My Hip Surgery

By Alix Jean Shutello

This is the first time I am writing about myself in a deep and personal way regarding my recent hip surgery to fix a labral tear. Interestingly, after I told the story of my journey of how it was even discovered that I needed hip surgery, many of my friends said I needed to write about it.

I realized that all of us, whether we are athletes or not, may have issues with our bodies at some point in time during our journey through life – and while I am not a trained psychologist or physical therapist, I am a runner with over 30 years of personal experience and a certified running coach who has coached people to successful races. I hope that you find this story helpful if you find yourself in a similar situation.

The Young Hurdler Turned Cross Country Runner

It all started many years ago when I was a young athlete starting out as a hurdler on the Watchung Hills Regional High School track team. I have no idea why or how I fell into doing hurdles, but I loved it. I competed in the 100m and 400m hurdles all through high school. In my senior year (1986), I took to distance running and joined the cross country team. I wasn’t the best on the team at either of these sports, but I finished in the top two-three on my team for all of my events, and therefore held a decent status in both track and field and cross country.
In college I joined the Syracuse track team. Let’s just say that was humbling, because I jumped into one of the country’s top running programs and found myself struggling. Between issues juggling a poor self-body image, bad eating habits, and that fact that I really couldn’t keep up with the training, I eventually dropped out of the program. To get over that failure (at least I thought it was a failure), I decided to train for the Boston Marathon as way to redeem myself. I didn’t think much about it, I just did it, and was proud to complete my first marathon at age 18.

My sister, Amy, and I at the Marine Corps Marathon

After that I ran recreationally and enjoyed the sport for what it was – my sanctuary to reduce stress and keep fit. I didn’t feel the need to run marathons; just shorter races for recreational purposes. I was also a veteran equestrian and competed for the Syracuse equestrian team. I worked off horseback riding lessons by mucking out stalls and cleaning barns. To this day running and riding are two of my favorite sports.

Fortunately, during all those years of running competitively for high school track and even for the Syracuse track team, I never had bad injuries. When I was a senior in high school I probably had what chalked up to tendonitis of my knee, but aside from that, whenever I went to the doctor for issues concerning pain, all they told me was that I didn’t have an injury, but that my patella was in the wrong place, or my femur bones were too long and that I probably shouldn’t be running.

So I just kept running. The only anomaly I ever noticed about myself was that when I did leg lifts, my left leg would click as I lowered it to the floor. It didn’t hurt, it just clicked and felt weird.

Running into Motherhood
It wasn’t until I got married that I decided to run my second marathon, the San Diego Marathon, some 16 years later. I had no problem with training for the race and used a run/walk method to train. I ran that marathon two months pregnant and had absolutely no issues except for some tightness in my left hamstring.

I ran my first 5k nine months after having my first son. Aside from feeling grossly out of shape, I finished the race in under 30 minutes and started building back my fitness. I had my second son three years later and started training for longer races, like the Cherry Blossom 10 miler, and fell in love with that distance.

Through all of my training, I was never running crazy distances, even though my friends and family assumed I was out there logging 50+ miles a week I wasn’t. Between work, motherhood and my hamstring pain, I really had trouble for a number of years finding the right type of balance in my life. Through all of my training and competitions through the years, my left hip still clicked when I did leg raises, and the top of my left hamstring always seemed to give me issues. In fact, I started a blog entitled Tighthams named affectionately after my left hamstring. Little did I know I didn’t have a hamstring issue per se….ah what little we know about our own bodies.

In 2010, I ramped up my distance training. With my boys out of the baby stage. I felt it was time to start competing more often. I turned my focus to endurance running. My goal was to kick out a few marathons and then try to do a few ultras, but my efforts were hampered by pain on my left side when I ran training distances of 16 miles or more, and worse, I started to experience a bad tightening in my right calf. Those issues would lead down a very long and painful road to discovering I had a major injury which needed surgery.

Labral-Tear-of-the-Hip-Joint2011: A Stellar Year turns to DNF
In 2011, I had a stellar year. I ran some great races. I had a personal record (PR) at the Cherry Blossom 10-Miler (1:27:39), a PR at the Falmouth Road Race (sub 1-hour), as well as a PR at the Wilson Bridge Half Marathon (1:56).

In fact, things were so good I decided that I should run the Marine Corps Marathon (MCM)! I trained diligently, but experienced pain in both of my calves where they’d tighten up to the point where I’d have to stop and walk. It was a hot summer (aren’t all Virginia summers hot?) and I figured I was dehydrated. Again, just like lst year, the pain would start when I’d run longer than 16 miles. The fits and starts with my running hampered my efforts to get in he distance training in that I needed to be successful at the marathon.
Despite the issues I had, I went into the MCM somewhat confident, meaning I had my strategy in place but really worried what would happen after 18 miles or so. What hung heavy in the back of my mind was wondering what was going on with my legs.

I trained as best I could for MCM, but frankly the calf pain on both legs really sucked the mojo from me; and this was a big race I had talked up to everyone. My sister came in from New Jersey to support me. My whole family and long-time running partner, Christine Erbacher, were waiting for me, at mile 18. Christine was poised and ready to run miles 18-26 with me and I was amped up despite the physical issues I was having. I had my whole race planned out in my head and planned to hit certain milestones. I was ready….until I wasn’t.

Unfortunately, as you might guess, the MCM was a disaster. My body failed me at 13.5 miles. My goal was to run the first part of the marathon in 2 hours or under. After I completed 10 miles, I started to feel fatigue in my calves.

Christine, who was following my pace online, noticed a big drop-off after mile 12 when I wasn’t keeping my 9:30 pace, and knew there was something wrong.

I tried to eat my way through the pain, worried that I was dehydrated. When that didn’t work, I didn’t panic, but I had to start talking to myself about the pain and how I was going to work through it. I doubted my decision to run a marathon in shorts when it was 32 degrees andthought that maybe my calves were cold. However, I’d run other shorter races (like the Cherry Blossom 10-miler) in freezing temperatures in running shorts and was just fine, so I trusted my decision – that is, until I started to hurt.

Teaching Moment: When pain sets in earlier than you expect it to it can wreak havoc on your mental game. I was prepared to walk during the marathon if I needed to as part of my race plan, but only after 20 miles if my pain was really bad; I certainly didn’t expect that I’d fall apart earlier than that.

By mile 16, both of my calves seized up so badly that it felt like my calf muscles were torn from the bone. Unfortunately, because it was so cold, I started to shiver violently when I stopped to stretch my calves. When I passed my family at mile 18, I was preparing to change my race plan. I was so embarrassed – everyone was there waiting for me and here I came looking like I wanted to cry. Christine joined me, and about a half mile later I had to stop. I couldn’t stand up, but sitting made me cold. Poor Christine was helpless, because there was nothing she could do at this point except stand by and watch me go through the mental anguish of pulling out of the race. God love her, she stood with me while I tried to regain my composure, but in freezing temperatures, a sweating human body at rest wearing only a t-shirt and shorts will start to go hypothermic almost instantly. I pulled the rip cord and just walked off the racecourse, disgusted and in tons of pain. To add insult to injury, Christine didn’t get her training run in and my family stood in the cold for nothing.

2012: Success on the Trails and Tears on the Sand
I took some time off after the MCM to heal and figure out what to do with myself, and over the winter, I started training again. In June 2014, I completed my first trail race, The EX2 Off-Road 10k. It was a hell of a hilly race and all I wanted to do was break 60 minutes. Not only did I do that (my time was 58:28), but I came in the top four women in my age group and actually made the podium (and then of course I got mad that I didn’t really apply myself and thought I could have done better!)

I attribute the success I had at the EX2 to a speed training program I joined with the Potomac River Running Store in Burke Lake, Va. and my coach, Kelly Kavanaugh.

Unfortunately, we were all so dedicated to the class, I joined our sprint session at 4 p.m. the day of the EX2 10k. All I can tell you is that I overdid it. Something popped along the back of my left side (obviously not my hamstring or I would not have been able to run at all) and after that afternoon, I had to slow things down for a few weeks just to make sure I didn’t force my training for my next Falmouth Road Race in August.

There is no proof that this was the day I tore my labrum, but let’s just say after that fateful afternoon, things got progressively worse. My Falmouth race was okay but slower (I was trying to run the race every year) because I could not kick it in during the finish.

I was signed up for the Gulf Beach Half Marathon in Milford, Conn. on September 25, 2012. Training for the half proved difficult like it had for the MCM. While I could run up to 10 miles with no issues, it was beyond that where I would have complications. Pain in my calves would start and soon I’d seize up and would need to stop and walk, but I went to Milford motivated because I was running with my friend, Barb Murillo, a very strong endurance runner. After 7 or 8 miles, I started to feel pain and at my regular 10-mile threshold, I started falling apart and pulled back.
The race was painful and difficult. I crossed the finish line in tears due to pain in my calves. My time was a disappointing 2:08:53, over 12 minutes slower than my race at the Wilson Bridge Half Marathon a year earlier. I was starting to slow down and couldn’t figure out why; so I went back to the drawing board, took some time off and started training again.

2013: A Pseudo Year Off
In 2013 I ran some decent races as long as they were less than 10 miles, all of which ended fine but with a lot of muscle tightening in my calves and feet. I even went to the doctor to have my
plantar fascia looked at, since by now issues with my feet were more chronic than with my calves. That proved to be a useless endeavor. The orthopedist didn’t send me to PT and I decided to go on my own. The cool thing about The Jackson Clinics here in Northern Virginia is that that they were able to analyze my running form. From there we learned my form was good, but they noticed some weakness on my left side, which wasn’t surprising. We worked on some basic exercises for my hips and calves. I did them, felt stronger and went back out there and tried to be more balanced in my approach to running and strength training.

2014: Rest, then Training, Doesn’t Work
In 2014 I started off strong in the spring and ran a PR at The North Face Endurance Challenge 10k in June. However, as I trained through the summer, I (again) was hampered by my calf AND plantar fascia issues.

My performance at Falmouth in August was terrible. I shook it off and concentrated on my next race, the Rohoboth Half Marathon in December. Training for half marathons is relatively easy for me, but on one chilly November evening Christine and I went out for a long run. We were moving along so well, until at mile 8, my feet just cramped up. The pain was unbelievable and I stopped to walk. Christine ran ahead and finished her 13 miles. I choked out 10 or so before calling in a ride to get me home.

I really considered dropping from the race, but Rohoboth is extremely expensive; so I took a couple of weeks off before the race and decided to power through. Frankly, although I was absolutely dying in pain, I ran pretty well. My time was 2:05, but I pulled up at mile 9 allowed myself one minute to give my feet a break from the pain. I knew my middle miles were slow, but after I took my break, I averaged an 8:46 pace for the last five miles. After the race I had a masseuse work on my feet. She said she honestly didn’t know how I ran, considering how tight my plantar fascia were.

2015: Devices of Torture, Salt Pills and More Pain
In the winter of 2015 I took another 6 weeks off to build core strength and endurance through cross training. In the spring of 2015, I prepped like hell for the summer training season. I did a lot of yoga and added spin classes to my cross training routine. My running was strong, but when I really started to kick up the miles the pain came back again. I ran a local 10-mile trail race and had difficulties at mile 8 with calf pain and tightness in my feet. Same old thing! I was disappointed about the pain but decided I was fit enough to train for a marathon again. I joined the Potomac River Running Distance Training program to prepare myself.

I started off the training program well. I didn’t have any calf pain until my first 14-mile training run. I appoached my coach, Taneen Carvell, and she thought that dehydration might be contributing to the calf issues – especially since my pain subsided after I ran.

enduralytesI incorporated salt pills into my training and I also started rolling out on what I call my devices of torture (foam rollers). Nothing hurts more than rolling out on a studded roller. I had rollers for my feet and my legs and used them to make sure I was improving circulation and loosening my tight calf muscles.

Nothing seemed to work and it seemed my dreams of completing a marathon were fading. One week, my 16-mile training run hurt like living hell. The next week, I’d run 15 miles with no pain at all. The week after that, 16 miles hurt again, and so on and so forth. It didn’t matter if I ran fast or slow or what doses of water/salt/calories I fed myself. The results were the same, and the more I ramped up, the quicker my issues went from acute to chronic. My left upper hamstring was hurting more, but at least my other issues seemed to be at bay – unless, of course, I ran more than 13 or 14 miles.

I designed my training program so that I would run the Yellowstone Half Marathon in September 2015 as a fast training run for the Baltimore Marathon a month later. Then, if I ran the marathon well, I was going to train for the JFK 50k and see if I could move myself beyond the marathon.

Things would not work out that way. I went to Yellowstone very nervous about being in pain, but I was super mentallly prepared. Despite the 6,200-foot elevation, I ran a very solid race and was thrilled at my performance at elevation in excrutiating pain. I ran despite my pain and picked people off one by one until I was about as far ahead of the pack as I could go. I will admit, the end of the race was difficult for two reasons: First ,my time was a lot slower than predicted, but the race was literally 13.1 miles uphill at elevation, so I tried to cut myself some slack.

However, within minutes, after I finished the race I couldn’t even stand up. My calves were screaming in pain to the point where I had to sit down. The masseuse at that race said my calves were pulsating and she wasn’t sure what to do.

Being the stubborn oaf that I am, I was still training for the Baltimore Marathon and needed to run another 5 miles to complete an 18-mile training run, but there was no way I could run anymore. Instead, after my pain subsided, I hiked 5 miles later that day in Grand Teton National Park.

I reported my race experience to Coach Taneen and decided not to run the Baltimore Marathon. I changed my race entry and ran the Baltimore Half Marathon a month later.
By the time I toed the line for the Baltimore Half , I decided to see an orthopedist. I couldn’t run like this any longer. Like every other race, I ran strong until mile 8 or 9 before pain set in. The last 5miles of the Baltimore Half were depressing. I wanted to get the race over with instead of savor the experience. I finished, went home and found some help.

Finally, Some Answers to Long-Term Problems
I ran the Yellowstone Half Marathon extremely nervous I’d fail there. Lisa Smith-Batchen, the famous endurance athlete who is the race director for the Yellowstone races, wondered if I had compartment syndrome, since my pain would subside within an hour or two after I stopped running.

I read up on compartment syndrome and wasn’t pleased. If I had compartment syndrome, there were surgical procedures I could do, but there was no way I’d ever get surgery to fix this type of problem; I’d just need to accept it and relegate myself to 10ks. Endurance running would be out of the picture forever, for running with compartment syndrome and pushing it is dangerous and could create long-term health issues.

So when I started the Baltimore Half, I knew this would be my last race for a while and that I owed it to myself to find help.

I was referred to Dr. Lonnie Davis. Dr. Davis, who’s run a marathon or two, has seen many of the runners in our area. I went to him and explained what happened during the Yellowstone Half. He agreed I might have compartment syndrome but asked me to go to PT to do some strength training on my hips. When I told him about the upper hamstring issue he wanted me to take a couple of weeks off, do some strength training and come back in a month.
I did just that. I shortened my runs to just 3 miles and did the PT dutifully. In late November, Dr. Davis felt that I didn’t have compartment syndrome. He asked to me to a couple of simple tests and concluded that there was something wrong with my hip. I was shocked. My hip?

mcdc7_labrum_jpgDr. Davis told me athletes tear their labral cartilage all the time. In fact, while sometimes our sports is a large factor in causing the tear, that may not have been the case for me. I probably tore it many years ago, just from daily use. Exercise made it worse through time but the body is an amazing thing. It adjusts itself, and in the process of that adjustment, our running form changes. Dr. Davis suspected that my running form changed to take the pressure off my hip, so I relied more on my calves to do more of the work when I ran. My calves (and feet) could take the pounding for only so long, which explains why they fatigued after a point, causing me great pain and tightness. To prove this theory, I needed an MRI.

An MRI and a Decision
Dr. Davis reported in the follow-up exam to my MRI that I had a very severe labral tear, as well other small tears in my left hip. I was so relieved to hear this. Finally, somebody found an injury which was contribuing to my other acute running issues. All the calf-tightening and pain I experienced when running long distances came from adjustments my body made to take pressure off the tear. As a result, I was unaware that I was asking my calves to do all the work.
I asked him, “Can you fix this?” He said surgery was the best option to fix the tear, but that there were no guarantees that the tear would heal properly or, if the tear was really bad, that there wouldn’t be long-term complications if I started to ramp up again; but for most athletes, fixing a labral tear is a routine thing which enables us to resume competition. The downtime, the doctor said, would be three months – mandatory 12 weeks of rehab only – no training, no running, no hard impact period.
I asked what would happen if I didn’t choose the surgery. He advised that there was a possibility of having complications with arthritis and, of course, continued pain in the years to come.
I decided on the surgery at the appointment. Two weeks later, I had the procedure done and have been in recovery for six weeks now.

IMG_7139It’s been challenging for me to not exercise because I am so active – and it will be difficult for me to start training again literally one mile at a time; but three months is a small price to pay for building myself back up again, and hopefully, making a comeback stronger than ever before, and more importantly, willing to go any distance that I choose.

Alix Shutello is the CEO and Publisher of Endurance Sports & Fitness.

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