For a quick recap: I've been competing in powerlifting for about 5 years - The past several years I've been dealing with consistent hip pain, a whole lot of popping/clicking noises, and had trouble with wide stance training (wide squatting, sumo deadlifting, etc), it grew a lot worse during my recent training cycle for XPC Finals at the Arnold Classic, where I competed in the multi-ply equipped division (and saw my squat continue to decline from the past year)...
For a long time I didn't have medical insurance and neglected the doctor, but now that I have pretty good coverage with my job and the Arnold is done, I've been trying to really address the issues. I've been getting a lot of help from EliteFTS Columnist & Physical Therapist Dani Overcash, and using PRI techniques and some motor patterning stuff has helped with evening out some issues and improving my range of motion. I've also been traveling to Columbus to see Dr. Ryan Smith (who is a long-time associate of elitefts) where he's been helping me with some soft tissue work as well. Ryan recommended getting an X-Ray and MRI, and I got both, which leads us to today.. Ryan set me up with an appointment with Dr. Thomas Ellis, who specializes in hip joint conditions and works a lot with athletes. Dr. Ellis discussed my MRI/X-Ray results with me and then took me through some range of motion tests. Some of the issues from my MRI were:
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Bony proliferative changes of the femoral head-neck junctions bilaterally suggestive of cam type deformities.
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Small tears in both labrums (anterior-superior).
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Low grade irregularity of the superior right acetabular cartilage.
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Subcortical cysts along the anterior left femoral head.
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Indistinctness and thickening of the ligamentum teres bilaterally suggestive of prior injury.
..Dr. Ellis said he was actually really surprised with my balance of range of motion (which I credit to the work I've done with Dani & Ryan), and the fact that I'm not struggling more with pain considering the severity of my MRI results (which I credit to being a masochist). Long story short, I have very naturally restricted hip joints, and flexion with rotation (like with squatting) has caused the bone spurs (which have grown over time) to tear at my labrums and damage my joints further. Dr. Ellis said it's hard to say exactly how soon, but I'll most likely be needing a total hip replacement in the next 10-20 years. The current temporary surgery option is to do a hip scope, which would shave down the bone cysts and cam deformities, and sew up my labrums. Pros of the surgery: It would reduce pain and the prognosis short-term following surgery has been good. Cons of the surgery: Long term effects (more than 5 years) post-surgery haven't been evaluated yet, and there is a risk it wouldn't allow me to return to competing at the level I can now.
So..
Because I'm functioning fairly "normally" day-to-day right now, and making changes to my technique (close stance raw squatting in olympic shoes versus wide stance squatting equipped, and some other technique fixes) has improved my pain and ability to train, we think holding off on the surgery for now is a good option. I'm going to continue to make adjustments to training, work with Dr. Ryan and Dani, and keep an eye on things before re-evaluating with Dr. Ellis in the Spring (or sooner if pain worsens). I'll need to get X-Rays done on a yearly basis to keep track of the hip joint and see if it's worsening, so we'll know if I'll need surgery sooner. We also discussed equipped vs raw squatting (with Dr. Ryan) and he thinks sticking with raw squatting would be a good idea because both of the biomechanical setup and just the common sense load difference (aka my hip will get worse a lot quicker squatting with 700-900 lbs on my back than it would with 500-700lbs, etc).
In conclusion..
It sucks that my hips are effed up, but overall I'm very happy that now I KNOW what the issues are and have a gameplan moving forward. Competing in powerlifting at an high level for a long time has it's risks, and the idea I would need a hip replacement down the road wasn't exactly mind-blowing, and on a positive note hip replacements have come a long way, so I figure in 10 years the technology will have progressed so far my squat will actually go UP from it! But seriously, I'd been considering making some training changes and competing raw this Fall, and this confirmed that decision. In a way this whole thing just puts more fire under me to put some big numbers up in the coming years and continue to work at proving myself as a competitor. In addition to that, I know these experiences and working through them will all make me a better coach and educator, which is a huge priority for me.
I'll continue to find ways to train smart(er), and the plan is to compete in Fall and I want to qualify for a big raw meet in the next year (if my hip continues to remain stable). Follow along and hopefully my training journey can help others in similar situations,
Prepare. Perform. Prevail.
