Femeroacetabular Impingement

Am I the first?

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22/12/2011 at 10:29
Hello to loverunning and HW. Good luck with your process, loverunning.

My operation (arthroscopy) is tomorrow (unless it gets rescheduled again!). I'm getting nervous as I haven't done enough core work since the last one got postponed at the start of November. Life, a virus and frustration with the whole process got in the way. I vow to be better with recovery exercises and keep my core work going when I eventually get back to running. Got quite a bit of lower back pain and ache in my right hip at the minute, which isn't great when it's the left that's being operated on!

How are you doing now mrmoosehead?
22/12/2011 at 10:46
Scrap that...just had a call from the hospital to postpone it again No idea when it is now, but my original appointment with the doctor/ referral was a year ago yesterday!
22/12/2011 at 13:31
On noes. Sorry to hear that, pipes.

I'm doing ok. off crutches for a week almost. Walking almost normally again. Been a bit crap with exerciese as work and parties got in the way.

Still got lots of rehab work to do on adductors, but I can stretch them now.
22/12/2011 at 17:37
Poor Pipes. Paracetemol not helping? (I was thinking if you're already on the max daily dose, perhaps going to the GP to ask for better painkillers couldn't hurt... famous last words eh :/ ).
22/12/2011 at 20:28
Good to hear you're doing well, mrmoosehead. I know what you mean about things coming before the exercises, but I'm going to do my best in the time I have left before the op to get a bit stronger in my core.

F2D - I'm not taking painkillers. The pain isn't bad enough, even though it is pretty constant, and I don't want to be taking them every day. It's just worrying me that my back and 'good' hip might not be able to support my time on crutches after the op. I will survive, though, and may pop to Abingdon parkrun for a trot around before the op actually happens.
22/12/2011 at 21:51
I'm in the system now and my case will be put forward to IFR panel which I've been told won't be till February time. I've read the commissioning policy for my PCT and it's clear they will not commission the procedure so don't really know if my IFR will be successful.

I will have breached my 18 week RTT so I've written a letter of complaint to my PCT to try and get some answers. All seems a bit silly really when there is clear clinical support for me to undergo the procedure and I'm facing delays to treatment all because of a commissioning policy.

Also worried that as my symptoms and pain are getting worse despite enforced rest and inactivity that any delays will be doing long term damage to my hip. Need some light at the end of the tunnel, want my life back and to enjoy all the things I used to enjoy! So blummin frustrating.

Pipes - that's really bad news about the cancellation of your op. Any idea when they will reschedule? Lots of pressures with beds across the country with norovirus closing wards. You've waited a long time to get this op - is there any hope you can share with me re your experience?

23/12/2011 at 09:28
Just had a call to offer me surgery next Wednesday (28th)! They got a cancellation and I was top of the list as I had been messed about so much. Fingers crossed it will happen this time.

loverunning - what sort of hope would you like me to offer? I frequently read blogs and posts from people who have had surgery. I read one recently from someone who had achieved PBs, including 2:56 marathon, since surgery (http://www.captainapplesauce.com/fai/#ido). I don't think there's enough yet known about long-term efficacy, but I feel very hopeful that I will be back to regular running when all this is sorted.

I understand your frustration - been there for over a year now, after having had a really good racing season just beforehand. Have they checked you for FAI? Did you ask your consultant what could have caused the tear? With me, I know there is something in my hips that will cause further problems, in addition to the tears that already exist. During my waiting time for this op, I have felt my condition deteriorate, mainly in my 'good' hip, so I want this op asap to avoid more and more damage. Your treatment, if it's just for a tear (without the need for bone-shaving too), should be simpler, if they agree to fund it. Hope the case goes in your favour.
23/12/2011 at 14:08

FAI - emperor's new clothes?

Symptoms are rarely caused by only having cam or pincer impingements. Prolonged rest (totally unrealistic!) would eliminate symptoms.

The symptoms are most likely due to have having poor control, which caused the extra bone growth leading to the FAI....Control and function need nailing or failing to progress into invasive treatment.

Even with invasive treatment, which some people will definately need, unless the control issue is nailed post op, I'm pretty sure symptoms will appear at a much later date.

24/12/2011 at 10:03
6p - when you refer to control, do you mean core stability?
24/12/2011 at 10:36
Yes - and all that it entails. Spine, pelvis, hips, lower limb and foot.

Ho ho ho
28/12/2011 at 20:14
Hey pipes. I guess (hope) you've been done now and you're feeling ok.

Keep piling the ice on - better than painkillers.

let us know how you got on and what the surgeon found.
28/12/2011 at 20:33
Thanks, mrnoosehead. Yes - I've been done!! Feel really comfortable now - sure the pain will kick in when some of the medication runs out. I will take what is offered to stay on top of it.. The surgeon spoke to me briefly when I woke up, to say he'd repaired the tear, but didn't say anything else just yet. I will see him and the physio tomorrow. What a relief to have had it done!

When are you crutch-free again?
28/12/2011 at 20:43
Glad the op went ok pipes....keep us updated on your progress
28/12/2011 at 20:49
am off crutches. in the pub!
29/12/2011 at 13:00
Hooray for you being off crutches! Makes life a lot easier, I'm sure. You'll be able to fetch your own drinks in the pub.

Thanks, loverunning

The doc has just been and read the surgeon's notes to me. He said there was a large tear that they repaired without cutting too much of the labrum out. There's grade 1 residual damage which isn't bad. He removed bone from a couple of parts of the femoral head. I only have 2 war-wounds - I expected 3! No need for micro-fractures. He says no running for 3 months. I have a follow up appoinent with him in 6 weeks and physio starting soon. Seems like a positive result overall. Just waiting to be discharged from hospital. Feel good and had a restful night!
02/01/2012 at 11:55
All seems to be going well 5 days after surgery. Pain has been minimal and I have been able to cycle on no resistance without any pain or problems. I can get around slowly on crutches but haven't really been outside much. Popped into a shop to break up a long journey but didn't feel steady and confident enough on my feet amongst crowds of people.

Mrrmoosehead - would you mind telling me some specific exercises or cycling times you were advised to do after the op? I was given 5 simple exercises and told I could cycle but not for any specific amounts of time. My next physio appointment isn't until Friday so I wondered how I could progress my rehab a little, without pushing my luck.
02/01/2012 at 15:48
My booklet says 2x15 mins, when you feel like you can, increasing by 5mins a day up to 2x45 no resistance. I had to put some resistance on as my legs are pretty strong, so no resistance was spinning too fast and out of control.

Exercises wise - lots of isometrics - static muscle tightening

Ankle pumps, whilst sitting on the floor/bed
Tense and release quads 20x5sec reps
Tense and release glutes 20x5s
Pilates style pulling belly button in, hold release 5x20secs

hold on, here's a link:
http://www.ernestschilders.com/PDF/Hip-Arthroscopy-Rehab-Programme.pdf



02/01/2012 at 16:28
Thanks for the info. and the link - I shall take a look at the website later. I have been doing a couple of little sessions on the bike (actually, I was the same as you - had to put a little resistance on or else the legs were trying to go too fast) and am now happy with today's plan to do 2x20 mins (as I did 3x10 yesterday no problem and did 20 this morning).

Another question - how long were you unable to drive? I didn't have quite as much done with my hip as yours, as I didn't need micro-fractures, but don't know how long that will limit me for.
02/01/2012 at 16:33
is it right leg or left? I believe that if right leg, then you won't be allowed as soon due to emergency stop issues.

If automatic car then even sooner I guess. Up to your surgeon - with right it was about 4/5 weeks for me, left was 2 weeks. But then schilders did also say that he's letting people drive a little sooner now.


02/01/2012 at 16:50
It's my left and I have a manual car. The nurse said I should contact my insurance company to see what they said.

Do you have any more follow up appointments? All looking good enough for some sort of running again in a few months?
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