In this video I'm going to tell you how to avoid surgery and naturally help heal a torn hip labrum.
Now I'm going to be discussing with you a strategy and an approach for fixing a hip labrum tear. And
I'm not going to be going into specific exercises in this video, but I've got lots of videos that
I've linked in the description below that do give you specific exercises, stretches and
other tips and advice to specifically move your hip muscles and joints. So don't forget to check
that out before you're done with this video today. My name is Dr. David Middaugh, I'm a specialist
physical therapist at El Paso Manual Physical Therapy. And this channel is dedicated to helping
people stay healthy, active and mobile. While avoiding unnecessary surgery injections and
pain medications. Please consider subscribing to our channel so that you don't miss out on
any of the helpful videos we upload every week. And we're going to answer the question first,
is it even possible to avoid surgery? If you have a torn hip labrum? Or said differently? Can you
heal a hip labrum tear? Without Surgery? Is that possible? And I'll tell you right now,
doctors are going to tell you know, if you have a hip labrum tear, and you went to go see a doctor,
you probably had a diagnose through an MRI, or an MRA, a magnetic resonance arthrogram.
And the doctors will often tell you, well, we'll see how long you can tolerate it. But eventually
you're going to need surgery. And the reason Doc's tell you this is because there isn't much research
on people healing naturally from a hip labrum tear. But that doesn't mean that
it's not possible. It just means it's not recorded right now. We're so cutting edge
and talking to you about this right now that there isn't any research available.
That's good, that can support what I'm telling you. But we see it here in the clinic all the
time. And what I can tell you that doctors see is they probably don't see many people
recover from hip labrum tears naturally because they tend to send people off to surgery, or these
tenants and people to physical therapy that isn't the best for healing something naturally without
surgery. Now what you should know is that surgery for a torn hip labrum is variable.
Some are good, and some are not so good. There are different options out there, they're still
doing research studies on which surgeries are best for a torn hip labrum, they're leaning more and
more away from doing what's called an excision, which means they cut out a chunk of the labrum
and instead doing a repair meaning these so parts together to preserve as much
of the labrum in the hip joint as possible. But what we do know from research is that you're
way more likely to get hip arthritis. In later years, if you've already suffered a hip labrum
tear, but we're going to look at getting you off that pathway. And what I'm going to tell you next
is where to start. If you're dealing with a torn hip labrum right now,
what's the first step that you should take towards healing it naturally without surgery?
Well, number one, you've got to determine at what point of healing you already are at your
body naturally wants to heal as soon as he gets the chance and the right environment,
it starts to send all the right cells to the area and release the right hormones
and go through the healing process. You just have to go with that you have to help your body
get into that right healing state so that you can truly heal the cartilage inside your hip.
An easy way to determine if you're a very irritated or sensitive hip labrum tear right
now is if you stand up and you have pain, and it's got to be in this location. If you stand
up and you have pain right in the front of your hip joint about right in here. And every time
you lean more onto that side, it causes you more pain, then you have a very irritated hip
labrum. And the number one thing that you should be looking to do right now is not any exercises.
There's no specific exercise, it's going to help that right now today, you've got to offload it.
What you need to understand about the hip labrum is it's a weight bearing structure. It's a piece
of cartilage in the hip joints. The hip labrum is a piece of cartilage a thick piece of cartilage
that surrounds the edge of the socket part of the hip joint right here all the way around.
There's one little gap but it's pretty much all the way around the socket part of the hip joints.
And when it tears, you lose a lot of stability to your hip joints. And so it's a weight bearing
structure. So as soon as you stand up and put some weight through your body through your hip joint,
it's supposed to absorb some of the forces of you standing on it.
So the more you stand on it, the more you put pressure through it. If it's injured,
it's not going to support your weight very well. And now, sure weight loss can help with this.
But what you need to just do is get off your hip, you need to get off your feet and stop
putting pressure through that so that he can have a chance to calm down flare down
and then you'll be in a much better position to do some exercise later on.
Now it's not realistic always for everyone to just completely get off your feet, go to a
wheelchair be in bed all day long and do nothing you stuff to get around you start to do things.
So what a more realistic option. for you is to use some crutches or at least one crutch or a cane,
offload your body somehow, if you can get a crutch under your arm, and lean away from that hip. So
if your right hip is bothering you, you should ideally use a crutch or cane on the left side,
or you can totally get the weight off your hip. If you just use two crutches and just pick up
your leg all together, then you won't be putting so much forces through that labrum.
And you can allow it to heal and calm down enough for you to begin the right exercises to address
the root of the problem. Because just getting off your feet getting the weight off the labrum,
that is not enough to fix the problem for good, that's just enough to heal it.
So that you can begin to stress it a bit more in a good way so that it gets more dense and strong so
that you can truly heal. So if you're having pain, when you stand up, you need to get off your feet,
you need to offload your hip, use crutches or use a cane. Now, if you can stand up,
you can tolerate being on your feet for a while, but it starts to bother you as a day goes on or
it locks up on you at times, or just gets really stiff sometimes, then you're not in an irritated
state, you're just dealing with the tear, and you're aggravating it as you do more activity.
So in that situation, you've got to begin some light mobility and gentle strengthening exercises,
the focus of these exercises should be on allowing for range of motion in your hip,
so that you don't lose full range of motion, because that's the beginning of arthritis.
And so that you can use the muscles that control your EZ hip motions, your stabilizing hip motions,
you need to be able to use those muscles very well, I've got a video talking exactly about
these exercises, go check out that video in the link in the description below.
The video is called the top four exercises and stretches that actually give you hip pain relief.
And I titled it that because you should actually feel a little bit better, you should feel like you
can move easier, you'll be activating your glutes if you do the exercises from that video. And that
tends to feel tremendously better. And you'll start to feel better not only immediately, but
you'll begin to experience the long-term benefits of glute strengthening for this, which is going to
be very key for offloading the part of the labrum that's become injured in your torn hip labrum.
The next thing that you need to be working on is re learning how to walk. And I know
it sounds ridiculous for some people out there because they're thinking I walk all the time.
Why do I have to relearn how to walk but let me break it down for you a bit. If
you have a hip labrum tear, it is a chunk of cartilage is one of the most durable tissues in
the body. If you didn't have any sort of accident or trauma that set off this hip labrum tear,
or it was more of a gradual development with some chronic pain over time, then you have
been moving in correctly somehow, some way. And chances are, when you walk when you go
to get up and move around, there's something funny about the way that you're walking that's
feeding into this hip labrum tear. And if you can remove that funny pattern and begin to move
better when you walk, then you can make walking helpful for you rather than harmful for you.
I've got a video that tells you exactly how you should be walking, it's linked in the description
below. And it's titled watch how to walk right if you suffer from bone on bone, hip arthritis.
And I know you're dealing with a hip labrum tear if you're watching this video, but like I said,
you're going to end up having hip arthritis, it's very likely if you don't address this hip labrum
tear now so learning how to walk right if you have hip arthritis is going to benefit you if you have
a hip labrum tear as well. So go check out that video and start implementing that walking pattern.
And that's the way you should be walking all the time, not just when you exercise.
When you jump on the treadmill. If you go for a walk in the yard or down the street
or at the park, you need to be walking like that when you get up to go to the bathroom,
when you get up to go to the kitchen when you're walking to the grocery store.
If you're walking to the parking lot to your job or to some area that you're going to run, that's
how you should be walking just about all the time. Now the last phase and I'll tell you how long
these phases should take and estimations here in a minute. The last phase that you should be moving
into is gaining more strength after your hip is no longer flared up and you've mastered walking and
you feel more confident in using your hip but you still might be having some hip pain here and there
some locking or if you're doing too much it starts to bother you. That's the point where you need to
start to get a little more aggressive with your exercise and pursue strengthening specifically
and glute muscles as well as some other muscles. The reason for gaining more strength because this
is probably counterintuitive or against what a lot of the healthcare profession would say
and if you've seen a doctor or a physical therapist for this they might tell you
don't do any weightlifting. Are you crazy I've torn cartilage in your hip joint but
you have to do it because once your hips calm down I'm not saying go weightlifting
if you're flared up right now, absolutely not. You should not be weightlifting. But if your
hips Calm down, it's been a while you're doing other things better you're on the up and up you're
overall improving. The next logical step is to now load the question cartilage gradually and properly
with enough rest in between the loading cycles. So in other words have days off from strengthening.
If you load it properly, you'll stimulate the cartilage to become more dense and healthier.
You'll stimulate the scar tissue, the cartilage scar tissue to develop, as well as the normal
cartilage tissue that's still there in the labrum to thicken and respond the way it's supposed to.
I mean, how else does a big bodybuilder or power lifter pick up 567 100 pounds plus, without more
dense cartilage in their hip joints? I mean, how does somebody squat or deadlift, that much weight?
How does somebody out of the Olympians do what they do are the professional athletes
out there do what they do without messing up their hip cartilage, you can argue that some
of them eventually tear it. But I mean, if you were to go pick up 700 pounds right now
squatting with a torn hip labrum, you'd be paid for it. I mean, you might enjoy other things.
If you can gradually increase the strength from where you're at right now, doesn't mean you need
to pick up Superman weights, you need to just pick up a few pounds at first, first, get the
technique right, and then add two pounds to it, then add maybe five or 10 pounds to it. And as is
appropriate for you for your size for your gender. For your living situation. You know, if you're a
more active individual, you're probably going to need to get stronger than somebody who's less
active, to be able to maintain the strength that you need for your daily activities get stronger.
I've linked a playlist of videos that talk about how to squat properly, and how to begin to add
weights and even how to deadlift down in the description below. It's called squat advice and
tips. And that would be the next direction to go. After you've learned how to walk right and after
you've calmed down your hip. If it's really flared up, if you can't even stand on it or bother, you
just have to a few minutes of being on your feet. So the next question you probably have is
how long do I take in each of these phases? Or how long do I strengthen or how do I know when I need
to start strengthening, if I've been walking for a while. And let me tell you this cartilage takes
six to 12 months to heal naturally. If you're doing everything right, then it should be on the
shorter end of that if you have flare ups along the way, then you're looking at the longer end
of that potentially even past 12 months, if you have too many flare ups or too severe flare up.
This is much longer than what your doctor might tell you, your doctor might tell you, you need
three to six months, I will usually double or triple whatever the doctor tells you,
because they just aren't following up with you for rehabilitation for day to day movements and
strengthening. That's not their job, their job is to give you a treatment that can
give you pain relief right now or fix some structural damage, like some massive tear.
And they're just looking at when they need to let go of you. And that's their timeframe for when you
should be healed enough to be on your own. So if you do have a hip labrum surgery,
doctors will often say about three or four months, you'll be back at it back to normal 100%.
But really what the doctors really thinking is the patient's 80% Heal, there's still some
more healing, that's going to happen, but it's going to be much slower at this point.
And I don't need to see them anymore, they should be okay, as long as you're not trying to go, you
know, jump over hurdles or something like that. So that's why the doctors will give you such a
short time to recover. And it's not accurate as a physical therapist who sees people regularly
weekly, who have had a hip labrum tear, it takes several months, you're looking at six months
minimum to confidently get back to what you're doing before. And that's if all goes smoothly.
So don't be afraid to take a while with the walking and very slowly progress the walking.
If you're flared up, it may take you more than a month to flare down.
I mean, if you have to get around and move around, if you live by yourself, if you have to encounter
stairs, you're going to be in a tough spot. And it's just going to take you longer to heal.
And then the strengthening part just naturally takes a long time. Once you
get to some actual weightlifting or just even bodyweight exercises,
it's going to take you weeks to gain strength and over the course of months, then you'll get
enough strength to be able to confidently say I think I'm over my hip labrum tear.
Now if you had another MRI with a tear be gone. This is a question I get all the time. And my
answer to that is probably not. If you have another MRI, they're probably still going
to be able to see the tear in the MRI or the MRA. But what you should experience if you're
doing everything right is that you feel fine. The reality is and we know this in the research, that
there's instances of people that have hip labrum tears, you also have a chunk of cartilage in your
shoulder called the shoulder labrum. And people tear that all the time to and they have zero pain.
And my reason for that my belief is that it's flared down and the individual has
normalized the muscles, the imbalances and they can function just fine even with torn cartilage
and their shoulder or the hip. So if you're in that situation Yeah, you're a little more risk
for having hip arthritis. But if you know what you need to keep strong if you know what you should
avoid, then you could probably avoid having a hip replacement surgery or some other surgery
and keep your quality of life up without putting yourself at risk for an unnecessary surgery.
So to me, it's a no brainer you have to go through this process. If you're suffering from a torn hip
labrum, at least give it a good shot before you decide to have a surgery if that's what you need
to do it we'll hope this video was helpful please give us a thumbs up if you thought so. And don't
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with somebody that needs to hear this. Thanks, so much friends and we'll see in the next video. Bye