Recurrence of Hip Pain post-Surgery

[Mr Hip Guy]

So I know there are a lot of threads in here already, and many will cover what I am about to address so I apologize in advance for the redundancy/duplication. However, I have learned with this issue that "talking it out" will soothe the situation so I'm selfishly hoping for some relief in starting this thread.

My background:

So I'm a late 40s endurance athlete (running and cycling) that started having some significant groin/hip pain back in February of 2018 following a difficult ultra marathon. I had dealt with overuse injuries for 10+ years of my running "career" and had a pretty good toolkit for dealing with all of them (usually solved by "rest" for a significant time). Stress fractures, broken ankles, shin splints, sprains, you name it I've probably experienced it.
So when I got hit with this particular pain I applied my "toolkit" and figured it would resolve itself. Unfortunately in this case, despite a number of techniques applied (rest - ART - chiropractor - more rest - total rest - crutches) my symptoms seemed to actually continue to worsen and after 4 months of pain I succumbed to having surgery. FWIW, it almost doesn't matter but my diagnosis was "torn labrum" and "FAI" and the surgery was a labrum repair (stitched back in place) and a "rim trim" (ball and socket of hip ground down to more accomodate the space). Pretty gruesome.

To say this period was traumatic is putting it mildly. I had a pretty good case of exercise withdrawal, and the subsequent looong stretch from anticipating surgery to surgery-recovery was difficult. I could go on about this 6 month time period but long story short I eventually recovered from the surgery (6 weeks of crutches - 4 months of PT etc) and I was cleared to resume running in late 2018. When I did so however I had a resumption of symptoms. No problem I thought, I came back too soon so I took another 2 months off. Repeated that 2 months later, again symptoms resumed so I shut it down again. Finally another 2 months later I started again but yep, symptoms again.

That was in February of this year and that is when I somehow came across Sarno and his methods. Again long story short, I went from reading about his techniques online to watching the Stossel and Howard Stern youtube videos to finally ordering and reading his book.

Much of what I read made sense and spoke to me and I began applying his techniques. But the best "medicine" I used was "return to activity" and that's what I did. I pushed through the pain I had experienced before and it was a revelation, within weeks I was running pain free and "ramping up" my mileage again (conservatively of course). I was elated. I did a number of races again and got to the point over the summer I was back to my old 40+ miles per week of running. All pain free.

Of course you probably see where this is going.

Yep, about two months ago I started noticing symptoms again. That burning/stinging/on-fire sensation in my hip...particularly after long periods of sitting. A trip to Florida's Universal Studios with my son for "Halloween nights" was particularly memorable. The 8 hour drive and the constant standing around waiting in lines all day/night was pretty rough. Still I remembered my reading and I tried to just push through it and keep up my activity. Oddly I feel pretty good while running and even more oddly I feel good for hours and even the full day after running in the morning. It's the sitting and non-active days that all the symptoms occur. I fall asleep at night feeling pretty good all the way through to waking up and my conscious mind starts making the hip hurt laying in bed.

And I haven't been able to shake it this time.

I can't seem to get it out of my head that the surgery was "bad" and I'm stuck with a 'structural' problem even though I also know that just a few weeks ago I was running 10+ miles through the woods.

Some of writing this is purely therapeutic but I'm also looking for suggestions on dealing with a "relapse" and "reoccurrence" of symptoms even if just personal anecdotes.

Thanks for reading this lengthy post, I appreciate all comments and feedback!

 

[Baseball65]

The 8 hour drive and the constant standing around waiting in lines all day/night was pretty rough.

I can't seem to get it out of my head that the surgery was "bad"

That's fine. You'd be really fucked if you though the surgery was 'Good'. Then You'd have to wait for the placebo effect to wear off , go through several more months of failed treatment before you'd be open to the truth again.

The closest your whole post came to the 'truth' was the vignette about the difficult vacation-esque time with your kid. I Hate driving. I hate waiting in lines more. I hate waiting in line for things I really don't care about even more still.
But I have to do them some time. I don't want anyone to not like me. I am a 'good guy' 'good dad'..whatever.

It is those things that we do like that, responsible, good, altruistic even, that really expose TMS in all of it's glory. The needs and concerns of others who we love that we put in front of our own 'selfish' needs. Sarno himself came down with some stuff when he had to go on a cruise with his wife.... He thought and thought and realized that even though the cruise would SEEM more relaxing, soothing on the outside, his inside real self just wanted to stay home and work on a new book...

I am 54 and just started playing hardball on the weekends again. I am the oldest guy out there save one. I watch 20 and 30 something guys drop like flies with injuries every week. It's funny in that they are all the same injury regardless of what the guy was doing when it 'occurred' (trigger)... each sport has it's litany of beliefs and that includes injuries. You being a runner, you have your own list...

Stress fractures, broken ankles, shin splints, sprains

Mercifully I found this work 20 years ago and not only am free from the beliefs of my peers, I can actually help a guy or two. The recovery isn't from some structural thing , that is DEFINITELY some normal part of aging and NOT the root of the pain. The recovery is from my own conditioning and beliefs, and learning the deep dark, unsavory truth... that at the core I am not such a nice guy.... I am just a guy. I want to win. I want to beat you. I don't want to get older and slower. I would rather hit balls off a tee than go to my Girlfriends dance recital.

Then, I can go to the dance recital, paste on a smile and focus on the 5 year old inside who wants to be on a baseball field, playing guitar, running or whole host of other self involved activities....pain free.

The answer is deeper inside than any MRI machine can get.

peace

 

[Mr Hip Guy]

The closest your whole post came to the 'truth' was the vignette about the difficult vacation-esque time with your kid. I Hate driving. I hate waiting in lines more. I hate waiting in line for things I really don't care about even more still.
But I have to do them some time. I don't want anyone to not like me. I am a 'good guy' 'good dad'..whatever.

Wow. You're absolutely right. Here, I've been wracking my brain on what triggered this latest episode (once I relented that it was in fact an "episode" and not a true injury returning). I looked back into October and just couldn't come up with anything. But you nailed it. While I was definitely looking forward to time with my son and giving him an experience he would really enjoy, deeply inward I was resentful of the time and expense involved. That started an entire cavalcade of symptoms for a month and a half that continued to worsen.

Also, I was hoping for an immediate response to my post above but in fact I think it was the fact it took awhile that proved helpful instead. I was forced to poke around in the forums and read some of the previous threads instead. I've found reading success stories, other symptoms descriptions, etc actually helps "wake up" that part of me that realizes this is TMS and not some structural problem. In fact I recall when I had my breakthrough 6 months ago it was reading these forums that was so enlightening as well. Many of those posts/threads included a response from you, Baseball65, so I appreciate the response here but also all of those other responses too.

Update: After having read through these forums and doing some self-inspection, yesterday after work I took my dogs for a run in the woods. No hip pain and the hip felt pretty great the rest of the night. I did some gym work and managed to tweak the back of my knee so now I'm in the process of trying to figure out of this is the symptom just finding a new spot or not. Also, I slept great but after waking I had that time period of ruminating and of course the hip pain came back again. But running again this morning with my dogs proved just fine. This stuff is absolutely fascinating.

 

[Mr Hip Guy]

Update - I think the "symptom imperative" is at work with my TMS issue. I have run every day since making that post above and generally not having many issues with the hip, although my old friends do flare up in certain situations that I consider a "trigger" environment. But what is more interesting is I'm experiencing strange onset of pains in other areas. Even more oddly they're all on that (right) side of the body. A crazy persistant earache. A shooting pain in my shin. The back of the knee I mentioned in the above post.

 

[Mr Hip Guy]

Continue to have success in my hip area (it's still there but very mild - 10% of what it was only 2.5 weeks ago) however other symptoms continue to cry out for attention. The earache is particularly bad when it comes (but then it goes half the time). The previously-fine knee "tweaks" every so often. I could see how I could easily tumble down the rabbit hole of obsession on these things if I don't already know what was going on here.

 

[Baseball65]

That means whatever work your doing is working. Now KILL IT. Whatever your swimming in, dive into it... when you see daylight hit the hole hard with your head down.

After my recovery I started being open minded to a lot of stuff I would have laughed at previously. One was Louise Hays encyclopedia of symptomology and the area of your life indicated by that symptomology.

Low back=supporting yourself shoulders=emotional shit (usually primary partner) etc etc etc...

Right side is always male. Most of my early issues were around marriage, fidelity, an affair I was ashamed of(women)...all left side sciatica. The day a production designer changed a set on me at the last minute was the day it went into the right side. I wanted to KILL him.... but I am such a nice guy (OW). The Neuro surgeon had a theory so preposterous I won't repeat it here, BUT in light of my experience (21 years worth) the right side-left side thing is often scarily accurate.

I still stick to Sarno basics because the ISCHEMIA / autonomic thing makes sense... but once that door is open, so do a lot of other things.

 

[Mr Hip Guy]

Right side being the male side is an interesting thought.

 

[Mr Hip Guy]

So it's pretty interesting that I have been making excellent progress on my hip. Since that initial post back on 12/9 I would say my issues with that hip are 2-5% of what they were.

But what is interesting is I just was on the registration website for a mountain race, my number one favorite race and the one I have generally done my best in. My hip immediately flared up and has been on fire for the last 20 minutes since.

I'd say there is some anxiety going on there for sure.

 

[Mr Hip Guy]

That hip had pretty well resolved 100% around the time of my post above (3+ weeks ago), but in the last week I have had a recurrence. I can pinpoint a couple of "triggers" though that I think brought it about:

- Finding myself in a position of extreme hip flexion (tightly bent over), I can't remember what I was doing, maybe working on my shoes or my feet or toes? Doesn't matter, I just recall thinking, "wow, this is something that would've given me trouble when I had my hip problems and now it doesn't."

- Sitting on bleachers in a gymnasium watching my daughter's band concert. The last time I was in this particular gymnasium I was watching my son a couple of years ago and in a significant amount of discomfort just sitting on the hard bench bleachers.

- Driving to one of my remote office locations to work there for the day. This office is in the city where I had my hip surgery and I spent alot of time going back and forth there in the car. Boom, the hip started that familiar burning/stinging/aching feeling.

I am trying not to get frustrated with this recurrence. But It's particularly hard not to visualize a structural problem deep in the hip and therefore doubt my TMS diagnosis. I just try to remember I have recovered from this a couple of times before and I will do so again.

 

[Mr Hip Guy]

I've noticed that apparently my dreams can trigger an episode. Many times I'll go to sleep at night feeling fine, only to wake up at 3 or 4am with a shot of pain in my hip. Reading Sarno I know there is absolutely nothing that could possibly happen during sleep to physically give me a problem (though I still have a deep inset feeling/belief that sleeping ON the hip is a no-no), but it's hard to dismiss getting that jolt of pain suddenly. Instead I know there was something in my dreams that must've triggered the episode. Dreams are deeply connected to the subconscious afterall, try as a I might I couldn't pull up exactly what I was dreaming about but I'm certain it was something that was a trigger.

 

[Mr Hip Guy]

I worked through an episode of shin pain thinking it was a stress fracture, got that resolved only to have the hip pain flare up as bad as ever. I am going through a stressful time to say the least (my father passed a week ago after a long bout with dementia), but none of my proven techniques have so far quelled this particular flare.

I did manage to get a pain free night of sleep (usually it flares up when I lay on my "bad" side) last night. The only thing I did different is I did some self-talk while cycling earlier in the day. I got this from one of the podcasts I listen to:

"we're fine, everything is okay."

"we're safe, nothing is going to get us."

"all good, you don't have to do that."

That sort of thing. Previously I've tried to either ignore flare ups or get mad at that part of me (reading Sarno's books and this site also helps). But this was the first time I've tried this "gentle" approach.

 

[bagofwater]

It's been a couple years Hip Guy. How's the hip these days?

I'm a TMS veteran who has been mostly pain free for a decade or so, but I'm now contending with a hip, butt pain flare up that's pretty bad. I haven't had an MD rule out structural issues yet - but as you found out the hard way, unless you go to a TMS-aware MD they'll almost always find some kind of surgery-centric solution.

So I find myself searching the TMS Wiki for success stories that line up with my symptoms. Since your handle is so specific your posts are coming up a lot. When I don't have symptoms I don't ever visit this forum, I'm hoping that's the case with you.

 

[Mr Hip Guy]

It's been a couple years Hip Guy. How's the hip these days?

Absolutely fine!

Which doesn't mean there hasn't been a sensation or tweak here and there, but the big difference now is that I automtically dismiss these sensations/tweaks and they immediately go away.

I am pretty active...I run/bike to the tune of 10+ hours a week...so it's not like I am babying it either.

You may want to find my other thread about my knee issues - symptom imperative at work means that I am playing a little whack-a-mole with pain, but I am making progress there as well.

Thanks for asking! I hope yours is nothing to worry about.

 

[Enrico100000]

Hi, wanted to refresh this thread, as it mirrors what I'm currently going through. I first discovered Sarno's methods in my early 30s (I'm 44 now) and used them to cure 2 years of horrific back pain. That's a whole story unto itself but it cured 2 years of misery to put it mildy. Like Mr Hip Guy, I feel the resumption of exercise and all activity was key to my recovery. I haven't had any back pain since. Fast-forward to a couple months ago...

Began to experience right hip pain in the crease between the pelvis and hip. I immediately began applying the TMS methods, which, for me, are mostly just ignoring and acting indifferent to the pain and continuing on with my life without worry. The pain went away and really wasn't that bad but then came back a little, and then I probably made a big mistake. I had concern that I possibly could have a sports hernia or something legitimately requiring a surgery, and so I went to a hip specialist, hoping to rule that out and expecting some minor diagnosis of hip flexor strain or whatever. And that's when I'm hit with the "FAI" diagnosis, and the doctor grimly pointing to the shape of my right femoral head. He ordered an MRI, which I probably shouldn't have done, and then that added labral tear to the diagnosis. And then the grim prognosis of live with it or have an arthroscopy and the counsel that this probably wouldn't get better absent surgery.

So here I am. Since seeing the doctor, my pain has increased exponentially, and I'm honestly kind of mad at myself. The pain exhibits many hallmarks of TMS:
- Moves around. Sometimes it's my groin, sometimes the opposite side of my hip, sometimes the center. Doctors will say hip joint pain can manifest in different areas but I doubt it.
- Comes and goes randomly
- Clearly increases with higher stress and perceived danger. My pain skyrocketed after the doctor's visit
- I can't think of one clearly stressful event that occurred but there are certainly possibilities (angry at my job, my dad's health, relationship issues)

But despite all this, I think my mind is now hung up on the "diagnosis" and the "imaging." My average daily pain is now way worse than it was before, which alone is evidence.

For me what makes this more difficult than past pains is the "imaging" and "diagnosis" and surgery recommendation. With the other pains of my past that I've cured, I was perhaps lucky that there was nothing clearly wrong on image and no surgery recommendation.

I'd be happy to hear any pointers. The crazy thing is I feel like I'd almost beaten this...until I saw the doctor. So I'm none too pleased with myself. So I'm fighting to regain my footing and get back on a healing path. If anyone has any recommendations, please let me know.

 

[Mr Hip Guy]

Everything you said describes exactly what I went through. You CAN beat this as TMS. While I had the surgery, I was having symptoms on my other hip and both THAT and the recurrence of my operated hip were both cured using TMS techniques.

You said you acted indifferent and basically ignored the pain away. While that can work sometimes, you may have to do some additional stuff. What usually works for me:

- Rereading Sarno books (I also have the Ozanich books and while not as good as Sarno, they're fine). I almost always find a passage that "speaks to me" and my current issue and situation.

- Reading Success Stories on this forum.

- Listening to Podcasts. I like the Eddy Lindenstein "Mind and Body Fitness" - he has a huge backlog of great podcasts, which I usually listen to while running or cycling. Nicole Sachs' "cure for chronic pain" is also good, but it's a little bit too feminine for me.

- Journaling is sometimes very effective for me, although I don't do it as a regular practice.

- Write down "evidence sheets." Pros/cons of why it could, or could not be, physical/structural.

The above are pretty rock solid in getting me past a flare up. Other stuff that works not as often:

- Trying to feel my emotions. I'm pretty stunted emotionally, but I can dredge them up sometimes.
- Meditation. This one is more about calming my nervous system. In other words, finding something that will calm me down. Finding a good go-to for this is excellent when you can't get MRI imagery out of your head.

Good luck, you can do this.

 

[Enrico100000]

Thanks so much for your reply. It's really helpful to hear about your success with the same story. Great advice and recommendations. I've already started rereading some of the books, Alan Gordon's, enjoy Schubiner and PainFreeYou on youtube. Going to reread Sarno's as well.

The good news now with some time after the doctor visit freak out, I'm feeling much more confident again. And yes, will do an evidence sheet again. This helped tremendously with my elbow pain a couple years ago. The good news is this hip pain is exhibiting the kind of TMS attributes I now recognize much more easily. The pain movement with this is incredible; it's actually almost completely now shifted from my groin to the other side and top crease of the hip. This morning I was tight in my hamstring on my other leg. It's all increasing my confidence.

Will keep you updated and thanks again for the support. Glad you're doing so well.

 

[Mr Hip Guy]

It's funny that you talk about that pain moving around. While we recognize this as a TMS symptom, it's also a commonly referenced FAI symptom too. I even had my surgeons PA tell me "that's classic FAI, the nerve endings can refer pain all over that area." I now recognize this as complete nonsense of course.

Let me give you a rundown of what I've done since my 2018 surgery and self-diagnosed TMS:

- Ran the Pike's Peak Ascent (1 year post-op)
- Ran the Pike's Peak Marathon (2 years post-op)
- Ran the Imogene Pass run (similar to Pike's Peak with lots of elevation gain/loss)
- Ran a difficult southeastern 55K
- Rode one of the hardest cycling centuries on the East Coast (assault on mt mitchell)
- Ran the Mount Mitchell Challenge
- Completed "Pitchell" (a 65m run between two southeastern summits)
- Rode one of the hardest Mtn Biking Endurance rides (off-road assault on mt mitchell)
- Lots of other shorter races/events

And of course all the training that needed to be done to lead up to those above. at an "advanced age" (50+).

Of course my surgeon is proud of me as his "most successful patient." I don't disagree with that accolade necessarily but I firmly believe I could've done all of the above without that surgery.

 

[intense50]

bump ....great reading

 

[Mr Hip Guy]

Discovering TMS and the treatment for it, is one of the great discoveries of my life. An "eye opener." A true "life hack" if ever there was one. I continue to apply it every day...though I admit I have so much to learn and am constantly reminded by my blind spots etc.

 

[Enrico100000]

Okay time for an update, it's been an interesting 3.5 weeks. What's most interesting, and perhaps surprising, is that despite having successfully used TMS to cure 2 years of horrible back pain (13 years ago), a year of elbow pain (2 years ago), wrist pain (1 year ago), and chest pain here and there the last couple years, this new hip issue has still caught me by surprise, and I still went down the fear rabbit-hole that is modern orthopedic medicine. This current hip issue has been a challenge, I cannot lie, due to the crazy fear statements by this one doctor and his "reading" of my images.

Anyhow, since Sept. 5, I've rededicated myself to ingraining the principles that have helped in the past (rereading books, creating a detailed evidence log, using a daily evidence journal, somatic tracking, increased meditation, and creating a plan for flares). My original plan of simply indifference won't be enough here, given this doctor's statements. He basically looked at my x-ray and started telling me how "deformed" my femoral head is, how he could "tell" there's a labral tear simply from the x-ray, cysts, I'll only get worse, etc. What a horrible thing.

I created the following pros/cons of structural vs. TMS/neuroplastic:

Structural
1. My right femoral head does look different than the right on X-ray. The head is not a nice sphere.
2. The one doctor's horrible statements.
3. There's an internal rotation movement that causes more pain and so it "feels" structural (1-2 years ago I suddenly couldn't do crows pose anymore in yoga due to pain in the hip, though it wasn't for another year that the pain existed outside that one pose)

TMS/Neuroplastic
1. Tremendous pain movement: Sometimes in the high groin, sometimes lower in groin, sometimes in mid hip crease, sometimes the other side of the hip
2. Tremendous pain fluctuation: Fluctuates without reason during the day and from day to day
3. After meetings with a TMS pain psychologist (I've worked with in the past and now), pain goes down dramatically
4. Pain goes up and down based on stress level (there are also several stressful things going on in my life)
5. The official MRI Report is actually beautifully normal, even though the radiologist was presented with the diagnosis; it was only the one doctor who gave all these fear readings from it; the second doctor I saw actually couldn't really conclude anything about the labrum other than wear/tear
6. The one bit of google research I did that helped was to see the very high prevalence of FAI in the population in general (studies show 25-40%!)
7. I've been prone to mind-body symptoms over the years, especially the past two years, and I've worked my way out of all of them

Anyhow, it has been an up-and-down 3.5 weeks. I strung together almost 5 very low/almost pain free days a week ago, as I gradually started running again (from 0.5 mile up to 2 miles). In the past, for me I've found re-initiation of feared activities is critical to my recovery. With the re-initiation of jogging, an amazing thing started happening. Pain immediately began in my groin for the first 0.5 mile but then subsided for the rest of the run. Then during one run, I had shooting pain in my opposite ankle! In addition, after these runs, I've begun adding back all leg stretches I had avoided as well as leg weight exercises. During my longest 2 mile run a few days ago, I admittedly had pain throughout the run and then flared majorly after and the day after. And I'll admit I panicked a bit, but I'm human, and so now it's been a worse few days lately.

So I will continue with my process, and plan to get right back to jogging when I'm ready. My biggest thing I'm working on is maintaining calm and indifference during flares and really committing to the evidence this is TMS. Appreciate all the support from this board!