Hip cam defomity preventing kicks?

[lizliz]

Hi gang,

I've been a striker for 8 years and a BJJ girl for about 2. Since 2014 I had a nagging groin pain that wasn't painful but made kicking on the left difficult. Fast forward to June 2017 and it becomes difficult to sit. Moving to Nov. 2017 and to me getting ready for both a standup tournament and a BJJ tournament (same month but a week or two apart) and I noticed I needed to really rub the front of my hip after doing a set of kick drills (literally, between each set I had to stop and rub). Then I discovered forward hip escape was super aggravating on my hip... and soon enough, I couldn't walk! I went to a doctor, got a script for PT and made some progress (I can now walk again and run short distances and even kick for a short while) but any length of inactivity (sitting, not doing my PT homework for a day, etc) causes burning in my hip. Seems counter-intuitive that less activity would hurt just as much as full activity....

I should note, there is NO tear showing on the MRI, just bone spurs.

My doc suggested I go back to training and if it flares up again, he thinks he should scope.

Although the MRI doesn't show a tear, I have a high pain tolerance and the burning feeling in the front of the hip will NOT go away even if all other symptoms subsided. Might that be a sign of a tear? Even if there isn't a tear... the doc said I will eventually tear my labrum if I continue martial arts (which is my life.. I also teach!)

Should I wait for the tear or scope sooner for a faster recovery? I'm 30 but on some days I feel like I'm 100. The cam deformity has been with me since puberty I think - it prevented me from doing certain movements back when I did high school gymnastics but I suppose since I was a teen I was able to keep on truckin' without knowing I had FAI.

Anyone who has been there done that, I'd appreciate your thoughts and I'd love to hear where you are now in your training. Right now, pre-surgery I'm modifying how I throw my kicks, making sure to use more glutes and psoas initiation but how can I modify BJJ aside from avoiding things like Spider or forward hip escape? Seems impossible to reach my potential with FAI....

Thanks!

 

[ARIZE]

Deleted cause other people have better answers than mine.

 

[Ryyonvin]

there are some hip mobility videos done by Andreo Spina (under Onnit) that have been very helpful for me. It's not surprising that you feel pain while sitting for awhile since the muscles are contracted in that position so it would definitely benefit you to work on your mobility there to help open them up.

 

[shincheckin]

Hi gang,

I've been a striker for 8 years and a BJJ girl for about 2. Since 2014 I had a nagging groin pain that wasn't painful but made kicking on the left difficult. Fast forward to June 2017 and it becomes difficult to sit. Moving to Nov. 2017 and to me getting ready for both a standup tournament and a BJJ tournament (same month but a week or two apart) and I noticed I needed to really rub the front of my hip after doing a set of kick drills (literally, between each set I had to stop and rub). Then I discovered forward hip escape was super aggravating on my hip... and soon enough, I couldn't walk! I went to a doctor, got a script for PT and made some progress (I can now walk again and run short distances and even kick for a short while) but any length of inactivity (sitting, not doing my PT homework for a day, etc) causes burning in my hip. Seems counter-intuitive that less activity would hurt just as much as full activity....

I should note, there is NO tear showing on the MRI, just bone spurs.

My doc suggested I go back to training and if it flares up again, he thinks he should scope.

Although the MRI doesn't show a tear, I have a high pain tolerance and the burning feeling in the front of the hip will NOT go away even if all other symptoms subsided. Might that be a sign of a tear? Even if there isn't a tear... the doc said I will eventually tear my labrum if I continue martial arts (which is my life.. I also teach!)

Should I wait for the tear or scope sooner for a faster recovery? I'm 30 but on some days I feel like I'm 100. The cam deformity has been with me since puberty I think - it prevented me from doing certain movements back when I did high school gymnastics but I suppose since I was a teen I was able to keep on truckin' without knowing I had FAI.

Anyone who has been there done that, I'd appreciate your thoughts and I'd love to hear where you are now in your training. Right now, pre-surgery I'm modifying how I throw my kicks, making sure to use more glutes and psoas initiation but how can I modify BJJ aside from avoiding things like Spider or forward hip escape? Seems impossible to reach my potential with FAI....

Thanks!

Im not a doctor but I am a nurse. I also have personal experience with labrum tear surgery of the shoulder. The good news is surgery will bring you back to the point as if it never happened, basically 100%. However mine was of the shoulder, I am not certain of the hip.

As I was reading your post, before you mentioned it, the immediate red flag I got was a torn labrum of the hip joint. Im sure you know or have read up on the symptoms of it.

Where was your MRI done? Are you sure it was an MRI and not a x-ray? a MRI will reveal a torn labrum, but you mentioned bone spurs. Bone spurs are typically revealed on a x-ray.

Now for my health insurance rant, as I worked in health insurance for about 6 years. Medicine in america is for profit. The goal of health insurance is to do nothing, or as little as possible to save money. This is why they prescribe you pills (money to be made of selling them to you) and send you to physical therapy (more money to be made) rather than curing the problem through surgery. IMO physical therapy is bullshit, its great for post surgery, or for very old people to keep their range of motion(ROM), but thats about it, it does nothing for injuries.

I would suggest moving forward with the surgery. You should also do it quickly, as most insurances wont approve it after the age of 32 as your considered to old to benefit from it. Lastly, they dont care if you need surgery so you can do a sport, their attitude will be, great quit that sport so we can save money. You will not get the surgery approved unless your injury interferes with work or your activities of daily living. So make sure that you let them know that your injury "IS" effecting both those things.

 

[Sano]

First of all, nicely written and informative OP.

I want to clarify a few things in this thread.

When it comes to mobility work you have to be selective in what you choose to do, as forcing yourself into especially passive flexion and internal rotation can worsen the pain and symptoms of FAI. I'm sure you're aware of that already, but I just want to make sure that point is understood, as mobility was mentioned as a solution to your problem.

In regards to whether or not you should opt for arthroscopic surgery, well that's hard to say. Looking through the litterate it seems that short time outcomes of arthroscopy are relatively good and that it's a safe procedure (https://academic.oup.com/jhps/article/3/4/318/2525441). Yet long term outcomes are not well examined and there is no strong evidence at this point to suggest it being either superior or inferior to non-surgical options (https://www.sciencedirect.com/science/article/pii/S1063458416300486).

I know you are seeing a PT already (I'm guessing that means physiotherapist), but if it was me (funny enough I have FAI as well), I would seek out a musculosceletal physiotherapist who specialises in hip complications. There are certain manual techniques that can be applied in combination with a very specific exercise and rehab protocol that might alleviate some of the problems you are dealing with. Btw, it makes total sense that complete rest will increase the pain as well as too much activity, as the right amount of movement can help de-sensitise the tissue and improve the healing. It's about finding a balance.

Ultimately you might have to come to terms with being limited in a few areas. That doesn't mean that you cannot get better though. As I said, if it was me I would seek out a specialist first and give it a few months before you opt for the surgery. Either way, you have options! In regards to the alternatives to your BJJ techniques, the BJJ subforum is probably a better place for that as already mentioned. General rule of thumb is doing less of what hurts and more of what makes it hurt less.

Good luck with everything!

- A physiotherapist