“Good, good.” Dr. Zhang made another note. “I have your medical file and the results of your latest MRI. I’d like to run through a quick examination of my own on the joint before we go over everything. Does that sound okay?”
“Absolutely.”
Dr. Zhang asked her to demonstrate a few different exercises that revealed how much range of motion and strength she had in her leg, then he palpated the area. He was quick and efficient. A couple minutes later, she was once again seated at his desk.
“I can tell that a lot of the ligaments in and around the acetabulum, which is the fancy name for the hip bone, have been overused for a long time. Based on your history and my own examination, I’d say that having some time off from all the activity has been beneficial.”
“The original diagnosis was tendonitis,” Gemma offered.
“I agree that you may have had some tendonitis of the hip flexors early on, but it’s secondary to the other issue going on inside your hip.” Dr. Zhang loaded a black-and-white image on a tablet. “This is the MRI of your good hip.” He zoomed in. “This area here, where the head of the femur meets the acetabulum, is where we have what’s called the labrum. It’s a ligament that acts like a cushion between the two bones.”
“Uh-huh.”
“When we change and look at the image of your right side, you can see that we have all sorts of fraying.” He enlarged the image. “Have you ever experienced a sensation where your hip didn’t feel stable?”
Gemma nodded. “Yes, it used to happen every once in a while on jumps, but lately, it’s been more frequent.”
“That would be because the labrum is torn.”
She inhaled sharply. “Torn?”
“I’m afraid so.” Dr. Zhang folded his hands together. “Gemma, what you need to know is this is a relatively-common injury for figure skaters and hockey players. I’ve seen quite a few in my career. The good news is that, one, it’s repairable with surgery, and two, you don’t have a complete tear.”
“Surgery?” Her fingers coiled tightly around the arm of the chair. “Are there any non-surgical options?”
“That depends entirely on what your long-term plans are.”
“I’d like to be able to get back on the ice, coach, and continue to have an active lifestyle.”
He nodded. “Those are all extremely realistic with both types of treatment available to you.”
“And what are those options?”
“If you went the non-surgical route, we’d focus on treating the symptoms of your injury. I’d have you continue with physical therapy to continue to strengthen the muscles around the hip and recommend a few more weeks of rest.”
“Would I be able to skate again?”
“Yes, but not at the same pre-injury level. The labrum is a ligament that doesn’t heal on its own. You would still experience instability. Also, standing for prolonged periods of time on your feet, or in your case, skates, will continue to be painful.”
“And if I had surgery?”
“I’d go in and repair the ligament. After a few months of recovery, there is a high probability you’d have a normal hip. As with everything else in life, there is a small chance of complications, but based on your age and you being in excellent physical shape, it’s my professional opinion that any complications are slim.”
“This is a lot of information to digest.” Gemma swallowed hard. Her mind was whirling with the news of the torn ligament and trying to process all of the facts.
“What questions do you have for me?” Dr. Zhang asked.
“Let’s say I did elect to have the procedure. How does it work?”
“The surgery is done by arthroscope. I make a few small incisions about the width of a pencil around your hip and tie the frayed parts of the ligament back together. These days, it’s an outpatient procedure. Patients walk out of here on the same day they check in to go home.”
“Oh, that’s brilliant. One of my major worries was that I’d have to be on bed rest.”
“Sometimes patients do, but it depends on the extent of their injury. For example, you don’t have a full tear, so you wouldn’t need me to resurface the joint.”
Gemma resisted the urge to cringe. Resurfacing a joint sounded horrid. “What’s the total recovery time?”
“Bodies all heal at different rates. On average, however, it tends to take about three to four months to be back to full activity. Patients start with six weeks of PT, three times a week, and adjust accordingly. You could be on the ice in as little as a month if you’re hoping to coach as you recover. Of course, that would be no jumps, spins, or anything risky until I fully clear you.”
