Labral Tear

Hi QuestGirl,

It’s good to hear from you, and this does sound rather synchronous. :-)

There is a very long answer to your question, which yes, is all contained in my new book, Save Your Hips. I will try to summarize my viewpoint as best I can.

First of all, by the late 1800s, orthopedists (who at that time practiced what they called “mechanics” - it was truly biomechanics) had a very good understanding of common hip disease. They knew that initially it was virtually always about the soft tissue surrounding the joint. They also knew there are stages to the disease and the earlier the degenerative process is arrested the better. They used ingenious casting, bracing, alignment and traction to balance forces around the joint.

At the turn of the century radiographs had just been invented and a profound political shift occurred in orthopedics. As you are probably aware, muscles, tendons, and ligaments don’t show up on x-rays. Only white, glowing bone reflected back to capture the imaginations of a certain faction of these doctors. Some percentage wanted to practice surgery and they prevailed. In 1903 the first edition of the American Journal of Orthopedic Surgery was published. From then on chronic hip disease (even the name changed from ‘cox arthrosis’ to ‘osteoarthritis of the hip’) was believed to be all about the bones and absolutely nothing about the soft tissue. In the 1980s the well-known orthopedist William Harris stated that primary arthritis of the hip does not exist. All is secondary to subtle deformities of the bones of the hip. So it remains today.

Reinhold Ganz described “femoroacetabular impingement” around the year 2000. Hip arthroscopy was being refined and now there appeared on the scene a new disease caused by genetically misshapen bones. Suddenly labral tears were being widely diagnosed and treated. It is not inconsequential to consider that the surgeon must remove the labrum to get to the bones that are to be ‘re-contoured’ during FAI surgery.

As I reference in my book, labral tears are recently being considered by some researchers to be a natural part of aging and they often resolve on their own. Furthermore, it is controversial whether fibrocartilagenous tissue even contains pain receptors.

All that said, it is recognized that virtually all chronic hip disease is focused on the top-front aspect of the joint. This is where the labral tears are said to exist, but it is also where an inflamed psoas tendon can become scarred onto the underlying capsular ligament and labrum. Ligaments and tendons contain large numbers of pain receptors.

From the WW perspective, the center of mass of the body should be centered over the arched acetabular roof of the joint. According to Wolff’s Law, “Form follows function”, this structure would not exist unless gravity had formed it over time (the socket is cartilage at birth). Because of an age-old anatomic misperception reinforced by standard imaging studies, orthopedics does not see the arched roof as being evenly load-bearing or important. In reality, this structure explains the whole story of degenerative hip disease.

When you (1) bend slightly forward like a very aged person, or (2) pull your abdominal wall in like virtually every young person in our culture, you are placing your center of gravity over the front aspect of your joints, instead of distributing it evenly throughout. Add a lot of hip flexion (running, biking, working the pedals of a car) the front of the joint suffers great wear and tear.

So the question is, QuestGirl, have you been living in WW posture? If so, we have to trouble shoot - are you really holding your abdominal wall forward (allowing a wide-radius lumbar curvature) where it belongs? If not, then all the more reason to either begin or get back to it asap. I would also invest in the restorative program contained in SYH. As the doctors of yore understood, chronic hip pain must be stabilized and reversed in its early stages to avoid serious disease.

Wishing you well!

Christine

Well…after reading the book, hopefully you will have a more thorough perspective on the whole situation - both your hip condition and current diagnostics and treatments. I certainly cannot tell you not to take the advice of your surgeon, but have given what I believe is the first balanced view of the state of orthopedic hip surgery today.

The ability to rotate the hip is what is commonly lost in adult-onset hip disease. Interesting that in places where people still sit cross-legged on the ground these conditions are almost non-existent. You can think about this like a set of 3 nested Russian dolls:

We come into the world with a completely straight spine and with our hips externally rotated. Just like a little amphibian, whose hind legs come straight out the sides of its pelvis, the newborn is like that too. Place her face-down and her thighs and belly are in the same plane. This is the first Russian doll.

When she begins to crawl, she draws her legs underneath her by rotating her hip joints medially. This corresponds to four-legged mammals who also carry their hind legs directly underneath their body. Her thighs do not point in or out, but she crawls with them directly underneath her and pointing straight ahead. Although she is using her hip joints in this forward-propelled way, she still maintains the ability to externally rotate her hips. This is the second Russian doll.

When she begins to stand and walk and run, she develops a profound curvature in her lower spine. This is because her pelvis and lowest vertebrae (sacrum) are still in the horizontal position and remain that way. She only stands up by curving her spine to the front. She is walking and running forward, but maintains the ability to externally rotate her hips with full lumbar curvature. This is the third Russian doll.

The adult body is supposed to maintain the ability to rotate the hips while keeping the lumbar spine in its natural, wide-radius curvature.

In a woman with hip disease, the littlest Russian dolls are no longer nestled inside the big Russian doll. Many of the muscles surrounding the joint are either shortened and contracted, or pulled so long they become spastic and tense. The hips dvd illustrates this problem very well.

I’m sure we will all love to hear of your progress, QuestGirl!

Christine

I have been doing the "New Kegels" and the WWPosture for about 4 weeks now and my Cystocele is still at the entrance of the vagina, (some days I get maybe a couple of hours before it comes to that stage). I have taken to wearing a tampon most days as I don't think I could carry on with normal life without it. Please can someone tell me approximately how long this programme takes to work. I have given up my slendertone abs belt and my stomach crunches and also using the kegelmaster which my doctor had recommended but if this continues like this I just feel like giving up altogether. I am becoming very depressed about all of this and hope and pray that I'll get some sort of results soon.

Hello Hopeful,

It could take a year or more for an older woman to see significant results.

I put the new kegels up to illustrate how traditional kegels do not address the problem of prolapse. This is about moving your organs forward over your true bony pelvic floor and against the rounded pocket of your lower belly. It really is a long, slow process of returning to natural breathing (that's largely what positions the organs in the first place) and learning to live with your abdominal wall pulled up, not in, and therefore your lumbar curvature in place. Many women with significant prolapse need the extra pull of breathing exercises such as WW firebreathing and WW nauli, which are demonstrated in Whole Woman Yoga 3.

I understand how much you want your condition to resolve, but this requires patience and building a whole new relationship with your body. The tampon is a short-term solution, because your tissues will eventually break down under the constant irritation.

How marvelous that you have some reprieve in the mornings! Early morning walking in WW posture might extend this period. I would suggest paying close attention to when you begin to feel symptomatic. At that point, take a break and do a few rounds of firebreathing and nauli. Continue to stay pulled up in the posture - both sitting and standing. Make sure you are allowing your belly to be held (not flopped) out front by a strongly lifted chest, etc.

There really is no giving up once you understand how senseless and unsuccessful the surgeries are. Thrashing around and indulging in self-pity doesn't help either. Only you can do this.

Wishing you well,

Christine

Hi hopeful - I began this work at age 60 almost 4 years ago. I have both cystocele and rectocele. It was probably sometime in my second year that things started to change and the posture itself became natural to me. There is no cure and no quick fix for this. But when you understand the forces that are at work, and what you can actively do to help yourself, you lose your fear of feeling the bulge, and you can get on with things.

A cystocele sitting at the entrance to the vagina is frankly not a huge big deal. Four weeks of working at the posture is barely scratching the surface of what you need to do. This is for life, so get going. Learn and practice firebreathing and jiggling, learn to guard your lumbar curvature at all times, avoid constipation and straining. If you want to start seeing and feeling a change, you need to kick things up another notch, and make things happen, instead of waiting for them to happen. - Surviving

Thanks both of you for your comments. Christine, I have purchased the book and also the First Aid for Prolapse DVD as I thought that was the one that demonstrated the breathing techniques. I am on a business trip at present but I am sure that The DVD has arrived by now. However it looks as though I have bought the wrong DVD. As yet I haven't read through all of the book as it is not something you could bring out on a plane ( I spend a lot of time on long haul flights ) and really that is the only time I get for reading as I also have a grandson who takes up a lot of my " free time". Does the book also have instructions for the Firebreathing and Nauli?

The information about firebreathing is in the book, and also in the first aid for prolapse where it is described very well in the dictionary of movements. So, you have the right information, now it is time to start reading and watching. A busy lifestyle is perfectly understandable. Many women come here who often ask how they can fit this one more thing into their lives, but if you really want to feel better, you really do have to put the work into it, and some of us, especially those of us who are older, have to put a little extra work into it. That is really what it is all about, managing prolapse, day in and day out.
Best wishes to you.

Once you learn the posture, you are doing it all day long....you do not even have to carve time out of your busy day. Firebreathing takes just minutes. Nauli is an advanced move which I haven't even tackled at this point, but if you want to learn it, WW Yoga Third Wheel is the best place. - Surviving

Thanks for digging this one up QuestGirl - such a gold mine of information! - Surviving

That's great news, QuestGirl. I am interested to know what anti-inflammatory supplements you are taking. I know I should be achieving this with diet alone, but I am hoping to jump-start the process. I have something on my radar but haven't checked it out yet. - Surviving (PS, it's OK if you mention a product by name, we know you aren't hawking anything!)

Dear QuestGirl,
I highly recommend Christine's Hips DVD and book - WWP alone stopped hip dislocation and the last few months I have been doing the DVD almost daily while adding the other DVDs.
Hip dysfunction is a muscle and ligament issue long before it becomes a skeletal problem.
My latest benefit is being able to actually sleep on either side and on my back, with NO pain or discomfort in either hip. Wishing you all the best QuestGirl.
In eternal gratefulness to Christine,
Best wishes,
Aussie Soul Sister

Thanks QuestGirl, this is an awesome post. Zyflamend is the one that I have been considering. Dr. Christine Horner (interviewed by CK elsewhere on this site) recommends it and sells it on her site; in fact according to Amazon she is on the advisory board of New Chapter. I understand that it's basically a collection of natural anti-inflammatory ingredients that are combined into a supplement. i have been slow to adjust my diet and I'm thinking that taking something like this for awhile would help me prove to myself just how much I am being affected by inflammation. Then I could take it from there, probably saving some money in the process! Thanks for all the info. - Surviving