Femeroacetabular Impingement

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  • Hi Rebecca,  I also  had a consultation this morning with my surgeon as I am now 7 months on my right hip and have the tightness in the muscles and throbbing as well.I am also having a steroid injection in 4 weeks time.  I convinced myself that the pain was coming from the Bursa or hip flexor. The surgeon says the joint may be inflamed and that is what is causing the pain and tightness. So the injection will be going in to the joint.  I have not taken any tablets for months now but am tempted to see if that eases it. I forgot to ask my surgeon if my symptoms are normal at this stage. Did your chap say anything positive to you ?  Parklife did your injection go in to the Bursa or the joint ?   Hope everyone else is fine. 

  • Rebecca, steady and moozer

    what an emotional rollercoaster these past 24 hrs have been. By chance I had physio for shoulder injury this evening and told her about the radiographer ordeal yesterday when got the cortisone shot.

    Basically, it appears that the cortisone has significantly helped the limp. Though I am not counting my chickens. Definitely walking more freely. Physio agreed. Such a relief. Physio felt the radiographer was talking out of his ;$e, that a lot of inflammation will not show up on screen from ultrasound. Seems he just had a bee in his bonnet about FAI. And to think I almost agreed with his suggestion not to have the cortisone I would still be limping, and worried it was nerve damage. Strewth!

    Noticed in work today that sitting hunched over a desk tends to compress the muscle so will have to avoid this, and keep the leg straight.

     

  • Yep, Parklife, I find it important not to slump over desk, not to let feet go under the chair, all the things you know you should not do but end up doing, and also to take a regular break so that I stand up and move around for a minute or two.

  • Hi all, Moozer, surgeon didn't shed much light on it really.He said it could be part of the healing from where they dislocated the hip etc. I'm doing well he said as have been back to activities....BUT its the past month (5.5months post surgery) that the pain has started.

    Parklife, sat at a desk all day is the worst, I did that ALL day yesterday and suffored. Its the stabbing and pulling and aches to the knee that worry me. Was going to go gym class this am, but thought better of it.

    Re the Bursa, i don't think I have that?? Do you think the injection is going to work, it gave me more pain when I had it before the surgery.

    Keep smiling Parklife, you will get there, you have been on a rollercoaster, feel for you, but be strong imageimage

  • Thanks Rebecca!

    Hard to know what the stabbing pains are, have to say I didn't have that.

    Still early days with the cortisone jag, I think it has so far helped the limp, I think I am moving more freely, though am still aware that a slight limp persists, frustratingly. I can't say my hip has been in pain, just a feeling of tightness, or like part of my muscles there hesitate to move when I take a step as part of a walk.

    Don't know if you have any info on this Rebecca-my physio told me to avoid any exercise including long walks for up to a month post cortisone jag. Says exercise tc can move the cortisone around the body rather than keeping it focused on the injection site at the hip??

    Thanks Steady, am having more success with resistance band drills on shoulder, and I think I will try a lesson to improve technique

     

  • Hope the Injection is working Parklife. Do you know if they Injected the Hip Joint or the Bursa ?  My pain is definitley worse when sat. 

  • I think it was the bursa, Moozer.

    I think over the past months I should have been describing my limp as slight-to-moderate, rather than 'slight'. Now I would say that post cortisone shot it is a slight limp. I have begun a simple stretch again which also helps.

     

  • HI all.  Not good news here I am now 8 months post op on my right hip and it feels like it is getting worse.. I have no pain on walking and no limp. However as soon as I sit down at my desk or go to bed it just aches so much and I get a throbbing pain. I started to take Naxporen again  2 weeks ago and it has made no differnce at all.  I  am starting to think that something is not quite right. I have a steroid injection in to the hip joint next Friday so at least that is someting to look forward to!! My life for the last 18 months has just been focused on this horrible hip pain, My consultant said to me to try and not focus on it to much however that is quite hard when you are in pain all day and tablets dont work ?? 

  • Hi Moozer

    I have the same, getting stabbing and throbbing on sitting, sleeping and walking now. Let me know if the injection works, that is my next option I think. Just not right to get this post surgery I don't think. Physio said could be scare tissue, but was a little concerned too. I hope they will do another MRI to see what the issue is as opposed to going straight for the injection, did they offer that to you?

    Hope everyone else is doing ok!

  • Hi Rebecca. I will let you know after Friday how it goes. I did not get offered an MRI. I Think maybe because the surgeon checked my range in the joint and he said it was quite good. At least when I get the injection if it shifts the pain then he will know if the problem was the joint. If it does nothing then the it would seem the pain is a musclar issue.  Rebecca are you still doing any stretches or physio on a daily basis ?

  • Hello have not posted for long while but seems we are all still talking around the same points. Have finally given up on running after bout 4 years of pain even though finding this depressing. Have now had two rounds of cortisone injections on the NHS into hip, one in Sept 2012 one in July 2013 after physio and hydrotherpy didn't seem to do anything. Both have been great although not a pleasant experience, with instant relief which lasted for bout 3 months when the pain creeps back in and I just about last until the next one can be sorted. Ran again after first and it only took a couple of 5k runs to put me back in a lot of pain.

    There is no sign of labreal tear according to MRI but is impingement pincer variety. Nowhere near bad enough for surgery thank goodness at the moment but it is the early days of OA but has taken a while to get my head round feel much older than 45. 

    So can't imagine what some people on this site are feeling with much worse cartlidge situations but I would say that the injections are worth a shot (ha ha) for some welcome pain relief.

  • Good Luck for Cortizone jag Moozer, and report back as always.

     

    I am one month post cortisone shot. It has helped my limp a fair bit at this stage. A bit a tight feeling in upper thigh remains, provoking a very slight limp/lack of nimbleness.

    I hope the limp doesn't become worse when the cortisone wears off.

    I also had arthrogram on my 2nd (left) hip this week, and await the call from the specialist for his interpretation.

    I would love to hear how Pipes is getting on and if she could offer any advice?

  • Hi All,

    I had my injection in to the joint 10 days ago. It has made no difference at all to the pain I get while sat down at work. The pain goes at the weekend and I  have no problems walking. Dont really know what to do now. I will be 9 months post op in a few weeks. Cycling and running seem like a thing of the past. I would give anything to be pain free.

  • Moozer, are you doing in rehab exercises?

    After the cortizone jag I've been getting back to daily clams to strengthen buttocks and bridges with a straight leg raise and using the pilates breathing style to strengthen transversus abdominus.

    I think it is slowly helping. The limp seems to be staying away cross fingers though a little bit of discomfort remains, but I think improving.

    Due to see the specialist next week to see if the left need done, ironically I think getting back to bridges etc has set the left off a wee bit

  •  Hi All

    Moozer, how annoying about the injection! I went to see physio again today who said the range of movement in hip was not good at all, but don't know if this is still to be expected, im just over 6 weeks post op. Im sure its worse that it was pre op. When she bends knee to chest it only just goes over 90 degrees and won't budge from there.....normal???

    Still getting pains too, particularly in groin. Back to see surgeon (Mr Conroy) on Tue, I just hope to get to see him to ask what's going on.

  • Seen surgeon and he advised I need to go for an MRi as there may be something that has come apart, happened - ohh the joys!

    Moozer, how is your cortisone jab coming along, any relief yet?

  • Rebecca the Cortisone Jab I had has made no difference at all. I dont know if this could be a good thing as it may mean the pain I get while sat is not coming from the hip joint. I went to see a new physio last Friday and he seems to think my hip is fine and the contant pain I am having around my groin/hip could be from a back problem causing the femoral nreve to be irritated. I start my new physio treatment next week. Hope you dont have to wait long for your scan. 

  • Hi moozer, that happened when I had the jab...hence not going in for that yet. Six weeks to wait for the scan...happy days.

     

    Hope the physio works, think they given up on me with physio image

  • Hi all, +3 weeks from surgery for impingement, had mine at Gobowen in Shropshire under Mr Karlaki on the NHS. Thought I'd offer my experiences where they differ from the general themes here. My diagnosis is impingement, thinning cartilage, early osteoarthritis.

    Waiting/funding: no apparent issues, pain wasn't chronic, I got mine diagnosed early so my op is to try to delay it worsening. It was bad enough that I'd stopped running a couple of months ago, after several years of reducing activity from marathons, through shorter Tri's to nothing expect walking. In context though, I climbed 12 Munro's less than a month before my op, as walking has never been that problematic, at least once I'd warmed up and got loose. Couple of ibuprofen after a day on the hills would generally see me sleep OK and be able to loosen up the following day, and I'd managed to find a job that wasn't dependent on physical ability, or compromised if I woke up and needed an hour to loosen up before commuting.

    Risk: Mr K's reckoning is a 70% chance of improvement, and by the 3 months mark we should be able to tell if any improvement, although 6 months to full recovery ( ie as good as it will ever get) is more realistic.

    Although that doesn't sound great odds, the chances of it being worse are pretty low (something like 5%) with a 25% of being neither better or worse. I suppose those numbers are really subjective and vary from patient to patient though?

    Worst case  is a joint damaged beyond repair and bringing forward a FHR, nerve damage (unrepairable) or the very very worst, which is very low risk but always present for any surgery.

    Hospital: op at 3pm, woke up 7ish, out 2pm next day. Had general & a spinal too, recommended additional spinal by anesthetist more to numb pain during first few hours of recovery than anything else though. She did make absolutely sure I understood that being unable to move my legs when I first came round was normal. They regularly do this op, and even FHR with just a spinal apparently especially for older patients

    Overnight was horrible, they fit air pumps to the feet to reduce DVT risk, which was really uncomfortable and although not really in any pain, it was generally a long uncomfortable night. Physio next day was really only able to get me on my feet and show me how to use crutches, and explain a set of mobilisation/clenching exercises to do at home

    Recovery: I had no pain, honestly, none at all. Until I moved. Then it was like a hot knife through my groin. So I didn't move much for the first night at home, day 2 forced myself to first mobilisations. I haven't cried with pain before. But it only lasts while you're moving, and by day 3 it was easier. 3 weeks on, I can move around the house w/o crutches, as of yesterday physio recommends using one (on opposite side of body) when I go outside or if tired. Still no bike, cross trainer type stuff though, just strength and mobilisation on the bedroom floor. Current "favourite" is pulling knee into chest 20 times for 20 sec. You know I said I hadn't cried with pain before...

    Physio reckons the main thing is to do the exercises, my employers have offered to pay for additional physio if it gets me back in work sooner, but it's mostly doing the exercises again and again and again that makes a difference, not doing them with a physio present.

    Painkillers: I'm not good with morphine, it doesn't work on me so I just feel sick and still have the pain, so all I got was Paracetamol, 8 tablets a day for 8 days is all I had once the spinal had worn off. It was enough.

    Prognosis: too early to say. pre-op Mr K set my expectations, I won't ever run marathons again, but it should reduce pain, improve flexibility and probably should be good for a few more sprint Tri' s and get a few more years out of it before I need a

  • cont,

    a full hip replacement.

    Thanks to all who've taken time to post on here before, it really helps to hear other experiences, whether good or bad.

    Stuff I've learned or did which I'd recommend: get simple things like toenails trimmed, haircut done BEFORE the operation as it's a heck of a meither afterwards.

    Stockpile as many books, DVD's etc as you can for the first few weeks, and make sure you can sit on a comfy chair and put the mobile on charge, reach the laptop, see the TV etc, even if you have an endless supply of family support YOU get sick of asking "could you just pass me the.. "

    Stick to what your medics tell you, there is endless info on line but they've seen your injury and know what happened in your hip when they operated.

    Allow 6 times as much time as you think you'll need to get up, get shoes on, get to car, stash crutches drive to physio, retrieve crutches, walk into hospital etc etc

    Make sure there is an hour every day when everyone leaves you alone, no visitors, no phone call to see how you are. Everyone means well but you need your rest and time to recover mentally as well as physically.

  • Hi everyone and welcome, miami mike.  Been reading about people's experiences with the cortisone. I had one about 13 months after my first op and, to be honest, it didn't make much difference.  I think the hip just took longer than expected to settle down, which was probably (partly) down to the fact that my other hip wasn't right. Once that one was corrected, everything gradually settled...after about 9 months! I had my first op in Dec 2011, 2nd in Sept 2012 and was running short distances without pain from April 2013.

    parklife - you asked for an update image.  I didn't want to repeatedly come on here with lots of positive me me me posts when, sadly, many of you are still getting pain/ discomfort and unable to run.  But things have been going very well. I got a 10 mile PB (sub 63) in October and won a half marathon in mid-November - accomplishing many things I never would have expected to happen again post-op.  I hope that gives people some hope, even if your aim is to return to a parkrun or similar.

    When I started building up my distance, I did my exercises religiously - bridges, squats, clams etc.. I haven't been so good recently and I know I have to do better.  When I try to do too much, my body tells me about it - I get aches and stiffness in my glutes, hip flexors, quads, shins, calves, achilles...actually, everywhere!  It may be weakness from my 3 years of not running.  I need to stay sensible and get regular (fortnightly) sports massage to let me carry on running.  I don't do any x-training - nothing gets me motivated like running does.

    I will keep reading and wishing the best for all of you.  People say it takes a long time to recover and it really, really does.  People also say that everyone's experiences of FAI/recovery are different, and that is also true.

     

  • Thanks Pipes, always good to hear a success story, and any tips etc always very welcome. Again, it is very encouraging to hear of how you have bounced back-I'm sure you are loving it down your running club!

    For my part, was doing fairly decent but just struggling to shake off last bits of tightness and an ever so slight limp - being 'in flexion' like driving the car or sitting at a desk for long periods seemed to make it worse so recently I again explored youtube looking for hip flexor exercises. This bloke here 'funk Roberts' has really helped, and I can now bring my knee up to my chin without pain, and today walked freer than ever.

    2 of funk's exercises are pure murder to do but about 1 minute after doing them I am already feeling freer and more flexible. Hopefully Hopefully this is the last crucial piece of the jigsaw, and I contemplate a graded return to small bits of running on grass, on top of a large pilates-based/clams strengthening programme.

    And I'll have to get my 2nd hip done

    Here is the link to funk if anyone is interested in hip flexor attention

    http://www.youtube.com/watch?v=9y8vwe-HWX4

    http://www.youtube.com/watch?v=lQ4kpvTMkYU

  • Hi again, bn reading everyone's posts for past couple of months and loving ur success story Pipes.

    I'm somewhat frustrated,  coming up to 5months post op and just doesn't seem to have made much difference.... previously I would get flare ups but now although not as intense, it just aches with the smallest of things, mainly driving which I do a lot of. I feel old!! I always dismissed the "worse in colder weather" but certainly feeling it more. Was really hoping to get back running in the new year but not looking at all likely (well not if I want to be able to move after!)

    Sorry that was just a moan!

    PS parklife those exercises look good, I just about died trying them but will work on it!

  • Be careful Triple! I am doing those exercises at 11 and a half months post-op when I'm trying to sort the last pieces of the jigsaw and I think am otherwise well healed from surgery!

    Remember building your core and glutes remains very important also!

     

  • Operation day + 5 weeks. Walking short distances without a crutch, although painful afterwards, and any kind of slope is more difficult. Any accidental rotation forces through the joint cause a sharp pain, but most of the time pain free when sitting still now. Can now see the rate of improvement slowing, which is to be expected I suppose. The hard work has started now hasn't it.

    Some of the range of motion exercises are really difficult, and I'm more prop forward than ultraman so flexibility has never been that good, and even getting to the starting point of some stretches difficult, so need to explore alternatives with physio at next weeks appointment. 

    This youtube is pretty good, the story is a youngish physio who's had a hip scope done in Ireland, it's day 0 (just after surgery) then he's posed about 20 more if you search by "more videos from this user" ,  as a video diary of his extremely rapid recovery. One of the comments even disbelieves he is genuine! May be he's got a high pain threshold or his op was less intrusive than some of ours. But I found them worth a watch as he's got knowledge of both the patients and professionals point of view, and gave me some ideas how to adapt the physio into ways that suit my frame better.

    http://www.youtube.com/watch?v=horQYkNU6PA

  • Now 1 year post op. Having spent a lot of time on exercises for strengthening core and using hip flexor stretching exercises which seemed to virtually eliminate my slight limp, decided I was ready to try small bits of running.

    Twice now have done 5x2 mins run/walk.

    But later on in the day I feel a return of groin pain reminiscent of the groin pain I felt when I tried to run post-op.

    Any thoughts/similar experiences/tips??

     

    Thanks

  • sorry, reminiscent of the groin pain I felt when I tried to run PRE - op , that should read

  • Parklife, it's a bit early in my own recovery to help with your specific query, but a good few years back I had trouble getting back into running after a fairly serious ankle injury, and in the end a stand-in physio, (ex pro rugby league physio) basically told me to grow a pair, "once the doc says it's fixed, then it's fixed; it will always give some discomfort whenever you push the recovery, trust the doc, accept it's fixed and run through it is the pain is less than OUCH."

    No idea if that will help you or wind you up, I promise that I hope for the first!

    It initially wound me up at the time, but next time out I ran through discomfort, and as it didn't get worse, I carried on. The next time out, it took longer for the discomfort to come on, and so on. Ten years later I was till getting the occasional twinge for that area, I suppose I'm saying to think whether it's pain from a continuing problem or a reasonable result of pushing on.

    Just had my post op consultation (+7 weeks), seems that the wear and tear was at the worse end of what Mr K had anticipated, meaning a longer recovery and potentially less success. But on the bright side, now able to drive a short way, turn legs on a bike (minimum load) and get myself to the swimming pool/gym regularly (because I was relying on lifts until now), so feeling slightly less institutionalized.

    Bye bye cash in the attic, whoop whoop

  • Hi Parklife and all, HNY!!

    I would be wary of the groin pain you are getting. I had a scan before xmas as the groin pain I am getting is almost worse than pre-op. No idea what they will find or do if they find something has gone wrong. The operation I had was pretty straight forward, just a small cartiladge repair, so no idea what is wrong now, unless its come apart !?!

    I did pick up exerise classes and 20mins of running about 3 months post op, but have had to cut it back as the impact (strangely not the running) hurt hip.

    Even when I have done hardly any exercise I get the pain, specifically at night image

    Hope you get on better soon!

     

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