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:

Saturday, 29 August 2009

Hip Arthroscopy recovery 7 wks, 1day

Yesterday was ok pain-wise, things calmed down, though with packing and having to run some last minute errands, for our last minute holiday in the sun, I pushed a bit hard.

Surprisingly despite this level of activity I was ok in both my operated hip and steroid injected hip, more muscular aches, although developed a weird stabbing pain in my groin of the operated side which I had never experienced before?! Scary as a very sharp pain that takes your breath away? I rested with ice and I hope if I take it easy today, the day before I travel, that it will completely disappear?

Dreading the travel as its a total of three and a half hours on planes or in cars. BUT when I get there, the hotel is almost on the beach, everything is close by. The sea is shallow, warm and calm as a rule and if not the pool is available, so HOPEFULLY the aqua therapy side of it should do me the world of good.
Away a week, keep well fellow hippys xx

Thursday, 27 August 2009

hip arthroscopy rehab 6wks, 6 days.

Saw surgeon yesterday for my second appointment post hip arthroscopy for FAI (pincer type) and labral detachment. I'd say it went well. He went out of his way to ease my fears and to help me understand the things I didn't understand.

I'll explain the questions I asked and the answers I heard, by that I mean I am not quoting by any stretch, its my understanding of his replies..which aren't always super clear!

Q: I have the same pain as before the hip arthroscopy, but worse, why?
A: You had chronic, misdiagnosed, pain for 6 yrs, My, surgeon's, personal research on patients over the years show that if the patient had a very bad pain and lifestyle score before surgery, it takes longer to get better. Someone in less pain, or for a shorter period, usually improves immediately from operation, be doing well at 2 months, to max improvement at 6 months. However someone like me will struggle to attain good results by 2 months and in fact may get worse by 2 months, but USUALLY the 2 groups of people meet at 6 months, at the same level of improvement.

Q: How often do they 'not' get better if they haven't got arthritis or another deformity.
A: Never happened.

Q: What grade of arthritis do I have now.
A: None, you just had the wave sign, the beginning of arthritis and that's fixed now.

Q: Where there any complications during surgery?
A: Absolutely non, your surgery went just as I hoped, I was very happy with the result.

Q: What complications could cause residual pain for me?
A: Possibly inflammation within the hip capsule

Surgeon then asked my when my pain level started to increase and I said when I came off crutches and apparently this isn't too unusual, I think I am to pace myself. He did say though, to use ice and anti inflamatries and to stay active, whilst pacing myself. Inactivity is bad.

He also asked about my fall. I demonstrated (Aly McBeal moment), I think we concluded it may not be that significant, but that a further MRA at this stage post op would not be clear enough to identify any problems. I agreed not wanting to further aggravate my hip at this stage.

Q: I asked about my psoas possibly causing further impingement?
A: He concluded that as it had discontinued snapping over 50 times a day and was now only snapping once or twice it was unlikely to still be a problem.. He went on further to explain psoas impingement on a pincer impingement, but I broke the golden rule of journalism and starting thinking about the next question (not that this is an interview, just old habits die hard!), I was anxious to get through all the questions and having concluded it was no longer an issue, I wanted to line up my next Q.

Q: What is the possibility I could have retroversion, or some such thing to require further open surgery?
A: I HEARD: not a problem for you, everyone that has pincer has some level of retroversion, then he waved his arms in the air demonstration imaginary hip sockets at different angles and I think I heard blah blah retroversion blah..pincer; he was explaining but my thoughts had stalled at everyone with pincer has some level of retroversion? ...and I was thinking but it does cause some people to have bigger ops, does he just mean just I won't need a further op? ..And blah blah blah?

Q: I asked about the pointy bits in my pelvis that stick out on x-ray.
A: I HEARD Blah blah, everyone like you has them, a 'blah angle'..I was just still amazed he understood my really bad diagram I drew to demonstrate my question!

Q: Does it take a while for your muscles and tendons to catch up?
A: Yes.

Q: Can I have an x-ray to show all the impingement has gone?
A: No its not necessary, the way I work is that I test and retest your impingement in surgery until its perfect, with the angles on x-ray you might not even see the improvement. (Still really wanted an x-ray, but I wanted a steroid more and that was my next question and I didn't fancy my chances of getting both!)

Q: My left hip, my good hip is really going downhill, can I have a steroid, because I need it to support my other hip? That's why couldn't go onto one crutch as one crutch is held in the opposite arm and has you lean a little on the opposite leg, causing further pain in that hip for me.
A: Yes no problem, now?

He then tested my mechanics and was quite happy I could get my leg close up to my chest. I described the sitting pain I get that travels down my leg, a lot into my calf and occasionally toes (I blame piriformis and then it pressing on sciatic nerve, though feels like pain on sit bone)
The surgeon pressed a few spots around my sit bone and queried hamstring tendinitis where the tendon meets the bone. Additional pain source, compensatory of my hip I think. He said we could follow up that query after my holiday with an MRI (Oh NO!!!) of some sort.

I went off for lunch in a trendy bar in Shipley (ringing bupa to quickly sort out the finance and authorization) and then came back for my steroid injection.
The worst part,back in hospital, was getting locked in the loo, prior to steroid injection!
I fiddled with the door a while, was a bit stiff and in the end thought wasn't locked, so thought I better pee fast! Then, when I went to open the door it was LOCKED and would not unlock (I can't begin to tell you how claustrophobic I am, hence MRI phobia!) I hammered on the door yelling 'Help I'm locked in the loo!!' Some weird calm descended and I thought 'Yes I knew this would happen one day! Confirming my paranoia! 'I've been rehearsing for it ALL my life, stay calm'
The voices on the other side of the door said "where's the lock pointing?" I thought, breath...calm.. "nine O'clock." I said urgently, thinking wow I sound like I know what I'm talking about, like Keiffer Sutherland in a crisis, in 24!
"Okay, the voice came back, turn it the other way" I thought I've gotta get this right "which way?" I shouted back.. "Err anti clockwise or clockwise?" then voice came back again "anti clockwise." I turned it, as hard as I could, it jammed for a few moments then released and flew of of the door, straight into my nurse saviors!
"That's never happened before!" they said. I retorted suspiciously, with narrowing eyes "And yet you knew what to tell me to do!?" The girl said 'I was just guessing and hoping!' ..I nearly threw up, but opted for laughing!

By comparison the steroid injection was a breeze! No, truly I was still a big scaredy cat,because I just am, but it only was as bad as a blood test, just more intimidating. Don't ever fear a hip injection, the nerves are too dull, its not like drilling teeth, there are no sudden shocks, at worst a dull ache that you can't quite pinpoint. I've had three now, all the same.

The only thing that has freaked me out was it gave me no pain relief I think! I still had the pain down my leg part, which shocked me and made me also think more seriously about what he was saying about hamstring tendinitis ontop of FAI and labral detachment. I think I may have a pain of 2 parts, hip/groin/sacro type pain, but the bit that travels down my leg maybe part muscular, perhaps in its way trying to protect the hip? Sounds a nice, neat theory, time will tell..

A long road still to travel I think, still chasing the end of that rainbow!

Tuesday, 25 August 2009

hip arthroscopy rehab 6 and1/2wks.. The culprit is living!

Well on Sunday night I took all the big guns that I took post hip arthroscopy to sleep. Diclofenac and co-codamol and after days and days I had pretty much a pain free sleep.

But again, a day later it is starting to flare up... and here's what I did yesterday after 4 days of stopping exercise and pretty much stopping all activity/living.

I sat upright for all 3 meals (all quick meals) I drove a half hour round trip for some minor errands (buying stamps, posting letters and then culminating with the most exciting part of the day getting petrol!!

4 hours later I got to go out again, 10 min round trip to doctors for more medication. I had to wait in the doctors for a long time, 1st 10 mins sitting, next 20 mins I found a bench to lay on.

I held Isabella for 30 seconds whilst standing (she was passed to me and taken off me, so no bending, twisting, lifting).

I also got back on the stationary bike for the 1st time in 4 days and did a half hour cycle, back down to NO resistance.(I don't suspect the bike is antagonizing the pain, as I have been able to cycle from day 2 post hip arthroscopy for FAI.)

Compared to last 4 days, yesterday was super active. I continued to make a point of not standing around the house and in the main I laid down a lot!

I iced once in the morning and once later, though the ice pack hadn't totally frozen again by the evening. I also started taking bromelain, an extract of pineapple said to be great for reducing inflammation post surgery and is widely recognized and used in Germany since 1993 for that purpose, after successful small study results. Worth a try.

Went to bed took the big guns again, diclofenac and co codamol and guess what... Yes you got it, MORE pain and LESS sleep and possibly more hip irritation.

The only variable is LOW, LOW, LOW levels of activity... I need to find a way to function as a mother of two soon. I am currently working at 5% capacity and everyone around me is cracking under the pressure of my inactivity. More to the point though, this isn't the estimated level of activity and ability expected at this stage of recovery by far. I'm supposed to be speed walking!

SO tomorrow I want to know why, specifics, not woolly "we'll have to wait and see" stuff. I NEED to know what's going wrong? How to get out of it? Can I get out of it? What grade was the arthritis found? How sure is he there is no retroversion? Or any other deformity? X-rays to show that the impingement has gone and from different angles? I NEED to KNOW the impingement has gone. Steroid injections a possibility? If anyone else can think of anything I should ask, please feel free to suggest.. Not looking forward to going, as its probably an hours round trip and I hope I get some answers for the 'physical' cost of traveling!

I'm also still limping, still on crutches on stairs and out of the house, but I can imagine that slowly sorting itself out and it doesn't seem unusual.

Sunday, 23 August 2009

hip arthroscopy rehab 6wks, 2 days Anything is too much?

I honestly feel like smashing things! Its only 3pm on Sunday afternoon and already I'm in pain on both sides. To hold my body weight I need to lean onto my good hip, only my good hip has gone so bad since the op, it was going downhill before the op, that I can't, so I put more weight on the operated side and guess what, I CAN"T! So actually I can't walk or go up 100's of stairs in this stupid 3 story house that I can't sell because of the credit crunch! I do not know what to do with myself to avoid any weight bearing on either side. I now need to use crutches even pottering in the house! Esle all pain flares.

I've come upstairs to explode onto this stupid blog to avoid screaming and crying 'someone PLEASE help me!!!????' ...and disolving into a fit of pointless tears on the floor by the cooker, in front of the children ...not that anyone could help me..

I am trapped in this crap body and can't even be a mother, let alone sit down long enough to hold down a bloody job as a journalist. I've lost hobbies and activities, followed by a career and now I'm feeling robbed of my precious time with my babies and motherhood. I have look through to find a nanny to do my job, not that we can afford that given I can no longer work blah blah blah blah ......and yes I know I'm not dying and yes it certainly could be worse and normally I can control my feelings with these platitudes, but today after several long, enduring painful days I am losing hope, and possibly perspective...then again in my shoes, from my perspective there doesn't seem to be much hope!

Right affected, faltering smiley face back on to have lunch, LAYING DOWN, with the family!

hip arthroscopy rehab 6wks, 2 days how much is too much?

Slightly better nights sleep. Feels to be calming very, very 'slightly'. But only because I spent all yesterday again laying about, as God forbid I should stand and weight bear, or sit! I even ate laying down yesterday, which is challenging when you have guests for dinner! I still can only sit for 10 - 15 minutes at a push, but I can feel that action really flaring everything up, it actually hurts instantly I sit.

Seeing the surgeon for 2nd review appointment on Wednesday. I'm rather concerned how I am going to travel an hour round trip to get there, plus the inevitable time sitting and waiting for my appointment. Very concerned how I will travel abroad sitting on 3 hour journey a week today??! I will end up crippled for the holiday! Very worried, wish I'd not booked the holiday now. The whole situation rapidly becoming a nightmare.

I need to write a list of questions for the surgeon, but almost can't be bothered as I suspect most answers will be summarized with 'wait and see!'
I do remember the surgeon saying some people actually get worse before they get better (I dismissed that thinking 'not me!') But I wonder if that's urban myth or real and if real, just how many people has this really actually happened to that HAVE got better? One, two?

This recovery is so disheartening and adding to the trouble my childcare person has had enough and all but abandoned us, as my recovery clearly threatens to stretch past the 6 week mark and be indefinite! So I need urgently to fix up some childcare solutions for Isabella, my 24lb, 10 month old little tank girl and my son, who starts school in 2 weeks. I have no idea how I can get him to and from school, esp with baby in tow!
Its very, very frustrating as one of the key questions I asked was 'how long before I can pick up my 'heavy' baby again?' 'Six weeks' was the answer, but that's completely laughable, not a chance, I can't actually carry my own weight!

If getting up, showering, eating meals, popping out for a loaf of bread, then settling down, laying on the sofa is too much for my hip, what chance have I of looking after 2 young children and all their demands, absolutely none, only a woman with children would appreciate this.

Pre op, I could do that badly, a total struggle, but currently that's a total impossibility... So I am beginning to question my decisions and actions and the wisdom of those around me... I suppose that's inevitable.

Saturday, 22 August 2009

hip arthroscopy rehab wk 6

Can't lay ofr more than few hours, can't sit more than 5 minutes, can't stand for long without consequence, can't walk without crutches or pain. Daren't do the most basic exercises. I can't calm down the pain with medication or ice. Don't know what to do with myself. Completely at a loss.

I am supposed to be traveling abroad to go on holiday next week, don't know how I can sit for 3 hours to get there, but I can't cancel, as travel insurance won't cover my hip. That didn't seem a problem when I booked it 2 weeks ago?!
Pain deep and all encompassing, want to pull my leg off and have done with it, as pain wraps around the whole area. I feel just awful, warn out with this persistant pain.

Looking back I think its started flaring up since coming off crutches, but trust me I couldn't do much less, unless I didn't sit for 'quick' meals, or stand to brush my teeth or lay down to sleep!!

Friday, 21 August 2009

hip arthroscopy rehab wk 6

I don't understand, night and day blighted by acute, chronic hip pain, worse than the days post op, as bad as worst flare ups in past. Hips are taking turns in who is the bad guy.. operated side by far the worst.
Beside myself... doing VERY little, even dropped exercises all exercises; and back on both crutches. What the hell is happening and why now...I thought I was going to be a success story, I don't understand!

Wednesday, 19 August 2009

hip arthroscopy rehab wk 5 - 6 concerns

Something definitely doesn't feel right. Another sleepless night. Last night had to take diclofenac and paracetamol and wear a heat patch. Normally one of these would be enough to knock out the pain...all 3 combined only dulled the pain enough to allow a light, broken sleep. I haven't needed that many drugs since week one recovery, post hip arthroscopy.

Could I be over doing it? ..but I'm only doing light tasks. Yesterday I did some work sitting at my computer for an hour, drove for 45 minutes and went to a shop to buy my son a pair of shoes, made myself lunch/dinner etc - used one crutch outside. Just did light stuff, its been this way for a a week now.
Didn't cycle yesterday because of the pain sitting towards the end of the day. Did my exercises, they don't feel hard. Noticed in 3 days I am supposed to start a walk/jog programme - absolutely no chance! I am still limping and nowhere near up to that.

I can't lay on my back comfortably, or tilt onto my operated side...though oddly I'm more comfortable fully on my operated hip short term, than on the buttock of the same side. I feel pain. I wonder if my piriformis is irritated as sometimes pain travels into my calf, or is it just my hip, its deep buttock pain either way. The pain also feels wrapped around my leg and as high as iliac crest too. Also standing in the shower I noticed putting some weight through my leg/hip on the operated side causes such a deep throb, its no wonder I can't wait to lean over onto the other side, but this can't be good for my gait and its how it felt before the scope. My leg on the operated side is apparently 1cm longer, I wonder if the means that that hip takes more pressure when I stand with an even gait?
I know this much, I don't know enough and I can't cure myself, but I can ask questions. I know also that I am becoming very concerned that this hip arthroscopy may have failed.

Tuesday, 18 August 2009

hip arthroscopy rehab day 1 million supposed bloody recovery!

Woke AGAIN with pain in bum/hip. This happens every night now! I still have pain when I sit and no idea if walking distance aggravates it, as I can't yet do that! WHY, WHY WHY hasn't it gone?

I had the hip arthroscopy to treat the pincer FAI with Professor Schilders. Its supposed to have been a success, but pardon my confusion when I feel very much the same as before?!

I have been told to wait for for results from the op, like some kind of 'will it or won't it work?' surprise.. but it feels the same and I fear thats not right.

I'd welcome different pain, I just don't understand why it feels the same? I am getting to my wits end with this ridiculous roller coaster, it would test the patience of a saint! And NO-ONE seems able to tell me why it feels the same?!?!?!?!

In the same way labral tears come with FAI, FAI often comes with retroversion or coxa funda or something, of the acetabulum, I have little comprehension what these are yet, but wonder if 'that's' the problem? Or has Schilders missed a bit? Or should I have had a CT scan to be precise, Or should I have had the rear of the acetabulum scoped? Have I over done or underdone physio?

What are my options? I just don't bloody know????? But I am bored of this, fed up of this, want to escape this, I feel trapped inside my stupid body, forever hoping someone can fix the problem and then the disappointment if they can't!

Sunday, 16 August 2009

Hip Arthropscopy FAI rehab 5 wks post op

Recovery from hip arthroscopy for FAI is going steadily, with some glitches, but ultimately I think I'm SLOWLY climbing the hill of recovery. I am able to do tons more this weekend. I have cooked Sunday lunch, cleaned, done laundry, been out to shops, been out for a meal, played with the kids. All of this I do with mindful movement and rest when too tired and if I want to walk outside of the house, then I take one crutch, as soon as I do more than potter about, I do still limp.

I am still suffering night pain which I find distressing, so I have gone back to one night time diclofenac and ice before bed. I suspect its the increase in activity and I suspect my muscles are playing catch up with my bones and still are using old patterns of movement. I think my piriformis has been over active for years and is having trouble backing off and taking a back seat in supporting my hip.

I also have to remind myself its still early days if you look at the big picture... I'm not saying I'm without fear, I do have my "my God what if this hasn't worked??" moments, but I'm really trying to put doubts to the back of my mind.
I can say my shiny, new hip really feels like it glides now when I bring my knee to my chest, as opposed to a deep pain and feeling like a tight bands pulling the opposite direction. I can only think its been like this as long as I can remember, as that smooth action feels entirely alien to me.
As my Gran used to say, just keep on plodding, its the plodders that get there!

Wednesday, 12 August 2009

Hip Athroscopy rehab day 33 helpful tips

Post hip arthroscopy
for FAI there are some things that will make your days a little easier and I have put some pictures up of how I arranged the bedroom to help survive first 4 weeks post op. Things that you need for FAI surgery, basics really.

1. Large, as can fit, non slip shower mat.
2. Shower stool, I hated everything about it, but frankly showering wouldn't have been possible, certainly the first 3 weeks without it! I got mine for £40 at Argos and really whist I thought it a bit pricey it was worth it. You could possibly get a basic chair in, but closing the cubicle could be challenging and also these stools have non slip sucker feet.
3. Also bought some suction grip handles to help with both manoeuvring around in the shower, but also one by the loo. £15 Argos for 2. In the early weeks this was super handy too.
4. The other thing I did was leave the exercise bike at the foot of the bed, just so it wasn't a hassle to go and cycle and I also put a foot stool there to make climbing on and off the bike easier.

The only other things I can think was with the crutches I put my DVT stockings around the crutch handles and taped them there, not pretty but super soft on your hands. Not one blister. I tried cycle handle bar tape, but by the time there was enough on to make the crutch handles soft, the handles we too big for my hands to fit around!

Also, in the last week coming off crutches, when on the stairs instead of doing the correct good foot to heaven, bad foot to hell, I swapped them over whilst still on crutches. This way, on the way down the stairs my bad foot/leg/hip got used to bending in a controlled way and on the way up stairs my bad foot/leg/hip got used to flexing at the knee with pressure to lift you upstairs. I did that to practice but would only recommend doing that for the few days preceding coming off crutches. I'm sure it helped as I haven't found our 3 story house as hard to get around as I thought I would early off crutches.

Todays progress?
Physiotherapy was painful today, as Louise did trigger point massage, agony but you know it'll pay off.. Still a lots of muscle spasm around the glutes and hips. One great thing is that my glutes are finally building up muscle in the side that has already had surgery. The other side that needs surgery despite doing the same exercises just isn't building, which is interesting because before my op no matter what I did I couldn't build those muscles and only ever succeeded in irritating them.

My physio also watched my gait when walking and advised that as I'm still limping it would be wise to use one crutch until the limp goes, so I'm doing that too.

Today I had a shower WITHOUT the stool, hurrah! Even after the shower just standing in a pair of jeans drying my hair, felt so good to be upright, unaided and without pain.

I'm a long way from better yet, but the changes are literally measurable.

Tuesday, 11 August 2009

Hip Arthroscopy rehab day 32 walking progress

Walking ability coming along slowly but surely. 3 days ago tried to walk, without crutches around the green where we live, its just under 1/4 mile long, managed a third of it. Today, 3 days later walked almost all before I felt some pain,then switched back to crutches when I felt pain. I see no point in pushing my body before its ready. A week ago today I would've laughed at you had you said I could walk that far, or at all, without crutches!

Cycling (stationary), I can now cycle for ages unless my 'good' bad hip plays up, but its nearly always that 'good' hip that hurts first when cycling and sitting too.

The downside at the mo, is am getting a fair bit of night pain again, but I think its because I'm pushing my boundaries after relative inactivity of the last 4 weeks and also I think with my bad, operative hip, there's a lot of muscle and tendon malfunction or imbalance from years of compensation. I hope thats the cause!

Thinking I want my 'good' hip fixed now, as the pain is becoming both acute and chronic and I don't want to allow the same damage to be done as in my 'bad' hip. It takes longer to fix the more damage done, entirely logical. I genuinely think if I fixed my good hip, 3 months later than my bad hip, that I will still see positive results faster in the good hip!

Looking forward to tomorrow, going to hurl the shower stool out of my shower cubicle (though only so far as the attic, for next time, utterly invaluable!!)

Saturday, 8 August 2009

Hip Arthroscopy rehab day 29 on the up

Post hip arthroscopy I am feeling stronger day by day.
Had a lovely conversation with Professor Schilder's secretary that really hit home. You need to give your body time to heal, at least 6 weeks to 2 months before you see results and all sorts about focus and perspective and with lots of anecdotal evidence. If you're surgeon's secretary is as helpful as Schilder's secretary you're lucky because they have a wealth of experience from been at the front line, fielding all the calls to the surgeons and see everything first hand. Whilst she won't go stray into Schilder's territory re specific physical post hip arthroscopy complaints, she will reiterate his advice in laymen terms and gives support.

Somehow her words of wisdom hit home and made me go out shopping and to enjoy the sunny day a bit more, instead of impatiently waiting to improve and googling to see why my recovery from hip arthroscopy isn't faster!

Walking is improving. All round strength is improving, all day by day. I now potter around the house, using one crutch when I tire and two crutches for the stairs and outside.. I intend to slowly ween off over the week.

ps re shopping, don't try hang your shopping off crutch handles when out and about. I brought home a bag of not apples, but apple mush because of the bags swinging and battering the crutches as you stride and a bunch of battered, broken flowers!!

Thursday, 6 August 2009

Hip Arthroscopy rehab day 27

4 weeks post hip arthroscopy tomorrow and I am allowed off crutches. I can now walk forwards, but with a limp, slowly and not very far at all. I can shuffle around within a room. I think I will be weening off crutches for a week or two sadly.
Frustratingly my good hip is hurting really badly again, partly over use, but mostly its on its way out. I can't bring myself to commit to another op though until I see some results from this one.. but battling with that argument in my head is the increasing pain from my good hip and not wanting it to become as badly damaged as my bad hip and so increase the recovery time.
I can cycle more smoothly with my operated hip now although having to prematurely stop the length of my cycling sessions because of the impingement on my good hip! The irony!
Exercises continuing and fairly uneventful, I'm looking forward to getting into the water but want to be steadier on my feet poolside before I risk water exercises.

Saw my original physio Louise yesterday, she tested my hip ROM. Some of my (ROM) movements were more flexible on the hip arthroscopy hip than my good hip which I thought interesting. She also tweaked the exercises I was given to make them more effective. No matter how well exercises are written down, it pays to check you're doing them correctly. I also realized how grateful I was that I had been doing similar and same isometric exercises before hand as they're familiar to my body, making them easier to do.
One other thing I wish I'd known earlier was that I NEED to massage the surgery incision points to stop them pulling the skin and muscle inwards and causing pain, a few days ago they looked like they were sinking (bit like cellulite, but worse) and my physio explained I need to firmly massage the area for 10 minutes a couple of times a day to reduce scarring. I hope its not too late to do that, the last thing I need is any source of more pain right now.

Tuesday, 4 August 2009

Hip Arthroscopy rehab day 25

Hip arthroscopy is definitely the long road in terms of recovery, but I'm going to have to stick to my life motto, 'always walk on the sunny side of the street', or long road in the case of hip arthroscopy!

Well, mentally feeling better, mostly bolstered by the support of you fellow surfers and bloggers and also by the advice of the surgeon. I does help that he allows patients his mobile number, so that when hope fails you, you can call and seek his opinion. He says in short 'its early days'. There's that long road rearing its ugly head again.

Well somethings happening because my body wants to go down to one crutch, I'm not allowing it yet, until Friday (4 weeks), but my body definitely has the urge to drop one crutch. It is unconscious as I certainly do not want to tempt fate, or risk pushing myself. I have also discovered I can walk backwards better than forwards, whats that about?? Might try moon walking next!!
My hubby shouted across the room 'WOW YOU CAN WALK!!!' And I went into evangelical "praise the Lord, I can walk!' and back into sarcastic "I could walk before the op you idiot!!" Bad tempers not left yet either, oh how I'd hate to live with me right now!

Anyway, trying to make the most of small improvements. I can kind of walk, err albeit backwards, but its a start.

Monday, 3 August 2009

Hip arthroscopy rehab day 23 despair

I'm starting to get quite upset again..its now over 3 weeks post op. Whist I can feel big improvements in the sense that after the op I could not longer walk and I am now building the strength to walk again. I am not seeing any real improvements on my condition as it was 'before' the hip arthroscopy. Pre-op I had no tolerance for sitting, walking and a little tolerance for standing with no chance of anything sporty. I can't yet walk or stand without crutches, so the only parallel I can compare is sitting tolerance and I think its slightly worse.

I know Prof Schilders is one of the best surgeons and I know he has reassured me not to ponder too long on the small ups and down during rehab for a conclusion can't be drawn before 6 months, but 6 months of not knowing if your better????
Surely there must be signs?? and surely my signs aren't great?
When its your body it is impossible not to doubt yourself, doubt your recovery, doubt if you'll ever get better. Have a problem with your appendix or suchlike, you have an operation and feel better, job done! With a hip arthropscopy you have an op and you're asked to suspend believe '6 MONTHS' before it can be decided if its worked? That's too long! I'm not blessed with patience particularly, but when things don't feel good, who can say to themselves 'never mind I'll worry about whether its worked in another 5 months!? Its not as if you can get on with your life to distract yourself! This is a life changing op from the point of view of quality of life, I was desperate to get better, that doesn't change after the hip arthroscopy, it increases as you're given some hope and with that comes a certain level of expectation. I expect to improve, but I'm not even where I was at pre-op.. how can this process not cause upset?

And all the time I am watching my baby get bigger and more distant and my son doesn't even ask to play now, because he knows I can't really do anything with him. I could cope with this loss if I knew in a few more weeks I'd be ok, but I fear this could drag on for months and months. It wouldn't be so bad if it was just rough and tumble I can't do, but I can't even sit and draw or read with him, because I still can't sit!

And theres the rub! I've had a MASSIVE flare, I think because I have sat to long - I had the audacity 3 weeks post hip arthroscopy to think I might be able to go out and sit through lunch for an hour and a half, then adding a 20 minutes each way journey there and back to Harrogate. I dared to sit for almost 3 hours!! That's not even a full day in the office, yet at this stage I would be expected to go back to work, so WHY CAN"T I DO THIS????
Half way through lunch I just got more and more deep pain in my hip and sacroilliac area and bottom and its so upsetting because I had the hip arthroscopy to treat this impingement?!
That pain wiped me out for the day. I was in lots of pain last night, back onto co-codamol, heat patch on piriformis, after ice on hip for half an hour and had a rubbish nights sleep. Also getting a lot of pinching in the groin, didn't get much of that pre op, what is that?

I worry that the op hasn't worked/won't work. Erin, same age as me, who comments a lot on this blog had the same op, as near as can be, except her labrum removed (which I thought was more risky). She had pain for 15 years, she is almost fully recovered!! I am not even where I was pre-op?

I am trying to find answers into what could be wrong ...could my acetabulum have been retroverted that has these ops fail? Could my psoas be rubbing on my femur, that could hinder recovery? Could my impingement be posterior, though I do remember Schilders saying my labrum was fine in that section, so that sounds unlikely.

I went to bed in a lot of pain and have woken similar and with this added pinching as well as the deep pains its just too much and dashing my expectations, all I did was sit through lunch! I don't understand. I really don't understand why I can't sit if the bones gone that impinged?
Did I do damage with the stumble early last week? Or have I done something wrong? I'm certainly not pushing myself and when I read some of the US style PT I feel positively lazy! But If I try do more PT, esp glute then = more pain.

I am sorry to be negative as I really want this site to be a source of hope, but I want to be honest also. Perhaps its a blip, but WHY CAN"T I SIT?
The hardest thing is I can't pick up my baby and I feel like her babyhood is slipping by, you don't get that back!

If I'm supposed to be able to go back to office work now, then why can't I sit for even an hour or so, without much deep pain that causes inflammation and more pain over successive hours/days.
If the sitting pain was from impingement and the impingement was taken away then why can't I sit? I absolutely don't understand, problem supposedly removed and yet problem not gone??

Saturday, 1 August 2009

Hip Arthroscopy rehab day 22 positive signs

Really tested my hip today as I had to go OUT, YES OUTSIDE, wuhoo, for a few hours to show tenants around one of my rental houses. And my post FAI operative hip feels fine, slightest grumble, in fact its my other hip that is REALLY irritated.. I spent the best part of 3 hours standing too.
My 'good', loose term, hip hurts when I lay, sit and walk in all the same places as the other hip (my bad hip) Its not really my good hip, its just better than the one thats just had the hip arthroscopy! I am aware my 'good' hip on its way out and that it apparently also has impingement; and no doubt labral detachment, or some such horror! If I need to have it treated I think I'll not bother with the MRI this time unless Prof Shilders thinks its necessary. Schilders can already see the impingement on X-ray and I can already feel the symptoms and why go through another MRI, as they're quite an intimidating procedure on there own. Injecting the dye into the hip is surprisingly painless. More a deep uncomfortable ache I found. My issue is I am seriously claustrophobic and that is my problem with MRI scanners.

I was thinking of a steroid shot to keep the pain at bay, but really if my operated hip improves, I think I should get this other impinged hip fixed with hip arthroscopy, before any arthritis sets in. I was lucky with my right hip as Prof Shilders has most likely stopped arthritis forming there and it was forming, as there was a large wave sign, so why push my luck with the other hip?!

Also today I took a few 'shuffly', unaided steps, which I think is amazing, as last week, when I tried my leg wouldn't hold and I swooped when I walked at few steps!! So that feels promising too. There are definite visible signs of improvement. Never the less am religiously staying on my crutches. I can't imagine in a week been off crutches, I suspect a weaning process ahead!