Femeroacetabular Impingement

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  • dav0dav0 ✭✭✭

    Hi there,

    Have been following this thread for a while now, but now being 5 weeks post op on my left hip for a labral tear and cam impingement, I feel compelled to post.

    I developed unexplained lower back pain after a roll around arresting someone at work last August, which pushed it over the edge when I fell hard across a kerb, resulting in a labral tear at the chrondrolabral junction due to cam impingement and a ton of synovitis.  Before this, I used to run 10k a couple of times a week...  Much investigation and head scratching (ignorant GPs anyone?) and a process of elimination led to the fai self diagnosis, and a hip block/cortisone injection allowed me to run again (albeit not pain free) for a while.  I'm only 28 and figured that if I left it, it'd grind itself to bits anyway and besides, I wanted my old level of physical fitness back.

    The surgery was the easy bit, but the recovery has been a real rollercoaster.  I was off crutches at 2 weeks (no microfractures or sutures) and began cycling with no resistance and physio (mostly working on glute med and max, psoas and rom) and had almost returned to walking normally at 4 weeks when it suddenly flared up.  My groin is now swollen and the pre-op pain (vague, deep seated pain in my groin) has returned.  Hip flexors are crazy tight and the Thomas Test (lying on your back at the end of a bed, pull up good knee to chest and lay backwards keeping bad leg flat, dangling over the edge of the bed) was agony!

    It feels like I am back at square one agan...  I am back on anti inflams hoping it will resolve itself, but one week of 'taking it easy' has yielded no results.  Lesson?  If you are like me and prone to 'overdoing things,' then don't!  I am the world's worst candidate for self control in this department (often to my detriment) and am paying for it, so please learn from this!

    It has been good to hear of other people's experiences with this, as it gives me hope that one day I will be able to return to running and front line policing again. 

    Keep the faith,

    dav0

  • PipesPipes ✭✭✭

    Been a while since I last checked in here.  Thanks for the link Tom Goom - helps me to help other people understand my issue.

    How are you doing now, Bumble1?  Have you been back jogging again yet?

    Any news on a date, loverunning? How's the cross-training going? 

    Hi dav0. Has everything settled down again yet? Keep us posted with your updates.  I hope you get back running and normal life again soon.

    I had a meeting with the surgeon last week, who put me on the waiting list as an 'urgent' case.  My operation date will be 14th September - hopefully there won't be any cancellations this time.  I'm very excited about the prospect of having it done so soon.  Now time to get some exercise done before the op, as I've been pretty rubbish at cross-training.

    I've had weekly sports massage on my quads, glutes and lower back to help with the muscular discomfort that has developed, presumably, from the hip problems. I know it won't actually help the deep pain within my hip, but it certainly makes everything else feel better.  Luckily, I know someone who is doing a massage course and needs lots of practice hours. She's fab and knows exactly what I need now.  

    As dav0 says, keep the faith image

  • dav0dav0 ✭✭✭
    Hi Pipes,



    Glad your date is relatively soon, just hope you don't get messed around too much with cancellations etc.



    Sadly, I'm still riding this flare up and have forked out for a 3T MRI to see what was going on in there. There is still some post op oedema swelling in the capsule (probably to be expected really) and, more frustratingly, a partial tear of the rectus femoris proximal head (where it attaches just above the acetabulum).

    Not sure if the tear is something related to the traction? Contracting my glutes still gives me bad anterior groin pain... Anyone else had rec fem issues after this surgery?

    I am somewhat gutted at the stalled recovery because i had worked really hard pre surgery on core strength, glute strength and cross training etc to assist recovery, but feel that this setback has negated all the pre op effort.



    I am also extremely jealous of your massage-on-tap situation!!
  • Hi everyone, i just found this thread, its a blessing.

     

    I have a labral tear in my hip which gives me pain which i can only describe as gnawing for 2 to 3 days at a time, i have limited range of movement in my hip which has been prominent for years.

    My hip pain is exacerbated my positioning and strain on my lumbar back area, it makes me walk with a pronounced limp and really interferes with day to day life when present i get no relief rom any standard analgesia at all, Ive had a consult with Mr Gaston at Edinburgh royal infirmary who was very sympathetic as he himself was a runner, he told me he can have me in and have the op done in a short space of time, My problem is i have just started my dream job and dont really want to take time off as it may hinder my prospects of remaining there, however the pain is becoming more frequent and more prolonged and gets me down,

     

    Catch 22 situation, do i or dont i go for the op,  interested to hear your thoughts, 

    sorry for bumbling on....

  • dav0dav0 ✭✭✭
    Hi Mark,



    This is a tough decision to make, because it is essentially elective surgery and the bottom line is that it is down to you. I too suffered with dreadful back pain as a result of the tear and have a very active job. Whilst i was never limping prior to the surgery, I felt that i didn't really have a choice in the matter as it wasn't going to heal and I feared that to leave it until it became unbearable would only serve to cause further, irrepairable damage.



    I am now 8 weeks post op and, to be honest, am beginning to regret having the surgery done. It was always a gamble, but at present i have bad inflammation of the joint and can't walk very far; in short, I am worse than i was pre op! Ci jope this is only a temporary thing, but there do seem to be some people who just dont recover from this...



    Conversely, there are numerous success stories on here, so i think i am just unlucky, and its probably too early to call it yet in my case. Hopefully you work will understand your predicament and be sympathetic towards it?



    Good luck mate,

    Davo
  • Davo thanks for that, Like yourelf im in an active job(Air ambulance), this is where the difficulty lies, it can interfere at times when you need to think and act fast, a bit like yourself, the flip side is when i deal with critical incidents it can trigger a flare up just because im crouched down, so im in a no win situation. My wife's very supportive and my kids are a bit older so i dont have too much about lifting a 2 yearold when he wants up..

    Cheers

  • dav0dav0 ✭✭✭
    I know where your coming from Mark. Like you, I managed to get myself a place on a much sought after team prior to getting injured; my thought process was that if i didn't sort it out, i was narrowing down future options for dealing with it and would just end up confined to an office job (which would psychologically do me in!) with a hip replacement and/or being ill healthed...



    I couldn't live with my labral tears in the end as on a bad day i couldn't tolerate sitting down/driving, and knowing that i had this problem shot my confidence to bits at work (its not the same having a roll around with someone when you know you're broken... hard to explain, but it does have an effect on how you do things).



    I really wasnt 100% convinced that i needed it done, but I was surprised at how much damage was in there when i came round and read the report. The joint was also mega inflammed... I felt i'd done the right thing and felt vindicated. If you haven't already, a hip block injection may assist you in your decision making process (local anesthetic and steroid cocktail into the joint); i had one done prior to surgery and althiugh relief was subtle, it made the difference between being able to run or not, which helped convince me of the decision...



    How long have you been symptomatic for? It was sold to me that early intervention is crucial with this which also swung it...
  • Davo, been symptomatic for over 5 years but only diagnosed  2 years ago.

     

    How long are /were you expected to be off work for, im aware the the physicall activity is a prolonged rehab programme, to be honest i would give up running if told,  i like mountbaiking and road cycling so its not as if i wouldnt have an activity to go back to.

  • dav0dav0 ✭✭✭
    I guess it depends on the extent of the damage, but as a rough guide, no running/contact sports for 12 weeks. Crutches is 2-4 weeks, or 6 if you end up with microfractures to 'plug' cartilage defects.



    I was told 2 - 4 weeks off until i could return to light duties, but i would imagine it would be at least 4 months before you could go back to a physically demanding job like yours.



    Everyone appears to heal differently... I thought i would be fine at 4 weeks until this setback...
  • dav0dav0 ✭✭✭
    How is everyone else getting on? Sorry if i seem to have hijacjked this thread, but I am grateful to the others that have posted on here and hope that people may learn somethinf from my experiences...



    Anyway, went up to London today to see a sports injury rheumatologist, whom I had been referred to by my surgeon. Ultrasound on the joint showed a fair bit of fluid around it and it was felt that this was probably the main source of the pain, not the rectus femoris. So, i had an ultrasound guided steroid injection into the joint in the hope to break the cycle of inflammation...



    Why is it so badly inflammed? Not really sure, think the issues are due to synovitis found in the joint during arthroscopy, which the surgeon noted was pretty extensive. I guess this makes one more susceptible to post op flareups and is exacerbated by my hypermobility, apparently...



    Anyway, fingers crossed that the shot calms it down. How is everyone else getting on?
  • Long time since I have looked on here, so hope everyone is getting on fine. Glad that you've got a date now Pipes - even though a few weeks off, good to know that there is an end in sight. As for me, well, not great news. Bit like you really dav0. Everything was going fine up til the 8 week post op point (had laberal tear repair on right hip, with fatty tissue impingement), then after a session on the turbo severe pain again in right groin, confirmed by consultant’s office and physio as being illiopsoas tendonitis/bursitis.  Continued with my glute strengthening exercises but stopped everything else.  After a couple of weeks it was no better and, in fact, then developed the same pain on the left side.  Concluded glute stuff was just serving to aggravate so stopped everything, apart from walking.

    To cut a long story short, rest has done nothing to improve pain, so had an ultrasound guided local anaesthetic & steroid jab into the illiopsoas sheath yesterday – just the right side to start with although the left side is also screaming out for relief.  Ultrasound showed up a lot of inflammation around the illiopsoas so the chap I saw recommended an MRI next if the steroid doesn’t do the job. 

    How is yours feeling now dav0?  Mine definitely felt a bit better once the anaesthetic kicked in, but is now aching like hell.  Trying to stick to instrucs of doing v little over next couple of days.  I suppose the good thing is that I am pretty sure that the pain is not coming from the operated part of the hip, but from the illiopsoas (sort of backed up by the fact that the left non-operated side is showing similar pain), but it’s difficult to be positive when there is seemingly no end to the pain.  Had hoped to be doing a little bit of running by now – still dreaming of the day when I can, but think my legs have truely forgotten how to put one in front of the other at any sort of pace!!

     

  • dav0dav0 ✭✭✭
    Hi bumble,



    Sorry to hear you are still suffering, there seems to be a wealth of info about psoas tendinitis being a pitfall of post op recovery, Phillipon (one of the big US surgeons) has done a study into it - not sure if any of it is any use?



    http://www.biokinetics.org.za/wp-content/uploads/2011/08/Philippon-Gluteus-Medius.pdf



    I hope your injection breaks the cycle for you and allows you to get back on track. I was told to rest since having the shot and have been since Tuesday, though i'm getting similar symptoms in my right hip (the good one, though also cam fai present)... I think this is just down to glute weakness and poor core (have picked up bad anterior pelvic tilt as my core is so weak). Some pain relief, but still got the swelling in the operated groin...



    I too was hoping to be jogging at 12 weeks, but at the moment i'd be thrilled if I can walk any distance pain free. This really does test your nerve; its certainly the hardest thing I've ever had to deal with... Hope it picks up soon for us!



    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642547/
  • Thanks dav0 for links - have printed off to have a good read in peace once my little boy is in bed tonight.  Still trying to take things easy (not always easy with a 4 year old!), think pain is a little better than it was, so maybe the steroid is working?? Or maybe it's the ibuprofen which I'm necking at regular intervals.  How are you today?  Did you have the jab directly into the hip joint or into the muscle? 

    This recovery process is just such a rollercoaster ride - the surgery itself was easy by comparison.  Getting so frustrated, no running for me for a year this week (amazing to think a whole year has gone by, my husband will tell you it has felt more like 10 years with all the moaning!) because I had chronic AT before the laberal tear (ironically, the laberal tear only happened because I was doing a little abs routine at home whilst not being able to do anything because of the AT).  Strewth, it's certainly character building if nothing else.

  • dav0dav0 ✭✭✭
    Hi Bumble,



    Glad the jab seems to be doing something. Mine was directly into my joint capsule, seems to have calmed it slightly (or is that the lack of any activity since i had it?!). Still have a noticeable 'ridge' in my left groin though...



    I don't know how you cope with children and trying to get over this - it's bad enough just dealing with myself!



    It will be a year for me at the end of August, and I'm beginning to forget what it was like not to have to worry about hips etc. The investigation, diagnosis and surgery etc currently stands me at ??12000, which also grates. Certainly, if i get over this, it has changed my perspective on a lot of things and I think i will now be quite content just to plod everynow and again rather than the balls-out-must-be-the-fastest approach i had before... I really dont want to go through this again if i can help it!!



    Hope those links are of some use - seems that professionals are very much still learning with this procedure and those that have gotten back to running by 12 weeks are the lucly ones... Thinking happy, healing thoughts for us both!!
  • Hi all,

    Thanks for the advice Mooshead.

    Just to keep you all updated, I've done a bit more research and have ended up down in London with Paul Jairaj. I've got an apointment with him in 2 weeks. From what I've read and heard, he does a less invasive procedure which results in better  and faster recovery rates. I will let you know how my consutlation goes but it looks like things are now starting to progress...

  • Wow. It's got a bit busy since I last looked in. 

    Troubling to read of people with post-op problems, but I guess that's the nature of the beast - it's not usually one singular thing, more a combination of problems, some of which will be solved, some of which may get exacerbated and some new ones from what is still invasive surgery, albeit a fairly light touch in comparison to olden days. 

    bearing in mind my history (caught early) and my inability to take it easy, plus sparing a thought for those not findign resolution I just thought I should wave the flag of my latest progress. 

    Biking lots more than running since ops. It's been just over a year since the first one. Run at least once a week. But hadn't done more than 10 miles so I thought I would try a bit further. So last saturday managed 18 miles offroad over Simon's Seat in just under 3 hours. Got into a rhythm that I felt I could have done further. Tired legs obviously, but hips seem generally alright. Short run on monday evening, MTB on Wednesday, everything workign correctly. 

    Physio seems to think getting bounce back in muscles. Lots of rehab exercises to do still - more than I can possibly deal with, easpecially as working a 6 day week in 5 days at the moment.

    Stretch hamstrings and glutes/priformis etc every night. Regularly use thigh master for adductor strengthening. Lots of foam roller and sitting on a hockey ball for deep tissue massage. 

     

    All in all, things goign well. Not going to kid myself that I should run marathons regularly, but nice to know that there is life in the old dog yet. 

    My old racing partner thinks I should do the OMM Elite again. I have disabused him of this crazy notion...

     

    ...though maybe next year?

    Good luck all. Keep trying different things - there is no one solution to these problems, but ultimately if the problem is a mechanical one (too much bone in the wrong place) there is only one real solution - get rid of it. Then you can get to work on the rest of the problems. image

     

  • dav0dav0 ✭✭✭
    Glad to hear that you are doing well, mrmoosehead - even more so with the work that was done (microfractures etc, really some cutting edge stuff). It's good that you keep posting on here as it gives hip scope biffs like me something to hang on to!!



    Bumble1 - how is the tendonitis? Can I ask how it actually feels pain wise, and where when you have psoas tendon issues? Still struggling with mine, and the other hip has developed a similar pain too, which i think might be tendonitis of some form?



    Really drained with it all now, to be honest...
  • Hi folks have been keeping an eye on thethread from afar, a question i was going to ask.

    Has any one one had any relief from Physiotherapy, i totally appreciate that the problem is a mechanical one but the thought had crossed my mind.

    Cheers
  • You may get some relief, but as you know, if the problem is too much bone in the wrong place, physio isn't going to help that. 

  • dav0dav0 ✭✭✭
    You can try and 'manage' it, but like mrmoosehead says, its not gonna go away and it wont 'heal' given enough time...



    I have heard stories of some lucky folk with labral tears that become asymptomatic, but i think these folks arent anatomically cursed with FAI. The rheumatologist who injected me treats military personnel at Headley Court (the services rehab centre) and stated that they are seeing more and more guys coming through with this injury - mostly from infantry units. He reckoned only 50% of them made it back to front line service and that the governing factor to success was early intervention. Those that had put up with it for a couple of years before getting operated on were generally found to have less favourable outcomes owing to the extent of the damage...
  • At last, I'm getting my surgery!!! It's taken a whole year to get to this stage!!!

    Got a phonecall late last week and offered 13th August for my hip arthroscopy with Mr Conroy at Harrogate....pre-op yesterday, in at 07.30 Monday morning and told will be an overnight stay & 6 weeks off work to recover.

    Any bits of advice/what i can expect post op would be gratefully received...starting to feel a bit anxious right now.

  • Many thanks to pipes for highlighting this thread to me

    I await a second scan (this time with the one with the contrast dye) in about 8 weeks time (nhs) as specialist thinks i have 'hip problems'. This is a full 13 months after injuring my groin in hill sprints, 1 crap physio, 1 good physio who frictioned scar tissue away and started me on pilates core work, one MRI scan, some leftover groin pain which lates specialist thinks could be hip issues. Guess i have to wait for the scan

    Im guessing that due to the particular scan he's thinking labral tear or FAI.

    Can run with some discomfort, have to run slower tempo - after a year out any running is a relief and boy do i enjoy the camaraderie and social aspect of returning to my lovely local parkrun. Question - am i likely to do myself any more damage by continuing a limited amout of running in the interim? I also keep up my pilates/core work and use an exercise bike once a week?? Im 34, male

    Thanks

     

  • Parklife, I was advised by my consultant not to run at all as it would just do even further damage. He advised swimming (although find breaststroke aggrevates my hip) and cycling.



    I've reluctantly taken this advice although my hip pain has just got progressively worse over time....I'm in more pain and having serious withdrawal symptoms from not running, not a good combination.



    I'm 32, had my MRI last autumn, showed labrum tear....then spent months battling with my PCT to get them to approve funding for hip arthroscopy, finally approved in April....referral to Mr Conroy in Harrogate, had further x-rays when I was referred which showed FAI Pincer....at this point was told to stop running immediately, which I haveimage
  • dav0dav0 ✭✭✭
    Loverunning,



    Glad you got a date for your op and you should be in good hands with Mr Conroy, from what I've heard. In terms of the recovery, here's what i've learnt (still trying to recover from mine, 12 weeks out)...



    - Don't get hung up on rehab schedules... Listen to your body and don't think 'its week x and i shoul be doing this cos the schedule says so'. Let your body tell you when you are ready - you will know the warning signs when you need to back off, so take heed. If, like me, you are a type A personality, you are gonna need to reign that in!



    - Make sure you have help for at least a couple of weeks. I couldnt put on ny iwn socks for this period of time, and needed assistance with dressing etc.



    - Get a good stash of decent anti inflams - diclofenac, naproxen, whatever. With hindsight, i think I came off these too soon and at the same time as ditching the crutches, which really didnt help things. They also help keep scar tissue at bay which is crucial to stop the joint bindin up with adhesions. I hate taking anything, but they serve a purpose. Ice will also help with inflammation, so keep a good stash of that too.



    - If you have issues with your good hip, be advised that this will take a hammering whilst on crutches - which may be anything for up to 6 weeks if you have microfractures... When it comes to weaning off them, i think it is crucial to do this gradually and use them until your gait has returned to almost normal and you are able to walk without limping.



    - Dont take your eye off the ball during the rehab. Just because it doesnt hurt doesnt mean the pain wont come back. Just when you want to relax, soft tissues flare ups can come out of nowhere and bite you on the arse (psoas, rec fem, adductors etc). I am battling this at the moment, and cant help but feel that less is probably more sometimes with the rehab.



    -if you do have a significant amount of synovitis in the joint, this appears to make you more susceptible to flare ups post op, so be mindful of that during rehab. I still think that those that recover in 12 weeks are the exception rather than the rule, too. I went in to this with too high expectations of recovery progress based on that timescale.



    Im sure others will chip in, but anyway, good luck. Remember, the surgery is the easy bit, recovery is the test...



    Davo
  • PipesPipes ✭✭✭

    Good luck, loverunning - delighted that you have got a date and not much time to wait until it arrives!  Dav0 makes most of the points I would have made, especially about keeping on top of the pain and inflammation with tablets.  I expected the post-op pain to be a lot worse than it was, which is obviously positive.  Also, the point about flare-ups is important - I had some days where everything seemed to be going well, then others where discomfort would suddenly return. Sometimes, this was due to trying to do too much; other times, it was just a normal part of recovery.  I still get good and bad days and can't always find an explanation for them.

    Being on crutches was annoying and frustrating.  I found it difficult to be around crowds early on, as I was afraid of being knocked over.  It took a while to get my confidence back in shops/ on busy pavements.

    Parklife - good to see that you've made your way over here. Lots of useful stories and advice.  You and I are the same age (for another 2 days, anyway!).  With regard to running before my first op, I could do a bit, but usually ended up taking a few days to recover each time.  I also love parkruns, so I'd use them to motivate me to go on the cross-trainer, which I find boring.  I did a few parkruns to get the buzz of running hard and having company and went to my club's speed sessions for a while as the run/recover/run formula worked better for me than continuous running. 

    That was with my left hip. Now that my right hip is bad, I can do no running.  Running for even a couple of minutes gives me sharp pains in the right hip and leaves me very sore afterwards.  I even struggle with the cross-trainer.  I'm not sure whether the tear is in a slightly different place, but the hip just can't cope with it.  

    If the tear is not caused by impingement, I'd imagine it should be ok to carry on running, while waiting for the op.  But if it's caused by a bone abnormality, I think there's the risk of causing more damage.  Perhaps if I hadn't carried on running a bit last year, my unoperated hip wouldn't be so bad...

    mrmoosehead - great to hear your report - it's motivational, as ever.  I have started using the roller and stretching every day but only in the past week - I've had a few months of doing next to nothing and everything is stiff/ sore! Congrats on your long run!

    I'd like to think that the left hip op has been successful, but a lot of what Dav0 and Bumble1 have said makes me more aware of the aches and pains still in my operated hip. For example, I've been trying to do an exercise my physio gave me (lying on my back, bringing one knee up to my chest then returning it to the ground) and, again, I get loud clunks in the hip when I do it. That doesn't happen in the unoperated hip! Also, the hip flexor is so tight it feels like it will snap - I'm trying to loosen it, but may be making it even worse.  However, because of the op I'm having next month, I'm blocking out these doubts and focusing on the hope that the tightness etc is different from the pre-op pain and therefore something I can work on when I've recovered.

    Sorry for the long, rambling post and hello to anyone (eg. Mark S) that I haven't mentioned.

  • Ive just taken the time this evening now that i have my laptop back to read through this entire thread and take a few notes(geek!) and ill read through the links that people have put up in due course. All very informative.

    A number of people have really been through the mill my sympathies are with them, hope all those affected have an upturn in luck soon. Some of the stories have made me a think alot just this evening about my expectations and i think the penny is dropping about some advice Dav0 gave about not going hell for leather and not doing too much. Running has been such a central part of my life but I might have to reign it all in and work round it somehow, even if it means an ongoing low level ache in my hip/groin. Perhaps i can do 1 or 2 genuinely slow runs a week, one on grass, and a slow parkrun, i can volunteer at parkrun, use an exercise bike(though that is a bore!) and maybe get hold of a real bike, i should count my blessings.All my nonrunning friends tell me im too old for it and its time to retire but they dont understand the soothing calmness of running between villages or along coastal tracks!! But i have to weigh things up.

    Good luck loverunning with your long awaited and much deserved treatment, and  to pipes with your second upcoming op, and also hope Dav0 has a change of fortune and gets back to work role he wants.

    Someone asked about physio - i must start a new thread at some point on how crap my first physio was and how really good my second physio was in taking forward adductor/core problems. Only when these seemed to resolve did the supposed hip issues become revealed.

    Only when i upped the tempo of a run last night for the first time, has my hip discomfort/pain got worse - pain was at front of before today now its moved to the back of the hip and lower back. Could this be a sign of impingement?  So stupid- wont be doing a tempo run again!

  • dav0dav0 ✭✭✭
    Pipes, sorry to hear about the grief that the unoperated hip is giving you. This can't make it easy for rehabbing the operated one... Interesting point about the crutches - I was shocked at how vulnerable they made me feel when out and about (always looking over my shoulder at the best times anyway!) and hated it - glad it was only for a couple of weeks. I'm still struggling with hip flexor tightness too, have been told that glutes still need strengthening/re-educating (gonna be doing clams and bridges for the rest of my life at this rate) and that stretching is a no-no at this stage. It is getting easier though, as at first I couldn't squeeze my bum cheeks without sharp anterior pain over the front groin.



    Thanks for the kind words, park life. At 34 you are far too young to be hanging up your running shoes; all the other activities are fine, but the trouble is that nothing else quite hits the spot like a run. Much of my pain started off in the lower back, and although most of it was groin based, rear hip pain can also be an indicator of impingement (check out Byrd's c-sign on google as a classic indication of FAI pain - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953301/ ).



    The MRA should give you a definitive answer and hopefully they'll put a steroid/anaesthetic cocktail in there at the same time which should give you a true indication of how much pain is coming from the joint. If you do head down the path to surgery, then from personal experience I would urge caution about running up to the surgery. I rode the wave of my cortisone shot I had two months prior to the op to cross train and sneaky treadmill runs (albeit at a gentle 10kph) thinking I was giving myself a head start on the other side of the op - bad idea. All the muscular strength I had gained was negated by the massive Inflammation I had caused in the joint, thereby causing post op problems in rehab...
  • Cheers Dav0 i'm thinking of just knocking all running on the head until i get the scan at least. I had been injured for a year until a good physio sorted out adductor problems and graded me back to running before hip probs were revealed. During this year off i did no running at all(groin always got sore quickly) but went on an exercise bike regularly. Would do no harm to return to this regime for a while longer, along with core. However.......

    Not long back from the leisure centre where i did 30 mins on bike - i always put the resistance up systemically every 3 mins or every 2 mins til im up near full resistance-is this wise?? I have noticed that the hip pain has now begun to move to the back of the hip- like a faintish burning sensation not too bad but worried that even exercise bike will make this worse?? Such pain is also in the context of trying running over the past 6-8 weeks including that stupid tempo run 2 nights ago.

    I rang the NHS hospital department today - secretary told me that the specialist suspects a 'small labral tear' and i am waiting for arthogram, but she didnt think there was any cortisone/steriod shots nor any xrays?

    By running on a labral tear am i likely to cause an impingement?

     

  • dav0dav0 ✭✭✭

    Parklife,

    The arthrogram is an MRI with a contrast dye injected into the hip in order to better visualise the labral tears/articular cartilage (sorry if i'm teaching you to suck eggs?)  Not wishing to freak you out, but they will put a big bastard spinal needle into your thigh to get to the joint and place the contrast down this - most folks have a steroid down there also as a diagnostic tool (if the pain resolves in subsequent days, then the joint is the generator of pain).  The procedure is pretty painless, i found, though there is some soreness afterwards...

    I'm not a medical professional and I know how it is when you have your running curtailed, but if it were me, I'd steer clear of running for the time being until you know what the score is with your joint from the arthrogram.  Some people run on labral tears with no issues (some cadaver studies report a high instance of asymptomatic labral tears in people), but I would imagine that they don't have FAI.  I guess you could minimise it when cycling with a high seat height etc, and the lack of impact has got to be better than running but I guess you have to let pain be your guide.  Core work (planks, bridges, clams etc) helped me immensely in the run up to the op...

    I'm still having big problems and can't walk, stand or sit without anterior groin pain.  Only ice gives me relief.  Had another steroid injection into the hip area - rectus femoris insertion - which was pissed off and angry on the ultrasound scan, but to be honest I think it is too far away from the pain area (an inch or lateral to the spot where the groin lump is and the pain centres arounf) to be the problem, although it might be part of it.  The scan did show that there isn't much fluid on the joint and that there isn't much scar tissue in there, either, so I'm at a loss as to where the pain is coming from.

    It still hurts over my anterior groin to lie on my stomach and if the groin lump isn't coming from the joint, then the only other thing I can find which might suggest the problem is iliopectineal bursitis?!  Has anyone had any experience of this?

    Found it hard today watching everyone in the sunshine, running and cycling etc...  At the moment I feel like I have played russian roulette with my body and lost with this surgery!!

    Yours, a very frustrated dav0

  • Thanks Pipes and Dav0 for your advice it helps hearing from people who have experienced this 1st hand. 

    Dav0 sounds like you've had a pretty crap recovery so far and your hopes of getting back out and running must be very low at this point, makes it even harder when it's a nice sunny day and you see others out running.....but, hang in there, and be positive, your time will come. I've found the hardest part of FAI has been the psychological aspect from not being able to run...the physical pain I can deal with, but not being able to run or be active and outdoors makes me a grumpimage

    Pipes - I cant believe you are now need surgery on your other hip, how frustrating, I wonder how common it is to have the impingement in both hips? Surely it would make sense to have the MRI and x-rays in both hips rather than wait for symptoms to appear by which time the real damage is done. 

    Parklife - don't run on it, no matter how tempted you are....it's scary how quickly my hip has deteriorated in such a relatively short period of time..mine started just with pain and stiffness after running....12 months later whilst waiting for surgery and having continued running/jogging for 9 months of that time I'm now in constant pain, walk with a limp, can't sit/drive for any prolonged period and hurts to lie down/the pain keeps me awake at night...I really think that the impact from running has caused that deterioration. My MRI authogram last November time only showed a tear, the consultant I was under at the time said I did not have FAI and advised me to continue running.

    It wasn't until I got my referral to Mr Conroy at Harrogate in June and he did an X-ray that it showed I had FAI pincer impingment. He told me that running/jogging was THE WORST thing i could possibly do and told me to stop immediately!

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