Many of our patients with pelvic pain, hip pain, or other pelvic floor issues report they've been diagnosed with a labral tear in their hip. They're wondering if they should go and get surgery to 'fix' their symptoms. Or they've already had the surgery but haven't had relief. So what is going on?
First of all, the hip labrum is a ring of cartilage around the hip that cushions the joint and allows range of motion. The labrum is often damaged, either by injury or just by the decays of time.
The truth is the majority of people - both with and without pelvic pain, hip pain, or other pelvic health issues - actually have a labral tear. One study showed 69% of asymptomatic (people without any symptoms) have labral tears!
Often the first thing a physician will do when you report hip pain or pelvic pain is order an MRI. These tests are extremely powerful and detect a lot of 'abnormalities', including labral tears or arthritis. But then we jump to the conclusion that the labral tear must be the cause of your symptoms - and this is where we go wrong.
Because it's actually far more likely that you've had the labral tear for years or decades. While it may be a contributing factor, it's unlikely that simply repairing the labrum is going to make all your symptoms disappear. So many patients have an unnecessary surgery - causing more trauma and scar tissue to the area - and come out of it with additional problems to address.
If you're going to need physical therapy after a surgery anyway - and you should always be getting PT after any surgery - why not see your physical therapist before you go under the knife? A few visits may be able to identify the true underlying cause of your symptoms and prevent surgery. Even if you do end up wanting to do surgery, you'll at least 1) be sure that it's warranted and 2) be in the best possible condition to recover before going in.
We always recommend at least trying conservative care first to see what can be done without surgery. Surgical intervention is always an option, but you can't undo a surgery. We see so many patients who have had a surgery they were told would 'fix' their issues, only to lead to more scar tissue and trauma to the area that only exacerbate problems.
At PelvicSanity, we support patients beyond the walls of our own clinic in Southern California. We offer an Out-of-Town program, remote consultations, and a Facebook support group for patients called Finding Pelvic Sanity.
Dr. Nicole Cozean is the founder of PelvicSanity Physical Therapy in Orange County, CA. PelvicSanity treats patients from all over the world with remote consultations and the Immersive Out of Town Program. She also runs Pelvic PT Rising, training other pelvic PTs to better serve patients.
Named Physical Therapist of the Year, Dr. Nicole is author of the award-winning book The Interstitial Cystitis Solution and the first PT to serve on the ICA Board of Directors, Her passion is helping those with pelvic health issues - regardless of where they live - find lasting relief.