Dr. Settipalli Saravan Pramod
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I strongly believe I have a slight hip labral tear, which is devastating me mentally. I intend to become a professional dancer very soon as my main training is almost over. I can walk and do everything as normal, but I hear pops, and I have a slight vague pain which is not really bad unless I dance, especially when I have to twist. I had this problem earlier this year but got rid of it with physical therapy thinking it was a regular strained hip flexor. I really need to know because all I have done in my life is dance and fitness training, and I could never do without it. I had a "strained hip flexor" earlier this year by making a breakdance move called the windmill for a long period of time. There was no trauma, and stretching it out seemed to work, but now it is back and is affecting me. Can therapy cure this, or will surgery or prolotherapy has to be done?
Please help.
Hello,
Welcome to icliniq.com.
Many hip labral tears have no signs or symptoms.
Do you occasionally experience any of these symptoms?
Locking, clicking, or a catching sensation in your hip joint or groin area?
Stiffness or limited range of motion in your hip joint?
Physical exercise might cause a labral tear, but without any symptoms, it is not better to comment on it as a tear. In most cases, other structures within the hip joint also have would have sustained injuries.
As you are saying that you had this problem earlier this year but got rid of it with physical therapy, I think it is more likely a sprain than a tear.
Muscle strain can be relieved with physiotherapy or physical exercise, but this is not with the tear.
If you have any recurrent pain or recurrent episodes, the final stage of treatment should be a surgical repair. But before commenting anything on treatment, it is better to have radiological evidence to proceed further. A diagnostic procedure like a scan can confirm.
I hope this was helpful.
Patient's Query
Thank you, doctor,
I believe it is a labral tear because it is in the region of the labrum tissue. It makes popping noises. This flared up out of nowhere, and I am honestly paranoid because it would ruin me. There is a pain but no stiffness. I can move it well. Since I can walk normally and it had to be resolved before, what do you recommend? Should I just do physiotherapy and strengthen it? I do not want this to come back, and I am extremely worried.
Please help.
Hello,
Welcome back to icliniq.com.
Without any radiological evidence or any clinical picture, I will not be able to make a decision that it is a tear. But, it cannot be ruled out. It might probably be a minimal tear.
I suggest physiotherapy and mild analgesics if pain persists. Also, I suggest you get an MRI (magnetic resonance imaging) scan soon to get clarity regarding the treatment options.
There can even be a sprain or a tear or even nerve compression that can cause constant pain and can limit your movements.
Patient's Query
Thank you doctor,
If it is a minimal labral tear, can it heal on itself? Would therapy, rest and a proper diet fix it back to its original strength?
Hello,
Welcome back to icliniq.com.
If it is a minimal tear, it can heal by itself with strict bed rest and by avoiding few strenuous exercises and strenuous dance movements.
Have protein-rich food which will help you heal quickly as protein helps in muscle build up.
Patient's Query
Thank you doctor,
But after rest, can I do hip exercises and strengthen it to prevent this tear from happening again. This does not occur due to any trauma. But does it occur due to overuse and whipping action and strain of the hip?
Hello,
Welcome back to icliniq.com.
Yes, you can carry your regular work gradually.
Yes, definitely it might not be due to any trauma. Make only light movements. Simultaneously, you can go for physiotherapy.
Patient's Query
Thank you doctor,
Since I walk well, can I do nothing for it for one week? I then can gradually do the simple physiotherapy exercises each week and after that do the harder ones. Also after therapy, can I do exercises that make the ligament itself stronger so that this will not occur again? Is there any way to stimulate the blood flow in my hip to increase the healing such as a hot pack or a hand massage?
Kindly advise me on these.
Hello,
Welcome back to icliniq.com.
Yes, you can do physiotherapy so that muscle will gradually relax and get healed. Do not do any kind of hot pack or any hand massage as these will delay the wound healing process rather than helping it heal.
Patient's Query
Thank you doctor,
How do I stimulate a healthy amount of blood flow to the region to increase the healing process?
Hello,
Welcome back to icliniq.com.
Using heat or hot pack or vigorous rubbing will lead to vasodilation which in turn will lead to rupture of the blood vessels in already damaged tissues. This will prolong your cure.
Patient's Query
Thank you doctor,
If this somehow is not a minor labral tear in my hip then what are the other possible injuries I may have that can cause the discomfort and popping in my hip?
Please answer.
Hello,
Welcome back to icliniq.com.
There are a few conditions that mimic this. It might be a hairline fracture or a nerve compression or a sprained muscle. All these are mild symptomatic with related to walking but they would produce constant pain.
Patient's Query
Thank you doctor,
There is a constant pain which is bearable. There is a mild pain unless there is any twisting action of the upper leg region or hip movement. If it is a fracture or compressed nerve, how would it heal?
Kindly reply.
Hello,
Welcome back to icliniq.com.
If it is a hairline fracture there is nothing to worry as it will heal by itself without much intervention.
Nerve compression will require TENS (transcutaneous electrical nerve stimulation) and this will help you.
You need strict bed rest and a little bit of exercise.
Patient's Query
Thank you doctor,
I would like to know if all these can be healed without surgery? Can even the minor hip labral tear be healed without surgery?
Kindly give your suggestions.
Hello,
Welcome back to icliniq.com.
Yes, all these can be cured without the need of surgery.
Take care.
Patient's Query
Thank you doctor,
That would be great. So, I am starting therapy today and would like to know how long should I do this? Will two months of the therapy be sufficient for me to go back to my regular training and dance practice sessions?
Please share your opinion.
Hello,
Welcome back to icliniq.com.
Generally, it requires around one to two months of duration based on diet and exercise.
I hope you will recover soon.
Patient's Query
Thank you doctor,
I would like to know about nutrients. Would vitamin C, zinc, and protein be helpful in my case?
Please advice.
Hello,
Welcome back to icliniq.com.
Yes, definitely. These will improve your wound healing fast. Consult your specialist doctor, discuss with him or her and take them with their consent.
Patient's Query
Thank you, doctor,
I would like to know if I have hip impingement. What do I do then? Will therapy help this? Or will I need surgery?
Please give your suggestions.
Hello,
Welcome back to icliniq.com.
Treatment of hip impingement and femoroacetabular impingement begins with conservative and nonsurgical methods.
Rest, activity modifications, and analgesics with anti-inflammatory drugs will heal the condition where there is abnormal wearing contact between the hip bones and muscles.
I hope this helps.
Patient's Query
Thank you, doctor,
Is there a possibility that I can have it? Of note, my legs are straight, and I am not bow-legged.
Thank you.
Hello,
Welcome back to icliniq.com.
There is a probable chance that you can have hip impingement. It can be caused due to constant use of the hip joint.
Take care.
Patient's Query
Thank you doctor,
I would like to be double sure if it is curable with rest, therapy and a good diet?
Hello,
Welcome back to icliniq.com.
These issues are not quite serious.
You should be fine with normal rest and a good diet. It does not require any major surgical intervention.
I hope this helps.
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Internal Medicine
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