Montana teen scores football college scholarship four months after hip surgery
The pain
Alex Swenson was just 16 years old when lingering discomfort escalated to pain.
"It was just weird; it wasn't really something I'd felt before," said Alex. "I played through it for my whole football season. I thought maybe it felt like it could be the groin or something.”
Alex is an active teen who participates in football, lacrosse, skiing and surfing. He is used to the bumps and bruises that can come with all that physical activity, but he knew something was wrong when this pain did not go away at the start of his lacrosse season. His parents did what any sports parents would; they took him to an orthopedic surgeon in their hometown of Helena. After X-rays and MRIs, the issue became apparent: Hip impingement and a labral tear were the source of his pain, and it was not getting better.
Hip impingement
As Alex made dynamic moves such as cuts and pivots on the football and lacrosse fields, he had no way of knowing the ball part of his femur, also known as the femoral head, was misshapen. It pinched the hip socket with each move, causing damage to Alex’s labrum, the cartilage that stabilizes the hip joint. The repetitive pinching also caused cysts to develop near his labrum.
Care teams in Helena, Mont. told Alex and his family he had two choices: physical therapy with cortisone shots to manage the pain or surgery. The first option would give Alex a chance to complete his junior year of lacrosse. Surgery meant Alex would "forgo his junior year of lacrosse to get ready for his senior year of football, where he was trying to earn a college scholarship," said Jeremy Swenson, Alex's father.
Making choices
After consulting with his parents, Alex decided to move forward with surgery. He said he had surgery in eighth grade after a lacrosse injury left him with a broken collarbone.
"When I got my collarbone fixed through surgery, it made a difference really fast. So, I wasn't afraid of surgery. I knew this was going to help," said Alex.
Not only did Alex choose surgery, but he wanted to recover in enough time to get back on the football field. It was already late 2023. Alex hoped to return to the field by July or August of 2024. With the time crunch in mind, Alex's father, who works for a medical device company, talked to some industry members who suggested he consult with Ryan Fader, MD, a sports medicine surgeon with Allina Health Orthopedics in Minneapolis.
"What drives me and motivates me is helping people restore their lifestyles," said Dr. Fader, who spoke with Alex and his parents virtually after learning of Alex’s story and reviewing his imaging. He explained what he thought would make the surgery and recovery successful.
The surgery
Dr. Fader ordered advanced imaging, which included an MRI, a specific sequence of X-rays, and a CT scan with 3D reconstructions.
With a 3D representation of Alex's anatomy, Dr. Fader mapped out his surgery plan. In late February 2024, Alex and his father drove an hour from Helena to Bozeman, Mont., and then boarded a plane for a two-hour flight to Minneapolis. They arrived one day before the surgery to complete one final CT scan in preparation for the surgery. The following day, the pair headed to WestHealth Surgery Center for Alex's hip arthroscopy.
"I like to tell the patients that I let the hip tell me what's going on," said Dr. Fader, who performs an estimated 250 surgeries of this kind a year.
Once inside Alex’s hip, it was clear what needed to be done. Dr. Fader first removed Alex’s labral cyst, repaired his labrum, and shaved away any bone on the socket that was misshapen or contributing to the impingement. Once Dr. Fader completed the labral repair, he carefully reshaped the femur, with the assistance of computer navigation, to ensure it fit perfectly into the hip's socket. Reshaping the ball portion of the femur is called a cam resection, and according to Dr. Fader, it is the "most important part of the surgery. When the surgery fails, 75% of the time, it is because of an inadequate cam resection.”
Recovery
The surgery took about 75 minutes. Once Alex recovered from anesthesia, his dad wheeled him out of WestHealth Surgery Center and took him to a hotel across the street.
"It was pretty painful the first night, I remember," said Alex. "But after that, it got a lot better."
"We had two different machines we traveled with. One was a CPM (continuous passive motion) machine that kept his knee and hip moving slowly and aided in reducing scar tissue," said Jeremy. "We also had a machine filled with ice and water to circulate cold therapy around the surgery site."
One day after surgery, Dr. Fader’s team coordinated a visit for Alex with a physical therapist to ensure things were progressing as expected. Two days after surgery, Alex and his dad flew back to Montana.
Thanks to an upgrade, “we went first class,” said Alex. “I was getting wheeled around in the wheelchair through the airport, so it was pretty nice.”
Hard work
Back home with physical therapy well underway, Alex continued to use the CPM and cold therapy machines while relying on help from his parents, sister and twin brother to do things like lift his leg, get into bed, and travel around town.
Dr. Fader likes his patients to start moving right away; many of them use stationary bikes a couple of days after surgery.
"I tell patients the physical therapy component is so crucial to the outcome of hip surgery," said Dr. Fader. "I have a specific protocol that I have my patients follow."
Dr. Fader’s experienced physical therapy team in Minnesota was able to help direct Alex’s care remotely, communicating with his therapists in Montana.
"I slowly started to get around on one crutch, and that's when physical therapy started to pick up a lot more," he added. "The PT started pushing on the gas pedal, and we started doing harder workouts and more dynamic stuff."
Back on the field
Alex stepped back onto the football field, ready to participate four and a half months after surgery. "I definitely was a little nervous, but I knew I was ready to go."
By the end of 2024, the 6-foot, 195-pound outside linebacker had secured his football scholarship to Montana Tech.
"He crushed it all the way through his recovery," said Dr. Fader. "He was super diligent and prioritized his recovery every day."
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