T Nation

Knee Injury ?

Femoral Acetabular Impingement & Labral Tears

Anyone had this or know of someone with this?

I was recently diagnosed with this and given a cortisone shot to a) help inflammation and b) assist diagnosis of a tear as well as given PT. I am doing my PT but I’m really not sure its making a big difference, which will mean I’m staring down the barrel of surgery. My doctor (who is a sports doctor) says he would expect this to be a fairly common injury within BJJ.

Cheers,

  • J.

I probably should explain a bit further. I am a Brazilian Jiu Jitsu practitioner (BJJ for short).

It started around Oct last year. I had just come back from a severe knee problem (patella femoral pain syndrome - I get all these funky ass injuries) after a 5 month layoff, was back on the mat for a month with a competition two months away when this came up.

I wasn’t about to take more time off so I said f*ck it, train through it, ice and anti inflammatories and work through it. After the comp I took two weeks off, no luck. Still there. My approach was to keep training around it, try to stretch more, etc.

My rationale was if its just pain and muscular, it can be ignored/managed but if its something else, then its time to get it fixed. Pulled groin muscles was a sign my body was overcompensating for something.

After 6 months of this, the pain got really bad. I was in the middle of changing clubs and about to get some time off anyway so I figured what the hell, get it checked properly.

The pain radiated from the top of the thigh right around to the inner groin. Felt like really aggravating tendonitis that would not go away (I mean the strong pain that is there all day, even when sitting or standing and makes you a moody son of a b*tch).

Saw a sports doctor who suggested a cortisone shot to assist with the inflammation (pain was so bad I couldn’t sleep properly, even with prescription anti inflams), do strengthing of the hip and gluteals and go from there. If there’s still problems, we will need to go further (MRI, possibly surgery, etc).

So I had the cortisone shot. As of now, I don’t have pain but there is slight discomfort on the outer front of the hip. (I believe that’s a sign its a labram tear.)

So I’ve been back to my physio for about 5-6 weeks now, 3 weeks afte rmy cortisone shot. I don’t have pain, I can do pretty much everything but my hip does not feel right and it lets me know on some exercises (squats for example).

I know the cortisone is only maskng the pain so I have no intention of beating myself stupid but at the same time I don’t want to stop all training (I want to get this fixed, operated, whatever, do my rehab and get back out there). My followup physio session is today so I’ll tell him today I’m not convinced its working, my appointment with the doctor is next week.

I was supposed to go back to BJJ at the new club this week but now it all seems so uncertain. I don’t know what to do. I’m just trying to find out if this sort of injury is as common as my doctor thinks it is in BJJ. Whats the recovery like from surgery? Rehabilitation? Duration time in total off the mat, etc?

cheers

  • J.

Hate to break it to you, but the surgery can be very invasive. It depends on the surgeons choice of action and your condition as to which of two primary methods to correct your problem.

Femoral-Acetabular Debridement: Opening up the hip, dislocating the femur from the pelvis, shaving off extra bone that is causing the impingement.

Periacetabular Osteotomy: Non-invasive surgery where the ilium, ischium, and pubis are separated. Each is moved into a new location and screws are used to hold in place.

The recovery for the former method is 6 months for a FULL recovery. You will generally need two crutches for 6 weeks, and then a cane or single crutch for the second 6 weeks. The non-invasive option may be less recovery time, I am less familiar with this procedure.

The real bad news is that heavy running and jumping (and probably sparing) would not be advised for even longer than 6 months after the surgery. It is a tough decision, but you were right when you said the cortisone shot was just masking the pain.

My advice: get A LOT of opinions from several doctors before you decide what your course of action is. Good luck.

I don’t know who changed the header to knee injury. Its actually a hip injury.

Thanks for the advice.