♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Well hi there folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we're the most famous
physical therapists on the internet.
- In our own opinion of course, Bob.
- We're gonna talk about a common,
(mumbles) I'm sorry.
Common adolescent hip and groin pain
can lead to emergency surgery.
Exclamation point.
Must see.
This is SCFE or you call it SCFE.
- SCFE.
This is something that I dealt with upfront.
A 12-year-old girl,
common hip pain. - Just happened to you,
right?
- No it happened a few years ago.
- Oh it did.
- But I remember it clearly
because I thought it was just a groin pain,
just some common stretches,
and she did end up going to the Mayo Clinic
in Rochester for emergency surgery.
- Wow. - And she's okay now.
- All right.
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- There you go.
So I don't wanna get people all excited
about your youngster who's active,
or maybe not active.
- But showing up with groin pain.
- Showing up with this hip pain
that they're gonna need surgery.
But it can happen,
and it actually has the name SCFE,
which means slipped capital femoral epiphysis.
Epiphysis. - Epiphysis.
- Which is a growth plate problem.
- Yeah it's a growth plate.
- And it can be very serious if it's missed.
And oftentimes this is misdiagnosed.
It was in this girl's case. - She went out for months,
you said. - Yeah.
And it was just very,
you know,
I remember distinctly.
- Well you remember it
because it's such an unusual case.
- Right.
- These are the ones that register in your head.
- And it's easy to diagnose properly
if you have x-rays.
- Sure.
That's all you need to do.
- They'll show it and then let the doctor,
the orthopedic surgeon carry on from there,
and things will all...
It recovers very well.
- What is the frequency Brad?
How often? - This is the good news.
Okay?
The good news is it's not very common.
10.8 cases per 100,000 children.
- Sure. - It's not common.
But when it... - Not that common.
- Right.
But what happened to me -- - The thing is though,
you know,
that's kind of a little misleading statistic Brad,
because that's out of 100,000 kids.
That's not out of 100,000 kids with groin pain.
So I wonder - Right
- how many people with groin pain
at that age actually have this.
- Which is a good point.
So you're kind of wondering,
well how do I know that this is a possibility?
It's typically the symptoms are
vague groin pain.
Not groin pain but hip pain.
Oftentimes like a pulled groin muscle.
- Sure. - Very typical.
That's what I thought this young girl had.
So I assessed her and I wasn't the only PT.
I was the second one that worked with her.
We both thought the same thing.
So she was just doing general exercises.
Take it easy,
don't get too aggressive.
But it continued to carry on.
- Kept getting...
Stayed the same or worse.
- Then she started to limp.
That's the second very common symptom with this.
So vague pain in the hip,
a constant limp when they're walking.
And actually with this girl,
she had gym class at 12 years old
and the gym teacher was completely unawares.
That was a day from the one-mile run.
So she did the one-mile run. - He made her run a while.
- Which was the straw that broke the camel's back
and it actually got worse.
And then her parents took her to the doctor.
The doctor took x-rays,
immediately sent her to the orthopedic doctor.
And the next day they had surgery.
- Where they put a pin in it,
you said. - A screw.
- And then the rehab was how long?
- Six to eight weeks no weight bearing,
and then about four to six months after that.
- So this is a long haul here.
- So what is this?
It's the hip bone right here where the ball of the hip,
and the growth plate is right here.
And what happens is the x-rays are quite dramatic.
You'll see on a bad case,
you always show the worst cases
when you look this stuff up.
But the ball stays here and it shifts,
and you can see it's no longer round.
It's like it actually shifted over on the growth plate.
And there's an artery that goes through the femoral head.
And when that artery becomes compromised or fractured,
you can actually have serious leg problems.
Matter of fact,
the doctor told the parents,
I don't know if this was true.
Maybe in extreme cases where you could lose the leg.
- I certainly can see how you would lose the hip.
You'd need a hip replacement,
because you see that in adults,
where they get a fracture of that
and they end up having to replace the hip.
- Well Bo Jackson. - Bo Jackson.
Bo knows everything you know.
Bo knows.
I mean he ended up having a hip replacement at...
He was a young guy.
He was still playing football and baseball,
right? - Right.
But that's a different diagnosis.
- That's a different diagnosis.
But it's similar. - Similar, right.
- There's other things I know that,
common things.
It could be like a tendonitis or an impingement.
But even with the impingement,
a lot of times you get femoroacetabular syndrome.
You need to go in for x-rays on that too.
Because that's how that's diagnosed.
- So if your child has this
and you go in to the doctor to see it,
just maybe we could have x-rays.
Sometimes if you ask the doctor,
you say,
if they have these symptoms
and the doctor will say...
Sometimes they don't always remember.
- Right. - It's not real common.
And it's a very...
The x-rays are pretty simple. - Well femoroacetabular
syndrome is more uncommon.
- Sure.
- And I've seen four or five cases of that Brad.
I mean before and after surgery.
And I saw one girl this last year who came in.
They didn't know what was going on.
Cross country runner,
good runner.
And I did the test on her.
It's like,
"I'm sorry but I think that's what you have."
And that's what she had. - Sure.
- So again,
same thing.
They had her go in for x-rays.
So you know,
I think there's a lot of times
people discount it because kids do get hurt
and you wanna see if it's gonna...
And I think you can wait a little bit.
- Oh yeah. - You can wait a couple weeks.
- If things aren't getting better,
because they usually get better in a couple weeks,
and then these symptoms arise.
Another thing that they find common
with this particular diagnosis,
obesity.
Kids that are overweight can have this.
A growth spurt.
If they're going through a rapid growth spurt.
- Sure. - That's another time.
- Now your friend's daughter was not obese though?
- Oh no.
She's very active,
played hockey.
She played volleyball,
doing all kinds of things.
- It's funny.
With the girls I've seen
with femoroacetabular syndrome or impingement,
they're actually every one of them was thin.
And everyone very active. - Sure.
- So it's just kind of a weird...
I mean like I said,
five cases and they're all very active.
But I could see how if you're overweight
it could cause that bone to shift easier.
- More stress on there. - Right.
- And same with the growth spurt,
when things are happening so rapidly
when these children are growing.
So again,
you cannot get too excited about this,
but it's nice to know that if these symptoms,
this limping and this vague pain that's been going on
not getting better,
when you see the doctor,
they'll take x-rays
and if it's not that,
it's good news.
And if it is,
it's really good news that you found out
ahead of time. - At the right time.
- So very good. (men talking over each other)
- Go ahead.
What were you gonna say?
- Keep your kids active and keep 'em moving.
But just be aware.
- And remember Brad and I can fix just about anything.
- Except for --
- A broken heart.
- But we're working on that. - But we're working.
We can't fix broken hips either.
- No but we know where to send 'em.
(laughs) - Thanks for watching.