Femeroacetabular Impingement

Am I the first?

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12/02/2013 at 11:20

Moozer wrote (see)

 Funny thing is that everybody seems to have had a MRA scan. I haven't I only had a 3d CT scan ?

Hi Moozer, you've just prompted me - I think I referred to an MRI scan in my message to you but thinking back, half the frustration with my diagnosis in the first place was that nothing was picked up by X-rays or the MRI scan, and it was in fact a CT scan that identified exactly what was going on, after my first appointment with a hip specialist where FAI was diagnosed from simply mainpulating the hip.  Would have been nice to have got the CT scan done straight away, although maybe that's easy to say in hindsight, and/or scans are carried out in order of cost to the NHS??

12/02/2013 at 18:15

@Moozer my initial diagnosis came from a physio and a physical examination who had FAI himself and he said he was 99.9% certain I had FAI.  I then had MRI and the dye x-ray which only picked up a tear in my right hip and I was told I did not have FAI and that i'd be fine to keep running which I did for a further 6 months.

When I finally got  a referral to see my consultant he did a simple x-ray there and then and said he could see I had CAM & PINCER FAI and that I should stop running immediately

It wasn't until he actually did the arthroscopy a few months later that they also found stage 3 arthritis and a large tear. CT scans, MRIs and x-rays don't always pick things up, the only way to truly know what is going on in there is to have the arthroscopy. I wish you all the best with your surgery.

12/02/2013 at 18:23

@Parklife so you are 7 weeks post op, how is your hip? Have you returned to work yet? The worst part of all of this is to go through the arthroscopy with high hopes you will be back running and then to find out that running is off limits. Those who come out of this the other side and are able to make that return to running are so lucky. I miss it massively! there are other sports - like you say swimming and cycling are good low impact options. Ive booked myself on an open water swimming course in the summer in the Lake District with the aim that in 2014 I will do a relay team Triathlon (just without the running part)!

 

 

12/02/2013 at 18:31

@Pipes

Hi I'm home, had a bad 1st night at home, the hospital discharged me on paracetamol and codeine and it just didn't take the pain away. Back to my GP yesterday and got my trusted combination of tramadol and naproxen which works and has enabled me to get some sleep.  This side seems much more painful recovery wise so far. I've aldready felt pain in my reviously operated 'good' hip - I supppose given the fact its only 6 months in after my right arthroscopy  & the OA I have in the right side it's kind of inevitable I will feel some discomfort - not sure it's up to the job of supporting my left hip. I'm just making sure I rest a smuch as possible. Good thing about tramadol is it just knocks me out so no trouble on that front!

How did you find your recovery 2nd time round?

 

12/02/2013 at 18:59

@markstrickland

Don't know about you but the spinal helped initally but once it began to wear off my post op pain has been worse this time round. I can remember waking up in recovery and being really scared beacuse I couldnt feel anything down below!! Not what you want to wake up to!

It'sgood that you went home the same day, I had to beg them to let me home Day 2 as they wanted to keep me in another night because my BP was low and  my pain was not under control. Wonder what makes an easier recovery? Sounds like if your hip was a bit of a mess they must have done quite a bit in there? What was their prognosis? Will you be able to run agan? Did they find any OA?

The boredom is the worse part although right now all my body wants to do is sleep. The tramadol knocks me out!

 

12/02/2013 at 22:47

Love running welcome home and don't expect too much of yourself initially! If the doctors give you a rehab protocol i think 'little and often' was a good rule to go by for me.

Back to work last week, still with a hobble. Hip seems ok, pain at the mo mainly consists of twinges. Major life change indeed not being able to take on long distance running though i haven't ruled out 5ks/parkrun as a possibilility but its forced me into seriously considering cycling and learning to swim and a triathlon has crossed my mind too but am ahead of myself! My immediate aim is to rid myself of the hobble.

13/02/2013 at 11:59
Loverunning, everyone's response is different, to a GA and invasive procedures, still think it was bad practice they never gave you spinal when awake, for exactly the worry you had when you woke up, I have felt pretty tired for the last week, not sure why as I stopped paracetamol and ibuprofen on day 3 post op prob the boredom and rest is the cause.
I didn't get any proper feedback from surgeon apart from they stiched down the laberal tear and shaved of the impingement, there is some degree of arthritis, I'll wait till my 4 week follow up for the full debrief, I hadn't been running much for the last year down to sheer laziness, but if I'm allowed I'm going to restrict myself to 5kmwith the odd 10k, and lots more mountain biking.

Park life- your first paragraph is spot on, I think too many people want to run before they walk, excuse the pun, but take each days it comes and don't expect miracles, its a major procedure, but because its arthroscopic i think some don't see it that way.

Wish you all well with your recovery..
13/02/2013 at 17:17

Does anyone know why cycling is seemingly permitted before surgery ? I would have thought that it is still causing the bone to bang in to the cartlidge.

Parlife did the consultant who you visited last week say how long the hobble should last for ?

13/02/2013 at 18:45
Moozer- As far as i'm aware its all to do with avoiding hyper flexing of the hip, and its not high impact.
13/02/2013 at 18:50

Moozer i think its largely down to you - if it doesn't make the pain worse then it should be ok. I used an exercise bike non-stop for months when it became impossible to run.

I think seat height is part of it, a lower seat means more likelihood of 'nipping' by the unshaved bone.

I get your point though, the femir and pelvis still moving at an angle to each other so you'd have thought there was a chance of 'nipping' taking place if irregular bone matter.

I think impact is part of it though, the cartilage has been torn and is weakened. Impact from running impacts it further but cycling has less impact. Thats why ive been told to concentrate on cycling for the long term as my cartilage, although repaired, is now weaker and less able to withstand cycling from running.

Consultant said the hobble likely to go when i get on with my rehab. Physio to focus more on muscle strengthenu=ing from next week. I think its getting better at an almost imperceptible rate

19/02/2013 at 16:23

Love running, hope you are getting on the mend!! A quick q as you were also under Mr Conroy. Did Harrogate arrange you physio or did you get it via your own doctor, they didn't seem able to advise when I enquired.

Hope everyone is on the mend!

19/02/2013 at 22:54
Hi Rebecca, I'm doing good, had a very painful 1st week post op but my 2nd week is much improved. Still resting & not really left the house yet - boredom is setting in!!

They will ask you when you are admitted which hospital you want to be referred to for your physio. It's entirely your choice. The morning after your surgery the hospital OTs will come to see you and get you up and walking on crutches. They give you a leaflet with some basic physio exercises to do in week 1 & 2. Once discharged they will send off a referral to your chosen physio. They then write to you and you ring and make your 1st appointment.

I've chosen wisely this time; last time I just chose the hospital closest to me but the physio was not that good. This time I've chosen mid Yorkshire hospital as they have a state of the art rehab centre with gym and hydrotherapy pool and done good physios. My first appointment is next Tuesday.

How is your hip? Any news on a date?
20/02/2013 at 13:14

Hi Loverunning, I hope you can get about a bit more. This week it is bad for some reason, constant twinges and stabbing pain. I have been getting about fine since diagnosis and using cross trainer...im sure it gets worse when I have been swimming though.

Sometime if I have been sat down all day then it is worse. It is mostly stabbing pain in side of him and front of thigh that I seem to get. I guess the challenge with physio is making sure you get someone good and it is easy to get to (as in no chance of driving) not being able to drive fills me with dread, but just want to get it all sorted now!

Still hoping for late April for opp, but I know there is still a long waiting list.

Keep cheery !!

20/02/2013 at 19:44

Hi All,

Good that this week is better for you Loverunning.

Rebecca Stanley what stroke do you swim ?. I have been swimming 3 times a week for the last 9 months, I just swim front crawl as Breaststroke definitely aggravates the hip. I noticed at first that when I was turning and kicking against the wall to turnaround it ached my hips afterwards so I just manually turnround now and it is fine.  Walking hurts me more as there is more weight on the hips than swimmimg with your legs more or less straight.

I have just found a good website for post op rehab if you are like me and forget the exercises that physios gives you the moment you walk out. They are on a surgeons website he is called Damien Griffiths and they are very detailed and easy to follow. I have my surgery on Tuesday and the pain in my bad hip has almost gone, however the other side has flared up big time. Just a question for everybody what painkillers/ Anti inflammatory have or had you been taking pre op ? And how often ?  

 

 

 

20/02/2013 at 20:32

Moozer I ended up on tramadol at night before my 1st op due to the pain and they worked brilliantly; downside is they made me feel like a zombie the following day!!

Post op I was also given naproxen (anti-inflam)

I use a combination of the 2.

However, its all trial and error as some people really cant tolerate tramadol and naproxen.

 

26/02/2013 at 09:17

I've written an article which has been published on sportsinjurycommunity.wordpress.com to raise awareness of FAI and the early onset of arthritis. See link below.....

http://sportsinjurycommunity.wordpress.com/2013/02/25/catherine-dale-bilateral-hip-fai-and-early-onset-of-hip-arthritis-running/


26/02/2013 at 09:25

Thats me off to the hospital now. The pain on my bad leg still not hurting ? Interesting what they will find when they go in with the camera. 

26/02/2013 at 13:44

Moozer - all the best with the op.

loverunning - I got a bit emotional reading that. I'm obviously one of the lucky ones who went through the diagnosis and referral process relatively easily and recovered well from the surgery, but the thought of never running again certainly crossed my mind on many occasions.  During the many months of pre-op and rehab I did re-stoke my passion for cycling though, and I consoled myself with the thought that if and when I can't run any more, there will definitely be something else I can channel my energy into.  I'm sure with your attitude you will find the same with swimming or whatever floats your boat!   

It's a great article by the way.  Hopefuly it will come up in a few people's internet browsing, answer a few questions, and get many more more injuries correctly diagnosed and dealt with.

26/02/2013 at 14:37

All the best moozer,  let us know how your post op recovery goes, and use what painkillers your offered, painfree is good for the mind.......

 

Loverunning- good article you wrote , im due back at surgeon on 7th March, so i'll see what he has to say about a return to activity, ive resigned myself to only doing 3miles if im allowed to run again and make use of my mountainbike more often, i feel my recovery has been pretty good, only a mild tightness in the area affected but ive had no symptoms of  past (so far)which can only be good.

 

M

27/02/2013 at 14:46

OUCH.

Well just got back from the hospital, totally mad 24 hours seeing various people coming and going, excuse me if this does not make sense as I have had no sleep and quite a few hits of Morphine. I got taken for surgery at 2pm, woke up in recovery at 4pm in mega pain that made me swear out loud and I was shivering quite a bit so they hit me with morphine and warmed me up a bit. The surgeon then came to see me and told me that it all went well. He said I had a severe Labral tear and hardly surprising I was in lot of pain last year. He stitched it back together and shaved a tiny bump that caused it. He said I had a small scuff of cartilage damage so no arthritis. Because of the Big labral tear he wants me on crutches for 5 weeks with 20% weight bearing. Hydrotherapy to start next week and just basic leg shuffles for the first 5 weeks. He said that what he did will definitely shift the pain that I had been getting. I was relived if that makes sense as I said on here earlier the pain was non existent for the past 5 weeks so I wasn't going MAD after all. He gave me photos of the work as well!!  I could not sleep last night and the nurse who was on duty was a credit to the NHS, Every 2 hours bringing me another liquid morphine shot which sorted the pain out. They put something around my ankles for DVT that kept buzzing all night so that's why I couldn't sleep. 

Loverunning I have read your article and Like Phil said I hope lots of people see it.

I think that when people type in to google groin pain symptoms it would save a lot of time and pain if FAI was mentioned with the other possible causes. Hope the swimming goes well for you. I am going to do the windermere mile swim this year.

Im off for a couple of pints then going to get my head down. 

 

 

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