FAI Hip Impingement (Femoro-acetabular Impingement)

FAI Hip Impingement Awareness facts - It is estimated that approximately 15% of the young, adult population have hip impingement, so who do you know that might have it?
Hip impingement causes painful labral tears within the hip socket.
Hip FAI symptoms are misleading to the average medical professional, as FAI hip impingement pain frequently presents as low back pain and interesting only 10% of back pain is ever clinically diagnosed and cured... Which begs the question what percentage is actually caused by hip FAI or hip impingement, as its otherwise known.
The more active you are, the more likely you are to trigger hip impingement symptoms, so busy mums and gym bunnies beware... but at least you're in good company as many premiere league football players have also suffered FAI hip pain.
Hip impingement is diagnosed through x-ray and labral tears are diagnosed through MRI arthograms - but both need to be read by hip consultants specifically trained in FAI hip impingement.
There are 60,000 hip replacements every year in the UK and it now appears that FAI hip impingement, over the years, could be the leading cause of hip osteoarthritis. A silent epidemic.
Hip arthroscopy can reduce the hip impingement and reattach the torn labrum to the hip socket. This surgery can eliminate the pain and disability caused by FAI hip impingement and divert the need for hip replacement in later life.

Also please feel welcome to join in our help and advice forum for support. We have 3 advising FAI expert hip surgeons, 3 PT/physios and a sports medicine doctor as well as the largest international FAI hip impingement forum on the net:

Monday, 8 June 2009

A diagnosis - FAI and hip labral tear is the cause of back pain and hip pain symptoms

Femoral Acetabular Impingement (FAI) Pincer type and Labral Tear.

Meaning hip, back and groin pain caused by hip sockets been too deep, hitting bone on bone when flexed and tearing own hip lining, or in short "OUCH!"

Labral tear and FAI hip impingement - there it is, just like that a diagnosis after 5 years and 6 months of pain and partial disability. Its taken over 20 health professionals to finally arrive at the door of a consultant who is knowledgeable enough to spot what is wrong with me!
THANK YOU lord!  I have FAI hip impingment (pincer type) in both hips and at least one labral tear.

Its has been a long journey to this diagnosis. I have seen EVERYONE from top consultants to chakra alignment spiritualists and spent thousands, probably over £20,000. I have seen doctors, physios, osteopaths, chiropractors (lots), acupuncturists, prolotherapists, spiritualist healers (anything when desperate!) and 6 consultants and for what it was worth may as well have consulted one of the checkout girls from Waitrose! At best I had temporary pain reduction and worst I was mislead down the wrong route with foundation-less diagnosis.

My FAI hip symptoms: (10 of the symptoms below are typical FAI hip pain symptoms, I've starred them for you.)
1. Deep ache mainly in right buttock.*
2. Pain down leg. (common complaint on hip impingement forums)
3. Pain around sacroiliac area and just above.*
4. Groin pain.*
5. Hip pain.*
6. Muscular spasm pain (lots). Mainly in QL and buttocks, multidifidus and also feels locked in thigh with tense TFL and iliotal band.*
7. Pain intermittent, worse on activity.*
8. keeps me awake most nights.*
9. Really hurts to sit.*
10. More recently limits walking to half hour on a good day.*
11. Hip clicks when flexed.*

Had to give up job as journalist/producer and curtail almost all sitting activities, driving (live in a village so hard to stop), cinema, meals over hr long at best, most social activities; and sport...as if, no more horse riding, swimming etc. and can't lift heavy stuff well.

Misleading diagnosis I have had:
in date order.

Sept 03 GP: muscular back pain. Told pain back as hip pain can't refer into back, but back can refer into hip - Here begins a trend!

Oct 03 physio: mild muscular spasm lower back. Told do pelvic floor. Surprised as pelvic floor strong... I thought!

Oct 03 GP: postural problems

Feb 04 GP: suppressed depression, when I said I wasn't depressed!?

March 04 Osteo: bit out of alignment. Do pelvic floor.

April 04: consultant neurologist:
MRI shows nothing bar "very mild dehydration at L5, unremarkable MRI" and so mild myelitis diagnosed.

May 04 chiropractor: (quote) you've got real problems. Told back pain refers into hip and groin hence symptoms! Do pilates.

July 04: Fell pregnant for 1st time, and in the absence of any cure, sort good bed as a cure.
In the space of 6 months bought a firm cheapish mattress, followed by a tempur 20inch, followed by an inflatable £18.99 mattress from Argos that I could alter night by night to help. Sleep on the Argos mattress for 3 and a half years - yes v sexy!
Was for some reason generally better during and shortly after 1st pregnancy, though did resume some tablet taking post pregnancy.

July 04 acupuncture: Low energy.

March 05: 1st baby born.

May 06: Symptoms suddenly much worse (prob from carting weight of 28lb toddler around.)

May 06 GP: Same old, "who knows, but take some of these" approach, (given up with GP now)

May 06 Osteo: questions twisted pelvis, v temp relief.

July 06 Pilate's tutor: back too curved, but Pilate's makes it worse.

Sept 06 muscular skeletal specialist: mild anterior pelvic tilt, glutes not firing, otherwise unremarkable. Told do Pilate's/pelvic floor (yawning now!) Have 2 caudal epidurals, cause more pain. Refers me to pain specialist.

Sept 06 Pain consultant: *Its my discs, so performs discography, but I'm fine.
*So it must be my facet joints, so have steroid injections. *Not sure if have some relief, so think best action is denervation (burn the nerves away) of area. Am in agony for weeks!
*Must be sacroiliac joint, steroid injections. Again didn't seem to work.
*Check for inflammatory illness high ANA's come back, told bad news, now scared, more tests, takes week to finally come back and is negative.
Am so glad will not be dying within next 10 yrs pain pales! Told can't be fixed, told don't know why got pain in groin, told to learn to live with it at pain clinic.

Feb 07 Podiatrist:
Twisted pelvis, lower back too curved refers to Chiro before treatment.

Feb 07 Chiropractor: Twisted pelvis, though eventually thinks back 'too flat'. Stay with this chiro for 18 months as temporarily helps and he keeps trying and trying. Told can't be my hips as hip pain doesn't refer into back. told do pelvic floor.

March 07: consultant muscular skeletal: Told sacroiliac dysfunction need prolotherapy in ligaments. probably 3 sessions of 20 odd injections. But I have 11 sessions over many months = about 250 injections. Means I can now sleep on a flatter bed as all ligaments accidentally support hip area I now think. Told to walk for 2 miles each day, I do for one yr; and do pelvic floor, but PFE doesn't help as doing pelvic floor exercises always hurt.

Jan 08: fall pregnant again, but this time at around 26 weeks I lose ability to walk for more than 10 mins, told symphasis pubis. I accept that and start seeing lady chiro

July 08: Lady chiro: says pubic symphasis and pelvic girdle pain been the problem all along even though started before ever pregnant. Does a lot work on hip flexors, TFL and illiotal band, but insists, as all others, can't be hip problem. Says twisted pelvis, do pelvic floor.

Oct 08: Have baby and symptoms worsen considerably. Now struggle to shuffle round 3 or 4 isles in Waitrose. Can't sit again. Leg gives way whilst shopping. Desperate.

Nov 08 Obs Physio: post baby. Says hips stiff, recommends Pilate's and pelvic floor. I point out everyone says that and it hurts to do PF exercises, I ask for internal check rather than blind diagnosis of pelvic floor. To her surprise and not mine she finds pelvic floor in spasm and abs pinged back, says must be compensation for back. Refers me to pain clinic.

Dec 08 new Chiro: the best: Says maigne syndrome and twisted pelvis, do pelvic floor arrrrgggghhh! Says back too flat and told legs uneven length due to twisted pelvis. I ask for standing xray and I do have 8mm discrepancy, but is actual, not pelvis related. Had been told many times previously about leg length, hence my insistence to clear it up.

Jan 09 Another post baby physio: internal work to relax pelvic floor, obturator internus real problem. Given hip strengthening exercises..

Jan 09 new physio: (for external stuff) Does trigger point work, gives relief of muscular pain, starts to question hips and triggers reoccurring. Start getting pain both sides now, identical.

[march 09 my baby daughter has leg length discrepancy, I google and decide she qualifies as hip dysplasia, I take her to my chiropractor for confirmation as doc appointment a week away. They say sacroiliac/pelvis twisted no dysplasia. As does Doc, but this time I insist on scan! Scan confirms hip dysplasia.. she is treated with 12 wks in pavlik harness and it works, just... but I am now furious at how it was nearly missed and the subsequent consequences; and doubt both doc and chiro have a clue!]

April 09 physio: writes to my new Doc (one that listens) asking for her to refer me to hip specialist and to MRI whole area. Physio suspects labral tear, as despite working on me for a few months I do not improve (at last someone picking up on my symptoms). Thank you Louise Grant at Cookridge Hall, Leeds, Physiocure. She also looks further into labral tear/hip problems and literally finds that 5 more of her patients with vague, changing unrelenting pain have this problem. She is proved right within subsequent weeks as these patients undergo MRA scans. I later wonder if there is a silent epidemic! (Adding this 2 years on and Louisa Grant at Physiocure has now found over 100 patients with FAI, within a small suburb, within the city of Leeds... it is a silent epidemic and I wonder how many people are out there misdiagnosed and suffering like I was.)

April 09 specialist pain consultant: (this NHS appointment arrives 2 days before my private hip diagnosis) : Told not sure of my diagnosis, but that it CAN'T be a hip problem as I'm too flexible. So it must be my sacroiliac joint, even though when pushed he told me I don't test positive for sacroilliac problems, however this must be the problem as he can find nothing else?? To live with condition and medicate with stronger stuff, anesthetic patches or try coccyx steroid injection for sitting disability.

April 09 Consultant private hip specialist in labral tears: Thinks most symptoms match labral tear symptoms. Says xray completely normal, but MRA shows labral tear (MRA not actually painful to have, just uncomfortable, I'd been dreading it so much I almost didn't go ahead with it!). I don't remember a tearing incident, but he says many don't. I'm grateful at last for a diagnosis.

May 09: I raid google 'labral tear' sites and look for top top top specialists as I learn 3 things:

1. Get THE best specialist you can - and there's only a small handful in the UK.
2. Find the cause of tear - else you'll likely re-tear and need revision surgery.
3. Rehab, rehab, rehab

I seek out the best consultant in my area. 
From my X-ray alone he sees I have Femoral Acetabular Impingement (pincer type)  Hips should be around late 20's/30 degrees, (average presenting patient at 37 degrees) but my bad hip is at 50+ degrees, good one at 43 degrees and of course one labral tear on tested side,  a suspected tear on other.  Thank you lord, I am home!

...But I am not am I?! I have all this hip arthroscopy surgery ahead of me, so this is where I am at and how I got here.. Its an end in one sense, as I have a diagnosis at last, but here begins the cure (I HOPE!) and I will be blogging as I juggle life, my kids, crutches in a 3 story house, my frustrated, but ever patient husband and these scary ops and believe me I'm scared!
So feel free to follow this recovery blog and I hope in some way I can help, because I know out there are many more people suffering like I am with FAI hip impingement, that don't even have their diagnosis yet it!

Updated from 2013:
If you would like advice and help, as to whether your symptoms could be pointing towards a labral tear and FAI please come to our facebook forum, with onsite surgeons and advisors: https://www.facebook.com/groups/FAIhip/

If you would like to find the best FAI surgeon then please click this link for the best FAI Surgeon's names:


  1. oscarsmum said...

    Have you tried pelvic floor exercises?!!!

    Lol, sorry couldn't resist!:)

    Glad to have found your blog, will keep following.
    Don't worry you are in good hands,
    Kate x
    07 June 2009 04:27
    louisawb said...

    Thanks Kate lol...If I 'never' hear the words Pelvic floor exercises, twisted pelvis or sacroilliac dysfunction again it'll be too soon - fashionable diagnosis of the moment and about as accurate as saying you have monsters and trolls living in your back hurting you, flippin quacks - hmmm bit of leakage I suspect!
    ps following your progress and wishing you well x
    07 June 2009 10:19

    1. Tim Gray here, from US. I have had a similiar issue now for 8 years. I've been going to the doctor and they get xrays and they come back only slight arthritis. The next time a little worse, the next time worse, and an MRI says labral tears but told to relax. Finally, after 8 years they find I have a Cam impingement the size of a grape on the lower part of my femor head. It's literally as big as the femor head itself. When I saw the Xray's I'm wondering what these guys were looking at before. I have less than 10 degree flexion movement and about 45 degrees bending straight ahead(the cam was on the side. So now I'm waiting to see if 8 years of damage will require me to have a THR. I worked through what they were telling me was "slight Arthritis" because I tried to stay very active. That turned into literally dislocating my hip everytime I flexioned beyond 10 degrees. It's sad to see you go through this too but I'm glad to read I wasn't the only one who had some poor doctors.

      And my lower back pain was one of my symptoms, told it was due to not stretching properly

    2. Argh that is just awful! Come to my faceook group and let us try help you. This one is for support: https://www.facebook.com/groups/FAIhip/ AND this one for finding the best FAI surgeon in your area, which you must do, no more half witt hip surgeons: https://www.facebook.com/groups/BestHipSurgeonsReviews/

      So so sorry to hear this story.

    3. Thanks for taking the time to discuss that, I feel strongly about this and so really like getting to know more on this kind of field. Do you mind updating your blog post with additional insight? It should be really useful for all of us. Osteo Sydney CBD

  2. Another example of someone going to Chirpractors and getting absolutely no relief. Don't be mad, it's very, very typical. The lesson learned? Always go to a MD before anyone. I had the same thign happen to me.

    Good luck.

    1. I went to multiple MDs and it still took 4 years for my diagnosis.

    2. my daughter who is just 12 has been experiencing severe hip pain since october2012, after 2 A&E visits 2 GPS consultant at the fracture clinic and 2 visits to the pediatric orthopedic a private physio and chiropractor an nhs physio and hydro therapy she is still in as much pain as ever. she is an elite gymnast training 24 hours a week and every symptom she has and every possible reason for getting an FAI and labral tear she fits the bill . all the research I have done pooints to this though doc having only wobbled her leg around a bit and becasuse the xray looked clear is adament this is just a pulled muscle. she has not responded to physio chiro or anything she can bearely walk or sit so anything else is out of the question. she is heartbroken that she cannot do her beloved gymnastics and and tear, I have demanded an mri and am waiting for that now but told it could be 6 weeks as she isnt urgent ( matter of opinion)but am still worried it wont show on the mri but the time she has the mri and the results come back it will be 5 months since we first sought help for this and in all that time she has been in a continuous pain, shes very small typical gymnast build its awful to see a once little powerball gymnast reduced to a bundle of agony. any advice ????

    3. Yes she needs to be seen by the right people, the wrong consultants ie general orthopedics or general hip will not spot this. Where are you and do you have any private healthcare (not essential but helpful)? Was clicky hips ever mentioned to you when she was a baby? Is she at all double jointed? I am sure I can point you in the right direction and fairly quickly. You might like to contact me on facebk, could be faster but I will look out for your reply either way to help speed things up.

  3. I am in a similar situation but only 8 months and 12 Drs, Chiro's, PT and surgens. I am a trainer, yoga and pilates teacher so very strong. I found out a I have a slipped L5 and a bulging disk. My first complaint was hip pain nagging groin, and low back. The first PT thought impingement but Orthopedic ruled it out. That was 6 months ago. Gave up teaching still not better. This found new hip specialist and he thinks it is a labral tear so I will have an MRI with contrast. MY THIRD ONE. So I pray I will have a diagnoses finally as I can in massive pain and have tried everything for back pain SI pain, pelvic floor excercises hip therapy. I then will see a specialist in Portland Oregon. I wish you luck you are not alone.

    1. what kind of symptoms did you have for your slipped disc. im having similar problems recently diagnosed with FAI. but i also have tingling in my big toe while walking.so was wondering.

    2. it took them ten years and finally now surgery ---the worst I have been called a liar by health professionals when their treatment did not work

  4. Thanks guys, it is utterly ridiculous isn't it that we all go through this, the main failing I believe is specialists arrogance and so refusal to listen to the patient! I was once told they didn't want to hear my stories of pain (like it was fiction!) Dear Anonymous from Portland, find the very best and I wish you some resolution to your pain. Every time I panic about this imminent op, I remind myself I'd rather that, than not know what was causing the pain, that is so much worse, so good luck to you too!

  5. Wow - Interesting reading - I was just diagnosed after 6 months - I researched alot and had discovered FAI awhile back and what do you know - Finally that very diagnosis. I am very near to run out of sick time as I have been told I can not work from my employer (I am a police officer) I have a flare-up aka disabling incident about 5 times a week. This is horrible! Now I am getting a hard time from my employer. I ride police horses or sit in a cruiser for a living - job related????? I am not happy. Getting an injection to see if that helps, then surgery if needed.

  6. Hi, glad you have posted your blog for others to see,as i am in a similar situation to your self, i have been suffering with similar pain symptoms to you for the last 5 or so years, and have visited almost all the so called specialists that yourself have been to, but can say none has been able to put me right yet, and at my last visit to my GP only to be told there is nothing more he can do for me. Very comforting to hear this from the one person that we all rely so much on to put us right, hmmmm
    Hope all works out for you, and you get better.
    Good luck

  7. Dear Jose and anonymous.. you both are the reasons I decided to blog, I knew there had to be more people than me suffering out there.
    The ignorance and arrogance of the medical profession is astounding!
    Jose the injection definitely helped ease my symptoms/tolerance, slowly though, but it will not help you long term. I'm so sorry re your job. I was a journalist/TV producer and spent hours at my comp writing and literally became unable to work. I was in fortunate position to be able to buy 2 rental properties so set myself up as a landlord where I was able to work without sitting and be my own boss. Your condition is most likely curable, though not a super quick cure, will the police not give you 6 months out with an option to go back, you have a disability, but it can be fixed. Funnily enough I'd started horse riding again just before mine started hurting in 2003 and often wondered if that might have been the trigger.
    Anonymous also, I don't know where you are, but please make sure you get the BEST spe'FAI' not just labral tears and also in 'hip arthroscopy'. There are names in the north and south of the UK and the States that come v highly recommended. Don't feel afraid, or duty bound to anyone you're seeing right now. Make sure you get the best you can, its your body and its all you've got!
    Anonymous where are you? your GP can and must refer you, its their duty otherwise switch GPs. Find out who you want to be referred to first, make it easier for them and it makes it easier for you. They're unlikely to send you to the right specialist. Trust me there are hip specialist and FAI, labral tear hip arthroscoopy specialists. If you have private med its easier, if not in the UK for sure you can choose which hip specialist you go to now, its called patient choice I think. Not sure how US works but again some excellent surgeons names out there that I hear of regularly in positive light and that is what you need. Good lucj top you and please keep me posted.

    Keep in touch and if you repost post where the latest most up to date blog is because then I'll see your post sooner. I'm no expert, but if I can help I will. It is a horrible invisible, ill understood condition and you need specialists and people with similar experience to help, otherwise you'll be lost in the system!

  8. Well, I had my injection yesterday but no relief yet. Some relief while it was still numb, though. I'm sure I'm going to have to have the surgery. I have worked for the PD for twenty years so I won't lose my job, I just won't get paid for 6 months while recovering unless I get this related to riding and driving which it has already been written by 2 Drs. I just want my life back, I can't even do my barn chores or walk the dogs. I am grateful for your info posted and for the fact I located an FAI specialist in Worcester, MA

  9. intesting!! I have been having the run around since June 2002! Started on left side but last 2 years has been bi-lateral, i presume from screwed up posture/gait all these years. My main issue is pinching left groin, pain in backs of thighs high up sort of ischial tuberosity area and low back outer hip. The pinching is mainly left but other issues are both sides. I have been suspecting hernia for a long time but now i am thinking labral tear so i need so see a hip guy to see what they say. I have bupa and i am in London - where should i go!! ??


  10. Hi Jose,
    My steroid injection took 3 weeks to deaden my symptoms, in fact I'd given up hope when I realized I felt a bit better! Retrospectively I think as steroid injections are only an anti inflammatory I think 5 and half yrs of bashing, it was very inflamed in my hip, so it took longer to take effect perhaps.
    If you have FAI it will be activity related and both sitting and riding have your hip flexed so yes there is a connection, in that it will induced the pain. It won't have caused the pain though I don't think, in the sense you're born with a predisposition that may or may not develop into FAI condition (its actually a bit sketchy as to whether the condition is developmental or congenital.) But yes if you have labral tear and esp FAI sitting/riding will irritate the condition. I know I haven't been able to sit for 5 and half years, its exhausting!
    You probably would recover enough within 2 months to return to light duties, might they compromise with that? Glad you've found a surgeon. Keep me updated, good luck.

    Hi Tom,
    All sounds familiar and I certainly recommend checking it out, wish I'd known mine 5 yrs sooner! Esp if you're like under 50, docs just dismiss a hip possibility all together!
    Bupa cover it, thank goodness and in London there are a few names I hear of, Richard Villiars I think is the London name. I think there is another but it escapes me now.
    If you can face a 2 hour, 10 min train journey I would recommend Schilders. He has has apparently outstanding results. I have also not seen one negative thing about him yet. I don't know if Villiars is specialist in FAI though and that is key because unless you had a moment (and you'd remember it!) when you had a trauma and felt a severe pain in that region, you could have some FAI involvement.
    It is critical you have that addressed either way, else you run the risk of a re-tear.

    My advice would be get an MRA and Xray with a 1. FAI/2. labral tear/3. hip arthroscopy expert (you want all 3 things in that specialist). Make sure you feel comfortable with them. If you feel you only have half the story, go for a second opinion elsewhere. This is a huge decision, make sure you get it right.
    I can only really recommend Schilders at the Capio Clinic, Bingley, (now Yorkshire clinic) as I only have 1st hand experience of him, though there are other names around the south. Google their names in positive and negative terms, Villiars is meant to be a pioneer of hip arthroscopy (many claim that though) but then I've also read a few posts that he missed peoples FAI and they re torn, how how accurate these forums are I don't know for sure.
    I would've traveled to London had I thought I'd get better care there, but I couldn't find anyone with as clean a reputation as Schilders and athletes travel to see him and so I guess that was my decision made. I was just lucky he was relatively local to me.
    Do your research well, sites like coolrunner and yahoo FAI are full of people with symptoms and post op and with surgeon recommendations.
    Wish you luck, keep me posted and feel free to ask and q's. I am only a laymen, so I suspect my knowledge very specific to my experience, but I'm happy to help. Good luck

  11. Just had my MRI scan on 18.09.09 not good news i have Labral tear in right hip joint. I am Golf Professional in Leeds so next step is to get a consultation with Prof Schilders.He seems like the main man!Had back problems for many years last few months had chronic pain after playing golf.will keep you posted on what happens.

  12. Dear Golf Professional,
    Do keep me posted. I do read that action of golf can predispose to this injury.
    Funnily enough just prior to surgery Professor Schilders told me I was in the top 5% worst FAI pincer cases (a great thing to be in the top 5 for !!) but that the only other case he'd seen worse was a professional golfer, so I would guess he'll have seen your injury all before.
    Also it is quite possible any back pain might fade for you after this op.
    I'm happy with his determination to fix me, which I have not encountered before, I think you'll be in good hands. Do let me know how you get on though.

    Good luck

  13. louisawb - have you had your surgery yet?

    I am three weeks post-op, arthroscopy for FAI & torn labrum. I too went through a number of diagnoses over two years & tried to avoid surgery.

    The recovery is a sloooow process. The pain I had before surgery was relieved, although I'm feeling pain from the sugery itself. Just yesterday I'm starting to feel the same pain I had when all of this first started. Last night was the first time in weeks that I had trouble sleeping [again]. I am very concerned, but Dr says it's likely muscle spasms, PT says to watch level & frequency of pain. I'm not going to panic just yet as I know I'm still recovering.

    I will be on crutches for probably 4-5 weeks & anticipate relief and returning to an active lifestyle. I am 41 y.o. female who enjoyed a lot of biking (which I understand can exacerbate FAI) and racquetball until two years ago.

    One PT told me the best thing you can bring to surgery (& I believe anywhere) is a positive attitude. I know it's hard sometimes (& is for me today), esp when dealing with chronic pain.

    I look forward to your updates & wish you a pain-free future!


  14. Hi fellow sufferers! So glad to find this UK-based website and read your experiences. I've another tale of woe I'm afraid. Exactly 5 years ago I felt a painful ripping feeling whilst pushing down with my right foot on the back of a heavily loaded double buggy to get it up a high kerb. After that I got a sharp pain whenever I turned my right leg outwards and it often gave way, even when I was walking. The GP wasn't very interested and referred me to the practice physio. Long wait before appointment. She taught me exercises to 'strengthen a torn aducter muscle' and gave me 3 acupuncture sessions (she'd just done a course). Extremely temporary relief, exercises made pain worse, so stopped them. Put up with recurring pain (worse when pushing/manouevring heavy old wheelchair of boy I was teaching assistant for for 3 years from 03/05 to 07/08, and lifting him about for his physio!!). Until last Christmas I had to visit A&E as the pain had got that bad, resulting in them recommending I have an MRI scan. Instead the GP said before he'd refer me to hospital specialist I had to try seeing their physio again (different person) and if she couldn't improve it then they'd refer me (although admitted could be 3 month wait for appointment once referred!). Physio sent me for 6 weeks of exercise classes as suspected a back injury might be causing my pain, but classes and home exercises only made problem worse. So grudgingly the GP sent me for a hip x-ray for suspected osteoarthritis as I could barely limp let alone walk. Xray clear (they said), so GP finally reffered me to the Rheumatology clinic. Instead of consultant I expected, I was actually seen by a Spinal Physiotherapist, who decided pain might be muscle tear (hey ho, echo). Very, very luckily the specialist doctor was next door and she sought a 2nd opinion. He rule out muscle tear (no dip), then manipulated my legs, and said my hip sockets were shallow so my leg joints kept semi-dislocating. Hurrah! He sent me for an (inkless) MRI scan on 8/9/09. Today I received a letter from the Spinal physio to say I have A LABRAL TEAR IN THE HIP AND ALSO A SLIGHT CHANGE IN THE SOCKET OF THE HIP JOINT. But, then say 'it may be worth returning to my GP to discuss whether an orthopaedic opinion would be appropriate for this problem as clearly your symptoms are not spinal in origin'! I can't believe it. Seemingly it's ok for a formerly fit 45 year old woman to be barely able to walk down the road without severe spasms of pain, never mind not being able to get upstairs one night. Talk about life-limiting! Can't they deal with this a little more urgently, like send me an appointment for the orthopaedic clinic??? Sorry to have gone on a bit! It's reassuring to have read various good websites including this one. I'm going to have to get assertive and demand best NHS bod assesses me. Any ideas? I'm presuming Schilders and Villiars are private, they may not be. If so, what sort of fees do they charge for consultations and surgery please?

  15. Dawn and anonymous so sorry not top have got this earlier. To be seen easily on blogs comment at the most recent updates.
    Dawn I really hope you're doing well. I am 13 weeks post op now, very up and down. definate improvements, biggest problem is with muscle spasm, not caught on hip better yet. By FAR the most effective thing I have done is walk in water and hour a day, killed my limp and I feel so much better after, its really really helping.
    Anonymous.. yes I know exactly where you're at, I've been there and don't let THEIR failing bring you down.
    You do need a specialist. They are the top 2 names. I know Schilders did do NHS, but now may have closed his lists. You could make an appointment taking an Xray and MRA with you, you can get them back from the NHS. For a hundred and something pounds you will get a top opinion and he probably will be able to piont you in the right direction depending on your injury, circumstances and where you are in the country. Why not call prof Schilders Secretary she is called Rachel and is on 01274 621600, based in Bradford of all places! She I am sure will advise you better than me on fees and what he can do for you and is very generous hearted, which by the sound of it you really need after all you've been thru.
    Please do get back to me. I hope you're ok and not too despondant! It is especially hard trying to manage with young children. Just so you don't feel alone, the day before my private diagnosis, the NHS told me there was nothing else they could do for me..that it wasn't my hips as I was both too young and too flexable and that although it wasn't testing positive it was MOST LIKELY my sacroiliac joint and that to learn to live with the pain and I could have pain patches and counseling! I despaired that day, and the next was elated with a proper, in black and white diagnosis from Schilders! Dawn and anon Good luck and let me know how you are.

  16. I had surgery for a right hip labral tear 30 days ago. I spent many years misdiagnosed and mistreated. I had many or most of the symptoms described above. I was very dubious about whether the surgery would work, but I could not stand the pain any more.
    I am grateful to say that my recovery is less painful than pre-surgery. As it turns out, I am anatomically built in a way that predisposed me to this tear [ and likely it will happen on the left side as well]. The bone was banging on the labrum for years, shredding it and then causing it to tear away form the hip bone. The surgeon shaved my femur for more range of motion and that made all the difference. I go to physical therapy three times a week. I wont say it is easy, but every day I am better. It just takes a long time to recover and rebuild.
    I am so grateful for this surgery.
    And the injection with that long needle into the hip joint for the MRI is no big deal at all. It hardly hurt at all. Just dont look at it! I did not even know a long needle was put in me until afterward when I inquired.

    Peace, Sally

  17. Hey Sally, Thanks for that! I think other readers will find that comforting. I notice a lot of people are really afraid of the needle into the hip part for MRA diagnosis. I was so scared I almost passed on it thinking it'd be another dead end, and my hubby talked me into it saying at best you get a diagnosis and at worst you can rule out your hip, be brave. Now I'm very glad I did. AND the hip injection, certainly for me was no worse than a blood test as so few nerve endings there, it was just a scary thought and absolutely yes, just do not look! ;)


  19. Thanks Ursula,
    Really do keep us posted, v interested to know as frankly I am now in the same boat at the mo though I suppose only 4 and half months post op. Had my worst done first, but wonder if had other done might've been a better recovery with less damage done. What explanation has been offered?? Really interested to know.

  20. My husband's op was 3 weeks ago.Stitches now removed and he has had his first post op consultation and physio appointment. He feels MUCH better after this second op and is going like the clappers on his excercise bike. Mr Schilders and the physio were both pleased with him. The acid test will come when he starts doing lifting and gardening again - whether that dull dragging groin pain starts again. He has a bit of backache at night because his sleeping positions are slightly restricted. Just out of interest, he has never been supple. He could never sit cross legged on the floor, even as a young man. I'd like to know if any of you out there are the same. He was always fit, but never 'bendy' wheras I can do all the yoga positions but was always rubbish at sport. The physio can't believe how little rotation he has in his hip and knee. All his football moves were done by pivoting, maybe that's what caused the tear. Anyway, he is very grateful to Mr Schilders' expertise as were the other patients in the waiting room at Bradford Royal Infirmary as they chatted together during the 2 hour (normal) delay to see him. As one person said "He's worth waiting for" I will keep you posted with any further news about his recovery.

  21. Hi Ursula.. That is good news.. I'm anxious to have my second op too so its reassuring also. I too am hoping the next one seals the deal so to speak.
    Occasionally I come across Schilder's patients and they speak well of him, so that at least bodes well.
    As far as flexibility, apparently I am quite flexible, though oddly less flexible in my better of the 2 hips. One odd thing for me though and I don't know if it was the same for your hubby, but I never did sit conventionally, if at a dinner table would always end up either kneeling on my chair or sitting cross legged (um prob not if he couldn't do that!) etc and retrospectively ` think it was a precurser to my inability to sit now, which sadly, one op down, is still with me!
    Anyone else out there experienced the same inflexibility earlier in their life?

    Ursula please do stay in touch as, for obvious reasons, I am very keen to know how your husband does.. I wish him well and that you both will be able to resume a normal life soon.. I say that as my hubby is always quick to point of how much my condition effects him also, so I am sure it must be similar for you!
    Best Wishes.

  22. I was inflexible before my surgery & am still afterward, although I believe I'm the lower end of 'normal' as there have been no flags to PT or surgeon. So, the surgery has not affected my flexibility - it's always been substandard.

    I am now 10 weeks out & am still in more pain than before surgery. I can't seem to shake it. I am still, for the most part, hopeful, but wonder if the pain will improve. I'm so envious of your prompt assurance, Sally, but am very happy for you! I am also anatomically predisposed to this condition...haven't felt anything in the other hip and hope I won't - this is awful! Louisa, I don't know how you hold up with both hips bugging you! How are you today??

  23. Do any of you experience bun pain? On the same side where I had surgery, I experience more pain in the bun - feels like it's in a muscle. I am forced to sit on hard surfaces - was this way before surgery, too, but one year after injury. Some suspect is the sacroiliac. Have any of you had this problem or know of it?
    Thanks for helping and commenting - we're in this together!

  24. Hi Dawn yes pain in the bum, or bun as you put it around the piriformis, I have it, its common, though not everyone has it. Thanks re keeping chin up, you've just got to! Apologies for late replies on this strand, its the latest blog where I always she the comments, rather that this, the first ever blog.. but I always keep checking here anyway as it seems a spot people land on!
    I don't think is the sacro, as when my good side flares up its identical, I thinks its the hip bones behind the muscle, or poss the glute med/ piriformis. Hope you're feeling a bit better this week Dawn.

  25. Ursula, how's your hubby post second op? Mines scheduled end of Jan... still getting better albeit SLOWLY!

  26. I'm awaiting MRA results for suspected hip labral tear. I'm now counting myself very lucky as this was picked up by my osteopath (who was coincidentally treating my SIJ prior to the hip pain starting!) only 2 weeks after the incident causing it. I hoped it would settle down itself, but saw a physio about it about 8 weeks ago, without telling him what the osteo had said and he suspected it after only 2 sessions.

    Both the osteo and physio said it was becoming more and more common and so both had experience in diagnosing it.

    I've also been lucky that it's been manageable up up until now, still playing sport and going to the gym...however in the past week the hip has started to lock up in the front. Massage and traction provide some temporary relief as it's mostly muscular, but the contracted muscles are adding more pressure into the joint itself, which is not good.

    And for the record, the needle into the hip for the MRA actually also provided me with some temporary relief as the extra joint fluid created a little more outward pressure, almost like tractioning the joint.

  27. I see someone mentioned Portland Or. I beleive I have a laberal tear but my Kaiser doc doesn't do arthoscopic evals. It has been a year since my injury and I just can't take it any more. I have Ehlers Danlos so I bet that has made it all worse. Can someone recommend a hip surgeon in Portland, Or?

  28. Good place to ask is the understanding hip impingement group on facebook, as I'm afraid I do not know.
    To update anyone reading the beginning on this blog. I had the surgery with Professor Ernest Schilders 16 months ago with very mixed results. Unfortunately things didn't improve as he expected.. so I am to a degree in no mans land. I have booked to see another FAI specialist, but this time will not name him in anticipation of success as should it not pan out well I do not want to compromise this honest blog by holding back my personal opinion on my recovery.

  29. Thank you for your posts, no one understands the pain or frustration unless you have been through it. I am an emergency room RN, a least I was 4 1/2 months ago. Out of work since due to low back pain. Developed right hip pain this year, May 31st, then July 1st low back pain. Chiro's, MD visits, x-rays, MRI of low back PT for 5 weeks, working on core exercises. Begged for MRI of hip but my PA would not order one. Had one two weeks ago, today told I have a slight labral tear. Next step, lidocaine injection into hip joint to see if that helps hip/back pain. Then on to arthroscopic repair. Neuro surg and pain specialist not impressed with MRI of back. Slight bulge at L-3, poss tear in L-4 disc ( should not be causing back pain. My back pain is in my sacrum and both L-5 S-1 joints. Orig. told I too had SIJ dysfunction. PT did not think so. Am trying to hang in there. Not being able to work or ride my horses is killing me, not to mention I am the bread winner and need to get back to work. Any suggestions, I have not been told I have FAI.

  30. Dr. Andrea Herzka and Dr. Mark Wagner are the two experts in Labral Tears and hip surgery in Portland, Oregon. Arthogram MRI has to be done to determine Labral Tear. Common problems are hip and groin pain and misdiagnosis until Labral tear is found. Sitting with your knees level to your hip will relieve pain. Read this report: http://ptjournal.apta.org/content/86/1/110.full

  31. Hi Deb, all the symptoms you describe are FAI symptoms too, that's not to say you don't have an additional back problem, but go onto an FAI support site and ask other people if they have the samee symptoms as you, low back, sacrum and you have a deluge of agreement. The facebook one is great.
    Re your FAI, find out what kind you have and what op you're been offered, don't take labral repair without FAI repair or you will simply retear prob before you're out of rehab!
    Make sure your surgeon has done at least 1000 fai ops or ask for one that has..patient choice. Do the research now before you commit.
    I imagine your job forces you to lift in serious situations and this really will tax your hip. Are you UK or US? Keep me posted.
    Anon will look at that link thanks, personally I find knees lower that hip only thing tolerable for any period of time. Thanks.

  32. Thank God! I found this blog! I have been misdiagnosed for 2 years now and I saw the 4th specialist today.he told me there is nothing wrong with me, and ignored all my worries plus my chronic pain that is getting worse every day eventhough the MRI shows the tear in my right hip, so yet again I had to go see my family doctor to refer me yet to another specialist. I am tired and so frustrated at this point. I still yet to figure out how I got this injury.

  33. Hi mixed feelings reading this site, altough good to know I am not on my own! I have had lower back pain on my left for years, started seeing a chiropractor in 2004,xray, nothing, didnt help. then osteopath's, NHs physio, mri scan revealed mild posterior bulge L4/5,.. so it went on after returning to the physio again as back no better and recognising discomfort in my hip..plus said how my left shoe wore down faster than my right!? Back getting more discomfort. I had a hhip MRI scan - I have bilateral acetabular labral tears and evidence of impingement on my left. So Iam down to have steroid injections in both, to confirm diagnosis (re make sure pain not from myback that it is hips.. ) I can confirm it is my hips - I have being feeling more discomfort recently - stopped walking in my group, can only do 30-45 mins before sore, stopped giving massage treatments ( I was comp Therapist for last 12 months pre that trained for 12 mths and I am sure this has excellerated my condition. Now wonder if it has been my hips all along, impingement.. that irritated my back all these years... but who knows. So have been in touch with Professor Schilders secretary and he is private now.
    Total life changer for now. I do wish everyone well who is having treatment. I am concerned that maybe I should miss out the injections and go to see Schilders with my mri scan, as concerned what to do for the best.. and cos we are all individuals with unique health conditions.. its hard to know.. I am guessing I will need surgery later this year.. why not do it asap then!!

  34. Dr Carlos Gaunche from So Ca Ortho SCOI. Is a world renowned surgeon dealing on FAI Labral tears also Dr Jason Snibbe Beverly Hills Ca both surgeons specialize in this surgery. I was diagnosed two weeks ago by USC Dr Huoh who referred me to these Dr's since USC surgeons do not do this surgery it is too new and highly specialized, be careful who you pick I read horror stories a lot.

    I waiting to go for 1st hip surgery in 1 mo (got it in both one way worse) that is how backed up they are. I have been told for 3 years they could not find the source of my pain. Inferring it was in my imagination. I ride horses and have for years. The pain is now excruciating in my rt hip leg and across my buttocks both sides. Also up my back. I have been told this is typical of a labral tear with impingement. I'll keep you posted!

    Outspoken in LA

    1. Hi Outspoken. I wanted to see if you could give us some feedback on your surgeries...how are you doing? Which doc did you end up going to? I live in LA and am looking for the best hip doc around. Thank you so much!

  35. I have a similar story to pretty much every person who posted (years of dead ends, but a decent ending). I had surgery to repair my labrum and both cam and pincer impingement. Also had a ITB release and bursectomy to fix the external snapping and inflammation.

    If you are in the US, I'd recommend Dr. Bryan Kelly at HSS in New York City. What you will be asked is to submit your records to him (if you have already had extensive testing) and then they will contact you if they think you are a good patient. He's not arrogant, just a really topnotch Dr. If you are a good fit, you will then have to undergo additional tests and have an appt with the Dr to determine if you are a good candidate for surgery.

    He doesn't "push" surgery, but uses it as a last resort. I'm only a few weeks out but many of the pains have already subsided. Good luck everyone!

  36. Thanks Joe, please do keep us posted and there are 2 rehab exercise guides on this site esp for FAI rehab. Good luck!

  37. Oh I am lying in bed here two weeks post left hip arthroscopy with burning pain in my back - actually worse than it was before. I have put I the year from hell trying to figure out what was wrong and am panicking now it's not fixed. Saw surgeon for 5 mins post op and he wash optimistic. Due back on 7thmarch. Am a teacher and not able for work yet- still on crutches for another two weeks. Should I be panicked or is there anyone out there who had pain at this point and it passed?i just add it is not constant but def getsxworsebin the evenings. I have two small boys and was v active before allnof this. V depressed . Lisa

  38. are you resting properly and have you got tablets to medicate. what has your doc told you to expect and hace you a physio lined up?

  39. Thank you so much for writing this post! I have also been in pain for over five years and have had my symptoms either dismissed or misdiagnosed. Finally, a new orthopedist just suggested today that I might have a labral tear. I found your blog by using Google to search for whether labral tears can cause back pain.

    I am so happy to think that I might at last have an answer. Just reading your blog and seeing that I match the list of symptoms gives me some comfort that I'm not alone in feeling all of these seemingly unrelated pains.

  40. You're not alone at all, there are many of us! Keep pushing you'll get there, my diagnosis it gave me SUCH relief and I'm sure you'll feel the same, the right diagnosis and you're half way there! Good luck!

  41. hi,im glad to see many of us with the same problem,im 32 and have had this problem nearly 4yrs,i was given pain killers at 1st.but had to go bk 2 see my gp a few mths later,she sent me for blood tests which came bk all clear,i then was sent for a scan but that to came back all clear,i was given more pain relif tablets,after a few mths of wondering what is my problem i made another appointment to see my gp.i was sent for a x ray but that to came bk all clear,i was realy fustrated and in a lot of pain by this point.in febuary 2011 my gp told me she would send me to see a joint specialist i waited and waited for the appointment 2 see the specialist but no appointment came,my family in the meantime kept telling me to ring up my gp and find out what is happening,a whole yr later in febuary 2012,i managed 2 ask my gp what the hold up was in seeing a specialist and the words she told me i will never forget,i forgot to send a referal.i wanted to cry there and then,2 have suffered another yr without any help was to much to cope with,she told me she would send the referal today,a few wks later i saw a consultant,he did another xray and thats when he told me i had vulgus hips with incomplete coverage,signs of positive femoral acetabular impingement.i went bk to see my gp,she now wants me to have physio and a walking aid,im waiting for a mri scan and a cortazone injection in hospital,and a opperation of either key hole sergery or a big op in cardiff hospital which is the breaking of the pelvis or hip,i cant remember which as i was 2 upset at the time that they finaly found my ongoing problem,and rebuilding it therefor i wont need a hip replacement later down the line,im still waiting to hear about the physio and walking aid which i thought i would av by now and another appointment with my gp in 2 wks to up the dose of my pain killers.in the last few wks i had to give up my job (barperson) and even tho my partner works we are struggling money wise,if only more doctors could pick up the signs early on then people like us wouldnt have to suffer yrs in pain.at 32 im now unemployed,am unable to hardly walk without being in a lot of pain and very limited to places i can go,im only hoping there isnt much more of a wait as its all getting to much,gudluck all of you out there and hope at the end of it all,we live a gud life like we did before it all began. take care. jodie.

  42. Jodie,
    You've had a really rough time of it not helped by an incompetent doctor. Only give anyone 6 weeks and then start chaising, its your time, your life they're waisting.
    I'm slightly confused by your diagnosis of vulgus hips... Is that valgus hips due to positioning of femoral head and impingement too. I would say valgus hips is out of my area of full understanding, but that it would be worth looking of facebook for hip groups as generally there are big hip communities on there believe it or not. I do know many people who have had PAO's and a few reverse PAO, it is a daunting prospect I understand. My advice to you would be to understand the condition as much a possible and try and get the best specialist for the condition possible and if you're hip is super complicated don't be afraif to ask if there is an option for a hip replacement, sounds drastic but I know some people who have had them after failed surgeries and they've been life changing and they're in there 20's. But my gut feel for you and bearing in mind I am ultimately a laymen is you need to find some support whilst you get your head around this big decision and then find the best surgeon you can.
    Wishing you all the luck and please get back to me if I can help further.
    Best wishes, Louisa

  43. I have had 14 years of back spasm. MRI of back shows some arthritis in Facet joint. Right hip x-ray where pain is, shows arthritis but Dr.'s do not feel that is warrent total hip replacement. Left hip has already been replaced. I get intense muscle spasms that seem to come on with no warning and never sure what I have done. Pain is increased with activity. Going to Dr. next week to request MRI of hip with contrast? Would love your thoughts based on your personal experience.

    1. Hip pain does cause referred back pain so it is very possible that the hip can cause that pain. I also think that you are pursuing the correct diagnostic tests... you might need your GP to refer you to an FAI specialist, to request an MRI arthogram as that is fairly specialist and expensive tests so they probably won't hand those out easily. WHere are you in the UK? Do you already know of a good FAI consultant as opposed to a general hip specialist. If I were you I'd find the best FAI specialist, get a referral to them, have Xrays as the FAI is seen on X-ray (though only to a trained specialist and there are VERY few, then have an MRI-arthogram.
      Are you aware what caused your other hip to need replacing?

  44. Hi. This is a really interesting blog! I'm an emergency nurse. Having spent years on my feet and lifting patients has been my downfall I think! I've had a number of years with back pain etc. After months of right hip pain and trips ++++ to the physio who thought I had bursitis (wrong), lots of pilates and pelvic floor exercises (who then told me there was nothing they could do!). I went to see a Sports physio who then referred me to a Sport Physician. An MRI + arthrogram which showed some tendopathy to my right gluteal medias and small right labral tear. He suggested cortisone injections - agony for two weeks after and then much better. Now occasional groin pain, but still ongoing right outer buttock pain etc. Can't sit still for long!
    I've seen an orthopaedic surgeon who agreed that surgery was a good idea - but not keen to explain what he was going to do!
    My impression was that labral tears can't heal themselves. I'm worried that the surgery won't fix anything and I'll still be left with this outer hip/buttock/flank pain.
    Any suggestions?? I get different advice from every professional!

    1. Hi Jessie, all sounds good or correct until you get to the lack of diagnosis from the consultant. You are correct that labral tears can not self heal... but most importantly is the query as to how you torn your labrum. The two possible causes of a labral tear are a very high impact injuries such as car accidents or falling off a horse etc, if no such incidence has occurred then the cause will be due to micro injury and tearing caused by the FAI bony irregularity - However there appears to be no mention of this. If you have the time, read my most recent post on 'success rates for FAI surgery" as it explains why it is key to have a VERY experienced surgeon specifically trained and experienced in FAI... and one who has not explained how you have FAI may be lacking.

      So now knowing FAI causes the tear and eventual deterioration of your cartilage, then its easier to understand that removing the boney impingement and fixing the tear also, is what then should allow your body to heal and your muscles to begin functioning correctly again and by about 3 - 6 months post op your pain should be very much fading.

      Make sure this surgeons is on the button, steer clear if he doesn't diagnose FAI and also avoid any surgeon suggesting fixing the tear, whilst not addressing the FAI. There are under 10 good FAI surgeons in the UK, honestly make sure yours is one of them.
      See attached article and best wishes, do ask if you need further help.

  45. I am 24 and a footballer in Canada. I have had LONG TERM minor issues in my right hip and have just been ordered for this test. I have had sijoint pain on and off, with a bad right hamstring, trigger points around right lumbopelvic hip, and dull ache in the area.

    Just wondering anyone's thoughts. I am eagerly awaiting my mri arthrogram and results!


    1. find yourself the absolute best fai specialist, esp if your career depends on your hips and take it from there. there is a section within this blog about canadian surgeons, if you type in canada to the blog search, or alternatively come on to best hip surgeons - reviews on facebook and someone should be able to recommend. best wishes.

  46. Valuable info. Fortunate me I found your site by chance, and I'm surprised why this coincidence did not happened in advance! I bookmarked it.
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  47. I suffer from congenital F.A.I. luckily 1st chiro I visited turned out to be a top specialist who tested my hip motion range and sent me for xrays certain it was F.A.I., F.A.I was confirmed with xray, mri is not necessary, the overgrown bone,if there, is clearly visible on xray. If xrays are clear it is not F.A.I..I have a pincer on left side & CAM on right side. This means my hips cannot rotate as normal, and in some positions causes server pain as bone hits bone, or bone 'tugs at' cartilage. my hips, particularly right, dislocated very easily (if most weight is on one leg it will dislocate, not painful. Can also dislocate them as i please). Groin pain is rare and only occurs after exercising in a way that causes friction either bone/bone or bone pulling cartilage, eg walking uphill in my case. I also get back pain, and so to put less pressure on hips i have naturally stopped holding up my torso with my hips, but biult up a section of back muscle for support which frequently locks up, which i have learnt to 'crack'. Treatment is simple, get stronger hips. I have specific exercises to complete each day. Eventually, as the condition is degenerative, hip injections will be necessary to relieve pain, followed later by surgery. It is unavoidable. Gaining strength in the hips will only give me more time before surgery is needed. Exercise involving more hip movement eg zumba and running is an absolute no go for those with F.A.I., swimming is the best as reduces stress on the hip. Am 20 now and pain began at at least 15. Being congenital, I had it before then but was an incredibly fit child, involved in no less than 2hrs exercise every day. All in all not a big deal at the moment, although have frequent pain, inc. now sat on the sofa, its been that way so long I don't see it as unusual. Have been given an estimate of needing surgery in my 30's.

    1. See an orthopedic FAI specialist surgeon also. The xray (and better than that a CT) does tell the boney story of FAI, but its the MRI that shows up labral and cartilage damage, which is also key. Hip strength is very important but depending on the degree angle of pincer and cam, it will only buy you so much time. Given this is a deformity that takes out professional athletes its clear hip strength can only take you so far.
      The one thing you have said that worries me, or perhaps two things, is that one you have been diagnosed by a chiropractor, who whilst understands the condition, does not have the training in orthopedics and secondly and this is key, that you mention being able to dislocate your hips and THAT is actually a sign of dysplasia, which CAN co-exist with FAI.
      Let me just say I took my 4 month old daughter to a chiro, whilst waiting for a hospital appointment to see if she had dysplasia and they told my she had a twisted pelvis nothing else, the same as me... one month later under ultrasound at hospital she was found to have dysplasia and within weeks I was found to have FAI. They missed both our hip conditions. I am glad that your chiropractor has identified part of your hip problem, BUT, if you really can dislocate your hips you say, you absolutely must see a hip specialist, as you may have a more complicated case. Also that your presentation is so early, 20 years old, I doubt very much you will make it to 30 yrs before needing some kind of surgery and the sooner you're dealt with the sooner you'll recover. The longer you leave it untreated, the more cartilage damage, the more damage the lower a hip arthroscopy success rates. Its a complicated condition, but do some research and/or join the FAI groups on facebook of get a consensus of opinion, but most of all get seen by a GOOD FAI surgeon as soon as you can.

  48. hi I have just been told I have a hip labral tear in my right hip. Dr said I can have surgery or try a more conservative approach with exercises and modifying activities. I am at this moment unable to take time off work to have surgery as my husband is currently off work following another kind of surgery. My question is ( even though i think I know the answer) is will it get better by itself by doing exercises or will i need surgery in the end?. thanks

  49. You may be able to delay surgery by strengthening the support muscles of the hip, but yes you know the answer, surgery is inevitable. If you're in quite a bit of pain you could try steroids also into the hip socket to buy some months, just keep an eye on the cartilage as if it deteriorated too much a hip arthroscopy may not be effective. Sorry yo are going through rough times juggling surgery priorities. If it helps my hip that went misdiagnosed for 9 years before successful op is struggling, but the hip in pain for 3/4 yrs is doing great only 3 months post op. Good luck.
    Ps you need FAI specific rehab, look a couple of blog posts down, the blog for the hip arthroscopy rehab water and land, they can be used as prehab also BUT if ANYTHING starts to hurt more, take it back a step.

    1. Louisa, is this blog still active? Are you still helping/advising people with FAI? I have Ehlers-danlos so my situation is a bit complicated but I could use some advice and support. Please let me know. Here is my email. BeBrave4Change@gmail dot com Thank you so much! -RichellE

  50. Hello.
    I am so pleased to have come across this site.
    I am a 43 yr old female. I started having problems around 10 years ago but it started in my knees; hot aching and burning (I don't know if it’s related but they have found nothing wrong with my knee's to date). This went on for yrs and then the other things started to develop. Every now and then and I mean once in a blue moon, my hip would 'pop' and it would be uncomfortable but didn't really impede me. Then as time went by that 'pop' would be a searing pain and it would leave me limping. Then came the ache in my groin and then my right buttock, most of the issues were in my right leg but eventually my left leg started showing the same symptoms. I had always put it down to 18 yrs of cleaning, 3 children and a pretty active life. I did sports when I was younger but not a lot of physical in the way of gym or heavy fitness. My current job of 4 yrs has always been very active (I’m a home shopper) and do a lot of walking, generally fast walking, lifting, pulling etc. I am currently off work as the discomfort has been made worse by really bad backaches and terrible spasms in my lower back. To cut a very long story short; over the past 9 months things have become progressively much worse. They diagnosed me with Bursitis; I’ve had a steroid injection in my left leg and 2 in my right with no improvement. I had an x-ray in 2003 but nothing was picked up. I had virtually begged since 2010 for another x-ray but they ‘didn’t see the need’ but also because of that area they didn’t like taking the risk with women. Anyway, at the doctor’s suggestion, last Monday I had the x-rays and it seems I was born with the condition Coxa Profunda.... Nothing abnormal discovered with my back I must add.
    I have so many questions and my Dr. Told me that my appointment could be 4/6 weeks IF he can get me seen that soon. Generally it’s a 16/18 week waiting time!!
    Will I need hip replacements or something less invasive?
    Has anyone else experienced burning knees at the beginning & throughout?
    Has it affected anyone’s legs and toes? I am getting tingling and numbness quite often now.
    Week on week I feel it getting worse especially in both buttocks. I don’t know how long I can put off going to work. Doc said he can only do so much and has just given me my 2nd sick note (7 days each one). I can’t sit, stand or walk for long, it’s just too uncomfortable. I can’t even say it’s excruciating except when either hip goes but since I’ve been away from work, it hasn’t happened.
    10 yrs of this is really dragging me down and now my previously active life is so limited besides the fact I can’t work.. I feel so low. 
    Any help, advice or anything else would be so very much appreciated.
    In advance, thank you.

  51. Hi Louisa and Readers

    4 months ago after a 5 mile run I felt a very sharp pan in my right groin that repeated itself again all that day. I thought it was a groin strain. The sharp pain then went but I was left with a Dull ache only when seated and no pain on walking. I still thought it was a groin strain and rested from running, cycling for 4 weeks. Still the ache did not go away. I went to the doctors who sent my for a scan incase it was a hernia. Nothing showed on the scan. Then my doctor referred me to a consultant. The appointment was not for 6 weeks and the Dull ache in the groin seemed to be getting worse even though i was not excerising. I went to see a very good physio in manchester who said it could be a hip impingment. I then booked an appointment with a private hip consultant who sent me for a CT Scan and i turned out I have FAI Cam.I am waiting to get an appointment to get it fixed on the NHS, but I am worried that the wait could only be causing the labral to tear even more.

  52. Hi All,

    I was diagnosed with FAI yesterday, am doing some initial research and glad I found this blog. I am an avid runner and experienced a huge shock that went from my knee to my hip during a half marathon. I probably shouldn't have run the race as I was already experiencing some hip pain and was barely able to walk across the finish line.

    I was unable to walk for three days due to shooting pains in my hips. it has been a week and I can walk (with a slight limp), but am experiencing numbness in my thigh and the dull ache that Jamie (above) mentioned when sitting.

    The dr I went to looked at my x-rays, moved my leg 5 ways and then told me I have FAI. I got lucky because he is 1 of ~20 doctors (his words) in the US that do surgery for FAI. He's done about 100 surgeries and my concern is that he just wants a good patient to increase his surgery count. Should I be worried about this? The x-rays definitely showed a cam/pincer impingement but I want to be sure...

    I also haven't experienced any back or buttock pain. Should I be concern about a mid-diagnosis?

    Many thanks!

  53. thanks for all your comments, i have been dealing with this for three years, does anybody know of a good dr in michigan for large labral tear in front and small in back and fai?

    1. Holly try this site: https://www.facebook.com/groups/BestHipSurgeonsReviews/

  54. Considerably, this post is really the sweetest on this notable topic. I harmonise with your conclusions and will thirstily look forward to your incoming updates. Saying thanks will not just be sufficient, for the phenomenal clarity in your writing.

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  55. Amazing story it sounds just like my own.I also have struggled with hip/groin/lower back/upper back pain clicking popping hip leg giving way etc etc etc.Have also been to all the mentioned so called professionals again and again for years and years with no solving of my worsening problem.Finally i was put onto a hip specialist who within minutes of meeting knew exactly what the problem was (labral tear) and how to fix it thank god.Amnow waitng for the New Zealand government to hopefully fund my operation and recovery as mine is an injury from lifting a steel beam at work.

    Thanks and good luck

    1. Thank you and thank god someone worked it out for you! Many people now come to this site and recognise themselves in these FAI symptoms, then they ask what to do, I explain who to see and then they're diagnosed. There seems SUCH a lack of education in this area amongst health professionals and it I still shocks me. Best of luck to you. If you come to https://www.facebook.com/groups/BestHipSurgeonsReviews/ you will find a recommended surgeon in your area in NZ, although you may have him and I believe there may only be one.

  56. Hi all,

    I'm a male in my late 20s, and have been suffering from lower back and sacro-iliac pain since late in my teens, mainly when standing still or sitting for prolonged periods of time, and when playing football. When I was approximately 20yrs old, I noticed out-toeing of my right leg. The pain gradually got worse, and at age 24 I decided I would get to the bottom of the problem.

    Over the years I have seen many doctors, physiotherapists and chiropractors, and have had many different diagnoses. Initial diagnoses included muscular pathology from doctors, yet I knew that this wasn't quite right. In 2009 I went to see a podiatrist to get some specially made insoles, as I thought I had a leg length discrepancy. The podiatrist did too, and over a few months I had the step of the insole increased to over 2cm. This treatment relieved my symptoms initially, but then I started getting pain higher up my back, so I went to see a chiropractor in 2012.

    At the chiropractor I had X-rays taken, which showed sacralisation of L5, and the chiropractor put the pain down to this. So for 6 months I would get my back manipulated almost on a weekly basis. This relieved the back pain, and, allowed me to reduce the step of the insoles (at another podiatrist). I also seen a physiotherapist at this stage, who diagnosed muscle imbalance and had me working out in a gym 3 times a week to attempt to correct it (it did not). I then began studying graduate medicine.

    I learnt how to perform a hip exam, and discovered that on proper examination of my right hip, I had only 90 degrees of flexion, and could not internally rotate my hip at all. I have not got a true leg length discrepancy. I got hold of a copy of my X-ray from the chiropractor, went to the library and set out to diagnose my problem. On doing so I came to the conclusion I had FAI.

    Next, I took the X-ray to my GP, who dismissed the idea of FAI. My X-ray was 'normal'. The GP diagnosed 'lower back pain', told me to stop moaning and gave me some painkillers. She did not examine my back or hips. I asked for a referral to an orthopaedic consultant, but instead got referred to a specialist physiotherapist. So I paid to see an orthopaedic consultant, who after 5 minutes of examination and a quick look at my X-ray confirmed FAI, and sent me for an MR arthrogram. This confirmed substantial FAI, with a large cam lesion, evidence of osteoathritis and a labral tear. I am now waiting for referral to a locality that performs FAI surgery on the NHS, yet have been informed that sometimes the referrals are rejected, and decisions have to be appealed!!

    I have really struggled with playing sport for the last few years, and haven't been able to play any sport at all for 4 months or so. I really hope that surgery will help me get back to my sporting ways. I'm tempted to pay for private surgery, because on now knowing what the problem is, I am extremely keen to get it sorted. I have a tight budget, so was wondering if anyone could share the prices paid for FAI surgery in the UK, including consultation fees.

  57. Hi everyone,
    I'm a 32 year old female and I've just been diagnosed with an anterior labral tear of left hip following a year of increasing discomfort and pain in hip and groin whilst at rest and walking. I've been told surgery is the only option and am scheduled to have the op to remove the tear in the next couple of weeks (I've gone privately as I am now unable to work and want to speed the process along). I'm incredibly active (it's thought that's probably why I'm in this position!)and am worried about having this surgery as I know two other females from work who've had failed ops by the same surgeon as I'll be under. I don't think this is due to the surgeon, rather complicactions surrounding their own diagnosis and surgery. I wonder if I can opt to have the surgery performed by one of the recommended surgeons on this forum and if so, how I might go about it?? I want to make the best and most informed decision I can first time round as I've seen and read so many stories where surgery has not been a success. Does anyone know actual statistics for this kind of surgery? Any advice would be greatly appreciated, thanks.

  58. Hi everyone,
    I'm a 32 year old female and I've just been diagnosed with an anterior labral tear of left hip following a year of increasing discomfort and pain in hip and groin whilst at rest and walking. I've been told surgery is the only option and am scheduled to have the op to remove the tear in the next couple of weeks (I've gone privately as I am now unable to work and want to speed the process along). I'm incredibly active (it's thought that's probably why I'm in this position!)and am worried about having this surgery as I know two other females from work who've had failed ops by the same surgeon as I'll be under. I don't think this is due to the surgeon, rather complicactions surrounding their own diagnosis and surgery. I wonder if I can opt to have the surgery performed by one of the recommended surgeons on this forum and if so, how I might go about it?? I want to make the best and most informed decision I can first time round as I've seen and read so many stories where surgery has not been a success. Does anyone know actual statistics for this kind of surgery? Any advice would be greatly appreciated, thanks.

  59. I'm a male in my mid 30's and I recently was diagnosed with a hip labral tear and I been with this condition for the last 8 years. Like the author I too saw many specialist over the years and got all kinds misdiagnosis. The labral tear led to disaligment of the hip which had secvondary efffects in spinal disk herniations, SI joint dysfuntion, lower back pain, leg and on and on. I'm hoping the surgery will help put my hip back in place, thanks for the info provided here because now I know that other people had the same issues and I can learn from their expiriences.

  60. I am so glad to have found this website. I just got my diagnosis today after 4 years of suffering, two trips to the gyn, one to: neurologist, General surgeon for possible hernia, urologist, and multiple primary care visits. I am 43 and never had major problems after breaking my left hip at 12 and 3 kids ages 15, 9, and 8. I've never been overweight so I never worked out or did any major activities. I was about to give up hope and find a way to live with the pain until 4 days ago when I nearly fell from the intermittent sharp pains in my right hip that are progressively getting worse. I thought I was loosing my mind and becoming a hypochondriac due to my normally high pain tolerance. I'm scheduled for the injection this Friday. Hoping for relief.

  61. Ive had hip and lower back pain for almost 2 year that got to the point where after training ( jiujitsu , and muay thai) I couldn't walk 2 MRI 's later I have had open hip surgery bi lateral labrum repair, and shaving of femoral heads which was on ( May 1st 2013) By Javad Parvizzi OF the Rothman institute of Philadelphia! Since surgery I was told one month of rehab and swimming I was cleared to go back full BOAR to MMA in August. when I returned I felt the pain In the side of my hip and lower back - butt area again! went back to Dr parvizzi aug 15 2013 and he had informed me my hip wasn't re torn I just need more therapy. now NOV 27,2013 Im in therapy for my hips issues and also torn medial menisci left knee which had had surgery on NOV1 ( another story LOL) . But I still feel my lower back left side hip in in spasm and won't go away HOW LONG DOES THIS TAKE? I Only feels worse with exercise and when I spread legs out far ( split ). ANY and ALL advice would be appreciated!

  62. This comment has been removed by a blog administrator.

  63. Hi, very interesting reading thankyou. My GP just diagnosed me with FAI yesterday following a recurring injury I've been had 3 times in the last 4 weeks where I've been unable to walk due to the pain. Last GP 2 weeks ago sent me away saying she didn't know what it was & to come back
    If it happened again. Aargh!! Have just joined your FB group, thanks. Roxy

  64. In spite of the fact that a surgery is suggested by a large portion of the specialists for this infection, there is Hernias Natural Treatment get rid of.

  65. 8 years for me!!! Just diagnosed with a CAM Lesion and possible labral tear, after years of pain, discomfort, doctors visits, pain meds, seeing numerous spine specialists, best orthopedics, chiropractors, three physical therapy rounds and no relief. I am dumbfounded but hoping I caught it soon enough that I don't have to have hip replacement just anthroscopy. Crazy hoping this is my cure. But who knows could be another run around. Keep you posted.

    . Is my pleasure to comment on this site and i thank the admin of this site for his/her great work so far. I really don’t know how to thank DR WILLIAMS for helping me get cured for over 20 year of suffering from a terrible Hernia, my Hernia started when i was 28 year i thought is going to end one day but even get worse as days went by,i have tried all western drugs prescribed by doctors but to no avail i lost total concentration,I came across DR WILLIAMS contact through a headline news on internet about how DR WILLIAMS have help so many people to get cured of tinnitus and so many other with similar body problem I contacted him and he told me how to get his herb,few day later he sent me the herbal portion which i take every morning for 21 days, and his medicine was able to restore me back to normal and now am very okay without any side effects whatsoever If you have Hernia, you can contact him on his email address drjohnson958@gmail.com
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  67. Physio here in New York and thank you for the blog. I have seen what the physio who diagnosed your condition as fai as common and fai can be asymptomatic and silent and I will always do it with a back cluster test because the symptom referral I think is caused by associated muscle pulls and not necessarily from the hip itself .some simple hip extensions can actually aggravate it specially when loaded . I am currently seeing a patient who initially was referred to me for sij bilateral but noticed that it was a fai with torsion on opposite side hence pain on opposite sij, and the pain on the sij on the same side and back was caused by the fai itself with associated hip tendinitis .Your psoas and qls were probably holding on to dear life to provide hip stability hence they're on constant overload . There are new dynamic walking tests just recently developed to aid in the diagnosis of fai as all other tests are static and may overlap with other tests for other conditions.
    What I also see is that surgical procedures may help but cases of it not helping is also common( maybe 1 in about 10 ) I've seen in clinic for past 7 years.
    I feel that there is a need for doctors not to overlook pain referral to the back from hip as these are interdependent regions of the body
    Pelvic floor is usually not affected or weak unless you have leakage , incontinence etc.

  68. Injuries may occur while playing games, street crashes or activities of day by day living that result in a sudden injury. In phenomenal conditions, minor twisting while at the same time walking around uneven surfaces may incite to ACL tears.Acl tear treatment is the solution to these so visiting the knee specialist will be a wise and helpful decision.

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  70. I have been through so much in the last year and half and it all started after doing kettle bell squats.... I told the Dr. that my lower left back hurt along with groin pain.
    1- You have scar tissue build up from your hysterectomy -
    Result - Had surgery no scar tissue found
    2; You have an impacted bowel
    Result Had a colonoscopy and everything is fine
    3- MRI, XRAY 2 doctors - You have a Hip Impingement
    Result - shaved bone, put anchors on it, shaved femur
    4- Therapy therapy therapy for 2 months now and still hurting pretty bad so they
    have done 2 SI joint injections
    5 Therapist says my pelvic is twisted..... Day 5 still hurting....
    With all the misdiagnoses I feel like it is something else and I just don't know
    what to do at this point..... Therapist has been working on loosening muscles in
    reference to the twisted pelvic and it seems to be loosing up but when walking
    now, my left leg is giving out.....
    ANYONE HAVE ANY SUGGESTIONS????? I really need to stop hurting.
    Thank you in advance.

  71. Hi Louisa I was just wondering what this meant in your diary part Jan 09 new physio: (for external stuff) Does trigger point work, gives relief of muscular pain, starts to question hips and triggers reoccurring. Start getting pain both sides now, identical. thank you!

  72. This sounds exactly like my journey but it's been 10years and 2 kids later :( Any relief from the surgery? What kind of surgery did you have? My low back and hips are awful but I don't want to go through painful surgery and recovery to not get relief

  73. I have been diagnosed with both cam type hip impingment and right side pars fracture or spondylolisthesis with a grade one slip. I've been through one year trying to get a proper diagnosis, went from it's arthritis( never received PT went to Chiropractor tried to PT myself, received a injection into spinal canal wanted to do surgery but doctor wasn't very nice and spent maybe 15 minutes total with me so I said screw this and went to a sports medicine Ortho young guy .he immediately said it's fai cam type(shows on x-rays), did PT got slightly better but not much got a mri with contrast, it showed cam type lesson not tear, got a infection took like 2 weeks felt a slightly better for 1 to 2 weeks then got bad, during this time started to hurt some left side. Ortho said I needed a scope wanted a second opinion .Went to a neurosurgeon he said it was hip went to another Ortho spin surgeon he spent over a hour with me said it could be fai but looked over my MRI thought he saw a pars fracture .had lateral x-rays showed pars fracture with stenosis (spondylolisthesis)grade one slip. I've had there epidurals at once in 3 vertabra .Fracture in 5th vertabra . Main syptoms have been front hip pain(has never went away) lower back to middle back pain and stiffness, some pain on left side but not near like the right, even had some sciatica pain in buttocks and some down the calf. Now having a dilemma about what surgery to have, just wondering if anyone went through something similar?

    1. Sorry not both just cam type it is on both sides though .Symptoms on right side