16 months - unable to run pain free

[joshb7_]

Hi all,

I'm 16 months post op and still finding my range of motion in my hip flexor very limiting. Activities which affects it include; bringing knee to chest, sprinting, kicking a ball, tying shoe laces etc... Before the surgery with the arthritic hip, this level of impingement in the iliacus/hip flexor area was not as bad so I definitely feel its been made worse by surgery. On the other hand, other aspects of the hip have improved such as lateral movements.

For the first 9 months of recovery, I had sharp groin pain on certain movements, however, this seems to have improved although it is occasionally bit sore in that area.

I have had a few consultations with my surgeon Ronan Treacy who has told me to wait until 18 months to see the full range of motion. However, I feel not much has changed since 9 months so I am wondering if the actual joint itself is limiting my movement, rather than tendons or muscles.

I have had an ultrasound to diagnose any psoas bursitis and turns out I don't. Could it be a case of needing my psoas tendon lengthened surgically? Just to give you a background, I have been struggling with hip problems/lower back pain for ten years following a fall on ice snowboarding. I am an active 30 yo male who enjoys playing football, tennis, surfing, running, golf, snowboarding, cycling, however, these problems have seriously limited my involvement in these over the past few years. I have had so much muscle compensation/dysfunction which has also brought about aches and pains in my lower back, mid back, neck and now I have a left hip that needs replacing. I have had also had lots of soft tissue release work, but nothing ever eases the restriction of the hip being jammed up and painful when flexed beyond 95 degrees.

I will try and rehab lots over the coming months to help, but find that strengthening and stretching seems to have little overall impact in my quest to get back to playing competitive soccer and tennis. Has anyone got any stories of having had psoas tenetomy as I am wondering if my psoas/iliacus has become so shortened as a result of misuse/overuse/inactivity that no amount of stretching/strengthening will change. As far as RT says regarding my MRI post op, the new hip looks normal with enough space for good range of motion. I am awaiting CT scans for further investigation.

If anyone has had similar experiences, please get in touch because as an active 30 yo, I need to get back to living an active pain free lifestyle. I am contemplating either a psoas tenetomy or seeing if a revision of my BHR would help, although I would want to keep it as BHR not THR. I also anticipate that I will need my left hip BHR next summer, although the lack of progress in my right hip makes me think twice about it.

Thanks for reading.

Josh

[coloradopatrick]

Hi Josh.
I'm sorry to hear about your difficult recovery.  I am not a clinician and this is not medical advice.  But a couple things you may consider: Your non-resurfaced/bad hip could be bringing your pelvis or back significantly out of alignment, which could cause strain on the muscles around your resurfaced hip and could be generating the constant tightness in your psoas/flexors.  Also, you should do some research on the surgical psoas release - I have had a very good hip-specialist PT tell me that it is the worst idea in the world to cut the psoas to get it to release.  But that is just one opinion.  In addition, recovering from arthroscopy is not insignificant - worth it for sure if it works, but potentially could exacerbate the problem by cutting into the muscles around your hip, which will aggravate them in the short term.  Consider also doing the deep tissue work and stretches recommended in the "FAI Fix" on youtube.  Be careful with how aggressive some of them are.  You may need to just do the psoas dangle off the table while laying on your back if your psoas is already so aggravated.