Femeroacetabular Impingement

Am I the first?

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28/02/2013 at 20:17

Best of luck Moozer, thats good that you seem to have minimal cartilage damage. Have to say I stayed off all booze for 6 weeks post-op(even over Xmas) just thought it was a wee variable factor my wellbeing could do without. But then if I have one pint it usually ends up in 6.

Mark S - will be interesting to hear what your surgeon says about return to sport and what type of sport. I've been asking and pondering this question a lot.

Loved your article loverunning it really hit home and struck a chord i thought you summed a lot of things up very well.

As for me, had my review with NHS doctor today(he who referred me privately). A mixture of emotions. He thought I was progressing well at 9 weeks post op compared to others he has seen. He didn't rule out a longer term return to longer distance running he said we should keep an 'open mind' and see how I go. He seemed to think the bigger problems is with those who wish to return to twisting and turning sports like football. He said that with modifying my training - using tread mills/ running on grass there is a decent possibility. However I think I have largely resigned myself to vastly reducing my running and modifying my training to cycling and learning to swim I wonder if triathlons might be a possibility.

On the down side, he felt I had an increased risk of arthritis later in life due to damage to hip joint. Don't know why but this has sullenly played on my mind and reinforces the need for modifying any training and to be ultra cautious with running. We also discussed the possibility of needing the same arthroscopy on the other hip which has been xrayed as having fai can't say the thought of that enthralls. He also said that in his experience the procedure works in the short to medium term in getting rid of pain but he has had some people where symptoms can then begin to return. I only thought after; perhaps these were people who return to twisting and turning sports he was referring to, as he was more positive about long distance running??? He gave me atimeframe of 6  months for full recovery .

Pain levels much reduced generally, but just can't seem to shake the limp. Physio has given me more exercises to do on this - mostly focused on glutes and in particular a poor glute med. I think it may be ever so slightly improving.

Overall I feel pretty good and progressing not too bad. I think the appointment today has just reminded me of the need for future caution, I had been thinking along those lines anyway. I was asked in work yesterday was I glad I went for the op and I'd have to say that my answer at this relatively early stage would be a positive yes. Hope it continues that way though the fear of setbacks never far away!

All the best to those recovering or pondering or awaiting surgery.

 

05/03/2013 at 11:37

Hi All.

Well that's me 1 week gone. The swelling on my leg went after a few days which meant I could shuffle around on my crutches a lot easier and pick up a bit of speed on them. Watch out Oscar. The pain has been okay just every now and again I get a deep throbbing pain usually when I am reading in bed. I am taking Ibuprofen 3x400 and normal paracetamol. I feel like i don't need to but am conscious that the pain could return so will keep taking them for another few weeks I think. The only physio I have been told to do are basic leg shuffles, bridges and standing next to a chair and moving my leg/hip to the side. I feel I could do more and have a new exercise bike I bought the other week which is gathering dust. My surgeons Protocol is 20% weight (crutches) for the first 5 weeks and only the basic 4 shuffles due to NO hip flex ion beyond 90deg and NO forced hip extension both for 5 weeks. I feel like I could do some gentle cycling with no resistance but Definitely would not want to risk damaging the work the surgeon had done for me. Would I be right in saying that it  would be quite easy to damage the hip again at this early stage ? Or would you have to do something quite silly like climbing up a tree. The reason I ask is that I am on the same protocol as someone who has more advanced work on the hip done ie Micro fracturing etc.  I have been told by the surgeon I can start Hydrotherapy when I have my stitches out so have booked an appointment for next Tuesday which I am looking forward to. My other hip is playing up quite a bit and the surgeon says he will sort it out for me if it needs doing once this one is better. I have given myself a daily routine which is all timed as I figured that would help me with boredom. So its wake at 8am read papers and books in bed until 11am, physio, watch a film, sit in the garden for fresh air 1 hour, physio. read more then watch TV. I got offered a ticket for Old trafford tonight but had to turn it down as 76,000 and crutches don't mix. GUTTED. So 4 cans and HD it is. . 

Parklife I really hope your limp is getting better as once that goes then it will be a massive confidence boost and more proof you are making good progress.

Hope everyone is keeping positive and please keep posting about your recovery/ thoughts.

06/03/2013 at 19:24

MarkStrickland - hope your appointment tomorrow goes well and you receive the news you want to hear about a return to running. Let us know the outcome 

Parklife - It's great news for you that running hasn't been ruled out completely. With your increased risk of developing OA and FAI confirmed in your other hip It's got to be about finding a balance between getting your running fix and preserving your hip joints. Like you say modifying your training and doing more cycling/swimming/cross training as well as running may be the way forward. 9 weeks is still very early so don't be too disheartened about the limp. Keep at your PT and things will improve.

Glad you liked my your article, I found it really cathartic getting it all down on paper and even if it just raises awareness with 1 person I will have achieved my aim.

Moozer - how are you doing after your op? Cabin fever set in yet?? There are so many different protocols out there post op from different consultants. A lot of the US Consultants have you on a bike just hours after the op!! It was a good 10 days before I felt even ready to contemplate getting on a bike!! I'd say stick with the advice from your consultant and when you see your physio have the converstaion about maybe doing more. Everyone's recovery is different and it's hard not to compare your progress with others. Remember though that your hip & muscles need time to heal and as a guide the advice is limiting activity for the first 6-8 weeks as much as possible (no prolonged standing, sitting, crouching etc).Hydrotherapy should help too. 

Rebecca Stanley - any news on your op date yet?

I'm 3.5 weeks post op and must say that this recovery is much smoother than the right I had done 6 months ago. Comparing the two, I can see how hip arthroscopy can really work in reducing symptoms/pain in hips with no or very little arthritis. The impingement pain has definitely gone, still sore and stiff but have a great physio and this time i'm really focused on giving 110% to my rehab by resting, not over doing it and doing the daily PT exrecises Ive been given.

At 2 weeks I had my first physio appt and was given the go ahead to get on an exercise bike with no resistance. At 3 weeks I've seen a big improvement in my ROM and at this stage my most recent operated hip actually has better ROM in some movements than the hip I had done 6 months ago!! Must be the presence of arthritis which has vastly reduced my ROM. 

At the moment I've got to do 20 mins a day on the bike with no resistance and a whole load of PT exercises which is keeping me busy! Still not allowed back in the pool yet. Physio says I need to strengthen my muscles before getting back in the pool and will reassess at my next appointment  at 5 weeks post op.

Booked in for my follow up appointment with my consultant on 9 April.

 

 

07/03/2013 at 10:53

Hi all hope you are all reovering well, love runnings, sounds like you are doing well.

I have just heard about my op with Mr Conroy, booked for 22nd April....hopefully we will have nice spring weather for me to recover in.

I am moving house too...bound to co-incide with the op so that should be fun on crutches!!

Happy recovery to all

07/03/2013 at 11:17
That's great news Rebecca, fingers crossed for some spring sunshine! Plenty of notice too to get organised. I moved house during my op last year, wouldn't recommend it
07/03/2013 at 11:41

Are there any particular pre-op things you recommend...?

Re moving, ill just direct people with my crutches

07/03/2013 at 12:01
Before your op just try to stay as healthy & fit as possible as I'm sure it helps in your body's ability to recover quicker. In the week leading up keep really well hydrated & freeze some home cooked dinners which you can just put in the microwave post op.

For your op make sure you take some snacks, comfy clothes to go home in (joggers & slip on shoes) & some face wipes. Post op arrange some help at home for the 1st few days/1st week, invest in some books, magazines, DVDs etc & where possible sleep downstairs.

Sounds very sensible re the house move approach!!
07/03/2013 at 14:07

Ahh thank you....ill start training my husband in all house hold duties (hee hee) What do they do at the pre-op?

07/03/2013 at 15:00
Yes you should have a well trained hubby by the end of it; silver linings and all that!!

Pre op they take your bloods, BP, urine sample, weigh you generally just make sure you are fit for surgery and they'll talk you through the op and what to expect. Nothing to worry about.
11/03/2013 at 13:32

Had a bilateral hip arhtroscopy last May.

for 3 months in lead up did massive amount of hip flexor/ glute strenthening.  This was in an attempt to see if I could sort the issue without surgery. It didnt prevent the need for surgey but it was a major factor in allowing me to be back running within 9 weeks and Half Marathon within 16 weeks post op. Pushing the envelope according to surgeon but no real issues. 1 year on, apart from glutes that want to sleep for a week or two at a time that need kick starting I am easily more advanced in running compared to pre op.

Hope this helps.

 

11/03/2013 at 13:51

Loverunning: Consult went well, he was amazed at how well i was mobilising, told me to continue rehab as im doing and all should be ok, i asked about running and he said to come back to him in 5 months and we could discuss it then, it would be silly to try now when things are going so well.

 

Ive been told i can swim and do a bit of easy cycling, physio has given me stretches and strengthening excercises to continue with so im going to follow instruction.

Back at work on the 26th of this month, light duties for a month then back onto the helicopter, where i think i'll find if everything has worked out well.

 

hope everyones recovering well.

13/03/2013 at 10:15

I am now 15 days post op. My hip had been very sore for the last 5 days since I went for  my first walk on my crutches. It feels like it has become inflamed. Is this normal at this stage ??  Had my first Hydro appointment yesterday and that helped a little bit. 

 

13/03/2013 at 10:23

Moozer are you putting ice on it, and have you had your stitches removed yet. make sure you massagage the area with e45 or vaseline as it can become hypersensitive.

All the tissues will be starting to knit back together and this may cause some discomfort, you need to remember even tho it was arthroscopic they put alot of fluid into the joint your fascia, mucscles fat and other bits will all be joining back together, i started getting pain around top of my thigh near scar site after 4 weeks, consultant advised this was due to the capsule starting to reform and heal.

13/03/2013 at 10:41

Hi Mark,

I am Icing and that gives me a little relief. I just get worried sometimes that I have re torn the Labrum that the surgeon stitched back with anchors. Probably with having to much time on my hands to think about things.   I had my stitches out 5 days ago. Maybe I should take the codeine painkillers instead of the paracetamol.  Good news about your progress. Did you have a labral tear ? How long was you on the crutches for ? 

13/03/2013 at 21:56

Hi Moozer I doubt very much if youve retorn anything, sounds like all the normal inflammation we get - WE're all our own worst enemies worrying about things its very normal and I was the same (and still am). Keep taking the normal levels of ibprofen, and you must not over do things. Youve had serious surgery so 'little and often' with the rehab to get the right level. Your'e doing well.

Well done Mark S about getting back to work sounds the biggest problem you'll have is sticking to this boring rehab exercise regime. But if you do you'll be giving yourself the best chance.

Rick Hall - your return to running is amazing - are you worried about any long term hip preservation problems?

I'm doing OK , just can't rid myself of this annoying limp. And the exercises to strengthen my apparently decimated glute med muscle seem to iiritate the groin.  But just hgave to keep firing on at them.

All the Georgie Best to all

14/03/2013 at 08:46

Cheers Parklife mate. Good to know that the inflammation could be normal at this early stage.

20/03/2013 at 11:36

Hi Everyone. 

I am now 3 weeks post op, not much change since last week still a little sore and stiff but not to bad. I have had 2 hydro sessions and that seems to loosen the hip up quite a bit. I go back to my office job on Monday so I will come off the crutches then as that will have been 4 weeks.

Is it better to maybe go down to 1 crutch at first ? I have used the crutches everyday so far and am tempted to maybe walk up and down my garden today to see if i have big limp or get any pain. 

Loverunning.. I see that the last op you had your Labral was anchored and stitched back down the same as mine, how long did you have on the crutches ? Do you also know why some surgeons GLUE the labral back and why some like ours stitch it back together. How is your recovery going ? Have you been allowed to swim front crawl yet ? I cant wait to get back swimming again. 

 I hope everyone is well. Please keep posting.

21/03/2013 at 23:17

Hi Moozer

Good to hear that the hydro is helping to loosen up your hip and that you are planning on going back to work, do you feel ready?

I suppose there is no right or wrong for how long you should use your crutches – when you get to the stage of not needing any aid to walk that is the right time.

For my right hip (Aug 12) I was on crutches for 5-6 weeks and then progressed to a walking stick until about 18 weeks. I only used the stick for those times when I had to walk or stand prolonged periods. I was also acutely aware of the FAI in my left hip and didn’t want to put unnecessary strain on that hip in compensation.

For my left hip (Feb 13) I used my crutches for the first 3 weeks and then onto my walking stick. I’m almost 6 weeks post op and not using any walking aid (although I’ve not really had to stand or walk prolonged periods yet). Planning on going back to work in a week.

Still not allowed to swim yet, my glutes and hip flexors are still very weak and I need to improve my internal/external rotation before I can get back in the pool; when I do, it’ll be front and back crawl and swimming with a float. Currently doing 20 mins on a bike with no resistance and a range of daily strengthening exercises for my hips and shoulders (became symptomatic with mild impingement in my right shoulder when I started swimming post op last time and not swam since October)

Like you can't wait to get back swimming again - hope it doesn't flare up my shoulder or will have to rely on my bike for any sort of sweaty endorphin fix!!

No idea why they anchor or glue the labrum, maybe it depends on the extent of the tear?

22/03/2013 at 11:17

Hi Loverunning,

I kind of feel ready to return to work as this 5 star prison I am currently in is starting to do my head in. I have a desk job and not far to walk from the car to the office so will see how I get on.  

In your experience is is still normal for me to be feeling some dull ache/inflammation at this stage ? I am on day 25. 

22/03/2013 at 22:17

Hi Moozer I think its probably normal enough to have that achy feeling at weeks 3-4. Its never a smooth recovery it will feel like 2 days forward 1 day back but you will be slowly inching forward with your rehab. I was told by a fellow message-boarder that 4 weeks is nothing in terms of long term recovery and its a marathon not a sprint which was good advice.

OPtimum physio is very important and the rehab guidelines are just that guidelines - know yourself if it feels too strenuous and ease back, or if doing ok just keep at it. Always talk things over with your physio a good physio is invaluable for reassurance and ongoing reassessment of how you are doing.

About crutches, just grade yourself down very slowly maybe try one crutch for a little while then back up to two. Don't beat yourself up if you find this difficult. In the early days always keep both crutches nearby for reassurance.

I found little and often was a good mantra in the first few weeks of rehab in terms of doing exercises. Doing too much can inflame, its a near impossible tightrope but not the end of the world if you make a few wee mistakes. If hydrotherapy works for you then all good.

I had my labrum glued - this was because it was hanging off the bone and was 'flapping' and wes glued back to the bone. I also believe mine was stitched as I also had a tear.

 

Both LR and Moozer I found getting back to work a great relief as a milestone in recovery and for taking my mind off things, so good luck! There's a few 'auld dolls' where I work who made a fuss which was quite nice.

I think my limp is ever so slightly improving - the word is imperceptible. Physio reckons my glute max is good but glute med and min are well below power so have to concentrate on those. Am able to stick the resistance up a wee bit ion the exercise bike for the endorphin fix don't know how I lived without I feel a little flab has built up time to slowly wear it down again.

 

All the best, you're inching forward

 

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