Healthbeat: The hip rip

September 30, 2010 8:46:29 PM PDT
Pregnancy can cause all kinds of aches and pains, especially in the hip area, but what if the pain is still around long after the baby is born?

Yankees star Alex Rodriguez made headlines when he announced he had torn the lining around the rim of his hip, called the labrum.

These tears do not happen only to elite athletes.

A suburban orthopedic surgeon says some women, especially those who have had children, may have this problem and not even know it.

It has been years since Pam Wenzel has been able to relax. She says severe pain in her groin area was making life miserable.

It began with a difficult delivery involving her third child, who weighed nine pounds, seven ounces. Wenzel says that during labor, there were complications.

Over a nine-year period, she saw 16 specialists and was diagnosed with everything from multiple sclerosis to bad periods.

"No one's ever said, 'You know, maybe it's coming from your hip,'" said Wenzel.

Enter surgeon Benjamin Domb, an orthopedic surgeon at Adventist Hinsdale Hospital. Domb says he's seen about ten women with labral tears, and he believes carrying extra weight during pregnancy, and possibly the physical part of the delivery, may be to blame.

"The positions that the hips are put in during delivery put women at risk for labral tears," said Domb.

The labrum is a ring of soft tissue that lines the rim of the hip.

Athletes are at higher risk of developing a hip labral tear, but structural abnormalities of the hip can also lead to a rip.

Orthopedic surgeon Charles Bush-Joseph is with Rush University Medical Center.

"A tear may be present, but is that a clinically significant tear or truly a cause of the person's problem? That's what is in debate," said Bush-Joseph.

Bush-Joseph is not so sure about a significant connection between difficult births and these tears.

He says in the last several years, with newer imaging, experts are getting better at diagnosing all kinds of hip problems, and more often than not, hip pain can be caused by a combination of problems, and surgery is not always the solution.

Domb treats these injuries with a minimally invasive surgery, where the tear is stitched up. The hope is the repair will end the pain and delay the onset of arthritis.

Domb stresses many women do just fine with vaginal births, but thinks in some cases, this injury is being overlooked.

"Just an awareness of the potential for hip injuries during the process could be a big help in preventing hip injuries during delivery," said Domb.

Wenzel has learned she has several issues with her hip including the tear.

She's planning to have surgery in the coming months to fix the tear, and will also have some bone abnormalities repaired.

She says the biggest relief is knowing the true root of her pain.

"It's almost unbelievable that I could see so many specialists and not one of them could have pointed me in the right direction," said Wenzel.

A recent study by orthopedic specialists in Ireland noted a possible connection between pregnancy and labral tears.

Many doctors ABC7 spoke with say more research is needed, and that these cases are probably more the exception than the norm.

Dr. Benjamin Domb
Adventist Midwest Health and Adventist Hinsdale Hospital
www.keepingyouwell.com
www.hipcenter.org
630-323-6116

Dr. Charles Bush-Joseph
Rush University Medical Ctr.
Midwest Orthopedics at Rush
www.rush.edu/rumc/page-R11726.html
312-942-5052

American Academy of Orthopaedic Surgeons
Patient education website - www.orthoinfo.org
www.aaos.org


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