Femeroacetabular Impingement

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  • Really sorry to hear funding's been delayed again loverunning. It must be so frustrating. Have to say,w e're usually behind everyone else here in deepest Somerset ... Good that you're feeling optimistic and back to doing some running. My consultant told me I could do light jogging too and that I'd knew when I'd have to stop. He was right! It was just after Christmas when I couldn't keep up with the slowest group in the club and had to cut the run short. Knew then that the pain:enjoyment ratio had skewed too far in the wrong direction. I find that the best thing to ease the pain btw is spinning - I feel great for the rest of the day if I don't overdo the resistance.
  • Good to hear the updates, but not good to read that you're having to wait a bit longer for a decision, loverunning. Seems more hopeful, as you say, if other PCTs in your area are taking on board the recentish NICE guidelines. I, like you, used to keep myself going with the odd short-ish easy-ish run on flat. It made the hips a bit sorer for a couple of days, but that was worth it for the stress relief and catch-up with friends.

    Never been spinning, SW3. Might start it if I join the gym, which I'm hoping to do this weekend. Any news on your date yet?

    I'm going ok. Met with a surgeon at the hospital on Monday and, although it wasn't the surgeon who did my op, he was great. He was interested straight away in my other hip and has put me on the list for an MRI, with a view to doing the surgery if the expected evidence is found. Obviously, I'll have to wait for the MRI, then the appointment with a surgeon, then for the op, but I may be done by the end of this year. To me, this would be success.

    Not managed much exercise for the past week as I've had a cold and a tooth extraction. Operated hip is telling me that it doesn't appreciate the lack of activity!
  • Hey, what's new, hip people?

    I'm back out there, doing a fair bit. Probably too much. Hips doing well. Adductor problem, well - let's just say that is a work in progress.

    Lots of muscle tightness and soreness around femoral head on left - seems mainly to do with the fact that I have much more ROM in the hip join and I'm working muscles that haven't been used for a long time.

    PCT declined to pay for operations, even in part. That's still a work in progress.


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    Still logging on http://www.ar.attackpoint.org/log.jsp/user_1874
  • Hello havent written on here much but have posted messages to Pipes on FAI.

    Started running 2006.

    Started getting sore hip 2007

    After one particularly hard long run gradually more and more painful running and gradual loss of flexibility for yoga which I have done for 10 years.

    Eventually after trying to run through the pain, trying rest, trying Physio and Hydrotherapy after a year got appointment with consultant on NHS by moaning (or thats what it feels like!)

    After MRA at Derby Royal on Feb 15th have to wait until July 30th to see the consultant to discuss results.

    Hoping for some sort of diagnosis PT thinks it is FAI consultant not so convinced.

    Been following you all on this thread since last summer, keeping me sane thanks.

    Hope you end up getting some recompense for all the money you have had to shell out.

  • It's funny how this thread goes quiet for a couple of weeks, then several people post on one day! I was just logging on to say that I've just done my first post-op run (12 weeks to the day since the op) and it was lovely. Just 10 mins on the treadmill, but got to start somewhere. I started with a fast walk, then gradually broke into a trot, increasing the pace a little every minute or two until I felt a tiny twinge (that happened at 9km/h, so not pushing it at all), then went back down again. I'll do that for a few days, if there are no after-effects, then maybe add another 5 minutes at the weekend.

    Anyway, hello mr moosehead and Linz. Linz - I can't believe how long you have to wait to see a consultant although, thinking about it, I had my MRI at the end of last January and saw the surgeon for the first time mid-May. I did get some feedback from the MRI in a letter, though, so I knew about the FAI. I hope you get some feedback from someone before July.

    mr moosehead - I still follow your training log - looked at it tonight, in fact, to see how long you did on your first run back...more than I dared to attempt! It's great that you're back out there doing quite a bit - gives me hope of building up to a reasonable distance again if I keep being sensible. Have you given up your hip exercises (except stretching) now? Good luck with the adductor problem - are you seeing a physio with that? Shame about your PCT.

    Ooh - just to add - I have an MRA appointment for 20th April to look at my right hip - can't wait to get feedback from that and hopefully look at more surgery. I can definitely feel the difference in ROM between my left (operated) and right (unoperated) hips now.
  • That's great news pipes about your 1st post op run!!

    Well, i'm still no further forward, my case went to The PCT's exceptional cases panel again today and they have decided they can't make a decision on my 'pending case'!!! Very frustrated!!!

    Apparently, given that Bradford & Airedale PCT are now routinely commissioning Hip Arthroscopy following the NICE guidance my PCT have decided that they need to review their commissioning policy too...so, a period of consultation, decision making structures for approval etc in the meantime i'm a 'pending case' - pending their policy review.

    No idea how long it will take or indeed if I will fit any new criteria they introduce......really sick of waiting image

  • @loverunning - your PCT should be commissioning this surgery. There is no excuse now. Are you North Yorks?

    @pipes - I've never been known to take it easy. I've probably too much - but I had microfractures, hence the 13 weeks off running - in that time I was doing lots of other stuff including static bike and then back to biking. Just got back in from MTB night which was nice. I note that you say that you are using a treadmill - my consultant (schilders) has given me a lifetime ban on using a treadmill (not that I would anyway) because research has showed that they are really bad for the hips.

    @Linz - don't give up. there are things that can be done.
  • I'm West Yorkshire - Wakefield District PCT

    They should be but they are not.....Have emailed my MP tonight as not happy, see if it helps
  • Thanks, loverunning image Sorry to hear you're still waiting - very frustrating image image

    mr moosehead - my surgeon didn't tell me to avoid treadmills - he just said to avoid anything that causes any pain (eg hills/ speed), and even that was before the surgery. I trust your guy, though, so I'd imagine he has a point. Having said that, I've just (temporarily) replaced my kitchen table with a treadmill until I feel confident about going back on the roads, so I will stick with it in the absence of pain in the operated hip.

    15 slow minutes tonight image Only pain is in my unoperated hip. I'm hoping it'll ease after I've been back running for a week or two, otherwise I will have to just wait until after the next op.
  • How long post op are you now?

    I found that exercise bike was a good way of keeping going - no impact and keeps hip moving well.

    Once I was able to walk ok, then cycling on the roads became an option.


    Still doesn't beat running on the hills though.
  • I'm 12.5 weeks post-op. I've been turboing on the bike but that's starting to lose the ability to keep me motivated. I've also been doing a weekly aqua-jogging session. Now that I can run, I want to get out there, being sensible, obviously. I hope everything will loosen up in a week or so but if the unoperated hip continues to hurt like it does, I may have to do other things til the next op.

    Ran outside for the first time post-op yesterday - just a mile, but was glowing for the rest of the evening!
  • Such lovely afternoon on Friday and as we had been doing sport relief stuff at school had trainers on so whilst I was walking the dog I began to jog and kept going for about 15 mins didnt seem to hurt too much. Woke up Sat morn and can hardly walk but boy did it feel good whilst I was doing it. Feel like a naughty school girl, Ha Ha

    Its great to hear that you postops are so positive.

    We have just aquired a water rower from a friend gonna give that a try in a bit.

    Take care everyone.

  • Hi everyone,
    Had my hip scope on Tuesday. According to the op report, a massive labral tear had to be excised as it was beyond repair image He also shaved 5mm off the hip socket at the front. The arthritis turned out to be worse than thought - just a very thin layer left at the back. No micro fracture then. Still trying to take it all in. The surgeon said that I'll need a THR in around five years or so, but the scope should buy me some pain-free (hopefully!) waiting time. HE also told me hubby that I'd move to THR very very quickly if I tried to run, so I'm definitely grounded. Plus side - I helped marshall at a cycle sportive the other week and it was FUN, so can't wait to recover enough to buy a shiny bike and hit the open road!
    Sorry to hear your'e still playing the waiting game lovetorun. Hope your PCT sort themselves out soon.
  • Interesting about THR if you run. Was there any specific reason for this?
    My consultant has been happy for me to return to running, maybe he considers there to be enough bouncy stuff left. My microfracture location was only of the order of 6mm x 3mm or something like that.
  • Hi mrmoosehead. You've got it. I'm down to a very very thin layer over a big area. No chance of growing more. I think the major factor though is that I have a few hip abnormalities that a scope couldn't fix - femoral anteversion and acetabular retroversion (twisted thigh bone and hip socket that points too far backwards!).
  • Had my hip arthroscopy 2nd March. Had cam osteoplasty and labral thermal shrinkage. Was suppose to be a day case, but the general anaesthetic made me to sick, and had to stay overnight. Travelled back on my own in a taxi and train! Not something I would do again. For about two weeks I did exercises to gain  more range of motion. Difficult at first, but gradually got better. Had my stiches out 15th March. Surgeon really pleased with my progress. He suggested I could progress to strengthening exercises with a physiotherapist, which I am doing currently. Pain wise, there is some discomfort when I walk, and also after doing the exercises, which I was expecting. I am currently on 1600mg of Ibuprofen taken with Omeprazole. 

  • Good to hear from you, SW3 - sorry to hear that the op didn't give any more positive news than expected, but you seem quite upbeat about the whole cycling thing. Hope the recovery goes well and that you're on the road bike soon. Keep us posted on how the recovery and exercises are going.

    Hi Martyn - welcome on this thread and good luck for your recovery as well. I looked you up on Po10 as I thought I recognised the name and see that you're relatively local to me and have done some races I have done too (Mota Series '10). Finished a good 2+ mins behind you, though. That was a good year for me...haven't run much since! Where did you get your op? What has the surgeon told you about returning to running?
  • Hi Pipes,

    Thanks for getting in touch. Charndon 5k is my PB course, and my club are often well represented, being as it is so close to Aylesbury. I really enjoy doing the Motavation races, probably more geared up for club runners, but that isnt a bad thing as far as I am concerned.

    I had my operation at the Wellington Hospital, St Johns Wood. I am in the fortunate position of having private medical cover, which did fast track the process somewhat. It did take me about 18 months for it to be diagnosed though. Initially I went to Bisham Abbey, near Marlow, but I lost patience with them after a period of about 3 months. They put it down to functional weakness in my core, but I wasnt happy so I made my excuses. After trying a bloke at my club who is an osteopath, without much further success, he suggested going to Elite Physical Medicine in Aylesbury, and after seeing the guy in charge, Paul Thawley, he said I had a problem with my hip. I think they call it the Faber test, and that proved positive. So I got in touch with a guy called Rahul Patel, who did a few tests, and an X-ray. The results were inconclusive, so he suggested having an MRI, with contrast injection. Which did bring some relief. He concluded that the injection was a success, so would proceed with the operation. I believe the diagnosis was Cam impingement, and a small labral tear. The surgeon did say I could return to running, obviously take it very steadily. I also asked if there were any signs of osteoarthritis, which worried me, but he said he couldnt find any signs, which is good. 

    I havent set any goals yet, running of any kind would be good at the moment. Im looking long term to the next cross country season, whick will give me enough time hopefully to regain my fitness and strength.

    Stay positive, hopefully you will get back running at some point. I know it can be frustrating sometimes!

  • Thanks Pipes. I'm hoping positive vibes will do their stuff and get me back on my feet quicker! Take it easy on the non-op hip. Have you joined the gym yet and had a go at their spin bikes? Might be a good way to fill the gap between now and your next scope.
  • Good to hear that everyone seems to do be doing well. I'm three weeks post op now and really glad I bought an exercise bike. It's keeping me sane. Also really enjoying my weekly hydroptherapy session.

    loverunning - how's your PCT case going? Have they sorted it all out yet?

    Pipes - good luck for your MRA tomorrow. Hope all goes well image
  • Hi Sue and thanks for the good luck wish for tomorrow. Can anyone tell me what the dye injection was like - did it hurt/ make you stiff & sore afterwards?

    You seem to be keeping positive after your op, Sue. I remember the weeks post-op before I was allowed to do any cardio except the exercise bike - I was hooked on it for sanity's sake! Do you feel that the recovery is going well? What do you have to do in hydrotherapy? That's something I never had.

    How are you doing now, Martyn? Have you had any more post-op checks with the surgeon yet? When are you able to run again? Charndon's coming up next month - I'll be out marshalling again this year. One year, we'll be back running there...

    Things aren't quite as bad with my other hip at the minute. A friend doing a massage course has been working on my quads and glutes, which have been suffering and tight. I have also been doing more cycling, stretching, swimming and aquajogging, so things feel generally looser. The sharp pain in the hip is still there, but at least I don't feel quite so old and decrepit. Must do a spinning class when I'm a bit fitter as you suggested, Sue.
  • Hi Pipes, The actual dye injection didn't hurt. They injected local anaesthetic in first. Can't remember that hurting either! The joint did feel quite sore afterwards, though. This extra soreness lasted for about seven days and then it gradually settled back down again. I also felt a bit out of sorts for a day or two (but then I did have mine in the week before Christmas and I was rushing around like a mad thing!). I'd make sure you don't plan anything too hectic for tomorrow. Take it easy! I was treated as a NHS patient at a private hospital and there was an option to pay for hydro myself. It's £20 for a small group session with a physio that lasts for half an hour. I'm down for 6 sessions. The exercises are pretty similar to the ones I've been given to do on land, but you seem to be able to do more in the water. We also did sideways walking, star jumps, etc. Good luck!
  • Hi Sue - good news re your post op recovery.

    No decision yet, but did take it up with my local MP and was told on Monday to expect a decision by the end of this week on my funding case...a triage meeting is taking place and if I fit the Bradford criteria/pathway then I'm hoping for some good news....watch this space!!!!

    Hi Pipes, I had the contrast dye MRI and whilst it didn't hurt during the procedure, afterwards, almost immediately afterwards, I was very sore and much stiffer than normal - this lasted a few days. Hope it goes ok.

  • Thanks for your experiences with the dye, loverunning and Sue - very helpful. I plan to go back to work after (teaching), but will sit down!

    Best of luck with the decision, loverunning - sounds hopeful! Will keep an eye out for a result in the next week or so.

    I've been swimming and aquajogging again tonight - it really is refreshing and good to feel like I'm doing some sort of exercise. I still feel like a rubbish swimmer, but don't care if it gets me out of breath!
  • Funding agreed for my hip arthroscopy!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    Referral now to Mr Conroy at Harrogate, no idea of timeframe should know more next week - so happy at the thought of getting fixed image

  • Fantastic news, loverunning!! Must be such a relief for you. Hope you aren't waiting too long now.

    MRA done - injection was fine and, although I had to go into the machine head-first, the MRI was fine. Just got to wait for results now.
  • Hello fellow hip people.  Have been lurking on here for a while, and think I even posted a while back.  Had my right hip arthroscoped 19 days ago and they found (and repaired) laberal tear as expected.  Also found the labrum had come away from the bone so (in simple terms) stuck it back on.  Had the same hip arthroscoped for a labral tear 8 years ago where they just simply repaired the tear.  This time it was a new tear and they checked for any impingement at the same time.  No bone impingement but they did find a mass of fatty tissue which would have caused pain as well as impingement, so this was removed. 

    Obviously I have had more done this time than last time round, but I really cannot remember being in this much pain the first time it was done.  Have only just started to stop using crutches and I am continuing to take paracetamol to get through the day (have been taking Tramadol at night as well), last time I clearly remember not having to take any pain killers after leaving hospital.  I would be interested to know how much pain other people had after their arthroscopies, once coming off crutches.  I know everyone is different and it does significantly depend on what was done surgically, but suppose I am just looking for reassurance that all is normal.  I did contact mmy surgeon's office last week to ask their advices.  They said to ditch crutches as soon as I was comfortable without them, and expect to take pain killers for 6 to 8 weeks. I am sure I am worrying unnecessarily but you can't help but think is everything OK.   BTW, I hate taking any tablets so maybe this is what is putting my mind in overdrive!!

  • Loverunning-that's brilliant news! I really hope things start to move along quicker for you now. image

    Pipes, I'm pleased the MRA went ok for you. Fingers crossed for the results.

    Hi Bumble1, I'm 26 days post-scope on my right hip. I had labral excision and a rim trim. I tried to come off painkillers far too quickly, I now realise. When I got to my physio appointment at just over 2 weeks post-op, the physio told me that I needed to keep the painkillers going with regular doses. She said that it wasn't unusual to be still on them at 6 weeks post-op, which tallies with your surgeon's advice. So, yes, it seems to be normal. I hate taking them too, but it seems to make sense - if you're pushing your operated hip to deal with new activity, then you need to be as painfree as possible image I'm on one crutch for trips outdoors BTW. I think it's more a confidence thing than anything else. It's also very helpful if you bump into a friend and stand chatting - it gives you something to lean on!
  • Can I pick your brains here? I have lower back pain and have had it for 2 years now. I am trying to find out what it is via my GP as its been progressivly getting worse for almost 2 years now, it started off as a niggle and now its just painful! It started off and still to some degree feels like an irritation, I'd put it on a par with the intense irritation you get if you've ever gone to a womens bums and tums class and attempted to do the buttox clenches, nastily irritating!

    Its now progressed and feels painful, its at the base of my spine just where the sacrum meets the lumber spine and also hurts on the outside top of the illiac crescent. It feels like its a joint issue as its made worse by movement and feels at its worst after having to lean backwards or curve my back upwards so things like walking and carrying things (where the spine curves), riding a bike, swimming breast stroke and yoga (the second series) it hurts like mad afterwards and can often hurt for a day or two if I don't rest.

    It feels like a dull ache generally and all the time but following exercise feels more like I have been kicked very hard in a very small pinpointed area at two points just next to/around but not on, the base of my spine where my hip/illiac crescent is. Leaning forwards helps, leaning from side to side helps in a different way because it can help to stretch it out but it only partially helps because now aside from the irritation feeling there is the added ache/pain its now become.

    I am also hyper mobile which apparently puts me at risk of osteoarthritis and so after my GP sent me to a physio who basicly said he didn't know and sent me back to my GP, my GP just said it was regular back pain, palmed me a few prescriptions for heavy duty pain killers and sent me off. I am not happy to live the rest of my life between tramadol and coedine so went back and asked to be referred to a rhumatoid doctor to see if it was osteoarthritis. They ran an MRI which showed up nothing and I have been told its not osteoarthritis though am not sure if I believe that!

    So my question: what does a F.I feel like and do you think my symptoms sound like something similar to what you have experienced?

  • Hi Sue.  Thanks for your reply.  Has put my mind at rest that ongoing pain is quite normal after this sort of surgery.  My pain seems to vary day by day, yesterday was pretty bad so replied on the pills, today has been much better and I haven't needed any.  I read with interest that you have been on the exercise bike.  My rehab protocol says that I can do this from the 2 week point but I am holding back a bit - don't want to push too much too soon (my physio keeps reminding me of the tortoise and the hare story!!), but thought I might try bunging my mountain bike on the turbo this weekend, with low resistance, and see what aftereffects there are.  Do you get any pain whilst on the bike, or afterwards?

    BTW, agree with your point about the crutches!  Handy to lean on and take strain off the hips if chatting, also I have found useful at children's parties.  My little boy had a couple of parties at the weekend and all the little kiddies kept a wide berth, leaving me lots of peace!! 

    Don't suppose you're tried icing your groin area have you since the op?  Did it a couple of times about a week ago when I remembered, after physio at hospital had suggested it (and then I had subsequently forgotten to do as soon as I got home).  Haven't done since, not sure what impact it would have 3 weeks after op.  Anyway, hope your recovery is going well, always nice to have comments from others going through the same thing.  I'm treating myself to a road bike once I feel rehab'ed enough to give it a test ride (partic as consultant said I needed to do less weight bearing stuff once up and running (hopefully image) again).  Nothing beats running for me but suppose it adds a bit more interest to the rehab to try something I've never done before.  

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