Hip pathology is commonly associated with sports hernias and core muscle injuries. Some of the common hips conditions are Femoroacetabular Impingement (FAI) and labral tears. The impingements are further broken down into cam and pinch types, and these will be worked up by your orthopedic surgeon. A hip injection may be necessary to determine how much of the pain is coming from the hip versus the groin.
For the patients, who are diagnosed with both a hip problem and a sport hernia, a combined surgery is possible in many cases. This does take some coordination, but can be beneficial for the right patient. Ideally, patients who have a clear problem in both locations, and those who can tolerate a slightly longer procedure are good candidates. The benefits of doing a combined procedure is that both surgical procedures are done during one day under general anesthesia. Also, it allows for the rehabilitation to be done concurrently, which allows for a quicker return to sport since both sites will have therapy at the same time.
In some cases, a combined surgery is not possible. Often this occurs, an athlete may have a team surgeon who can perform the hip procedure, but needs to come to Houston for the sports hernia repair. While the concern is that this will delay a return to sport, we can still optimize the recovery period with coordinating the two surgeries. The recovery from most hip procedures is going to be approximately 12-16 weeks, and the recovery from the sports hernia is going to be 4-6 weeks. Therefore, as long as we can get the athlete in for surgery a few weeks after the hip procedure, your sports hernia recovery will fall within the hip surgery rehab time frame, so the athlete should be cleared near the same time as if both procedures were performed together. We have done this route on several athletes in the past with an excellent outcome.
This scenario can also arise when the groin is not believed to be the major source of pain. However, in some cases the sports hernia pain becomes more evident during the postoperative period for the hip. In these cases, I can still do the sports hernia repair within the hip rehabilitation.
Ideally, we can have the athlete travel to Houston for the sports hernia surgery 4-6 weeks after the hip procedure. This will have allowed the athlete to have enough time to initially heal from the hip procedure to travel and have the groin surgery. Traveling before this is usually not possible due to the hip mobility restrictions for the first several weeks.
REHABILITATION WITH COMBINED SURGERY
When a combined surgery is performed at both the hip and the groin, the athlete will follow the hip protocol given by the orthopedic surgeon. This is done since the hip rehabilitation is much longer than that sports hernia protocol, but it is important to not damage the hip joint with rehabilitation. The muscle repair in the groin is much more forgiving, and will be protected and strengthened with the hip protocol. This will routinely be 12-16 weeks based on the orthopedic surgeons findings and protocol.