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If you are experiencing those symptoms, best to get them checked out by your physician or surgeon. Safety first!

Allowing the hips to calm down and become less inflamed is the first step. In my program, the first week is designed to limit stress on the hip joint and strengthen the deep abdominals for this very reason. I understand your frustration, but know that there is hope, trying as many conservative options as possible is important as well!

Thank you so much 😀

@@uimprovedpt welcome bud 😎

You bring up a good point, and credit where credit is due. Upon further investigation, he does say in some of his articles that surgery is a last resort option which, again, I agree with. And my comments are not directed at Matt. A fair amount of the content the Upright Health channel puts out seems to discourage meeting with a surgeon or orthopedic physician, and is overall negative toward these professionals, despite the considerable evidence for labral repairs and reconstructions being very successful even after 10 year follow up.

@@uimprovedpt What evidence are you speaking of? I am not challenging you, but as someone who has a labral tear, I am trying to stay informed as my life goes on incase getting surgery becomes the path forward for me. I agree UH does seem to create that impression, but succeeding in the TH-cam algorithm requires frequent uploads, so his message can be a bit overdone, and at times, sloppily conveyed. There can be unhelpful generalizations. Like any professional, there can be good and bad ones. I have a great PT, and has helped me tremendously. I know others who get horrible generic advice, like doing 3x10 clamshells and some glute bridges, and they end up needing surgery. A big part of dealing with these issues is finding high quality experts, that are well regarded, and are staying up to date with studies and other information.

@@agilesamus I feel for you, and I have had very similar experiences. And I agree, the TH-cam algorithm can be tough to navigate without having dramatic titles, content, and thumbnails. And that is why I did not want to comment on Matt, but the channel, because there is a discrepancy between the person and what is presented. But here are some links to studies that support positive outcomes from labral repairs and/or reconstructions (not debridement: we know that one isn't great). www.ncbi.nlm.nih.gov/pmc/articles/PMC5127940/ pubmed.ncbi.nlm.nih.gov/34657092/ pubmed.ncbi.nlm.nih.gov/35850143/

Yes, I completely agree. And as I mentioned in this video, Upright Health has a ton of super helpful information for people struggling with labral tears. And the philosophy of "always think muscle" is very appealing. But anytime the word "always" is used, it is important to be a little skeptical. A better way to think of it is "think muscle first", because it is the structure you have the most control over. And once you get as much control over the muscles as possible, if you still have symptoms, that is when you should consider other approaches. Overall, Upright Health and uImproved PT will probably agree on a lot of things when it comes to labral tears, however as a Doctor of Physical Therapy, I am less dogmatic in my approach to treatment.

Anyone who can tell you if you need surgery or not based solely on an MRI report likely has another agenda. If I were a surgeon, I would tell you that you definitely need surgery. If I was a PT with no code of ethics, I would say "buy my program it will fix all of your problems". In reality, an MRI report, especially for FAI and labral tears, gives you MAYBE 10% of the information you need to make this decision. Right now, you have "structure". But we are missing the following: joint mobility, muscle strength, neuromuscular control, flexibility, lifestyle factors, level of pain, aggravating factors, relieving factors, type of pain, clicking/popping/grinding symptoms, range of motion, lumbopelvic stability, presence of anterior pelvic tilt, history of injury, etc (I could continue naming things but you get the point). All I can say is what I recommend to everyone with FAI/labral tears: exhaust your conservative measures first (a proper therapeutic exercise program like Pain to Perform: FAI and Labral Tears) and if you are unhappy with the level of your symptoms and dysfunction after reaching a plateau for a few weeks, talk to a surgeon (actually, talk to 2 or 3 if you can). TL;DR: I can't tell you the answer here, because I don't know the answer, and I would be doing you a disservice if I gave you a solid answer.

@@uimprovedpt Thank you sincerely for your response and the time you dedicated to me. Where can I find more information about a therapeutic exercise program like Pain to Perform: FAI and Labral Tears? I suspect that my issues are also exacerbated by nystagmus, which I have had since birth. As a result, I have always held my head slightly tilted to the right to steady my eyes when I need to focus, for example, on reading. In recent months, I have been dedicating more time to strengthening and stretching exercises for my hips and avoiding sports like basketball. The symptoms have improved, with less catching and popping in the joint. Best regards from Slovenia and thank you again for your comprehensive response.

You can learn more about my program specifically at paintoperform.com/fai-lt-lp. You could also try seeing a PT in person, but many of them don't have experience treating fai and labral tears. And of course my channel has a playlist for hip impingement if you are interested in learning more about managing your hips. Let me know how else I may be of assistance in your journey!

Oh yeah, they were having a blast!

I totally understand that, there are some exercises I would consistently do in my early 20s that irritated my hip, but people always said "no pain, no gain". It wasn't until I learned how to control my abdominal muscles and avoid exercises/stretches that increase my symptoms that I found the techniques that actually make my hips feel better. Always remember: if something is aggravating your symptoms, it is not helping (at least not the way you are doing it).

Or even just PTs who specialize in specific joints. So happy you've been getting good results! Love having your support here!

Absolutely. And of course, if we can manage the injury without surgery and get back to everything you want to do, avoiding the scar tissue from surgery is optimal. But that is not always possible.

Why hip internal rotation in flexion? Had minor free edge anterior 3 oclock tear repaired 4 months ago. MRA just confirmed it's torn again at 3 oclock and now full thickness tear. I am super bummed and feel way worse atm 4 months post op. Super worried. Having lots of pain and trouble as basic as walking and turning. Prior to this was very able bodied.

Most are never the same as pre surgery. A lot of NHL goalies have gotten it and none of them really get back to their level. Just an observation. I really don’t want a THR but it seems close. I believe it will never recover from THR. 🤷🏽‍♀️

Excellent question, and I understand your confusion. I was not presented with the option of conservative measures by my doctors before I had my surgeries. In addition, my surgeon did a debridement, not a repair or reconstruction, which is an outdated procedure still being done by some surgeons. I drew the short straw in many ways, but know that if I had gone and gotten a second or third opinion, I would have at least delayed the surgery and tried conservative measures.

@@uimprovedpt which surgery is best, repair or reconstruction? If you could’ve changed surgeries which would you have done? Do you think you’d be okay now if you hadn’t got the surgery?

@@zolinagy8537 it really depends on your injuries. like how severe is your labrum being teared.

The research shows they are pretty much equal as far as effectiveness, but it would depend on the specific labral injury, ie where it is located and the severity. I probably would've opted for a repair. As far as being "ok", it is hard to tell. I imagine that I would have other problems as a result, such as back pain, because I would not have learned more about these conditions and worked to fix the problems that contribute to it, such as limited capsular mobility, weakened abdominals, anterior pelvic tilt, restricted hip flexors, etc.

Yes, and unfortunately we live in a world where anyone can be an "expert" in anything online without credentials, often neglecting patient-centered and evidence-based care in favor of evidence-centered care.

I haven't found a consistent term for this, although "movement related cramping" may be a good one. there is also a term called "active insufficiency", but that is more describing the difficulty of a muscle to contract when it is already in a shortened position (which is the typical position you will experience movement related cramping).

@@uimprovedpt okay thank you

There are 3 potential things that I suspect could be going on here: 1. The location of your tear could be directly causing the pain in the lateral thigh, though this is less likely. 2. Compensations you have built up to avoid irritating the labral tear have placed greater stress on the structures attaching to the IT band 3. The labral tear and your symptoms are completely unrelated: you have an asymptomatic labral tear and happen to also have IT band syndrome. Difficult to determine which of these is your problem but hopefully this helps!

@@uimprovedpt yes, thank you. would your services be able to help with the IT band syndrome if I signed up?

@@flipdawhip2573 As a PT, I am only licensed to practice 1 on 1 in Florida, which means both me and the patient have to be in the state. Pain to Perform: FAI and Labral Tears, while specifically designed by me to help people with these conditions, although the whole idea of the program is to make your hips move like hips are supposed to move, which is a common problem in IT band syndrome. You could always give it a shot, I have a 30 day money back guarantee so if you don't benefit from it after 30 days, I'll refund your money.

Happy to help!

Best of luck!

@@uimprovedpt torn labrum, Dr is recommending getting it scoped

Actually, my surgery was not successful, it actually made my hips even worse. Now, regardless of the reason for the return of the symptoms, bone growths, and labral tears, a repair is typically a more successful surgery for hip labral tears. I did not get the repair because I wanted to explore other options before having more surgeries. And those other options worked for me!

Not really. Actually, my hips were a lot worse after the surgeries, both looking at my symptoms and at imaging following the surgeries. Restoring the proper movement of my hips has helped me significantly, so I have not needed more surgeries after the first ones.

It depends. By itself, it is a short term "fix". If it decreases unnecessary inflammation enough so that a proper PT program can be complete without pain, it can be part of a long term solution.

The research is pretty clear on the effectiveness of this surgery. Doesn't mean it the best choice for everyone, but it can be effective for many people!

Thanks for the support as always!

While I can't give you specific recommendations for your situation, I can tell you a few things... First, the extent of the tear is not always correlated with the degree of pain. If the hip isn't moving properly, it can just keep irritating even a slight tear, increasing the pain. Second, stretching can help, but with hip impingement and labral tears, there are usually specific muscles you want to stretch. Stretching others isn't bad, but without stretching the most affected muscles, you can further interfere with the biomechanics of the hip. Third, most of the research on stem cell therapy in regards to FAI and labral tears looks at it in combination with arthroscopy. I would encourage anyone to exhaust their conservative resources (physical therapy, therapeutics exercises, soft tissue techniques) first. And if you haven't seen it yet, check out the program I made specifically for people like you: paintoperform.com/fai-lt-lp

@@uimprovedpt thank you for the reply. I will check out the link. really appreciate what you do.

@@flipdawhip2573 hang in there, with the right program, consistency, and hard work, you will be surprised at what you are able to do 😁

Good luck!!!

It's difficult to give a 100% certain answer, but from what I have experience from both my patients and myself, even severe pain from impingement or labral tears (you may have torn the labrum during that heavy squat) can be effectively managed without surgery. Personally, I have squatted 300 lbs below parallel with FAI and labral tears and without any pain. I made Pain to Perform: FAI and Labral Tears specifically for people like me and you, I think you should check it out: paintoperform.com/fai-lt-lp

As long as the range of motion remains pain-free, most people should have no problem with hip thrusts, as the hip flexion angle usually isn't very deep with this exercise. There shouldn't be a problem with loading weight on the front of the hips, however doing a single leg bridge can likely challenge the hip extensors a similar amount, depending on your goal. Ultimately, if it hurts, modify the range, load, or exercise.

@@uimprovedpt thank you! What about Bulgarian lunges? My hips feel pretty tight after this exercise so I avoid them, but I’m wondering if I’m just being paranoid and they’re safe?

That's a tough one to answer, as Bulgarian lunges add some more complex factors, including requirements for lateral and rotational stabilization in the hip as well as lumbopelvic stability, if your hip flexors are compensating for these deficits it would not be surprising for you to feel tightness in the front of the hips. Generally speaking, if an exercise doesn't replicate your sharp pain/pinching, it should be relatively safe, however tight/restricted hip flexors can encourage an anterior pelvic tilt, which is known to be associated with hip impingement pain. Ultimately it is up to you to recognize pain vs discomfort, and if you aren't sure, ask yourself: is this variation worth it?

Will be out tomorrow!

Haha, I'm glad we have a consensus!

The one I use is about 1 inch width, but most medium width bands should do the trick!

I appreciate your feedback, title change incoming.

Will do!

Mean?

It depends on what you define as "failure". In this case, failure for me for these movements would be when I can not achieve the full range of motion of that movement.

I know right, i was a little confused there.

I may have failed to explain what I meant, and that is on me. In this case, I am talking about "dirty" reps. I have encountered this as a physical therapist, a personal trainer, and as a gym-goer of over 10 years. For instance, last week lets say someone got 10 clean reps of chin ups (full range of motion, RPE 9). This week, their plan says they need to do 11, but either lack of rest, lack of nutrition, or some other factor has caused them to get only 9 clean reps, so they force 2 "dirty" reps (decreased range of motion or faulty form, RPE 10 or more). They may mark that down as "11 reps", when in reality, they could only achieve 9. Does that make more sense?

The content and your arguments are 100% correct but the title is clickbaity/misleading.

@@rackhir100 I appreciate the feedback, title and thumbnail have been changed accordingly 😁

it may benefit you to decrease the intensity of the stretch. too much too soon may cause that soreness in the highly innervated capsule and make you compensate in response. let me know how that goes for you!

Same case here. Tried it weeks ago (the capsule stretchment first and the band distraction some days later) and my pain level increased. It’s true that the day after doing the distraction maybe I felt that walking was easier, don’t know if because the distraction or some other factor haha. Thanks anyway for the content 😊

Thank you for your input! And while this stretch helps a lot of people with FAI, if a restricted posterior hip capsule is NOT contributing to your symptoms, this just may not be the right mobilization for your hips specifically. This journey is all about learning what makes your hips feel better, and if something doesn't, then ditch it! And remember: more mobility without the proper strength, control, and stability won't lead to lasting results.

@@uimprovedpt Thanks for your answer! Definitely strenghtening is the most important for me based on my experience. Also avoiding activities and positions that make you feel worse, as you say. It's a difficult journey, but finally I'll be able to manage it!!

@@CarlosCasero82 That's exactly how I have managed it! Keep up the good work!

Thank you for the feedback! More to come! Let me know what you want to see!