Hip injury 18mo ago. Still in severe pain

[joannemojo]

Hi, I just thought I would post to see if anyone has an opinion on what has happened to me and possible causes.

I have hx of hypermobility (7 on beighton score) and as a child I suffered with subluxation of the left hip. I also have a shallow socket on the left (which I found out about last week).

Throughout my life I have felt a 'popping and catching' on the front of my left hip. It wasn't always painful but sometimes it would catch when walking and make me stop, regroup and then carry on. It would then remain sore for a while.

I would also have to crack my hip sometimes to get relief. I'd sit straight-backed in a chair and lean forward at the hips. I'd go so far and feel it 'catch'. I'd carry on and then a loud clunk or crack could be heard. Without doing that I'd feel like my hip was sorta stuck and needed to be released.


On June 10th 2008 I did the splits down the the stairs. My right foot slipped and as I went down, my left knee caught the step meaning that my leg was wrenched behind me and my foot ended up by my head.

Spent 9 weeks in hospital in agony and stuck in a wheelchair due to extreme pain. I was kept in for physio and pain relief.

All xrays, CT and MRI were NAD according to orthopods (who happened to not notice the shallow joint).

They diagnosed nerve injury and put me on gabapentin
QDS.

I have been under physio since discharge (over 1 year now) and made some progress but seemed to plateau slightly. Still unable to weightbare on (L) and limited ROM.

Last week I paid to see another specialist and he disgnosed the shallow socket and said that the most likely dx was tendonopathy. He decided that an injection of LA and cortisone into the tendon/joint - he mentioned injecting the tendon but during procedure it appeared to go into the actual joint. Injection was done through the front of my hip.

Had that done this wednesday and felt a degree of improvement.

Now, my question is:

When I did the splits it's assumed that I damaged the tendon.

My hypermobility is quite pronounced so my hip went backwards a hell of a lot more than a normal persons would, without a #NOF or #femur.

I have looked into internal snapping/clicking hip and that sounds a lot like what I have experienced all my life.

Could the damaged tendon be the one getting caught over the front of my hip? Thus meaning more pain and less healing?

I asked my physio about it today but she dismissed it saying that it's the wrong area and that its over the great trochanter. She was talking about the iliotibial band and not the iliopsoas tendon and I only realised once I was in the car on the way home (I'd had a rather intensive session and in pain so it slipped my mind).

I hope that's all clear. I tried to explain it as clearly as possible.

[csptqt]

I agree with you,

If we are talking about tendonopathy, it would most likely be the hip flexor tendon, not the ITB.

However, your history of hip subluxations, the need for you to "crack your hip" and a shallow socket may prime you for tears of the labrum. This is a difficulty entity to treat...especially if you have a shallow socket. I would say your problem sounds much more like a labral tear than tendonopathy. You might be a surgical candidate, but it's quite difficult to find a surgeon who will address the labrum. You've certainly done exhaustive PT and have had some relief with the cortisone...I'd consider a follow up injection and continue to work on your exercises at home before considering surgery.

You might need an arthrogram MRI to confirm a labral tear...

Sadly, in the end, most of the people I know who have this type of problem wind up having a hip replacement at an early age (although this is usually quite successful)

[MinnDasota]

I agree with the above poster. May be a labral issue vs. tendinopathy. Is your orthopod a hip specialist (more specifically, one that does hip arthroscopy)? That's where I would go to being that you've had this hip problem for a while now. Not sure where you're from, but some of the best in diagnosing this issue are in NYC (HSS) and in Vail (Steadman-Hawkins).