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, 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??


  1. Hang in there Louisa! You have to remember that you have had major surgery. You's had a buzzy little saw in there chopping off your bone and cartilage and sharp instruments stabbed through the middle of your muscles. Most injuries take at least six weeks to heal so I think you really should try to relax for now and let yourself heal.
    The pinchyness while sitting could be one or more of many things including raw bone being irritated by the joint capsule, nerve endings in the labrum, muscle tightness and of course the obvious, remaining impingement but you don't need to be thinking about that right now.
    I was out of action for three weeks after my scope for just a labral debridement and though I went back to work at three weeks, it was six weeks before I was anywhere near pre-surgery state and back on my bike for short rides.

    Do you have any pain, redness, swelling or discharge at your incision sites? Maybe they are hot to touch? Have you been on antibiotics? If you have a lot of pain it may also be due to an infection, so keep your eye on that.

    Nearly every story I have read, people feel great immediately after surgery, but they do have a lull and even go backwards at about the same point you are at before it gets better.

    Keep your chin up and give your body the time it needs to heal :-)

  2. Thanks Jess, how do you know all that stuff?? Think incisions healing quite well, I think I look better on the outside than inside. Could you sit though, can you sit now for long (long being an hour!!) Then again your impingement is still there isn't it.
    Reaasuring to hear you were still rocky up to 6 weeks with just labral work. I compare myself a lot to Erin, who's same age, v similar op a week apart and she's doing fabulously in that scoped hip!
    Thanks again, its a hard recovery for people to understand, it takes so bloody long and theres nothing to really see.

  3. Louisa, You have had as much done inside your hip as if you had an open procedure. If you have a 10"scar down the side of the hip you would think it was normal to be in pain, don't be fooled because it was keyhole.3 weeks is way to early to judge anything (Schilders kept me on crutches for 6 weeks and off work for 12-and I didn't have any bone work done!)I think you are being way too hard on yourself (this comes from the most impatient person on the planet as you will know from my blog) and expecting too much too soon. You will have a lot of ups and downs along the way before you even start to see any results.Think back to two weeks ago-have you improved since then? If you have, then things are going in the right direction. It is very much 2 steps forward 1 back, and the backward days are HARD! Emotionally and physically! Don't beat yourself up about having done something wrong, you are doing fine, everybody has flare ups, trust me.
    6 months may seem forever but in the scheme of your babies childhood, it is nothing. In the long run they will have a mummy who will be able to run and play with them and thats what they will remember, not the short time you were out of action.Hang on to that thought.
    Remember, what you have had done is harder to recover from than a THR, and that takes 3 months!
    Hang in there
    Kate xx

  4. Thanks Kate,
    Its just its not new pain, its the sitting pain I had before, surly that should go?

  5. I don't know, I'm sorry. When is your next check up?
    I was pretty sure mine hadn't worked at 2 weeks post-op, everyone kept telling me to give it more time, but deep down I knew it was the same.Schilders referred me at 8 weeks so he must have expected improvement by then, but mine was obviously completely different so can't really compare-and he did warn me pre-op that it was 50/50 whether it would work or not.
    I think all you can do is wait, and be guided by Schilders.
    Kate x

  6. I see him at 8 wks also, I'll see how I go over next few days, doubt theres much he can do at this stage. I think he expects full recovery for my condition.
    Thank you x

  7. I just want to hug you right now :(. I truly believe my recovery is an exception and not the norm. Each doctor does things so differently including PT and such. You only had 2 incisions which leads me to believe there was a ton of instrument moving compared to my 5. I was on crutches for 3 days, yours a month. I had no PT other than my own and I did it in the water. The only thing we really have the same is the surgery, and your anchors compared to my removal may make all the difference. I am one stubborn broad too !
    Have no doubts that when I returned to work I did struggle too. I had to stretch quite often or it got stiff and my hamstring pulled. You have to listen to your body and do what it wants, whether it is resting or pushing it a little. Take advantage of natural healing cures, good foods and joint health medicine (Bioflex - http://www.vitamincircle.com/glucosamine-chondroitin/sundown-osteo-bi-flex-plus-msm.asp). Taking a good multi-vitamin helps too, you have to give the body a little boost to help with the healing and rebuilding process.
    Blood flow is being restored to all the areas of your hip along with rebuilding of muscles, tissue and bone. That takes time. I am sure my hip still looks like hamburger inside and that I have pushed it a little too far a couple of times, but keep in mind I have so much other pain that is worse to keep me distracted !
    I wish I lived closer to you.


  8. Thanks Erin, I'm trying to calm down, just no point getting upset, though hard not to occasionally. How was your sitting pre op?

  9. ..and yes it would be lovely if you lived closer x

  10. It was awful pre-op. I always felt like I was sitting on the edge of concrete and the bones would feel like there was nothing between it and the seat. It was much worse when I would stand and then you would hear that hip pop, then the other and then my back. I also could not sit with my legs crossed because my legs would fall asleep at the hip.

  11. Don't know if it helps, know this is an old post but my surgeon said that it will be up to 6 months until you would expect the pain you had pre-op to go. I had really bad pain sitting pre-op, car journeys and flights were my worst enemy! Im still having that pain (not as bad but its there) so hang in there for 6 months, sure it will be better xx