Femeroacetabular Impingement

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  • Shame Rebecca, hope you get some answers from your scan.

    Miami Mike, I (partially) took your advice, and after a few days rest and core work, decided this time I would try exercise bike, though no running, as a way back into activity. Have done this x5 weekly past 2 weeks and the hip is coping I would say! Have graded up resistance so this eve did an hour burning 620 cals - not a bad work out at times pretty stiff resistance and lovely to have sweaty cardio back in my life! Pray it remains.

    Have to stretch extensively before and after. The limp slightly returns after, slight twinges of pain, so not perfect.

    I figure another few sessions of this to strengthen and waken up hip then I try short light running again.

    My hunch- I will be able to cope with cycling (which I would take!) but am less sure of running ability, there is a general feeling of lack of nimbleness in hip.

  • Hi all,

    You may not believe this, and the surgeon was VERY surprised.....I initially had a very small tear repaired in April....and it has re-torn, quite a lot more badily than the inital tear so I am now waiting to have it repaired for a second time....can't believe it, having to go through it all again image image. He said he only seen it happen 3 times in 6 years...must be a special case. image They therefore not surprised I been in pain.

    Parklife, hope all is going well for you, and to others too, just want to feel normal now and get this finished. Mr Conroy did say there is a possibility they won't be able to fix it, something to do with the structrure they used to fix the inital tear being stuck, if this is the case they remove the whole cartiladge, anyone have any ideas on whether that is good or bad? Conroy said it can be good because it cant tear anymore, but, the jury is out as to whether it needs to be there to act as a 'cushion'....hmmm

  • Rebecca, that is such rotten, rotten misfortune.

    At least you have got answers.

    I really can't advise about possible removal of cartilage though if it were my body I would be very cautious, surely some cartilage better than none? I would recommend more research on your part. I sometimes think surgeons see things in black and white, but its your body.

    Sorry can't be of more help, except to say I hope to purchase this book 'the entrepreneurial patient' by Anna Thomas; all to do with being an FAI victim.

    Best Wishes

  • Op booked for the 27th March, or sorry re-op, fingers crossed, hope you are all well and getting there with things!

  • that is despearate Rebecca but I hope things will begin to go in the right direction for you. Sorry for the pain you are in.

    I am OK. Had a good January, virtually no pain, slight limp vanished, was walking freely for first time in a year and had cardio through cycling back. All was well.

    Then I upped my cycling from 40 miles to a 70 mile blast and the next day some discomfort came back and 3 weeks later hasn't gone again.

    Strange thing is the discomfort is over my greater trochanter - I never had any pain here, and not where it was previously (mostly down the groin) Slight limp now also makes a reappearance.

    Discomfort in unoperated side slightly going up and will need done at some point

  • Rebecca - the re-tear, do you remember an 'incident' where this might have happened and what was it, or was it a retear that just seems to have happened under normal activities?

  • Hi park life, no idea on the re-tear. Surgeon said it can just happen, things don't knit together properly. Shame as initial tear was smaller. At least they are going to try and sort it out again. Think I'll be even more cautious post op, not that I did more that I was told to do. Hope are well now!

     

  • Hi I'd like to join the hip club please?

    Just wrote an extensive post but stupid ipad crashed. Anyway I might have saved you a boring read.

    Heres the gist of it:

    Not got the official Fai dx yet but pretty sure that's my problem.

    Hurty for 6 months and increasing with time. 

    Sent away by sports med specialist because Fadir test didn't cause me pain. Anybody else like this?

    I plan to go back and ask for an Mri artho, as fun as it sounds, I think I need it. Physio is getting me nowhere! I have zero external rotation, which feels restricted by bone. Surely that is Fai by definition.

    Em.

  • I would def ask for the MRI, I got turned away by surgeon's 'mate' first time as had no FAI pain....eventually had the op a year ago and now having re-op a year on next week!!

    Physio advised that I am off work for 8 weeks, anyone else been advised this? She is concerned as its a re-operation and I need to fully recover...

  • Thanks Rebecca. I'm due back at sports med next week so I will ask for an MRI referral. Sorry to hear that's it's come to the stage of a re-op for you. I'm in 2 minds about surgery. Sometimes it seems like it's my only hope but so many people still seem to be struggling after. It's really an impossible choice and only a crystal ball could help me make the decision. The worst part is I've emigrated out of the uk, and would probably need to travel back to get surgery, abandoning what has so far been a pretty successful emigration effort.

  • Hi all

    I am 1.5 weeks post my re-operation on left hip. They told me they had to remove the cartilage as it was too weak to repair, and they removed some more boney bits that could have caused the re-tear. I think I am doing ok. I can get around the house ok, frist week was not so good. Not sure what the removal of the cartilage means, they did say, its just can't re tear. Doing exercises,  basic streghthening, from physio, a little unsure whether I am trying to get around the house on own a little too early...Hope you are all doing well!

  • Hi all, I am now 5 weeks post op and get clicking in the groi and aching in leg down to the foot. I still need two crutches when out and about....I still have 2 weeks off work...to be expected?

     

    I am sure if wasnt like this the first time around....

  • Six months post second op, should I still be experiencing the stabbing pain in groin? Still kills if I do the FAI test. Hope all are doing well

  • Time to check back in folks as I am having a shocker, a nightmarish scenario.

    Now about 20 months post-op. Things had been going OK, went to see a new physio March, I had no pain, slight limp, and doing moderate exercise no running. He started strengthening further the muscle around my hip with squats. It worked, I had no pain, great ROM and was flabbergasted to gradually start gentle running again.

    About 2 months ago whilst doing a strengthening squat I felt a tear. Not for 1 minute did  consider it to be a labral retear, and thought it was a smallish groin strain. After rest was able to get back to gentle painfree running. Only to slightly reinjure it in very innocuous fashion about 4 times since,walking up stairs etc.

    This week the pain has shot up and is very similar to the type and location of pain prior to FAI surgery. I now understand this to be a retear of the cartilage. Am gutted.

    I went private for my op. I can't afford to do that again. Am frankly devastated. Spent over 6k only to be 20 months later be back where I started. Now have pain, back to no activity/diminished quality of life, waiting lists, funding issues with NHS to deal with. I can't believe this.

    Any thoughts all welcome.

    Rebecca, you have been through the mill many times over. What does your surgeon say?

     

  • hi all, how is everyone doing? I am 8 plus months post second op and still have severe stabbing pain, clicking and general pain down into foot, is this to be expected...? back to hospital tomorrow, but not sure they will do anything as I have had the op done twice now image

  • Oh Parklife, I FEEL your pain. Yes I had it done again and they removed the cartilage, but im still in pain daily, very much so at night too. Talk to your surgeon and take their advise. Ive been told they won't do anything a third time, but too young for hip replacement. I do want them to take a look though, but im sure they will refuse, ill let you know after tomorrow. Keep smiling...

     

  • Hi how is everyone doing in the new year?

  • Hi Rebecca I think its just you and me keeping this thread going at the mo!

    Happy New Year!

    My Right Hip, the one that has been operated on, is modestly uncomfortable but doesn't get worse with cycling I guess the boney bit doing the damage has now been shaved away. I can almost feel the ripped cartilage right round the socket- it goes into my glute.

    I took the bull by the horns and went and seen my surgeon again. He was very sympathetic. On reflection, my physio had me doing far too many lunges and squats putting far too much unnecessary force on the stiched up cartilage. I regret this a lot. I have not had a good overall experience with physiotherapy as a profession.

    Surgeon wants to operate but then that is £££ which kills me financially but I have no other option as I can't really go through the NHS to have a look at another surgeons work. Needless to say I have made savings in other areas of my life.

    This is the incredible bit - the month I had my op the surgeon tells me a new technique came out involving stem cell which might make the cartilage 'heal' better in lieu of it not being a vascular area. Costs an extre few hundred quid. I had a wry smile at this - the month I had my op this new technique comes out!  You have to laugh but I walked away headshaking.

    Now, I had been doing a bit of cycling which has been a bit of a godsend but the left hip is now accelerating in terms of pain/not coping with exercise. 2 problem hips. Previous Xrays had shown the jagged bone sticking out rubbing into the cartilage in classic FAI pose. So that will need an op at some point and I have already been referred for NHS consultation.

    Life's never a gentle rowing boat on the village lake, eh?

    That sounds hard going having had your cartilage removed? Does anything help the pain like even painkillers even a little bit? Do they even know what is causing the pain?

     

  • Grim stuff all around I'm afraid.

    FAI doesn't "just" happen in the vast majority of suffers. It happens because of something. If you do not change or identify the something, the pain will return.

    OS are great at dealing with structural issues - bits of bone growth or torn labral tissue, they are pretty poor at dealing or identifying functional issues - the whys and not the whats.

    There is now compelling research stating that tears and extra bone growth can be totally pain free and is pretty normal in an aged population.

    Unless you know why (as in bio mechanically) you ended up with FAI, dealing with the structure won't always change the cause and certainly will not alleviate your symptoms...

  • Thanks for ur post six physio,

    though I would say that the surgeon operating and shaving the bone and repairing the cartilage tear over the hip socket did eventually sort me out, I was pain free and felt as good as new....until doing lunge and squats (overdoing it in hindsight) caused a retear...too much pressure on a stitched weak spot?

    Possibly there is a difference between small normal degenerative cartilage tears with age, and great big rips in the cartilage?

    I would love to know why the extra bony growths occur in some people and not others; has their been any more research on this and I would be grateful if you could point me to relevant articles.

    Regards

  • Hi parklife - Here's the tricky bit - feeling better is not the same as getting better. It's pretty easy to make someone feel better, but harder to keep them better.

    If lunging and squatting caused a re-tear (after a decent time period) then unfortunately it was most likely going to happen anyway - the lunge and squat are just coincidental to the cause. Any OS worth his salt will try to deflect away from his work....

    Bone growth has a genetic element - can't change that, and if this is you it will grow back and you will have to have it done again, as your genetic make up remains the same.

    Bone growth also has a more biomechanical vibe to it too - and this is more common. Think OA hips and knees - the older you get (more joint play/movement) the more bone growth there is (can be pain free).

    The extra bone is laid down in a response to the excessive stress that's being put around the joint margins, due to the extra joint play and motion. I think FAIs could possibly fit into this category.

    Let's say your hip has excessive joint play (not necessarily range) and bone is laid down. The bone is shaved etc but the joint still has excessive play - nothing has really changed...your hip may well feel stiff, but that's most likely muscle stiffness which is trying to protect you from the excessive joint play...

  • Thanks sixphsio appreciate your response

    so is there anything that can be done about the biomechanics side of things?

    I had done a lot of pilates to strengthen core and a weak core had been identified as a previous problem.

    It will be interesting to see if any new surgery reveals any new growth of bony bumps, which was pressing into the cartilage from underneath.

    The thing is I had not been that active since the op at Xmas 2012. Just pilates, virtually no running and a fair bit of cycling, some swimming.

     

  • Yes - absolutely, this is key. You need to get greater movement through your thoracic spine to take the excess load away from your lumbar spine and hip - it's why you've had an issue with your "core".

    You can get your core as strong as you like but unless you have control of that strength, it's pretty pointless and you've lost control of it due having a stiff thoracic spine. All your rehab must be how you do it rather than just doing it. Getting stronger is easy, getting control is trickier as you need the ability to move better - this is the thing you don't and why after a good 12 months+ you re injured yourself.

    Don't worry about the bony lumps - your cartilage has no nerve supply so you won't feel it...

  • MinniMinni ✭✭✭
    Just read the first few pages of this and the last. I'm 6 weeks post op - arthroscopy to fix a labral tear. I'm really pleased how it's gone and I seem to have lots if strength back. Can't run for another few weeks but back to swimming and cycling.



    I have a question though. I didn't have any boney bits that needed shaved so the op was quite straight forward but pre op the worst of my pain was in the buttock. It sometimes felt like deep muscle and sometimes more like bone. The surgeon said the repair would not necessarily help this pain as it was probably unconnected but when the were in there they'd have a look and see if there was anything obvious causing it. While on strong pain killers following surgery this pain disappeared (first time in a year) however, as soon as I stopped the pain killers and started moving around this came back. Now the GP says this is probably sciatica because my spinal MRI showed a bulging disc in the sciatic area. The MRI was in July and this us the first time anyone has mentioned this.



    My question is have any of you had a similar pain in the buttock and side of hip area, that has improved since your surgery?
  • Hi Mini - your OS has fixed your structural issue (the labral tear) but hasn't a clue about the functional cause, hence the butt pain.

    Your symptoms are brother and sister and totally connected....

    Your butt will get better if you find and treat the cause...you'll also find it'll help your hip too image

  • MinniMinni ✭✭✭
    That's what I think too although the tear could've been the result of a bike accident. I've always been a neutral forefoot runner but you you think it's worth getting checked out for orthotics?



    I have been seen by various private and NHS physios over the last 14 months but everyone draws a blank.
  • Tear could be due to a bike accident, might also be totally coincidental - some tears are totally "normal" and symptom free.

    Not sure you need to worry about orthotics - neutral's good

    ....you just haven't met the right physio yet! Gotta (sometimes) kiss a lot of frogs image

  • Minni

    I have had survery twice, the first time the labrum re tore, the second time they remove the cartilage. I STILL get pain in but and hip, front and side of thigh and deep groin pain - same as pre both surgeries image

    Six Physio, any recommendations

  • Hi Rebecca - yes, find out why. Labral tissue is designed to take even load, until it finally gives up the ghost due to excessive movement/age. Unless you've had a traumatic incident you still haven't got to the why.

    The most common pre disposing factor for FAI/labral issues is excessive joint play (how much glide and slide between femoral head and acetabulum) - this is not the same as range of movement.

    Excessive joint play is the natural compensation for lack of motion elsewhere (and vice versa) - the general pattern is a stiff, pain free thoracic spine (postural driven - computers, sitting, slouching etc) and a lumbar spine - hip complex that moves too much as a compensation. The body detects this excessive joint play and so protectively stiffens up the muscles around the hip and pelvis - so the muscles feel stiff, but not the joints....it's super hard to distinguish the difference.

    The excessive joint play and compensatory muscle stiffness cause huge amounts of shear and grind through the hip joint (and labrum). This is where you feel your symptoms, but it's not the cause.

    Get your hip as strong and as mobile as you like, but unless you've got the ability to move better through your thoracic spine and less through your lumbar spine - hip complex you're, unfortunately, going nowhere fast..... 

  • hi every1 i too am dealing with bad groin pain in the right side mainly. i came across this 4d scanner ct article on cnet website

    http://www.cnet.com/au/news/see-marvelous-high-res-images-captured-by-ges-new-ct-scanner/

    but i live in australia, would love to know if any1 has used this to problem solve whats going on with there groin problem.

    gotta have cortisone shot in abbductor groin area to see if it helps. had a shot in right hip already a while back but didnt feel any difference.

    sports doctor thinks arthroscopy with labrael tear but he's not sure. so conservative treatment. not looking forward if surgery has to be done as already had in 2008 hernia op on that side.

    i have an xray of hip and 2 mri's of hip/groin area.

    life is pretty shit since my groin has gotten worse. when i sit pain begins to travel from gooch area up the panty line. so i try to walk very slowly and lie down here and there with ice pack. trying not to hit the anti inflams or pain killers all the time.

    tried physio for about 3 months but couldnt do exercises everyday as they wanted as causing new pains in the left side of groin.

    have just turned 35, 9 feb, and been dealing with this crap since last yr May 2014.

    hoping for a miracle but reading every1 stories it seems its a long road without any guarantee of success.

    im a healthy kid otherwise. dont know how long i can hold fort in my mind b4 i crack.

    fingers crossed new tech comes around to help us all.

    hoping hoping....

    Brunz

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