My Story of being a runner with a torn hip labrum

I have been thinking about writing this blog for a while...

…roughly 8 years.

Why am I writing this? Because I deal with the same negative thought looping most runners do after an injury.. even way after?

• Am I ever going to run again?

• Am I ever going to be able to run at the same level again?

• Is this injury ever going to feel better?

• What would my running have looked like if I never got injured?

• Was this somehow my fault?

I waited because it honestly took me this long to have a better handle on who I was as a runner with this injury. This is an injury I knew way too much about when it happened, and an injury I knew that was never going to heal. My hope was that my story could help other runners who have experienced injury. Although the way I was injured was unusual, the injury itself and the problems it eventually caused are some of the most common in the running world. Although I have run all my life, this was actually my first real injury..”go big or go home” like my basketball coach always said! I see new clients every day, and they share their stories with me as to how they came to need the services of a physical therapist who specializes in running. Almost all of these clients are currently injured, and I would say most are dealing with serious injury which has either greatly reduced or stopped their running all together. Some clients have very severe injuries and situations, much greater in magnitude than my injury I describe here, but I approach their situation with a same evidence-based methodology and positivity I apply to myself. I feel the loss they are experiencing and the grief of being without the sport they love. At the end of our discussion, I am always very sincere in my belief that they will be successful with some or all of their goals. Everyone’s journey may be a little different based on their circumstances, but I am my client’s biggest advocate to get them in a better place because I am that same advocate for myself in many areas of my life, but especially as a runner. I want to share this story because I love giving hope to others. Even if a small part of this story gives a more positive outlook to someone who is wrought with anxiety about getting past an injury, then I think having this injury in my life was worth it.

I was training for a 30K trail race which had a fair amount of vertical climbing. I was running routes in the Bent Creek area, and had come to a segment of single track that was sandwiched on a hillside with a long embankment below. I was about 3 weeks out from my race and my training had been going very well. 

At some point my eyes locked on a dog, about what seemed 100 feet away. The dog got low to the ground, opened its mouth to bare its teeth, and took off in a sprint towards me. I immediately looked at the man walking behind the dog and, in what must have been a fraction of a second, I knew that man was in sheer panic and had no control of the situation. His eyes went wide, and I braced myself for the dog to attack. I then noticed the dog was having to run uphill to get to me and it was slowing it down. I immediately lurched to my right down the embankment. All that registered was some kind of large brush in front of me and I hurled myself full speed underneath the low branches feet first. I’m still not sure what it was.. A down tree or low bush. I got most of myself under it but the part of my body that was closest to the opening was my head. I pulled my chin in tight to my chest and covered my face with my hands. This was all I could do, there wasn’t any more room to hide and I spasmed into a tight ball.

I heard the dog skid into the brush, and this was probably the worst part. I had squeezed my eyes shut, and I was too afraid to look.  I was ready to feel the dog bite my face any moment, but it never did. Maybe this dog wasn’t ever intending to bite me or maybe it couldn’t reach. I could feel the dog continuing to snap near my head, and it felt like an eternity, but eventually I heard the owner come up and the dog dragged away from the brush. Of course the next thing I did was completely ridiculauous, and I’m sure on some level comical. As soon as I knew the dog was being held back, my legs darted out of the brush, I hopped off the ground, and took off in a full sprint sobbing for about a mile. I didn’t even look at the owner. I was a complete mess of adrenaline. Over the next mile all I wanted to do was to stop sprinting, but I couldn’t seem to do that beacuse I couldn’t stop crying, and apparently the two had to happen simultaneously. So I just kept running until I couldn’t do either anymore, and if anyone saw me I’m pretty sure they would have called the authorities. I went home, tried to calm down, and eventually I felt better and very lucky overall.

Over the next 2 days I was feeling better, and noticed some strange welts along what I knew to be the path of a nerve down my left leg. I saw my doctor to rule out shingles. She felt it was a response to stress from the incident.  My left leg felt thobby, and sometimes I could feel the throbbing into my shin and foot.  The next time I tried to run I noticed extreme tightness and pain in the front of my hip and also in the muscles of the inner thigh and groin. I had to stop and stretch frequently to get through my runs, and my leg felt uncoordinated, like it wasn’t properly wired to the rest of me. I just chalked it up to  a strain from the fall. The race was just 1 week away and I figured I would just take it easy since it was taper time, and let things calm down. I actually wasn’t that worried about it.

Race day came, and I was very excited. I had trained well, and even hired a strength coach who taught Olympic lifts ( which I loved) and was in the best shape ever! I was strong and confident. Halfway through the race I realized 2 things. 1) I was in great shape and I was going to be very strong with the terrain I had left ahead of me, 2) My hip was in severe pain and I was going to have to mentally relax in the “pain cave” till I got to the finish. 

As I ran through the finish line I saw David (now my husband), and the first thing that shot out my mouth was “I’ve done something bad to my hip”.  Then I was all smiles after seeing my finish time, and enjoyed the after party with food, and beer of course. It  made me forget all about my left leg that had pretty much stopped working at this point. Having had two babies and also a case of encephalitis due to a very bizarre case of  viral meningitis a few years ago, I was very familiar with severe pain. On my last few miles of the race I knew I’d have to get  an MRI (magnetic resonance imaging) for my hip, because with the  kind of pain I was experiencing. I could have be dealing with a stress fracture and/or hip labral tear, and I needed to know exactly which injury it was so I could deal with it properly. Both diagnoses are very painful, but dealt with much differently.

After the race, my hip pain became almost unbearable and global. The pain was sharp, and then throbbing, and nothing I did was gentle enough to make it stop. I tried swimming, Pilates, elliptical...even just standing at work was excruciating. I would come home some nights, and just stand at the counter and start crying. Not really just because of the pain, but because of the loss of not being able to get on the trail in any capacity at this point, even just for a walk. It was also because of fear of the unknown. I call these times “dark days” and I had quite a few during that time with my hip. 

The first possible injury type would be a stress fracture, but that is a very uncommon injury with a single traumatic fall like I had. Traumatic falls would result in more of a full fracture which is quite different. Stress fractures usually happen after repetitive steps over time or a long hard effort like a marathon, but it still wasn’t impossible. I was fairly certain though I was looking more at the second option with these symptoms, a labral tear. The hip labrum is a cartilaginous ring around the socket of the hip. I sometimes explain the role of the hip labrum to clients as looking and acting like a rubber plunger that creates a seal which sucks the hip bone into the socket to keep it stable. We also have a labrum around the shoulder joint. 

The race was in September, and I had an MRI scheduled in December. When you are trying to see a hip labrum in an MRI, dye has to be injected into your hip to allow the picture of the labrum to be very clear and recognizable. I lied on a table as the dye was injected, and stared at the monitor screen showing the needle going into my hip joint. I watched the dye flood in and light up my hip socket. It was pretty fascinating to watch, and, maybe it was my imagination, but I swore I could see what the MRI report eventually told me that afternoon. I had not only torn my hip labrum but I had such a hard impact on my hip that a part of the cartilage was knocked out from the bone. This explained to me the different kinds of pain I was feeling. Pain from the bone lesion, pain from the acute nature of the tear, and eventually the tendons of the groin and hip flexor muscles that were being strained from the instability of the hip. My femoral nerve was also tractioned slightly during the fall, and produced a lot of sensitivity and nerve pain down the front of my leg.  I had an incidental finding of both hips having a Femoral Acetabular Impingement (FAI) where the ball of the hip bone doesn’t fit perfectly into the socket, and the bones abut, but I had no pain with testing and full range of motion so it was deemed minor.

A week later after going over the MRI and my options, I had an appointment with the orthopedic surgeon. I also had chosen to get a cortisone shot in my hip with my sports medicine physician to calm down the pain so it was manageable, now that I knew what I was dealing with. I really wanted to defer this option as long as possible, but due to the months of my hip pain being severe and working on my feet was becoming a struggle, I opted for one. In healthcare we try to avoid cortisone around tendons as much as possible due to its ability to weaken the tendon, and for joints there is more safety, but advised to be infrequent.

I sat down with the surgeon who I really respected and knew was a specialist with hip labral tears. I unfortunately knew the research. I was 40 at the time, and at my age (40+) there weren’t many studies regarding successful labral repairs and distance running. This is really more because there is usually already some age-related wear and tear on the hip labrum and the “plunger seal” I described does not have the most perfect edges anymore to anchor back together. That being said, it in no way means athletes in their 40’s can’t have wonderful results with a labral repair. It happens all the time, and the surgeon was very respectful and let me know it was my decision. What did dictate my decision was the surgical protocol and the research on rehabilitation potential. At the time my children were 5 and 7 years old, they were very active, I was a single parent, and I also owned my own business. The protocol after surgery is to have several weeks of non-weight bearing. This meant I would need a lot of help with child care and closing my clinic for several weeks. I wanted to try rehabilitating my own hip for a few months because the research was fairly good with time, strength, and a progressive sports-specific loading program athletes can get back to running. I always had the option for surgery, and I was open to doing it if I couldn’t get back. So this was the path I committed to for the next few months. 

So I did gentle strengthening,  treatment for my muscle pain and tightness which, for me,  trigger point dry needling felt the most effective and decreased the muscle spasms around the hip (yes..I did needle my own hip pretty much every 2 or 3 days, but I was properly trained and did treat myself to some rom-com Netflix movies during my sessions). I started a walking program that evolved into a walk-run program. I then had my “break through run” where I did 4 miles continuously. This was a day I would never forget. It was a huge turning point, and I knew if that was all I could do I would be eternally grateful for being able to return to some kind of running. 

Time went on, and one of my favorite races was coming up. I had been building mileage slowly. The Yeti or Not 25K in DuPont forest. I decided to head out there, and if the worst thing I had to do was stop and drop out, well… that wasn’t that bad.. I could handle that and felt it was worth a try!  I had only gotten up to 8-10 miles at that point, but I was feeling very good and no longer having muscle spasms or pain. 

I remember walking across the grassy lot, and saw Aaron Saft, our awe-inspiring and kind hearted local race director. He knew I had been struggling with this injury. As I passed by and told him I was going to give it a shot, he said the 3 most perfect words I ever heard… “You got this''. I lined up at the start and felt the most joy I had in a while as we started out. As we climbed up to this section of single track where the view is so nice overlooking the mountains, about 6 miles into the course, I knew I was going to have a good day. It was like magic. I ran that race, and felt wonderful. 

This was the beginning of my life as a runner with a hip that would need attention and care. The best way I can describe my experience with running on a hip with a symptomatic torn labrum is when I land on my right leg (the side not injured) it feels like a nice stable springboard that as soon as I load it, it stiffens, my muscles engage, and push me forward away from the ground. My left hip (the injured hip with the torn labrum) feels like quicksand when I land on it. The left hip feels loose and spongy, and my muscles have a harder time contracting to push me forward. It always feels like 2 different legs. I have many good times when my legs feel almost the same with that familiar rhythmic bounce from one foot to the next. I have fewer bad times now, when my legs are in completely different hemispheres, and my left leg just drags and drains all the power from my right leg. I have learned to give myself some space to recover after the bad times, and I keep going because I know those good runs are now possible and frequent. 

Since my hip injury, I have learned so much about how certain choices can either lead to great running success or disastrous injury. I can NOT emphasize this enough! Good decisions are my biggest tool for success. I have made poor choices, usually jumping into a track work out or not spacing races far enough apart, that landed me into a tendon injury or a hip flare. Keeping more strict with rules of healthy training (and less impulsivity 😊) have allowed me to run several trail 30 and 50Ks without injury. For that, I am always grateful.

Thank you so much for reading and always feel free to contact me with any questions at runnersmechanic@gmail.com !

**Side note: I love dogs and this is not a commentary on the dangers of unleashed dogs… I have dogs and ..like my children.. things can go a little sideways when not supervised but I always love them (: