Femeroacetabular Impingement



  • PipesPipes ✭✭✭

    Good luck with that, Mark.  Better to get it sorted than waiting until the pain is daily.

    Dav0 - feel free to 'rant on' - as Bumble1 says, a lot of us on here feel a similar way and it's good to read that it's not just us.  Your new physio sounds wonderful - shame I don't live close to Croydon. I will look into physio after recovering a bit from the 2nd op as there's not much point at the minute and would love to find someone with experience and knowledge of rehab after hip scopes.  I really would like to know why the operated hip is still sore, 9 months on.

    Linz - good luck with the decision-making but glad the injection has given some blissful relief for the time being.  How long do the effects of the injection last for? Would you have to keep going back for more? I, too, would be worried about the impingement still being there, despite not having a tear. A bit of a ticking time-bomb, at risk of slowly (or suddenly) causing more damage, especially if you are continuing to run.  But then again, surgery doesn't necessarily automatically resolve everything, as some of us on here are finding.  

    It was the operation that was cancelled, rather than an MRA.  It has been rescheduled for this Friday. Fingers crossed this time.  There was a lot of sweet and not-so-sweet talking to the secretary to get it sorted so soon, so it definitely does work, Parklife! Hope you get some answers yourself very soon.

  • Ah right well that was a pain that the op was cancelled especially when its a nightmare getting childcare and supply at school etc time off in education not as straight forward as it may seem and all that. Hope all goes well on Friday and that you get the solution you need to enable you to get some pain management and be able to consider eventually competing again. I will keep everything crossed for you.

    I was told the steroid jab effects could last up to 4 months if I was lucky. I think you can have up to three in a year. I think I have some side effects - that 'fat' tongue feeling like before you vomit, over salivation and a funny metallic taste- weird eh? has anyone else experienced this??

    Still the respite from horrible achy stiff hips is loverly!

    Good Luck

  • Pipes, I remember you saying a while back that you had got a bike - are you cycling and if so does it excarbateyour hip pain? Anybody else able to cycle - either exercise bike or real thing how is it going?

    I have a constant level of pain - not to the same extremes of others on this forum (though must be nice to have a break from it Linz) - but cant tell if hips are a little more sore after a good cycle?? Obviously on my mind that I may have FAI as well as probable labral tear.

    Phoned the NHS specialist secretary - up to 5 weeks before results of arthogram get back to specilaist then have to wait for next appointment with him though she wouldn't say how long that might be.I suspect it could be the New Year!!

  • PipesPipes ✭✭✭

    Just popping on briefly to say that I had the op today and it went well.  It took me a while to get out of recovery, but once I was out I went back to normal very quickly! Had the op at 12 and was discharged at 7! I was determined to spend the night in a peaceful environment and feel very good.  Maybe the pain will kick in after the local anaesthetic wears off a bit, but I remember that didn't happen with the last op so all should be good.

    Parklife - I was able to cycle. I sometimes used the exercise bike as it's more upright than the turbo, but I actually prefer the experience of cycling on the turbo.  I also did some spin sessions which weren't too bad on the hips - only one position (the hover) aggravated them.

    Shame it'll take so long to get some results, parklife.  I actually went to my own docs about 5 weeks after my MRA and asked to see a copy of the report.  I knew sort of phrases what I was looking for from the scan on the previous hip. My doc was happy to comply and even printed it out for me.  Is this an option for you?

  • Pipes - finally!! Pleased it went as well as it could have done for you; do you know what was found in there? Hope the recovery is a painless and quick one for you. In terms of physio, I think the sooner you find a competent one the better with these surgeries as I can't help but think that the relative inexperience of the first one I saw has put me back by at least two months.

    Great suggestion about contacting the GP for the MRA results - there is usually a three week or so delay for the reporting but once this is done, parklife should be able to ring up and get the GP to go through it with you. Gotta be better than a comedy wait til after Christmas to find out. Failing that, you can pay fifteen quid, get the imaging on a cd then book a private consultant appoin tment to short cut the system if you are anxious to find out.

    Still struggling here, am definitely getting stronger but have good days and bad days and still can't sit without pain. Thr physio has the attitude that I need to push through the pain, so thats what i'm doing; doing nothing clearly isn't the answer...

    Linz - pleased that you got relief from the shot, hope it stays that way for you. You never know?!!

  • PipesPipes ✭✭✭

    dav0 - thanks. I didn't actually ask what they found, unlike last time when I made them read out the surgeon's report.  The surgeon came to see me in recovery and said they'd shaved the bone and repaired the cartilage tear, but that there wasn't much other damage.  He commented that this hip was in a better condition than the other one had been when they'd operated, which is definitely a good thing.  

    I'm not in much pain at all. Didn't really sleep last night, though, as I couldn't lie comfortably on my side.  Did a little 10 minute static cycle this morning - no resistance and only 24 rpm, but just got things moving a little.

    I've asked for the physio care to be at the hospital, rather than my local, as I wasn't too impressed with the local one last time.  He was very pleasant, but went purely by the notes he had been given from the hospital - I don't think he'd treated anyone with FAI before. Hopefully, the people at the hospital will be more specialised and more hands on, rather than just asking questions, writing down my answers and setting another couple of exercises.  I want more feedback about weaknesses, ROM etc.

    Sorry you're still struggling, dav0. What are you doing to push through the pain?

  • Sounds promising Pipes, and the fact that it was repaired rather than debrided can only be a good thing.

    When i went into physio yesterday, there was a lad in there just finishing up his session who was 7 weeks post op. He was pretty much at the same stage I am now in terms of exercises, which really drove home the realisation that I've been well and truly burnt by not having optimum physio.

    Rather than backing off when something hurts, I'm just trying to work through it with caution on the basis that my pelvic girdle is weak and i lack control of my femoral head, hence the need to strengthen everything, recruit things that have shut down/become lazy again (the body has a way of taking the path of least resistance) and hopefully a reduction in pain when the dysfunction is corrected. One thing I am getting now is soft tissue massage which i'd never had before - i really find this helps immensely!

    If I'm honest, i'm trying to make the best of a bad situation and i honestly don't think i'll ever be pain free with it. I just need to get back to a level where i can function and do my job, and then see what happens...

    Hope you get a better nights sleep tonight!
  • Pipes! well done for getting through the operation, hope it proves to be a success - I am impressed and amazed that you were about to go on an exercise bike the day after a major operation - probably less than 24 hours after!

    Could i ask what hospital you had it done in and who was the surgeon - even pm this info?? There seems to be some surgeons at the top of their game in England, did you have anything to do with the NHS 'patient choice' scheme where you can pick who and where your teatment is done. I'm asking this for down the line for myself in case I have FAI.

    Good advice re getting the artrogram results, to be honest im going to talk nicely to the specialists secretary in about 2 weeks, over 1 week has already gone...and if no joy there then ill be down the gp surgery.

    DavO, the skill set and competence within physios seems to be quite varied. I WILL get round to doing a thread sometime about the first physio I went to see about my original groin injury - a clown. I actually know one or 2 others who went to see him at some point and some of the stories I tell ya..However, the 2nd physio was excellent and through Core stability work and pilates sorted out my adductor problems - only snag was this then exposed another issue which seems to be labral tear or FAI. If you'd told me the innoculous low level pain I had in my groin the day after doing hill sprints would still be keeping me out of running 15 months later I'd have become an alcoholic there and then. I was hoping to be back running in 2 weeks!! Its just a load of hurdles, monotonous rehab, reduced lifestyle, waiting weeks for next appointments, and still havent had a diagnosis. There were time in the first 9 months especially i was going up the walls, and im very mindful that your problems, along with many others on here are much worse than mine (though i have the paranoid fear mine could degenerate). At least the physiotherapy, and getting back to work is giving you something to focus on, and hopefully turn a corner at some point on the horizon.


  • PipesPipes ✭✭✭

    Parklife - I had it done in the Nuffield Orthopedic Centre, Oxford.  It's local to me and has a good reputation, so I didn't need to use the 'patient choice' scheme. My surgeon does NHS and private work, so only usually does one hip arthroscopy a week - I think he does a lot of prosthetic/ cancer work as well. I'll pm you his name.

    I remembered from last time that getting on the bike early had helped - mentally and physically.  mrmoosehead (from this thread) was following the rehab booklet from Prof Schilders (for a 2nd time), so I followed his example.  The main thing is not to have any resistance and not to turn cycle quickly - it's just a matter of getting some movement going.

    Dav0 - I sort of know what you mean about the soft tissue massage.  My friend has been training in sports massage for a while and has come to know my specific stiff bits and aches very well.  She has done a little bit of work on the scar tissue, but will concentrate more on that when some of my other issues are resolved.

  • PipesPipes ✭✭✭

    Can't pm you, parklife, but don't actually really need to - surgeon is Mr Whitwell. Apart from the cancellations (due to his more urgent cases), he and his team have taken excellent care of me.

    I'm icing the joint for the first time post-op...can't actually feel anything, though, as the area is still quite numb. Hope it's helping the swelling anyway!

  • How are you getting on pipes are you still doing a little exercise bike??

    Out of interest how is the first hip that was operated on feeling and how many months post op with this?

    Thanks for info the Nuffield is one of about 5 hospitals the NHS in NI use for flying patients to for this type of operation.(Though I though it was in Ipswich for some reason) I definately want to be clued up about a reputable surgeon/hospital to use nearer the time.

  • PipesPipes ✭✭✭

    I'm getting on ok, thanks, parklife.  Sleep still isn't what it usually is, but I'm ok during the day - mainly because I'm not doing much!  Yes, I'm biking a bit every day to keep things moving. Sometimes, I'll do it once - but I'll try to do it twice a day if it's feeling ok.  The middle of my thigh up to my hip is still quite numb, which I hope is normal and will decrease as time progresses! 

    My first hip was operated on at the end of December last year, so 9 months ago.  It definitely feels different to before (in a better way) but not quite right. That might be because of stiffness/ weaknesses/ scar tissue, or it might be because the op didn't quite sort everything out. I won't know until I have recovered from this op and can build up/ test it properly.  I'm being optimistic at the minute.

    Good to hear that the Nuff is one of the hospitals you could use if you needed/ decided.  There are other Nuffields in the country, one of which is in Ipswich, but I don't think the others are NHS.  Feel free to ask anything else, should you need to make that decision.

  • Cheers Pipes, I was astounded to come home from work yesterday to find an appointment letter to see the Consultant Specialist on 10 October! 2 weeks away. This means the arthrogram has been reported on and sent to the specialist.

    I rang the specialists secretary, my GP and the xray-scan department and all said id have to wait to see the specialist to find out the verdict of the scan.

    My symptoms defo getting worse though, pain in parts of the hips that werent sore before and cycling seems to now making it worse. Also getting pain in t'other hip.

  • Ah that's good news, at least you've not got a comedy wait to find out. It's frustrating when you know that they've got the results sat in front of them but the buggers won't tell you for fear of stepping on some consultants toes!

    Sincerely hope its not FAI for you mate and that you don't need this effin surgery!! Keep us updated...

  • Cheers Dav0!

    To everybody..

    When i go to see the specialist in couple of weeks time is there any particular questions/issues i should try to focus on or remember to ask the doc?

    He was quick to get me out trhe door at the initial consultation so i want to be well tuned up when i go in this time.

    Many thanks

  • Has or does anyone suffer symptoms of your knee feeling unstable when you are symptomatic?


    something ive felt recently and is quite unnerving.

  • yeah, ive had a bit of a sore left knee while hip pain ongoing Mark, at one point a few weeks ago it was pretty bad (no real stressors on it)But knee isnt as bad now touch wood

    Has anybody read through the American thread on 'labral tear/FAI support group' over on 'runnersworld.com' ??

    Interesting reading - they all mainly seem make a good recovery after surgery.

    Things ive noticed is that the docs and patients across the pond seem to be MAD into their post-op physio rehab protocols.

    Also, some of the times from appearance of first symptoms to then surgery are mindboggling, in some cases 2 to 2 and a half months! Guess thats enforced health insurance for ye!

    But there generally seems to be less worries of things going wrong, and plenty of stories of people being able to run 5k's at 6 months post-op..

    Another point is that in the USA it seems to be accepted that it will be a year before you are fully healed post-op, though you can have a graded return to running especially from 6 months on.

    Pipes - also a number of posters on that site who have had both hips done might be worth a gander for you (ive now pain both hips ive a close eye on all that too)

  • I read someones blog abput post op recovery, interesting, certainly gives you an insight into whats going to happen to you and your body.


    I think the word thats springs to mind is pain regardless of how good/ bad a recovery you make, and tbh i dont think any surgery can be judged as a success or failure until after a year post op, you look at these insurance claims for neck pain they take years to sort out due to surgeons et al not wanting to commit themselves to a diagnosis until they are absoloutley certain there will be no further improvement.


    My physio is making noises about pre op core strenghthening, Gulp!

  • PipesPipes ✭✭✭

    Hi Mark. I haven't had much knee instability, as such, although the lower part of my left quad often feels overworked and shaky if I'm on my feet for too long. Having said that, my left knee buckled yesterday as I was walking downstairs - that gave me a bit of a fright.  I think my left side is struggling to take the pressure of being the 'good' leg, having only been operated on in December.

    I really hope what you're saying about needing a year for the pain to go is correct.  The pain when I extend my left hip (eg to do the hip flexor stretch) does not seem to be decreasing as time passes - I remember making comments to my surgeon and physio about it 6 weeks post-op and it hasn't changed at all since then.  I'm hoping that it's something that I can sort out myself/ with a physio (rather than needing any further surgery) when the right hip has settled enough.

    I have looked on the USA RW thread but not for a while - thanks for the reminder, parklife.  I have made Facebook friends with a guy in the USA who had his op a week before my first and was blogging about his recovery.  His post-op rehab was quite different to mine, but I'm not sure it was all necessary (some seemed more like money-making opportunities).  Having said that, he ran 5k yesterday and is doing a 10k soon, while opting to wait until December to have his other side done as well.  

    Good luck with those pre op core exercises, Mark. My physio made the same noises but I wasn't very good at doing them regularly.


  • Just thought i'd check in 8 weeks post op. Not reallly feeling much different yet compared with pre op. Went back to work week 6; lots of prolonged sitting (in the car and at my desk) and less time & energy to do physio may explain why I feel the way I do. Have been swimming though and been out on my new bike and managed a few miles! Still needing my stick to walk any long period.

    My left unoperated hip has been causing me concern and have been experienincing the same pain and stiffness and pain at night. Had my 1st follow up appointment today wiith my consultant, he did x-rays there and then on my unoperated hip and it was a mirrir image of my right - both CAM and PINCER impingment. He's listed me for hip arthroscopy for my left, signed the consent forms today, looking at less than 4 months wait tilll the op;-( 

    Was a lot to take in today and the thought of going through all of that again and the recovery is not something I'll be looking forward to, although at least this time, I know exactly what to expect!

    How have you found your 2nd op Pipes?

    How is everyone else progressing??

  • It sounds like lots of you are needing surgery for both hips - is this really common? I am currently waiting for surgery for torn cartilage in my left hip. 'Loverunning' hope you are better soon, I understand the walking thing, that is what I struggle with most.

    Since having done the damage I haven't daren't attempt to run for fear of making it worse, assuming that would be the case !?! I have stuck to swimming and x-trainer. Just hope the surgery comes in soon and it doesn't take too long to recover...I hate doing nothing. Good Luck for your second op.

  • PipesPipes ✭✭✭

    Hi again Rebecca image I think the impingement in both hips is pretty common - my surgeon said the hips are often formed identically.  I don't think cartilage tearing in both hips (without a specific cause like impingement) would be that common. 

    loverunning - I go back to work next week (3 wks post op) and am worried about the stiffness from the reduction of rehab exercise that you mentioned.  Did you have any microfractures during your op to still need your stick or is it just ongoing weakness/pain from all the work they did?  

    It's good that they're on the ball with your other hip and trying to get that one sorted.  I'm sure that the delays in my first hip, then slow initial appointments for the second, resulted in increased damage and pain in the second hip.  Yes, the first hip struggled a bit with becoming the 'main' hip after the second op, but I'm so relieved to have had them both done in the space of 9 months.  As you say, loverunning, it's good to know what to expect when you have had the op before.

    My physio has told me I can come off crutches, as I'm not limping without them.  That's a relief to my other side.  Things are definitely easing up and I'm starting to think that I may be in less pain now than I have been for 2 years.  Neither hip feels anywhere near perfect, but the discomfort is more predictable and less threatening. I'm continuing to ice, take ibuprofen and do my cycling/ exercises.  Might try to get into the pool at the weekend, but without any kicking. If that feels ok, I'll try some light aqua-jogging next week.

  • Keep us posted loverunning pipes and everyone.

    I now have an even more special reason to follow your progress. Today it was confirmed by the specialist that I have joined the impingement club, the club noone wants to be in. To say I am gutted is an understatement, though i sensed a few weeks ago this was where it was headed. F. F.F.

    Cam impingement both hips. Arthrogram only showed smallish degenerative changes to labrum, he sent me for xray there and then, 1 hour later and its FAI.

    Specialist, a professor, was somewhat cautious about surgery - says about5% cases are left worse off, about 70 % are left better off but he seems to think mostof these unable to get back to previous high levels of sport - especially for football etc.

    However he accepted that hip is may slowly degenerate over time even with modification of activity.

    Funny thing is its the right hip that gives me most gip and pain, yet the boney growth was more prominent on the left side, which feels more normal.

    We left it that ive to try modified activity for the next 3 months, running on grass and cycling, and see how i feel then make the decision whether i wish to go for surgery.Can i live the rest of my life on modified activity which slowly harms the hip most likely anyway?? Or do i take the risk with the op??It russian roulette - would i just be better going for surgery asap before labrum/cartilage etc degenerate further and leave more permanant damage???

    Another thing - the time it takes on the NHS, especially here in Northern Ireland. If I decide in 3 months to go for surgery, they have to then make a funding decision taking up to 6 months. Then procedure isnt done in NI so they fly you to England most likely Dr Mohammed in Wrightington Manchester (after waiting on his waiting list) then 6-9 months recovery. If i go for surgery Ill be sitting here in 2 years probably not yet recovered, and thats only 1 hip!! And thats after already waiting 16 months to get a confirmed diagnosis only today!

    Ive had a shitty day so sorry for the rant. I will expore private medicine but i know its probably prohibitively expensive.

    Id appreciate any thoughts or questions. Best wishes to all fellow bone hip victims.

  • Parklife - hello mate, so sorry to hear the news, really hoped it had been something else for you.

    Your surgeon sounds good in that he acknowledges that FAI surgery is not the panacea that some would like it to be, and that 6-9 months is probably far more realistic for a proper recovery than the 'back running in 12-16 weeks' that's bandied about.

    The decision is frankly a shite one to make, and I do sympathise.  The jury is still out on whether or not early treatment of FAI will prolong your hip's longevity, though my surgeon and the rheumatologist that treated me argued that in their experience, to continue activity on a damaged, FAI afflicted hip will only accelerate deterioration.  Even now, some five months out, I still can't say if I've made the right decision with mine, and only time will tell with that one as I really feel in more pain now than pre-op, though the horrendous lower back pain I had on sitting has thankfully gone (touchwood it never comes back etc).

    I didn't want to moderate my activity - I can't, my job depends on it - and I figured that to leave it would only cause irrepairable damage in the future, hence the decision...

    On the flipside, at least you now know what you are dealing with for sure, though I know it will take time to get your head round it.  I'd write more but I'm off out, so will come back later. 

    Hope everyone else is ok...


  • PipesPipes ✭✭✭

    Really, really sorry to hear that, parklife. Lots of decisions for you now...been there, done that etc. Twice.  So I know it's a horrible position to be in.  But obviously, as I chose surgery both times, you know what way my decision went.  Has your pain got worse while you've been waiting?  If so, can you imagine it continuing to develop at that rate as time passes?  For me, the difference in the right hip in the space of about 6 (relatively inactive) months was enough to convince me that surgery was my best option - better to take the risk of not fully recovering than knowing that it would definitely always be there/ getting worse.  

    It's useful that Dav0 is more hesitant about the op as his experience of post-op recovery hasn't been quite as smooth.  I'm still not right at 9+ months post op on the left side, but I can definitely say that I'd rather have the discomfort I have now than the pre-op pain.

    It's a long process getting the op and recovering from it, and sounds even longer for you, if that's what you decide to do. I can't say anything to make that any easier image At least you wouldn't t have the 16 months initial consultation wait. And they may simplify the process in N.I. as time passes. It seems to be getting easier to get the op on the NHS now that the NICE guidelines are more in favour of the op (I think - as mrmoosehead had that problem over a year ago).

    Btw I had more pain in the right hip, but the surgeon says that it had less damage when he operated. I think that might have been something to do with where the tear/ impingement were positioned. But I may be wrong.

    How are you doing, Dav0 (when you're not out and about)? Glad the back pain has eased - at least that's something...


  • I had a strange dream last night, a gorgeous girl, reminiscent of maid marrion, was walking towards me holding out a femur bone in her hands???

    Thanks for the responses, its a bit late and ive to go to a wedding this weekend so ill post on sunday or monday, have a disturbed dream free weekend, if thats possible.

  • I have just found out where I am being referred to for surgery - Mr Conroy at Harrogate...waiting list is at least 4 months....if not longer..fed up!!!

    Is this about standard for the NHS, wandering if I should see if I can get referred to someone quicker, not sure how though.

  • I was referred to mr Conroy in April 2012 for my right hip, had my 1st consultation with him mid June 12 & was told 4 months wait for surgery but they rang me early August and offered me a date of 13th August which I took.

    6 week follow up with mr Conroy on 9th October, diagnosed with FAI in my left hip. Have been listed and advised 4 months wait again.

    4 months wait for surgery in the NHS is good in comparison to other Trusts + Mr Conroy is very experienced and an excellent consultant so in my opinion well worth the wait!
  • okthanks for the advice, Ive not got consultation app yet - what do they do during this? How did your surgery go in August?

  • At the consultation in June he sent me for x-rays there and then (at this point the only diagnostic test i'd had done at my local hospital was an MRI Authogram and this had only confirmed a tear, no FAI at this stage).

    Mr Conroy reported on the x-rays whilst I was there which confirmed Pincer FAI and Tear. He did a physical examination and I filled out some questionnaires on my level of pain and activity. I signed the consent forms and had MRSA swab/blood pressure and he put me on his list then for surgery.

    Surgery in August on my right hip found CAM & PINCER impingement, labral tear and degenerative changes/damage in my joint i.e. Oesteo arthiritis. Had my labrum anchored and the impingement removed. He said I had a section (about 15%) which was completely worn. I was in overnight and discharged the following afternoon. Mr Conroy saw me the morning after surgery and went through everything with me and said NO MORE RUNNING!!

    I was on crutches for about 4-5 weeks and couldn't drive until week 4/5 - still using a walking stick. Had 6.5 weeks off work. Started with pain in my left hip week 1 of recovery and has progressively got worse. Started swimming (only crawl) and bike at week 5/6

    Whilst my operated hip does feel different, it's still very sore even at week 8. Sitting for prolonged periods, driving and laying down still hurts and causes my hip to become very stiff. I'm still walking with a limp. Sleep is still affected by pain. If I twist it in certain positions it still hurts. My hip also locks and grates/cracks. Walking up stairs is still difficult without holding onto something. My hip feels like it lacks any 'power'. The scars have healed nicely but my skin still hurts to touch at the top of my thigh.Mr Conroy said this is all normal and could be 1 year before i start to feel any reduction in symptoms.

    What the surgery has done is stopped the impingement and slowed down the damage the FAI was clearly doing to my joint. Whilst it can't take away the OA and may not have relieved my symptoms just yet but i'm hoping it's delayed the need for THR.

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