Femeroacetabular Impingement

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  • Thanks, mrnoosehead. Yes - I've been done!! Feel really comfortable now - sure the pain will kick in when some of the medication runs out. I will take what is offered to stay on top of it.. The surgeon spoke to me briefly when I woke up, to say he'd repaired the tear, but didn't say anything else just yet. I will see him and the physio tomorrow. What a relief to have had it done!

    When are you crutch-free again?
  • Glad the op went ok pipes....keep us updated on your progressimage
  • am off crutches. in the pub!
  • Hooray for you being off crutches! Makes life a lot easier, I'm sure. You'll be able to fetch your own drinks in the pub.

    Thanks, loverunning image

    The doc has just been and read the surgeon's notes to me. He said there was a large tear that they repaired without cutting too much of the labrum out. There's grade 1 residual damage which isn't bad. He removed bone from a couple of parts of the femoral head. I only have 2 war-wounds - I expected 3! No need for micro-fractures. He says no running for 3 months. I have a follow up appoinent with him in 6 weeks and physio starting soon. Seems like a positive result overall. Just waiting to be discharged from hospital. Feel good and had a restful night!
  • All seems to be going well 5 days after surgery. Pain has been minimal and I have been able to cycle on no resistance without any pain or problems. I can get around slowly on crutches but haven't really been outside much. Popped into a shop to break up a long journey but didn't feel steady and confident enough on my feet amongst crowds of people.

    Mrrmoosehead - would you mind telling me some specific exercises or cycling times you were advised to do after the op? I was given 5 simple exercises and told I could cycle but not for any specific amounts of time. My next physio appointment isn't until Friday so I wondered how I could progress my rehab a little, without pushing my luck.
  • My booklet says 2x15 mins, when you feel like you can, increasing by 5mins a day up to 2x45 no resistance. I had to put some resistance on as my legs are pretty strong, so no resistance was spinning too fast and out of control.

    Exercises wise - lots of isometrics - static muscle tightening

    Ankle pumps, whilst sitting on the floor/bed
    Tense and release quads 20x5sec reps
    Tense and release glutes 20x5s
    Pilates style pulling belly button in, hold release 5x20secs

    hold on, here's a link:
    http://www.ernestschilders.com/PDF/Hip-Arthroscopy-Rehab-Programme.pdf



  • Thanks for the info. and the link - I shall take a look at the website later. I have been doing a couple of little sessions on the bike (actually, I was the same as you - had to put a little resistance on or else the legs were trying to go too fast) and am now happy with today's plan to do 2x20 mins (as I did 3x10 yesterday no problem and did 20 this morning).

    Another question - how long were you unable to drive? I didn't have quite as much done with my hip as yours, as I didn't need micro-fractures, but don't know how long that will limit me for.
  • is it right leg or left? I believe that if right leg, then you won't be allowed as soon due to emergency stop issues.

    If automatic car then even sooner I guess. Up to your surgeon - with right it was about 4/5 weeks for me, left was 2 weeks. But then schilders did also say that he's letting people drive a little sooner now.


  • It's my left and I have a manual car. The nurse said I should contact my insurance company to see what they said.

    Do you have any more follow up appointments? All looking good enough for some sort of running again in a few months?
  • I'll have follow ups every 6 months for the next few years. Then less regularly, but still follow-ups. This is to help provide the efficacy data for the procedure.

    Running can start again on 6th feb. image

    Was a naughty boy today and went to the planet-x showroom in rotherham and came out with some shiny black carbon. Going to start cycling this week, but only gently. At least the compact chainset on this bike will let me do that, despite the hills round here
  • Bet you can't wait until 6 Feb. My surgeon said 3 months, so I've been through the calendar and worked that out to be 21st March. I will obviously be sensible and see whether or not I'm ready, and get back very slowly, but that's provisionally my target date.

    New bike - exciting! When are you supposed to get back to cycling outdoors?

    I'm a bit frustrated with the crutches already. I keep having to remind myself that just because it doesn't hurt to walk with only one (or none, if I only need to go a few steps), it doesn't mean I should do it. The physio told me there was no set amount of time that I should be using the crutches, but judging from other blogs/ forums, I know it should be a matter of weeks, not days!
  • If no microfractures, then with Schilders it would be 4 weeks crutches. I had mf so 6 weeks crutches, 13 weeks no running. Twice in the last year. That's 6 months without running. No wonder i've been such a miserable bugger.
  • Hello - update from me 2.5 weeks post-op. All going well, as far as I can tell. I've been doing my exercises every day and cycling lots. I got bored on my exercise bike so moved onto the turbo...now I find myself setting little targets in my head (like going harder or on slightly more resistance for alternate 5 mins, like an interval session, trying to get the heart-rate up). I'm generally doing an hour of cardio in total and about 45 mins of exercises each day.

    I've always had a competitive streak and am finding myself having to remind myself that it's not that long since the surgery. Discomfort is minimal and I'm allowed (by the physio) to walk around the house without crutches, so long as I use one or two on longer walks outside. Back to work on Monday.

    Waiting to hear when my follow-up appointment is with the surgeon. I expect it to be in 3.5 weeks.

    How's the cycling going, mrmoosehead?
  • Cycling good. Great to get out. 3.5 weeks til I can run. woo hoo.

    Sounds like you're doing well. Just be careful not to overdo it... image
  • Good to hear you both recovering well and there's light at the end of the tunnelimage
  • How are you doing, loverunning? Any progress?

    3.5 weeks will fly by, mrmoosehead. Enjoy that first run back knowing that, hopefully, that's it this time image

    How long until your post-op niggles disappeared or eased (if they have) and the hip felt less sensitive (if that's the right word)? My operated hip feels looser than the non-operated, due to extra bits of bone being gone, but it twinges uncomfortably when I twist it, especially outwards. It's not painful, just reminds me every so often that there's a fair bit of healing to go (which is normal, I know, almost 3 weeks after the op).
  • Hopeful that my IFR will go to the commissioning panel meeting on 25th January to decide my fate as to whether they will fund my hip arthroscopy. Got an appointment with my consultant 1st February to discuss the outcome and next steps......still painful, still missing running more than everimage

    You and Mr Moosehead sound like you are through the worst of it and have the spring/summer to ease yourselves back into runningimage
  • Good luck with that, loverunning - keep us posted with how it goes on 25th. I know the frustration with missing running.

    mrmoosehead is further along in the process than I am, I believe, as he has had both hips done now. I think I'll have to get my right done sometime, if my surgeon agrees. But it's progress at least. I think the impingement is in the non-operated hip, but not necessarily the large labral tear as well (as I don't get the same occasional sharp pains from it - just a constant ache).
  • Both hips are more free as the bone is gone - I can theorectically get more ROM in both. But it takes a good 6 months for all the surrounding tissue to loosen up again and to get used to the greater ROM (as I understand it)
    This tallies with what I feel - the hard mechanical bone blocking is more or less gone ( I can occasionally get a pinch point still, but only at extremes) - most of the resistance in motion now feels musclular / tendon related.

    Left still a little achey, but I am stretching it a lot, so that's propbably part of it. Lef tstill has some 'transmitting pains' down the left leg, but these have diminshed to the point of almost being unnoticable.

    Just stretchy stretchy stretchy for me, and lots of adductor strength work to try clear up teh adducotr problems.

    It takes time. Be patient, and do what the consultant says.

    Just a word of warning - if your physio is not up to date with the rehab of hip arthroscopy, then double check the exercises and advice. Not dissing the physio, but there are a lot of stories about physios (and indeed consultants) giving poor rehab advice post surgery.

  • IFR for ny hip arthroscopy didn't get done in time for the exceptional cases panel on 25th January so now not going till their February panelimage

    Consultant has apparently recommended in my IFR that I undergo the surgery under a Consultant Orthopaedic Surgeon at Harrogate, Jon Conroy, anyone had experience at Harrogate?

    Another 4 weeks wait now to get a decision on fundingimage
  • Conroy is where all the Bradford and Airedale cases have been referred.

    Don't know his track record.
  • Thanks for the detail about your hips - it's reassuring to have contact with someone who is not only a few weeks ahead of me, but also has had the same surgery a bit longer ago!

    I am trying to take it easy and stick to what the physio is telling me. I did have to query him last week when he suggested I could run again next week. He checked back through my notes and changed his mind, saying that it's probably more for non-runners, than someone who is likely to go out and start trying to do a few miles! I queried him because I don't want anyone to give me any sort of permission to run again before I actually can, as I know what I am like.

    I've had a strange problem with my hand & wrist since surgery - the vein that had a cannula in has been sore, hard and raised for over 3 weeks now (ie since the day after my op, when it got removed). The doc said it should be fine - just to put a warm flannel over it and watch out for any spreading.

    Sorry to hear about being delayed even further, loverunning. More frustration image Fingers crossed something positive will come out of it next month.

    I was reading Athletics Weekly a couple of weeks ago and saw an interview with Lisa Dobrisky, who was talking about having had hip surgery fairly recently. Her description sounds a bit like FAI, although the name wasn't used. I think it said she was back training and hoping to do the Olympics this year. Different case from ours but does give me some hope of getting back to some sort of racing.
  • In almost the same situation as you are loverunning. Hip started hurting last February. Physios told me to rest through the summer. Had arthrogram done in December and got the results a couple of weeks ago - fai and labral tear and some cartilage damage. Now I've got an appointment in two weeks time to see another consultant who'll decide if they're able to attempt preservation surgery or just do replacement. Fingers crossed!
  • @Sue I sympathise with you, hope you get a decision when you see your consultant. Have you gone private or is this through the NHS? Let me know how you get on.

    My case goes to the Exceptional cases panel at my PCT on 22nd February although my Consultant is not hopeful at all that they will agree to fund my hip arthroscopy.

    Mine is a SLAP tear right at the top of my labrum, no impingement or mechanical abnormality that they can see from the MRI. If the funding doesn't get approved then I will be appealing it all the way - going private just isn't an option for me at presentimage

  • And on the subject of funding, Bradford and Airedale PCT have just declined my request for some help towards the cost of the surgery they should have funded last year.

    Apparently they only retrospectively fund if there was a pressing or urgent clinical need (or something like that)

    I wasn't expecting anything, but it's still a bit disappointing.

    Hope you're all doing well. Just been for my second run post second op - 5 miles in the dark and ice on Ilkley Moor - not quick, just a gentle run with a friend. Lovely. Life is good when you can run.
  • I've read from the beginning of this thread with great interest. I had a laberal tear arthroscopily repaired in my right hip 8 years ago and its been generally fine since (just have to be a bit careful  not to overdo it, and not attempt silly warm up moves and the like), well, up to about a fortnight ago that is!!

    Have got a bad case of AT at the moment so haven't run for around 6 months trying to get it better (getting more frustrated by the day), but had a little circuit I did at home incorp. some abs work and free weights.  Had noticed some clicking in my right hip with one of the abs exercises but didn’t really think much of it, a few days later had full on pain like I remember from the last laberal tear.   Really hoped it might have been a groin strain but don’t think luck is on my side. I am 99% sure it is a laberal tear again.  Fortunately I have BUPA cover so have got a referral to the surgeon that did the first op – there’s about a 4 week wait to see him privately but thinking that’s a good thing because it may settle down in the meantime (wishful thinking me thinks L).

    I suppose I’m just curious whether anyone else has had two surgical patch ups for laberal tears on the same hip and, if so, to what level of success.  The only positive to come out of this is that my AT has felt slightly better, probably because I’ve got something else to worry about now!! 

    BTW, I should also say that I have just had my gait thoroughly looked at and am waiting to pick up some prescribed orthotics next week to help with the AT problem.  I am now thinking that perhaps my biomechanical probs could be attributing to the laberal tear issue or FAI.  Does that make sense?  I can’t remember the surgeon referring to anything like that 8 years ago, he thought it was more likely to have been caused by 20 years of racket sports.  I will definitely be asking the question when I go to see him.  It's good to see from the thread that there is running after surgery, I suppose I am proof of that for the last 8 years!

  • Ok, so saw the hip arthroscopy guy today. Arthritis has set in and there's quite a lot of cartilage damage so it's worse than I thought. Seems I have two options. Wait until the hip deteriorates further and then have THR (sounds like a long  painful wait). Or have the hip arthroscopy with labral repair, rim trimming and microfracture, which he believes will have odds of 80% chance of some improvement and 20% of me ending up in more pain than before. I'm not a patient person so I'm thinking of taking the risk. They're not great odds, though. He also told me my club running days are over, which makes me one very sad ex-runner I guess.
  • Very sorry to hear that it was worse than you thought, SW3 image Although they aren't fabulous, those odds do seem to suggest there's quite a bit of hope in doing the repair work now. As you said, the wait for a THR could be long and painful. Do you know how long you will have to wait for the op? When you say ex-club runner, does it mean you may be allowed to do some running, but not faster or longer stuff?

    mrmoosehead - brave first runs back, eh?! You wouldn't catch me doing that even without injury or surgery! But then again, I'm from a town with no hills whatsoever, and retreat to the treadmill when it gets icy! Congrats on being back - must feel good. Have you had post-op meetings to look prospects for the long term (ie will you be able to get back into it as you were before)?

    Hello Bumble1. Sorry - haven't had 2 patch-ups in the same hip so can't help you, but I hope you get to see the consultant soon enough and that the symptoms have cleared by then. I definitely think biomechanical problems could add to the FAI - mine probably hasn't been helped by a weak core, despite quite heavy mileage and racing. I don't need orthotics, but I do need to keep the core work going.

    My recovery has been going ok, although a bit frustrating. The post-op pain in the operated hip (sharper than the impingement pain, and only really noticeable when I move it at certain angles) has not really improved in the past 3 weeks, despite improving quickly earlier in the post-op process (I'm now 7 weeks post-op). Plus the exercising I'm doing to strengthen that operated hip seem to aggravate the non-operated impinged hip, meaning that I sometimes struggle to take my weight on the non-operated side and therefore put extra pressure on the side that is recovering.

    Good luck on 22nd, loverunning.
  • Thanks Pipes. I've decided to go ahead and have just got the surgery date through -  27th March. Thought I'd have to wait for ages, so it came as a bit of a shock! No mention of funding problems, so I guess this issue is sorted in Somerset. The consultant was really clear about no running at all (well, I guess I'll be able to make a short dash for the bus...)  The labrum and cartilage have both degenerated quite a lot so I guess any repair will be pretty fragile, plus I have other femoral anteversion/retroversion issues he can't fix.  Can't deny that I'm struggling to come to terms with being a non-runner for the first time in 15 years. I guess it will get easier. Glad to hear that you're on the road to recovery. Any good pre- and post-op tips?

    Loverunning - hope all goes well with the funding meeting.  Fingers crossed.

  • My case was deferred on 22nd pending further evidence!!!! It appears that other PCTs in the Yorkshire & Humber area are now funding the hip arthroscopy following the NICE guidance issued in September 2011.

    So, my case goes back to the panel on 21st March for them to decide if they will fund or not.

    In the meantime have seen my consultant who was not very hopeful that I would get the funding and that if I can't afford the private option then my only real option is to try and manage the pain!!!!!!

    Following my consultation and given I have now not run for over 7 months and the pain is no worse for not running and I am missing it so much over the past few weeks I have been for a very gentle jog on the flat for 15/20 mins, on a sunday morning. The pain is there, but my consultant does not seem to think that some light gentle jogging will cause any further damage.

    So, another wait - but I am feeling hopeful and optimistic!

    SW3 - wow they don't hang about in Somerset do they! keep us posted on your opimage

    Pipes - how's your recovery going?
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