Labral Tears – Surgery or Not?

In my last post I wrote about my perspective as a Hanna Somatic Educator regarding chronic hip pain and what is counterproductive, and what works.

• Strengthening painful hip muscles can cause further pain or injury.
• Learning to relax the muscles and the pattern of contraction the muscles are stuck in can provide long lasting pain relief, relaxed hip joints, and balanced movement.

Exercises such as the “clam shell,” and lateral leg lifts tighten the hip muscles, making it more difficult to move the hip.  Sitting with the soles of the feet together and pushing the knees out to “stretch out” the inner thighs can cause tight adductors to contract back against the force of the stretch. Even psoas “stretches” performed in isolation, can induce the stretch reflex, causing muscles to tighten back against the stretch.

• Address the pattern of contraction, not the individual muscles.
• PANDICULATION is the most effective way of changing what the muscles are doing. Contracting a muscle first, then lengthening and relaxing it re-sets the muscle length at the level of the nervous system as it provides sensory feedback to the brain -  “waking up” the cortex.

I hope some of you tried the small sample of simple Somatic Movements I included in my last post. Here’s a series of movements to relax the center of the body – back, waist and trunk rotators. After you’re done viewing this series, scroll down for a wonderful variation of one of the movements you’ll learn called the “steeple twist.” This video was made by Charlie Murdoch, a Hanna Somatic Educator from New Hampshire. First mine, then Charlie’s:

All these movements are a good beginning to learning to relax the muscles involved in the “trauma reflex.”

Improved body awareness and muscle control is crucial when you have structural damage, like a labral tear.

If you know you’re injured, and your doctor tells you to “wait and see,” or “it’s not a big deal,” then it’s critically important that you become aware of how your brain is compensating to deal with the injury (Sensory Motor Amnesia), and how that is affecting your movement habits.  This concept applies to all of us – elite athletes, teenagers, and  Baby Boomers hitting their 60′s. From my personal and clinical experience, that functional problems left unchecked can, over the years, result in structural damage.

Do you have to be A-Rod to get a good doctor?

About a year ago I finally convinced my doctor to allow me to get an X-ray on my hip. I had intermittent hip pain that I knew intuitively wasn’t merely a functional issue.  The X-ray showed a tumor on my hip. An MRI confirmed the (benign) tumor, which was a result of two labral tears. My surgeon, a well known sports medicine doctor here in New Jersey, took a half hour to show me my results: labral tears, osteoarthritis, a tumor – lovely. He told me that, “there’s just not enough science out there about labral tears to go ahead and do the surgery.”

Unrepaired labral tears can possibly create the need for a hip replacement in years to come.

Before he walked out the door I asked my orthopedist, “do you think that if you DON’T fix the tear in my hip now, and I walk around for the next 5 years compensating due to the intermittent pain, that I might be causing worse structural damage, thus setting me me up for a full hip replacement?” He replied, “that just might be possible.”

As I said in my first post about hip pain, it didn’t take Alex Rodriguez’s doctors long to figure out that if the Yankees were going to get their star player back on the field, earning his millions and hitting home runs, labral tear surgery was a must. ASAP. No absence of scientific data there.

So where does that leave the rest of us?

In googling, “labral tear surgery” recently, I came upon a forum on both Men’s Health and Runner’s World. The desperate pleas for help regarding recovery from labral tear surgery were horrifying. Terrifying. Depressing.  From the feedback I read, never in my life would I consider this kind of surgery.  The one saving grace was this: I’d be willing to bet that few to none of these people realized that their original functional problem – the trauma reflex that got them into the problem in the first place – wouldn’t be solved by the surgery. The surgery helped to repair the structural damage, which is wonderful. It didn’t address the sensory motor amnesia that altered their movement in the first place.  I would venture to say that surgery combined with Somatic Education focused on regaining full functioning of the body as an integrated whole and skilled physical therapy would be a winning combination.

I’d be willing to bet that what A-Rod got was a winning combination: excellent surgeons, excellent functional trainers, and PTs who knew what to look for (gait symmetry, ribcage symmetry, evenly swinging hips, even leg length that comes from relaxed obliques, lats and abdominals). I would add to anyone’s rehabilitation program Hanna Somatic Education.

So while the jury’s not out about what route I will decide to take, improving my own sensory motor system and paying attention to my daily movement habits (which are fodder for yet another blog post) is profoundly helpful in creating long lasting pain relief….which is what we’re all looking for, right?

I teach a variety of workshops on how to release tight hip joints, hamstrings, backs, necks and shoulders. There are lots of movement patterns, and each one gives more and different sensory feedback to your brain, in order for your brain to intelligently and safely increase flexibility, proprioception and muscle control. If you’d like to bring me to your area for workshops, weekend seminars or private, clinical sessions, please contact me. There are lots of options for learning more: online video consultation, phone consultation or online class.

To learn the methods and movements of Hanna Somatics for rapid relief of muscle pain click here to buy my new, easy to follow instructional DVD.