Femeroacetabular Impingement

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  • @Moozer my initial diagnosis came from a physio and a physical examination who had FAI himself and he said he was 99.9% certain I had FAI.  I then had MRI and the dye x-ray which only picked up a tear in my right hip and I was told I did not have FAI and that i'd be fine to keep running which I did for a further 6 months.

    When I finally got  a referral to see my consultant he did a simple x-ray there and then and said he could see I had CAM & PINCER FAI and that I should stop running immediately

    It wasn't until he actually did the arthroscopy a few months later that they also found stage 3 arthritis and a large tear. CT scans, MRIs and x-rays don't always pick things up, the only way to truly know what is going on in there is to have the arthroscopy. I wish you all the best with your surgery.

  • @Parklife so you are 7 weeks post op, how is your hip? Have you returned to work yet? The worst part of all of this is to go through the arthroscopy with high hopes you will be back running and then to find out that running is off limits. Those who come out of this the other side and are able to make that return to running are so lucky. I miss it massively! there are other sports - like you say swimming and cycling are good low impact options. Ive booked myself on an open water swimming course in the summer in the Lake District with the aim that in 2014 I will do a relay team Triathlon (just without the running part)!

     

     

  • @Pipes

    Hi I'm home, had a bad 1st night at home, the hospital discharged me on paracetamol and codeine and it just didn't take the pain away. Back to my GP yesterday and got my trusted combination of tramadol and naproxen which works and has enabled me to get some sleep.  This side seems much more painful recovery wise so far. I've aldready felt pain in my reviously operated 'good' hip - I supppose given the fact its only 6 months in after my right arthroscopy  & the OA I have in the right side it's kind of inevitable I will feel some discomfort - not sure it's up to the job of supporting my left hip. I'm just making sure I rest a smuch as possible. Good thing about tramadol is it just knocks me out so no trouble on that front!

    How did you find your recovery 2nd time round?

     

  • @markstrickland

    Don't know about you but the spinal helped initally but once it began to wear off my post op pain has been worse this time round. I can remember waking up in recovery and being really scared beacuse I couldnt feel anything down below!! Not what you want to wake up to!

    It'sgood that you went home the same day, I had to beg them to let me home Day 2 as they wanted to keep me in another night because my BP was low and  my pain was not under control. Wonder what makes an easier recovery? Sounds like if your hip was a bit of a mess they must have done quite a bit in there? What was their prognosis? Will you be able to run agan? Did they find any OA?

    The boredom is the worse part although right now all my body wants to do is sleep. The tramadol knocks me out!

     

  • Love running welcome home and don't expect too much of yourself initially! If the doctors give you a rehab protocol i think 'little and often' was a good rule to go by for me.

    Back to work last week, still with a hobble. Hip seems ok, pain at the mo mainly consists of twinges. Major life change indeed not being able to take on long distance running though i haven't ruled out 5ks/parkrun as a possibilility but its forced me into seriously considering cycling and learning to swim and a triathlon has crossed my mind too but am ahead of myself! My immediate aim is to rid myself of the hobble.

  • Loverunning, everyone's response is different, to a GA and invasive procedures, still think it was bad practice they never gave you spinal when awake, for exactly the worry you had when you woke up, I have felt pretty tired for the last week, not sure why as I stopped paracetamol and ibuprofen on day 3 post op prob the boredom and rest is the cause.

    I didn't get any proper feedback from surgeon apart from they stiched down the laberal tear and shaved of the impingement, there is some degree of arthritis, I'll wait till my 4 week follow up for the full debrief, I hadn't been running much for the last year down to sheer laziness, but if I'm allowed I'm going to restrict myself to 5kmwith the odd 10k, and lots more mountain biking.



    Park life- your first paragraph is spot on, I think too many people want to run before they walk, excuse the pun, but take each days it comes and don't expect miracles, its a major procedure, but because its arthroscopic i think some don't see it that way.



    Wish you all well with your recovery..
  • Does anyone know why cycling is seemingly permitted before surgery ? I would have thought that it is still causing the bone to bang in to the cartlidge.

    Parlife did the consultant who you visited last week say how long the hobble should last for ?

  • Moozer- As far as i'm aware its all to do with avoiding hyper flexing of the hip, and its not high impact.
  • Moozer i think its largely down to you - if it doesn't make the pain worse then it should be ok. I used an exercise bike non-stop for months when it became impossible to run.

    I think seat height is part of it, a lower seat means more likelihood of 'nipping' by the unshaved bone.

    I get your point though, the femir and pelvis still moving at an angle to each other so you'd have thought there was a chance of 'nipping' taking place if irregular bone matter.

    I think impact is part of it though, the cartilage has been torn and is weakened. Impact from running impacts it further but cycling has less impact. Thats why ive been told to concentrate on cycling for the long term as my cartilage, although repaired, is now weaker and less able to withstand cycling from running.

    Consultant said the hobble likely to go when i get on with my rehab. Physio to focus more on muscle strengthenu=ing from next week. I think its getting better at an almost imperceptible rate

  • Love running, hope you are getting on the mend!! A quick q as you were also under Mr Conroy. Did Harrogate arrange you physio or did you get it via your own doctor, they didn't seem able to advise when I enquired.

    Hope everyone is on the mend!

  • Hi Rebecca, I'm doing good, had a very painful 1st week post op but my 2nd week is much improved. Still resting & not really left the house yet - boredom is setting in!!



    They will ask you when you are admitted which hospital you want to be referred to for your physio. It's entirely your choice. The morning after your surgery the hospital OTs will come to see you and get you up and walking on crutches. They give you a leaflet with some basic physio exercises to do in week 1 & 2. Once discharged they will send off a referral to your chosen physio. They then write to you and you ring and make your 1st appointment.



    I've chosen wisely this time; last time I just chose the hospital closest to me but the physio was not that good. This time I've chosen mid Yorkshire hospital as they have a state of the art rehab centre with gym and hydrotherapy pool and done good physios. My first appointment is next Tuesday.



    How is your hip? Any news on a date?
  • Hi Loverunning, I hope you can get about a bit more. This week it is bad for some reason, constant twinges and stabbing pain. I have been getting about fine since diagnosis and using cross trainer...im sure it gets worse when I have been swimming though.

    Sometime if I have been sat down all day then it is worse. It is mostly stabbing pain in side of him and front of thigh that I seem to get. I guess the challenge with physio is making sure you get someone good and it is easy to get to (as in no chance of driving) not being able to drive fills me with dread, but just want to get it all sorted now!

    Still hoping for late April for opp, but I know there is still a long waiting list.

    Keep cheery !!

  • Hi All,

    Good that this week is better for you Loverunning.

    Rebecca Stanley what stroke do you swim ?. I have been swimming 3 times a week for the last 9 months, I just swim front crawl as Breaststroke definitely aggravates the hip. I noticed at first that when I was turning and kicking against the wall to turnaround it ached my hips afterwards so I just manually turnround now and it is fine.  Walking hurts me more as there is more weight on the hips than swimmimg with your legs more or less straight.

    I have just found a good website for post op rehab if you are like me and forget the exercises that physios gives you the moment you walk out. They are on a surgeons website he is called Damien Griffiths and they are very detailed and easy to follow. I have my surgery on Tuesday and the pain in my bad hip has almost gone, however the other side has flared up big time. Just a question for everybody what painkillers/ Anti inflammatory have or had you been taking pre op ? And how often ?  

     

     

     

  • Moozer I ended up on tramadol at night before my 1st op due to the pain and they worked brilliantly; downside is they made me feel like a zombie the following day!!

    Post op I was also given naproxen (anti-inflam)

    I use a combination of the 2.

    However, its all trial and error as some people really cant tolerate tramadol and naproxen.

     

  • I've written an article which has been published on sportsinjurycommunity.wordpress.com to raise awareness of FAI and the early onset of arthritis. See link below.....

    http://sportsinjurycommunity.wordpress.com/2013/02/25/catherine-dale-bilateral-hip-fai-and-early-onset-of-hip-arthritis-running/


  • Thats me off to the hospital now. The pain on my bad leg still not hurting ? Interesting what they will find when they go in with the camera. 

  • Moozer - all the best with the op.

    loverunning - I got a bit emotional reading that. I'm obviously one of the lucky ones who went through the diagnosis and referral process relatively easily and recovered well from the surgery, but the thought of never running again certainly crossed my mind on many occasions.  During the many months of pre-op and rehab I did re-stoke my passion for cycling though, and I consoled myself with the thought that if and when I can't run any more, there will definitely be something else I can channel my energy into.  I'm sure with your attitude you will find the same with swimming or whatever floats your boat!  image 

    It's a great article by the way.  Hopefuly it will come up in a few people's internet browsing, answer a few questions, and get many more more injuries correctly diagnosed and dealt with.

  • All the best moozer,  let us know how your post op recovery goes, and use what painkillers your offered, painfree is good for the mind.......

     

    Loverunning- good article you wrote , im due back at surgeon on 7th March, so i'll see what he has to say about a return to activity, ive resigned myself to only doing 3miles if im allowed to run again and make use of my mountainbike more often, i feel my recovery has been pretty good, only a mild tightness in the area affected but ive had no symptoms of  past (so far)which can only be good.

     

    M

  • OUCH.

    Well just got back from the hospital, totally mad 24 hours seeing various people coming and going, excuse me if this does not make sense as I have had no sleep and quite a few hits of Morphine. I got taken for surgery at 2pm, woke up in recovery at 4pm in mega pain that made me swear out loud and I was shivering quite a bit so they hit me with morphine and warmed me up a bit. The surgeon then came to see me and told me that it all went well. He said I had a severe Labral tear and hardly surprising I was in lot of pain last year. He stitched it back together and shaved a tiny bump that caused it. He said I had a small scuff of cartilage damage so no arthritis. Because of the Big labral tear he wants me on crutches for 5 weeks with 20% weight bearing. Hydrotherapy to start next week and just basic leg shuffles for the first 5 weeks. He said that what he did will definitely shift the pain that I had been getting. I was relived if that makes sense as I said on here earlier the pain was non existent for the past 5 weeks so I wasn't going MAD after all. He gave me photos of the work as well!!  I could not sleep last night and the nurse who was on duty was a credit to the NHS, Every 2 hours bringing me another liquid morphine shot which sorted the pain out. They put something around my ankles for DVT that kept buzzing all night so that's why I couldn't sleep. 

    Loverunning I have read your article and Like Phil said I hope lots of people see it.

    I think that when people type in to google groin pain symptoms it would save a lot of time and pain if FAI was mentioned with the other possible causes. Hope the swimming goes well for you. I am going to do the windermere mile swim this year.

    Im off for a couple of pints then going to get my head down. 

     

     

  • Best of luck Moozer, thats good that you seem to have minimal cartilage damage. Have to say I stayed off all booze for 6 weeks post-op(even over Xmas) just thought it was a wee variable factor my wellbeing could do without. But then if I have one pint it usually ends up in 6.

    Mark S - will be interesting to hear what your surgeon says about return to sport and what type of sport. I've been asking and pondering this question a lot.

    Loved your article loverunning it really hit home and struck a chord i thought you summed a lot of things up very well.

    As for me, had my review with NHS doctor today(he who referred me privately). A mixture of emotions. He thought I was progressing well at 9 weeks post op compared to others he has seen. He didn't rule out a longer term return to longer distance running he said we should keep an 'open mind' and see how I go. He seemed to think the bigger problems is with those who wish to return to twisting and turning sports like football. He said that with modifying my training - using tread mills/ running on grass there is a decent possibility. However I think I have largely resigned myself to vastly reducing my running and modifying my training to cycling and learning to swim I wonder if triathlons might be a possibility.

    On the down side, he felt I had an increased risk of arthritis later in life due to damage to hip joint. Don't know why but this has sullenly played on my mind and reinforces the need for modifying any training and to be ultra cautious with running. We also discussed the possibility of needing the same arthroscopy on the other hip which has been xrayed as having fai can't say the thought of that enthralls. He also said that in his experience the procedure works in the short to medium term in getting rid of pain but he has had some people where symptoms can then begin to return. I only thought after; perhaps these were people who return to twisting and turning sports he was referring to, as he was more positive about long distance running??? He gave me atimeframe of 6  months for full recovery .

    Pain levels much reduced generally, but just can't seem to shake the limp. Physio has given me more exercises to do on this - mostly focused on glutes and in particular a poor glute med. I think it may be ever so slightly improving.

    Overall I feel pretty good and progressing not too bad. I think the appointment today has just reminded me of the need for future caution, I had been thinking along those lines anyway. I was asked in work yesterday was I glad I went for the op and I'd have to say that my answer at this relatively early stage would be a positive yes. Hope it continues that way though the fear of setbacks never far away!

    All the best to those recovering or pondering or awaiting surgery.

     

  • Hi All.

    Well that's me 1 week gone. The swelling on my leg went after a few days which meant I could shuffle around on my crutches a lot easier and pick up a bit of speed on them. Watch out Oscar. The pain has been okay just every now and again I get a deep throbbing pain usually when I am reading in bed. I am taking Ibuprofen 3x400 and normal paracetamol. I feel like i don't need to but am conscious that the pain could return so will keep taking them for another few weeks I think. The only physio I have been told to do are basic leg shuffles, bridges and standing next to a chair and moving my leg/hip to the side. I feel I could do more and have a new exercise bike I bought the other week which is gathering dust. My surgeons Protocol is 20% weight (crutches) for the first 5 weeks and only the basic 4 shuffles due to NO hip flex ion beyond 90deg and NO forced hip extension both for 5 weeks. I feel like I could do some gentle cycling with no resistance but Definitely would not want to risk damaging the work the surgeon had done for me. Would I be right in saying that it  would be quite easy to damage the hip again at this early stage ? Or would you have to do something quite silly like climbing up a tree. The reason I ask is that I am on the same protocol as someone who has more advanced work on the hip done ie Micro fracturing etc.  I have been told by the surgeon I can start Hydrotherapy when I have my stitches out so have booked an appointment for next Tuesday which I am looking forward to. My other hip is playing up quite a bit and the surgeon says he will sort it out for me if it needs doing once this one is better. I have given myself a daily routine which is all timed as I figured that would help me with boredom. So its wake at 8am read papers and books in bed until 11am, physio, watch a film, sit in the garden for fresh air 1 hour, physio. read more then watch TV. I got offered a ticket for Old trafford tonight but had to turn it down as 76,000 and crutches don't mix. GUTTED. So 4 cans and HD it is. . 

    Parklife I really hope your limp is getting better as once that goes then it will be a massive confidence boost and more proof you are making good progress.

    Hope everyone is keeping positive and please keep posting about your recovery/ thoughts.

  • MarkStrickland - hope your appointment tomorrow goes well and you receive the news you want to hear about a return to running. Let us know the outcome image

    Parklife - It's great news for you that running hasn't been ruled out completely. With your increased risk of developing OA and FAI confirmed in your other hip It's got to be about finding a balance between getting your running fix and preserving your hip joints. Like you say modifying your training and doing more cycling/swimming/cross training as well as running may be the way forward. 9 weeks is still very early so don't be too disheartened about the limp. Keep at your PT and things will improve.

    Glad you liked my your article, I found it really cathartic getting it all down on paper and even if it just raises awareness with 1 person I will have achieved my aim.

    Moozer - how are you doing after your op? Cabin fever set in yet?? There are so many different protocols out there post op from different consultants. A lot of the US Consultants have you on a bike just hours after the op!! It was a good 10 days before I felt even ready to contemplate getting on a bike!! I'd say stick with the advice from your consultant and when you see your physio have the converstaion about maybe doing more. Everyone's recovery is different and it's hard not to compare your progress with others. Remember though that your hip & muscles need time to heal and as a guide the advice is limiting activity for the first 6-8 weeks as much as possible (no prolonged standing, sitting, crouching etc).Hydrotherapy should help too. 

    Rebecca Stanley - any news on your op date yet?

    I'm 3.5 weeks post op and must say that this recovery is much smoother than the right I had done 6 months ago. Comparing the two, I can see how hip arthroscopy can really work in reducing symptoms/pain in hips with no or very little arthritis. The impingement pain has definitely gone, still sore and stiff but have a great physio and this time i'm really focused on giving 110% to my rehab by resting, not over doing it and doing the daily PT exrecises Ive been given.

    At 2 weeks I had my first physio appt and was given the go ahead to get on an exercise bike with no resistance. At 3 weeks I've seen a big improvement in my ROM and at this stage my most recent operated hip actually has better ROM in some movements than the hip I had done 6 months ago!! Must be the presence of arthritis which has vastly reduced my ROM. 

    At the moment I've got to do 20 mins a day on the bike with no resistance and a whole load of PT exercises which is keeping me busy! Still not allowed back in the pool yet. Physio says I need to strengthen my muscles before getting back in the pool and will reassess at my next appointment  at 5 weeks post op.

    Booked in for my follow up appointment with my consultant on 9 April.

     

     

  • Hi all hope you are all reovering well, love runnings, sounds like you are doing well.

    I have just heard about my op with Mr Conroy, booked for 22nd April....hopefully we will have nice spring weather for me to recover in.

    I am moving house too...bound to co-incide with the op so that should be fun on crutches!! image

    Happy recovery to all

  • That's great news Rebecca, fingers crossed for some spring sunshine! Plenty of notice too to get organised. I moved house during my op last year, wouldn't recommend itimage
  • Are there any particular pre-op things you recommend...?

    Re moving, ill just direct people with my crutches image

  • Before your op just try to stay as healthy & fit as possible as I'm sure it helps in your body's ability to recover quicker. In the week leading up keep really well hydrated & freeze some home cooked dinners which you can just put in the microwave post op.



    For your op make sure you take some snacks, comfy clothes to go home in (joggers & slip on shoes) & some face wipes. Post op arrange some help at home for the 1st few days/1st week, invest in some books, magazines, DVDs etc & where possible sleep downstairs.



    Sounds very sensible re the house move approach!!
  • Ahh thank you....ill start training my husband in all house hold duties (hee hee) What do they do at the pre-op?

  • Yes you should have a well trained hubby by the end of it; silver linings and all that!!



    Pre op they take your bloods, BP, urine sample, weigh you generally just make sure you are fit for surgery and they'll talk you through the op and what to expect. Nothing to worry about.
  • Had a bilateral hip arhtroscopy last May.

    for 3 months in lead up did massive amount of hip flexor/ glute strenthening.  This was in an attempt to see if I could sort the issue without surgery. It didnt prevent the need for surgey but it was a major factor in allowing me to be back running within 9 weeks and Half Marathon within 16 weeks post op. Pushing the envelope according to surgeon but no real issues. 1 year on, apart from glutes that want to sleep for a week or two at a time that need kick starting I am easily more advanced in running compared to pre op.

    Hope this helps.

     

  • Loverunning: Consult went well, he was amazed at how well i was mobilising, told me to continue rehab as im doing and all should be ok, i asked about running and he said to come back to him in 5 months and we could discuss it then, it would be silly to try now when things are going so well.

     

    Ive been told i can swim and do a bit of easy cycling, physio has given me stretches and strengthening excercises to continue with so im going to follow instruction.

    Back at work on the 26th of this month, light duties for a month then back onto the helicopter, where i think i'll find if everything has worked out well.

     

    hope everyones recovering well.

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