over time that will break down the labrum.

This topic is near and dear to my heart because I have labrum issues. I was a competitive baton twirler, and did alot of jumping, spinning, and torquing my body in positions that required quite a bit of stability. However, I never learned how to strengthen properly, stretch properly, and had the “swayback” that most dancers, gymnasts and twirlers possess. Over time, the over torque on my femurs have caused breakdown on my hip.

So how to do you fix it? Well, unfortunately labrums do not heal well on their own. There is not much blood supply within the joint to repair the tissue. Sucks doesn’t it? So is surgery the only option? NO!

The reason the labrum is breaking down in the first place is the poor mobility in the pelvis. Restoring adequate pelvis mobility will create a chain reactions of activating proper hip muscles required for stability. You can strengthen your hip as much as you want to, but if you don’t restore the pelvis mobility and lumbar flexion, you will not achieve the results you desire. Accomplishing these things should significant reduce your symptoms.

Unfortunately, this is not something that you do for 4-6 weeks and call it a day. Your body is going to need consistent input for a long period of time in order to fully establish this new position and new mobility. It is very easy for your body to resort back to it’s old ways, even if it means returning to pain.

So does that mean surgery? Well, possibly. But think about this. If you get your labrum repaired, and you don’t restore the pelvis mobility and stability, what do you think is going to happen? Your newly repaired labrum will start to break down again because even though the labrum is repaired, the POSITION has not changed. Let me say it again for the people in the back. The REPAIR is only as good as the underlying POSITION.

I can’t tell you how many people I have treated with hip and knee problems that don’t give themselves enough time to make the necessary changes and jump into surgery. Your body has established these movement patterns since you were a little child. It’s not something that will be fixed in a few weeks. And when your symptoms do improve, if you stop too soon, they will return. Joint care is a long term lifestyle change that requires attention. This is why pain comes back, surgeries fail, and people continue to go back for more treatment.

~ Courtney

Having hip problems? Even if you have been to physical therapy and feel that it failed, you may not have been looked at by a movement specialist. All therapists have different specialties and skill sets, and you might need a full postural assessment to see if you have any faulty movement patterns. Contact me for questions!

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