Hip Labrum Tear: How I Treated It & Avoided Surgery. Part 1.

Photo by Marlon Lara on Unsplash

Disclaimer: This is not medical advice. I make no promise and take no responsibility for anything you decide to do. This is simply what I did.

A user a Reddit sent me a message if I could explain what I did for my hips to avoid hip labrum tear surgery. It was a long journey to get my hips to a stage where I could train relatively pain-free. I was actually thinking about competing again in BJJ but then I tore my ACL.

To give a quick summary of my journey I saw 5 different physio, 3 orthopaedic surgeons and 1 sports doctor. I also bought the online program the“FAI Fix” and then asked for a refund from the FAI FIX. I think the very first physio I saw was over 4–5 years ago and I was missed diagnosed by that physio, the second physio and the sports doctors. It took another 1–2 years before I was properly diagnosed with a labrum tear.

My Hip Clinical Findings.

I’ve had an MRI, X-ray and CT scan done on my hips. These are the findings:

1. Degeneration of the right anterior labrum with a full thickness chondrolabral junction tear of the anterior and anterosuperior labrum, with small acetabular rim lesion.
2. Degeneration of the left anterior labrum with tiny intralabral cyst formation.
3. Mild right and minimal left trochanteric bursitis.
4. Mild Osteitis pubis.

I also have hip dysplasia which wasn’t on any of the reports but physio number 4 and 5 spotted it. You basically fix it as an adult by breaking the hip and realigning it with a surgical procedure known as periacetabular osteotomy (PAO).

Routine

First I will give credit to the last physio I saw, Andrew Wallis. He designed this exercise program. I also did a bunch of other things that you might find useful. So if you live in Melbourne Australia go and see him.

If you need a physio I suggest you try and find one similar to him. I would look for these qualifications. In no particular order of importance:

1. Specialises in hips. The human body is so complex. Best to have someone that specialises.
2. Works with professional athletes. There’s a big difference between someone that has never trained before (physically and mentally) and someone that trains on a regular basis.
3. Works closely with orthopaedic surgeons. You want someone that knows what the surgery is like. And has actually helped people in similar situations.
4. Has an actual set plan. The problem I found with all the physios but Andrew was that they never had a set plan. Andrew right from the beginning was like we are going to spend about 4 months doing a program it’ll have 3 phases in it. Every other physio seems to just throw together random exercises everytime you see them with no way of progressing them (same problem with the FAI FIX). This also meant I didn’t need to see him as often. Every other physio was like I’ll see you in a week. And I obviously went because I wanted to get better. Andrew was like I’ll see you in a month.

Soft Tissue Work

Andrew didn’t actually prescribe me any soft tissue work. But I felt it was necessary to do to clear the pain or impingement. The FAI Fix likes to do tissue work, stretching then exercises. I forgot if there was a reason for this but I tend to follow this order.

TimTam

I did a review of it here. It helped a lot. If I could only choose one item to do soft tissue work with it would be this. That being said I have found other things that help just as much in different areas.

Kettlebell Smash

This kettlebell smash is honestly one of the best things I found to clear impingement and help with tight abductors. If I could only do one thing specifically for my hips it probably be this. You get a different type of relaxation then the TimTam, but it does take a longer time. But be warned the first time I did this I nearly cried.

I would move around and find different angles and sore spots. Relax into it and then do some movements.

Broomstick

If you have Osteitis pubis the broomstick is amazing — the TimTam and the kettlebell can’t really hit this area. Plus it’s a little awkward having someone massage your pubic bone. I’d give this a try if you have groin pain. You might not even know you have a tender spot there. You can also use it to hit other areas of your abductors and hip.

Stretches

I was pretty flexible, I could do the front splits when I was a teenager. So the only stretch I found of benefit was the goalie stretch for my abductors. You might be different.

Even though I asked for a refund for the FAI FIX, their youtube channel does have good content.

Exercises

Time to get to the good stuff. My training program had 3 phases in it. We start with small movements and work our way up to dynamic and explosive movement. Each phase will last for a month. Once you complete a phase you don’t need to do those exercises anymore. Phase 3 is ongoing.

Phase 1

There are only two exercises in phase 1. And there is only one thing we are trying to do in phase 1:

Draw the hip bone into the hip socket and stabilise it.

I did both exercises every day for 4 weeks.

Side note: I noticed an interesting thing while doing these exercises. There were days where I couldn’t do tissue work (because I woke up too late to lie on the kettlebell before work or there were people in my house still asleep so I couldn't use the TimTam), so I just went straight into the exercises. And a lot of time after doing these exercises the impingement went away with no tissues work!

Exercise 1: Side Lying Hip Abduction

A key point that wasn't mentioned in the video is you need to draw you hip bone into the socket before beginning this exercises. I do this by trying to pull my foot into my hip socket. Naturally, you won't be able to do this because your leg is in the way. This should make your top leg short then your bottom leg.

Draw your hip bone into your hip socket by pulling your foot into yourself.

I did 2 sets of 15 on both legs and added ankle weights at week 2.

Exercise 2: Pelvic drop down.

This is the closest video I could find for what I did.

The focus is on the standing leg.

Guide:

1. Start with balancing on one foot with your other foot off an edge. You may gently hold onto something for balance. I did at the beginning and then get rid of it. Your pelvis is horizontal.
2. Relax the hip of the leg that is standing. This will cause the free hip to drop. This is not the same as dropping the free hip.
3. Draw the standing hip back into the hip socket until your pelvis is horizontal (do not go past horizontal). This is not the same as raising the free hip.

Draw your hip in. Don’t raise your free leg.

I did 2 set of 15reps on both legs at a much slower and controlled tempo than the video.

Remember:

Draw the hip bone into the hip socket and stabilise it.

Phase 2 and 3

I couldn’t find videos that match my other exercises that well. I’ll probably try and film myself for phase 2 & 3 and do a new post. This post should last you for a month anyway.

See you then.