I’m seeking a second opinion for treatment, keeping powerlifting in mind.
I have had a long term (~9 months) hip injury which stopped me from squatting/deadlifting at 100%. After an athrogram the diagnosis was a torn labrum (right hip) with femoral cam lesion. (I was told the tear itself was “relatively small-ish to medium” in severity)
I’ve been told the two treatment options are 1. Guided steroid injection & 2. Surgery to repair the labrum and smooth out the joint so hopefully it doesn’t happen again. The decision we discussed was to do the steroid injection and if the pain reoccurs then do the surgery. However, I was told that the steroid injection will not fix the underlying issue and I may need to avoid certain movements even if it’s ‘successful’.
If strength training and/or powerlifting is a goal should I just opt straight for surgery? Is a steroid injection sufficient treatment for someone that intends to continue strength training, assuming it is successful? My concern is that the steroid injection will just mask the issue for some time and could cause me problems later in my training. What would you do in this situation?
This is a very complex and controversial topic in the rehab world. I shared this post with a rehab colleague of mine and he said “I could write an entire dissertation on this topic”.
If it were me, I’d opt for the conservative (i.e., non surgical) option to start with and try to seek out a qualified rehab professional.
Thanks for the response, much appreciated. I only ask because I haven’t seen many posts from people in strength training forums with similar injuries, what their successful treatment was, or if (not) getting the surgery caused other issues later in training.
I’ll be getting the steroid injection sometime in the next few weeks and rehab should hopefully take 4-6 weeks. I can update for anyone else that has a similar injury.
*Disclaimer: Free advice is worth what you pay for it.
I’m a practicing orthopedic surgeon. The effect of steroid injection is time-limited - the effect of the steroid lasts 3 weeks. In my opinion, there really isn’t any physical therapy that can make any difference with a acetabular labrum tear. Surgery for this problem, hip arthroscopy, is pretty benign, and should be recovered in 2-3 weeks. In patients where the torn labrum really is the source of pain, relief is quick and dramatic.
Having said that, if it were my hip I would try the injection and see how it goes. If it feels better, then after 2-3 weeks, start lifting again, but low weights and higher reps for 2 weeks or so and then start adding weight. If the relief from the shot doesn’t last, then seriously consider surgery. The general rule of thumb is this: If it’s a mechanical problem, then it needs a mechanical solution (surgery). If it’s a medical problem, then it needs a medical solution (medicine).
Thanks for the advice. Curious that you said the surgery could be recovered from in 2-3 weeks. My consultant said it would be closer to 2-3 months so I was hoping it wouldn’t come to that.
As for the injection: luckily I have managed to get my squat from ~20% back up to ~80% of what it was over the last 9 months (albeit with pain that varies in severity), so I’m hoping the labrum itself isn’t the source of the pain (maybe something else is compensating and causing it?) and the steroids will just push me over the last hurdle. I’m booked in for the injection on the 26th. If anyone stumbles across these posts with a similar problem and wondering about which treatment to go for I’ll happily update if requested.