25 years of soccer leads to an overuse injury and rebuilt hip
Mike’s love of soccer began at an early age. For more than 25 years he was used to the bumps, bruises and strains that came from playing a sport of sudden stops, twists and turns. When he experienced what he thought was a groin strain, he didn’t think much of it. The pain would subside, he thought
He continued his pick-up games and his four-to-five mile runs. A month later, he reached for the ball, and said, “I really felt it.” He could barely walk off the field. But within a few days, and after rest and icing, the pain subsided.
Six weeks later, his return to the field lasted a mere 25 minutes. The pain returned, deep in his buttocks and now radiated around the front. But again, after a few days the pain subsided, sort of. Over the next month he struggled with his gym routine because of his hip and groin hurting too much. Unable to do pull-ups or planks, he thought he had a hernia.
When surgery becomes the only option
A visit to a sports medicine physician ruled it out the hernia. A labral tear (the cushiony cartilage around the hip joint that provides stability) was suspected. Tears can happen with overuse or an injury. They are most commonly found in athletes who play high motion sports.
A definitive diagnosis is generally made with an MRI, using a contrast dye. Treatment can vary. Depending on the severity of the tear, conservative care of anti-inflammatories and physical therapy with stretches and strengthening the muscles around the hip and core can be a benefit. Although this will not repair the tear, it can prevent further damage and lessen the pain.
For a tear that does not respond to non-surgical treatment, arthroscopic surgery is generally the only way to correct the problem. Over the last 10 years, with the advances in minimally invasive techniques, hip arthroscopy is becoming more common and getting good results
Mike consulted with orthopedic surgeon Dr. Warren Krammer III in Newport Beach. Dr. Kramer confirmed the tear and suggested surgery.
A one-hour outpatient procedure was performed to fix the tear and remove the bone spur. The surgery was a success, and a few hours after, Mike was on crutches and on his way home.
Surprising the physical therapist by walking 1/4 mile for his first appointment
A week later, Kim Marshall, DPT, the co-owner of Progressive Physical Therapy in Orange, was surprised to see Mike, but not for the reason many would think. For his first appointment, he walked the quarter-mile from his home to her office on crutches. Mike was doing great on his road to recovery, but he needed assistance.
“Patients who have had hip surgery have very specific protocols to follow,” said Kim. “There is a certain progression that takes place along with natural healing and it just can’t be rushed. Generally, it can take six to nine months or longer to return a patient to their sports depending on the level and type of activity they play.”
Therapy began with increasing range of motion, partial weight bearing and strengthening exercises. A specially-designed home exercise program (crucial for all rehab programs) was designed.
“Kim and the entire staff were great,” Mike said. “She really knew what she was doing and was very experienced. As hard as it is to believe, it was actually fun, because she made it that way. We always had a good time, even though she was pushing me.”
Running on the treadmill was a happy day
Within a couple of weeks Mike, could drive, and after a month, he lost the crutches. After making three visits a week for nearly four months, Mike progressed. He could now do full weight-baring exercises and safely returned to the treadmill.
“That was the happiest day I had,” he added. “I love to run, and it felt so good to be able to do it again, even though it was only for a few minutes.”
At five months, he was cleared to return to low-level soccer. Mike found a pickup game and was supposed to play for only 20 minutes. He felt good and was so excited to return to the field that he played for 40 minutes and paid for it afterwards.
“I learned my lesson,” Mike said. “I was definitely sore, but fortunately didn’t do any damage. Within two days the pain went away, but I realized that as good as I was feeling, it would still take more time before I was 100%.”
“For young highly-active people like Mike, the rehab process can be a bit frustrating; it takes time to return to rigorous and demanding sports like soccer and running,” Marshall added. “On the positive side, he was really good about listening to his body and really knowing what he was capable of doing and how much he could push himself. It is important also for the patient to communicate that to the therapist.”
A full seven months after surgery, Mike is fully cleared for sports (but too busy for his pickup games). He is, however, thoroughly enjoying his long four-to-five mile runs a couple of times a week and getting back to the gym.