Labral tear & Physiotherapy with a late diagnosis of Perthes

Bones, joints and muscles
1

Hi, I am a 29 year old female and was diagnosed as having undiagnosed perthes disease of the R hip when I was 15. I was very athletic and suffered ankle pain when they noticed i could had no internal rotation of my leg. I have a deformed and turned fermoral head and effectively no neck resulting in a 2cm shortening (not noticable unless I am in pain). As I grew older the pain (not arthritic) gradually become worse however analgesia managed this pain well until a recent injury 4 months ago.

I was playing frisbee of all things (a running joke with my friends) and must of hyperextended when I jumped and felt a strange popping sensation, landed with the same popping and then collapsed on walking forward. Incredible pain followed. My R leg/femur needed to be manipulated into a comfortable position and it was very difficult to weight bare. After having repeated xrays and an MRI it was found that I have a a superior labral tear with fluid within the cavity, which I later found could be a chronic degenerative tear. Has anyone experienced this? The full healing process etc? 

I am due to have steroid injections, which previously didn't help but I am hopeful this time. Due to my age, they want to put off a THR until as long as possible. I was on Butrans patches to manage the pain from the injury and these worked very well however I have had to come off them (unsuccessfully twice due to pain and horrendous withrawals) due to the lack of concentration and ability to complete my uni work. Tramadol and ibruprofen are now good friends of mine. I have been referred to the NHS physiotherapist but the waiting list is 6 months long but wondered if this will actually help? I am considering going private at my own cost but dont want to waste my money if its not going to achieve anything. 

I was cycling and swimming/aqua aerobics to maintain fitness along with normal activities of daily living until this week when a I became over ambitious on the surfboard. The crutches are back! Although I am hopeful that this wont be as bad as the last injury. :S 

Any information would be great. Thanks 

 

2

Please be more careful with your leg, your femoral hip is extremely fragile after what you've gone through, you do not want to cause more permanent damage. Regarding the healing process, you might require the fluid to be drained (as I did) and a keyhole surgery may be used to remove some tore up tissue/cartilage (this may depend on the damage). Cycling and swimming are great therapies for Perthes, I don't think you should go private...but just get enlisted on the NHS waiting list.

3

Hi Jodie, when you first notice the physical detriments to that than enables you to train or go about your daily business, it can hit like a bomb.

my Physiotherapist informed me that pain blocks muscle growth.

 

4

Hi Jodie,

I think I had the same things back in 2005, I had an XRay scan and the Doctor told me I had Hip Cysts, cracks in my hip with fluid in the cavity and he recommended a hip operation after 15 years. I then took up a lot of running in 2008 and for six months I was doing really well then I got a lot of pain and since then I can only cycle for long periods but walking is difficult. I am overweight now so this is the main factor, so for your age I would say exercise but don't overdo it and you may escape an operation for a long time.

I also found something the other day that took away the edge of the pain, a herbal remedy called Milk Thistle, to say I could rotate and twists and not hobble everywhere is an understatement, I take only when I start to get pain again.

Best of Luck