#4 – Should you get hip surgery?

Jill had hip pain that wouldn’t go away. Her surgeon warned her that she’d need arthroscopic surgery or she’d need hip replacement within a few years. But she decided against the surgery. Find out why on today’s episode.



Hey everybody this is Matt Hsu from Upright Health and welcome to Episode 4 of the Upright Health podcast. Today, we are talking about the topic of surgery and today’s topic is really focused on something that I’m becoming well-known for on the internet. It’s good to be known for something, I suppose on the internet, and if it’s gonna be something hopefully it’s something positive for everybody else.

If you’ve been on my YouTube channel you’ve seen I post things about hips a lot. I’ve talked about a condition known as Femoral Acetabular Impingement. It’s called Hip Impingement for short or FAI and it’s a really… the way one person has put to me in email, it’s really en vogue orthopedic diagnosis these days. And basically the diagnosis means that bones of your hip joints are shaped funny and it’s causing you problems. I’ve written about it a number of times already on my blog and talked about it on YouTube and discussed how I think this is a pretty shaky diagnosis just based on the way it’s diagnosed, the sheer number of people I have seen diagnosed with it, my own experience with my hips having the same symptoms, and discussions with people who have had it or have surgery or reading people’s experiences from doing the surgery.

I’ve also done a bunch of reading into the tests that are used to determine whether or not somebody has this condition. And in general if you’re reading between the lines and are reading carefully, it’s pretty clear that the methods that are used to establish this diagnosis are pretty questionable. And, then, moving from there ,the outcomes of the surgery, just from the anecdotal stories you read, nobody should go into one of those surgeries or any major surgery thinking that it’s going to be a walk in the park for recovery. So, there are two things I wanted to cover today. One is the philosophical/practical thoughts I have about orthopedic surgery and the other is actually I wanted to share a story that inspires this particular episode.

I actually received an email back in September from a woman named Jill in the UK. I’ve never met her, we’ve not spoken face to face ever but she sent me an email to thank me for doing what I do and she shared her story with me and I was very very touched to read the story and also really happy that she went into such detail and touched on a number of major points that I think people need to keep in mind. In general, when thinking about orthopedic surgery, my personal opinion — you can agree with it or disagree with it at own peril — is you should avoid orthopedic surgery as much as you can.

Actually, many surgeons will tell you as well, if you can avoid getting the surgery avoid it. I have had people tell me, ‘oh, my surgeon said maybe this could help but maybe not, so, I wanted to come try to make my body move without the surgery’. I don’t want to come off saying that my opinion is necessarily controversial on this, there are orthopedic surgeons out there who are really straight forward with their patients and these are the people you wanna see and they will tell you that a lot of orthopedic surgeries are not a sure bet.

Cutting into your earth’s suit, as I had somebody call it, cutting in your earth’s suit is never a good idea, right? Just don’t cut into your earth suit. You need this thing intact in order to survive. A lot of these surgeries are done to hopefully help a movement problem and to help a pain problem. Usually it’s the pain problem but the track record on all kinds of orthopedic surgery is a little shaky.

The clearest example of this is for back surgeries for the last twenty-three years. Back surgeries are really really popular and very common treatment for back pain and basically what was done was pathology — something wrong was found in an x-ray or found in an MRI — Identified, circled, a very scary sounding report written up and then that patient was then told you need to have surgery in order to fix this back pain and it will fix this back pain.

Over the decades, eventually, some studies were done to really carefully examine the outcomes of this surgeries, and it was found that the surgeries where kind of a crap shoot in terms of relieving back pain and that doing an MRI and/or an X-ray on somebody who has back pain actually severely increases the risk of having more back pain, and more severe back pain. It took a while for the science to catch up on that but in the end in modern day, in our times now given all that research, back surgeries generally not recommended for back pain because it usually is a, like I said before, crap shoot.

My general theory is, look, you need to avoid surgery as much as you can because it’s not a guarantee, there’s a recovery time from surgery and basically when you do a surgery you do damage that just cannot be undone. Whereas if you do things on your own attempting to stretch things, re-train your body to move well, to deep tissue work trying to get muscles learn to fire correctly. Even if that fails you could then go back and say, ‘I give up! Give me the surgery I really need it’.

Now, the story I wanted to share is fantastic. So, I’m gonna read some of the email to you from a very very … brave woman named Jill. So, here we go. She says, ‘I was just by chance looking on the net and came across one of your videos about labrum tears and CAM impingements in the hip having both hips been diagnosed three years ago and having read nearly everything on the net to help myself from having the surgery. Both my sister and my niece have had so many surgeries. My sister had nine operations and she is still in so much pain and is basically -oh man this is terrible- and is still being told she’s going to have a hip replacement in the next few years. You can understand my apprehension. I saw the same consultant about my hip and I did inform him that I wasn’t happy with him doing anything to me as his failure to help my family had worked’. I think he was a bit shocked, this is me speaking, if I were that doctor I would be pretty shocked too.

Back to Jill:  ‘then he told me I would end up with arthritis, you have to have new hips within a couple of years if I did not have surgery soon. I am still going and I am better than I was’. This is me again, she had this consult three years ago and after three years she is now better than she was, so, just want to make that point clear despite having been told that she would end up with a hip replacement and terrible arthritis, she’s three years out much better than she was before that without the surgery.

Back to Jill: ‘I’m glad so far that I walked away. I have a wonderful physiotherapist who helps as my pelvis seems to be unstable and I have a sacroiliac joint that seems to go out every now and then. I had thought that if my pelvis was more stable and aligned it would keep my hips working. They are much better but I still don’t feel a hundred percent right’. Then she says some very nice things about me, which I don’t need to share with you and then in the follow-up email she elaborated a little bit more on her views of surgery.

When I replied to her I told her that I thought she was really brave to actually say what she said to the doctor and to not do the surgery based on what he was saying about arthritis and impending hip replacement and her response was great. She said, ‘I have sort of thought I was more a coward not to have surgery and I was taking a huge risk by not having the surgery. Having seen what surgery has done and seeing my sister and niece being put on morphine patches as well as other drugs on crutches and still in such pain with every step. I just had to read, read and read nearly every night on the net trying to understand these problems’, and here’s where I think is great, she says, ‘once you’re on that route of surgery there’s no way back. The mechanics are changed and as I found out from one National Health Service research paper’, again she’s in the UK, ‘I discovered that the patient ends up committing themselves to numerous surgeries and most probably within five to ten years will have a new hip. It doesn’t seem like preservation of the hip to me at all but it is almost butchery. I know that’s a strong word but seeing what happens close up and not actually meeting anyone that is worth for, I’m not going to be a guinea pig. My CAM impingement and labrum tears stay in my hips’.

She then notes, ‘other studies done of cadavers show hip impingements and labral tears and while alive these people have no pain in the hips, so it doesn’t make sense. There has to be another route than surgery. It’s a new surgery and has major risk and even my physiotherapist who sees a lot of patients post-op says that having a new hip is the easier operation’. So she’s saying a hip replacement is actually easier and the physical therapist is very concerned about the numbers of people coming to her in awful pain after arthroscopic hip surgeries.

So, she just about covers everything, I mean everything that I would say you need to think about. The outcomes are never guaranteed, once you’ve done it you can’t undo it and the diagnosis itself for this types of issues are pretty shaky. I grant you that there are probably some situations where a surgery is necessary. I actually have had one client who had some pretty pretty bad stuff going on with his hip and nothing seem to really help and he did end up having a hip replacement surgery, but if you’re somebody who is pretty young — and I’m gonna say anything under 50, probably anything under 60s still — and you’re having hip stuff, or having knee stuff it would be a good idea to very carefully go through the research and see what you find on how these surgeries turn out.

This woman Jill, I don’t know how old she is but she does have a niece so I’m assuming she’s somewhere in that under 50 range, she did her research and she found some things that aren’t so good and she’s seen it up close. She came to the same conclusion that I came to which is ‘Don’t cut into you earth’s suit unless you’re absolutely absolutely … have to’. Jill closed her email and says, ‘At one point I was walking with a stick and not too far and it was just one of the hardest times so I had to find another way. I had to find another way to get better, and now,’ three years on, ‘now I go for at least two one hour walk a day with my pair of red setters, as I’m walking I try and do my exercises, there are days when it’s not quite right in my legs and hips but I try my best. It is something that I realized that it is a commitment I have to do as many times a day as I can to keep myself upright’.

So, I wanted to share this email with anybody who’s got the hip problems, who’s got different orthopedic issues that they’re facing especially those who have run into hip impingement issues. This is a really great email from a woman who really has a good head on her shoulders and who made an obviously very strong decision and she is now much better off for it.

So, Jill thank you very much for your email and thanks for sharing your story and to all you listeners thanks for listening. I hope you remember that, ‘Pain Sucks, Life Shouldn’t’.


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.