I first began experiencing hip pain when I was 17 years old and a junior in high school. I was trying out for my varsity soccer team when I felt that I had pulled my hip flexor. I took a few days off from practice to wait for it to heal, but unfortunately it never got better. I would wait a few days then try to run, and the same pain would always return, quickly becoming sharper and deeper into the joint. I saw a doctor in NYC, and he diagnosed me with a labrum tear in my right hip. I had my first hip arthroscopy done in the winter of 2008.

When I went back for my 6 month check up and complained to the surgeon that I still had the exact same pain as before the surgery, he looked at me like I had four heads. He told me it was impossible and sent me away. I don’t think I did any real activity for two years after that, but slowly broke into swimming, which seemed to make my muscles stronger. Eventually I did get back into running (approx 3 miles, 5 times a week) but that took about 3 years post-surgery.

After college graduation in 2012 I got into crossfit, and within a year of starting that, my hip pain came back in both hips. I went back to the same surgeon (stupid me) and he did more MRIs and told me there were still labrum tears in my left and right hips. He said that the surgery I had in 2008 was now more advanced, and they were more aggressive with shaving down the head of the femur so it did not tear at the cartilage in the hip. I had another arthroscopy on my left and right hips in 2015.

The pain stayed the same, originally only occurred when I was active (I limited my activities significantly) and day-to-day was manageable. But over the following months pain kept getting worse and became more day to day. Now I cannot walk around the block with my mom or go on hikes with my boyfriend. And I am a person who LOVES to be active, running or biking or weight lifting are all out of the question.
I met with a new doctor a few months ago (approx September of 2016) to look again at my labrums. He took a good look at my hip and mentioned that the joints appeared to be anteriorly rotated (basically, they were pushing forward out of the socket) so that the socket was not fully covering the femur. He referred me to a specialist who is supposed to be the best. The new doctor diagnosed me with mild hip dysplasia (you wouldn’t see it on a regular xray) and recommended me to have a PAO so that the femur is correctly seated and protected by the joint. He says my illiopsoas and hip flexor pains happen because they are essentially taking over the role of the hip socket and “holding” my hip joint in place. It seems like a believable explanation for my horrible tendon and muscle pain in the front of my hip and in my groin.
I’m now scheduled to get this PAO surgery on my right hip on August 8th. I need to wait a few months due to work obligations and needing time to pray about such a serious surgery. I have seen way too many horror stories on the internet of people who got worse from this surgery, and cannot function day-to-day without horrible pain. My pain is bad, but the devil you do know is better than the devil you don’t! Hoping that someone might have had a similar experience as me and might have some advice. Thank you!

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  1. Lucy says:

    Hi Cara,

    I have just read your story it sounds very similar to mine, though I didn’t start having problems until age 39.
    I have mild/moderate bi lateral dysplasia with the left joint coming out of the socket forwards, I’ve had two years of physio and steroid injections, all the while the pain has got worse I gave up work two months ago my job being physically demanding, I can walk for about 20 minutes at a time, I get groin pain and muscle weakness, I’m an active person so this has been an awful time, and I have felt on my journey with this that most of the health professionals I have seen just misunderstand whats wrong with me, with the exception of one who has offered me a PAO but referred me to a Hip Replacement surgeon also and I have been given a choice between the two surgeries, I have gone with replacements because one of the angles in my left hip is normal and because of this it could cause an impingement they just don’t know, I will be having this done in the summer like you.
    Its all very scary, I’ve never had surgery I don’t want surgery but you can’t fix a structural problem without it, I was rather hoping I could just put up with the pain, but its got worse, sometimes I can’t sit down and I’m now on quite strong meds.
    Try not to be too influenced by horror stories there are way more positive stories than bad ones, here’s hoping by the end of the year we are both up and running!

    Wishing you Good Luck,


  2. Cara M says:

    Lucy, thanks so much for responding to my story! I have never met anyone with similar hip pain, let alone for the same reason. I am glad to know I am not the only one who has pain because the joint is coming forwards out of the socket. Same as you, I had hoped I could deal with the pain- now I have pushed my surgery up to next month and sitting is the worst! The point you’ve made regarding one of the angles of your hip being normal is a very good one, I am going to ask about that in my next appointment. I hope everything works out for you, and praying that we are both up and running with no more problems very soon!

  3. Lucy says:

    Cara I don’t know anyone personally with dysplasia so its even less likely I’d chance across anyone with the forward joint problem too! I know that my dysplasia was caused by my position in the womb, my mum told me I had a foot stuck under her ribs for months, the docs diagnosed mild hip dysplasia at birth but said it wouldn’t cause me problems how wrong they were! The weight bearing angle with me is normal so it would mean if I had a PAO the bone wouldn’t cup the socket it would stick out, it may or may not be an issue, if it was they would shave the bone, my surgeon spoke to a lot of his colleagues about my case because initially he told me he would not do it, but after testing my range of motion he said he could because my hips are hyper mobile, however he could not guarantee me being pain free only reduced which is why I’ve opted for replacements, what I would say though is yes definitely do ask about the angles of your hips, I don’t think its a feature of having a forward joint problem, however I don’t know, so by giving you my history it may be helpful to you. I really hope that your case is more straight forward than mine, and your surgery goes smoothly. I’m on the waiting list with the NHS in England, I’m grateful for the super health service we have here, I would have the surgery tomorrow if I could I haven’t sat down properly for ages, I lie on my side on the sofa, its agonising so I’m just kind of hanging on in there, I never thought I would look forward to surgery but as nervous as I am I can’t wait for the relief it will bring. Please do let us know how you are doing, take care, Lucy.

  4. Angie Nelson says:

    Lucy, and Clara,

    When is your surgery? I was also born breach, with my feet behind my ears. I enjoyed an inactive life with very flexible hips. At 28 I decided to start running. No formal training. At 31 my iliopsoas spasmed and locked. My knee was stuck to my chest for 3 or 4 days (not sure, I had been injected and given valume to relax my hip). Long story short, I’m now 36, and had my first hip x-ray to show:
    Shallow hip joints (to explain the popping and pain), my right hip shows torn labrum, and my left (the hip that iliaopsoas locked) has tendentious of the iliaopsoas. Now I have PT, avoiding shots and surgery.
    I’m doing Pilates in my PT, and just integrated mat Pilates to my excersice regime. Today, my right hip hurts so much, but also something I can handle.
    Im afraid of further intrusion in my body. I want to have my PT and Pilates help. But I worry about further damage to my hip. I think sharing stories helps.

  5. Cara M says:

    Angie- my surgery is May 23rd. It sounds like your hip remained “dormant” up until you started being active- it sounds incredibly painful to have your knee stuck to your chest! Ouch!
    In my case I had no symptoms up until I was 17…I was always active, and I wasn’t born breach so I’m not sure what caused the dysplasia. I’ve had several surgeries but my pain keeps getting worse (nothing like yours where your knee was stuck to your chest!) but I’m kind of to the point where I know this structural problem won’t heal itself. I’ve tried everything non-surgical: PT, yoga, tendon release therapy, stim, chiroractor, etc. At this point it’s either I survive with it (day to day chronic pain) or turn to surgery try to make it better. Hopefully the PAO will make the pain at least more bareable. If it doesn’t work out, I figure I can at get a hip replacement, but I can’t live in this constant pain.
    I think if your PT and pilates are causing you pain, it would probably be best to avoid them (but I am not a doctor). Have you tried swimming? It may make your muscles stronger- it helped me back in college. If that doesn’t help it, surgery seems to be the only thing that will fix a structural issue. But you do need to feel 100% comfortable with the decision. I will definitely keep you updated on how my surgery goes!

  6. Jeannine says:

    My 17 year old daughter was diagnosed with bilateral hip dysplasia and torn labrum this past January. She has danced for 14 years but her activity increased 2 years ago when she added drill team to her schedule. She went from dancing 4 to 6 hrs per week to 12 to 14 hrs per week. The additional dance time and kick style began to wear on her. She tried PT and other things but the pain just kept getting worse. Her symptoms include groin pain, popping/locking, weakness and general fatigue. Now the pain is constant and radiates around to her sides and lower back. She is planning to have her first PAO this summer. She tried injections into her hips but this only relieved the pain for just over 2 mths. We have done lots of research and are seeking a second opinion before we go ahead with the surgery. There is so much information out there. We found a blog from a young woman,a Marine, who recently had the procedure. I have included a link for you. Please keep us updated on your progress!

  7. Lavonna says:

    Omg… I’m in so much pain. I was diagnosed with hip dys 8 years ago. When I was in high school I played every sport and cheered without any pain. One day, 8 years ago I took up walking to get in better shape. I was 2 blocks away from my house and a severe pain set in my right hip and groun. I’m telling ya, I could barely make it back home.

  8. Justine Lucid says:

    grateful that I encountered this website!

    Ever since I was a kid, I always had sevre pain after playing soccer or running. I thought it was a normal response to exercise, as nobody ever thinks to ask a kid if they are in pain post- exercise. By age 11, I started limping after a bad fall. I was MRI’d and we discovered that I had herniated my L5S1.

    Fast forward 8 years; I was working in a PT office and was trying to pop my hip back into place. Once again, never questioned the popping and locking that happened in both hips; just assumed it was a byproduct of my lower pain issues…One of the pTs exclaimed that I was dysplastic on both sides, which explained why I was in agony every time i sat into the car [bucket seats put even more pressure on the damaged areas!]

    After a few very scary surgical consults, I changed degree tracks and graduated in 2012 with a B.S. in Exercise Science. I work in a premier rehab hospital as a corrective exercise specialist, and manage multiple herniated discs and bilateral hip dysplasia with conservative treatments.

    Anyone with dysplasia has lowe back instability. You need to get into a quad and gluteal strengthening program, as our hamstrings never seem to relax on their own.

    My tried and true protocol is this:

    *straight leg raises [only up to bent knee height]
    *bridges [static hold for 30 sec, build up to dynamic
    movement 10 reps x4]
    *prone swimmers
    *bird dogs
    *side- lying hip abduction [NEVER use the seated ABductor
    in the gym, EVER]
    *Prone hip extensions
    *Gluteal kickbacks

    FOAMROLL ITB and thighs, stretch hammies daily.

    Eat lots of fuits and veg, restrict sweets and refined starches when you have a flare up.

    Take glutamine supplements if you have any soft tissue tears; this and vitamin c help to rebuild the collagen in tendons & joint capsules.

    use essential oils like lavender, peppermint, frankinsence and lemongrass TOPICALLY to reduce inflammation.

    Do gentle stretches daily.

    AVOID long term use of any pharmaceuticals. Many people experience pain rleief from medicinal marijuana consumption.

    STAY ACTIVE! walking and stretching help to bring much needed fluid to joints, which lubricates them. MOTION IS LOTION!! Just listen to your body and do not overdo it.

    I hope to start a youtube channel to demonstrate the things that have kept me off of the operating table. It’s been 8 years since I went to my first consult, and I am so happy that I did not give into the fear mongering. I even delivered my daughter naturally 3 years ago [ in a side lying position]

    Try chiropractic, Low Light Laser therapy, light to moderate exercise, acupuncture, and massage. See what works best for you, and let me know how it goes!

    will keep you abreast of my youtube channel progress.

  9. Amber says:


    Thanks so much for publishing your story. I’ve been diagnosed with hip dysplasia as well with very shallow hip sockets. I was told the same thing that my flexors and psoas have been overworking to keep my femur in the tiny socket. It was very relieving to get the diagnosis after being misdiagnosed since I was 13 with “tendinitis.” I’m grateful there’s a fix, but also terrified at the intensity of it.

    I’m now T minus 7 days for my first PAO. How did yours go? Any advice??

  10. Lee Sutherland says:

    Hi Cara,

    My name is Lee Sutherland, I am 41 years old and now been living with hip dysplasia for 11 years now. Your story is similar to mine.
    I was still playing semi pro football, (Soccer) when I was diagnosed. I kept getting groin strains and trying to rest for a week at a time then when I was coming back to training the pain would come back right away.
    After seeing sports physios for months on end and not getting any further forward, I decided to go for a X ray. after the ex ray I was told to go for a MRI scan immediately. it was then I new something was more serious.

    I then went to visit the specialist to get the results of my MRI scan and the news I got was devastating. he told me I had hip dysplasia in both hips but my left hip was worse and started show signs of arthritis.
    He said I would have had this from birth but it wasn’t picked up by the nurses at the time. he was amazed how I had managed to be as active as I was until 30 years of age.
    After discussing my options he said a PAO would be the best option but it scared me to death to be honest.
    I asked him how long I would be able to go before having to get any kind of operation. he said it depends on my life style.

    I decided to just leave the operation and try and live with it. I was married and had 3 young boys at the time and I just broke down in tears walking out the hospital that day thinking I wont be able to run again never mind play football, something I had done and loved for the last 30 years.
    I done no exercise after that for about 12 months and I gained some weight which was starting to get me down.
    I decided to try and get back to some sort of training so decided to start swimming,cycling and mixing it up with some weight lifting. 10 years on and I am probably the fittest and in the best shape I have ever been in.
    My hip pain is still there on a daily basis but I am just managing it the best I can. more importantly my mental health is in a good place.
    I am considering going back to my doctor to see if I can have another scan to see how much my hip dysplasia has deteriorated over the last 11 years.

    I know one day I will need surgery but I will be at an age where I will be told old for a PTO.

    STAY POSITIVE,STAY STRONG and all the very best with your PTO

    Thanks Lee

  11. Emily Nash says:

    Hi Cara!
    Your story is super similar to mine so it’s nice to know I’m not the only one! I am 24 and I’ve been an athlete my whole life primarily gymnastics and lacrosse. I started having pain two years ago in my collegiate senior year of lacrosse.
    I went to a sports med doctor who just thought I had strained muscles and tendinitis. After 6 months of physical therapy and multiple cortisone shots my pain only got worse. I was referred to a orthopedic surgeon who diagnosed me with a labrum tear and I proceeded with an arthroscopic repair including shaving down and reshaping of the joint.
    After my surgery I never received relief of my pain. At every post op appointment my surgeon kept telling me that it was post op pain and would eventually get better. Finally after 8 miserable months post op I got a second opinion from a new orthopedic surgeon where I was diagnosed with femoral anteversion of both legs, hip instibility, hip dysplasia and torn labrum… again.
    I’ve been told PAO is my best option and have decided to go forward and schedule it.
    My trust in doctors is definitely lacking at this point.
    It would be amazing to hear how yours went! Also what you did before surgery to help relieve pain as it is becoming unbearable for me.
    Thank you!

  12. Cara says:

    Hi Emily!!
    I will be 3 years post op in July. Overall, the surgery for me was tough, but not because of the hip pain but because of the muscle atrophy from not bearing weight for 8 weeks. It caused me a lot of problems with my recovery. Getting into a good PT Post-op will definitely help with this.
    I am so so glad I got the surgery, my hip does feel much better. One other thing that really helped me with my recovery was PRP and stem cell shots. I eventually ended up getting stem cells taken from my lower back and re-injected into my hips and hamstrings to help with the tendinitis that resulted from the surgery. It worked miracles for me. I’m able to do light workouts again!
    Hopefully this helps. Let me know if you have any other questions and best of luck with your surgery :)

  13. Jacqueline Best says:

    My daughter who is 20 will be having Bilateral PAO in three days time. Is there anybody who has had the PAO surgery on both their hips at the same time?

  14. Linc Reinalda says:

    Hey Cara,

    I am 25 and have been struggling with my hip dysplasia for about 8 years now. I got my left hip operated on in a similar way described by you, they shaved down the head of the femur to “protect” the hip.

    do you think that PAO was the only option for you?

  15. Cara says:

    Hi Linc, yes ultimately I thought it was the best option for me to regain hip stability. Only other option was a hip replacement, but those need to be replaced again depending on how active you are and I was in my twenties at the time of the surgery. I also had good cartilage, so that was another reason not to look at a hip replacement.
    One thing I highly recommend after surgery is stem cell treatments to help with healing (I think you can do them between 6 months to a year after surgery, but don’t quote me!) if needed. Stem cell therapy really helped my recovery.
    Hope all goes well for you!

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