The Second Opinion

Femeroacetbular impingement

I haven’t talked about the injury for awhile because there hasn’t been much progress. Physical therapy began three months ago, which has been tremendously helpful in strengthening my hip region, but the injury and limited mobility still persists. Fortunately I am a cyclist, so I have been able to train and gain fitness despite the injury. If I were a runner, I would probably still be on the couch.

The last appointment was this past Wednesday, and the decision was to keep waiting for improvement and to get a cortisone injection. After watching the experiences of others on the Haute Route, I was nervous about continuing to play the waiting game. Even though I can continue training, the injury still limits my performance. Multi-day events will become even more challenging because of the way the injury still reacts the day after a big day of riding.

Since my previous doctor had recently migrated to Boone, I took initiative to get another pair of eyes involved. Dr. Christopher Mazoue was one of the doctors who took over the practice, so it was easy to get him to see me. He’s the USC team doctor and has a stellar resume and reputation. I was confident that he would be the guy who could get me through this.

He started by reviewing all of my records from the past year, which was probably quite an information overload. He looked again at the February MRI and confirmed that there was a labral tear. I’m not sure whether the other doctor had overlooked this diagnosis, or simply failed to tell me, but it was good to finally know.

The tear still doesn’t explain why I’m continuing to have problems. He examined me and found that my right hip area has very little inward mobility, whereas the left hip is just fine. It is mostly when the hip crosses over my body when I experience problems. The normal up and down movement of riding does not engage the injury, but on the mountains, the hip requires movement in all sorts of directions.

There are a number of possible culprits, and determining the actual diagnosis is going to be a process of elimination. One possible culprit is Femoral Acetabular Impingement. Just based on the symptoms I’ve read on the internet, this seems to fit the best. It happens when the femoral head rubs the wrong way and can cause soft tissue damage, including labral tears and stress fractures. Another possibility is that I have an abnormal bone structure down there. Finally, what may be the most surprising possibility is a sports hernia, but not where it would typically occur. It could be putting pressure on the hip area and causing problems.

The injection will give some insight, and depending on the actual diagnosis, could cure this thing once and for all. If not, we’re back to the drawing board. He didn’t mention surgery, but depending on what the actual problem is, it sounds like a possibility down the road. I’m hoping for sooner rather than later if that’s what is necessary.

I was impressed with the doctor. He was sharp, asked me good questions, and seems to have an aggressive path for me to fix this thing. Afterward, Eric assured me that whatever this is will be fixed. I’ll be ready for that.

In the meantime, I can continue physical therapy and training. The way the hip responds at next week’s Tour d’Apple may answer a lot of questions.

8 responses to “The Second Opinion

  • doug brownjr.

    If you’re considering cortisone injections, first consider trying Planetary Herbals Inflama-Care. I’ve had both. If you decide for the cortisone injection instead don’t be too scared by the length of the needle. There is numbing medicine within the cortisone so it does not hurt too bad.

  • Steven Szymczak

    I tore my Labrum last October during a long run while preparing for a half Ironman. I had surgery Jan 4th and I am currently riding stronger than ever. The good thing about the recovery is that cycling slowly of course is strongly recommended everyday starting just a few days after surgery so I never really lost that much fitness. Running is a slower process but I am not having any hip issues anymore. Good Luck and hoping you have a speedy recovery.

    • aaronwest

      I had heard that it takes awhile to get back into running, but cycling is something that can be done pretty early. If surgery is needed, hopefully we can do it during the offseason. Thanks for the well wishes and keep riding and running.

  • bgddyjim

    Continued well wishes brother.

  • James

    Sorry you’re still experiencing such problems Aaron. It’s every sporting person’s biggest nightmare, the injury, and you have certainly, sadly, got yourself a long-term challenge in this one. It’s great to see that your spirit seems positive through it all, although I am sure you have moments where you curse! As we say in the UK, keep your chin up and keep sharing your road to wellness. Sharing helps!

    • aaronwest

      Appreciate the sentiment, James. Injuries are no fun, but as I was telling someone else earlier, I’ll take an injury that allows me to keep in reasonably good shape and ride my bike up mountains. Some people have it a lot worse. Even though the injury is still lingering, I really think it is nearing the end. We just need to find out what exactly it is and get rid of it once and for all.

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