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:

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.


  1. You know your own body. I knew by 6 weeks my scope had failed, luckily forme so did Schilders, everyone else kept telling me to give it time.8 months later it was worse so I understand where you are coming from, but I think you need to follow his advice, if it needs more time he will tell you, if it has obviously failed he will tell you that too. A friend of mine also had a failed scope and he referred her for a resurfacing which she has at 1yr post scope.Each case is different.

    I do think you are probably doing too much. I know in normal terms its not a lot but in terms of hip recovery it is. I am the worlds worst for doing exactly the same tho, and regretting it later ( I am at this moment,lol).
    Whendo you see him again(sorry I think you have already said, but I can't remember)
    Hang in there and remember the 2 steps forward, 1 step back days, and try not to get too down if you are having a 'backwards day' that is normal post scope.
    Kate x

  2. Kate, why did your friends scope fail? Does it need a solid reason to fail (deformity) or can it just be bad luck? Is she ok now after resurfacing?

    How much is too much?

    I'm seeing Schilders next Wed, I think via his Sec Rachel, that he's saying too soon to tell.. it possibly is.

    I saw my physio today she said the whole area, hips glutes, the lot is in spasm. She queried the amount of stairs in my house (3 story) stairs to go anywhere!! and wondered if that might be too much pressure on hips as should be about the start aqua therapy where you practice steps weightlessly.

    Whwn you said you knew it failed, was it becasue it felt the smae completely. The difference I feel is a gliding raising knee to chest as opposed to uncomfortable resistance... thats my good sign!

    Thank you for your in put.... just when you think you're out of the wood, it all falls apart!

  3. I feel so bad for you ! To feel like it has failed this early I worry. I guess I never really felt like it failed for me since it has been a relatively easy recovery so far. I have had so many other distractions and pain that I hardly even notice my hip at all unless I have done something to strain it.
    The aqua therapy is definitely a good idea, I have been advocating that right from the beginning. The water not only feels good but offers no real impact to the joint. It has worked wonders for my body and I really enjoy it.
    Some of it I wonder if it's actually normal, but there is such a lack of real information out there that it's hard to tell. We are the ones that establish the normalcy by documenting what we go through and the outcomes. Keep coming here with your updates !
    Hang in there Louisa and know you have the support of your doctor and your many virtual friends.


  4. Hi,

    Hers was purely down to Arthritis, and the scope was done with microfracture to try to bide some time before replacement. She is older (50s) so had the resurface. Every case is so different its really not possible to compare.
    My pain was just the same post-op but worse because the muscles were so weak so the joint (already shallow) subluxed constantly. Why not use the crutches to do stairs until things settle down again,and when you have done hydrotherapy maybe they will be strong enough. I had 6weeks hydro after the scope which helped lots with strengthening. I know I keep saying it but it really is very early for you-I was on crutches 6 weeks post scope, then used one for about 2-3 weeks before full WB. I think at 5-6 weeks you are doing LOADS and should ease off or rest more inbetween things. Use the crutches if you feel sore, don't push through pain or imflammation will just increase,unless its just muscle soreness then thats to be expected of course.
    Make a list of every concern/question that you have, and make sure he answers them all at your appointment next week. Be specific about timescales and ask him when you should start to see an improvement. I am 14weeks post PAO (way different, I know) and don't yet feel better than pre-op,things take ages and thats the hardest part, but you need to understand the timescale and expectations that he has and what he considers is normal for you( not anyone else) at each stage.
    Hope this helps a bit, try not to worry and good luck with that appointment,
    Kate x

  5. Kate and Erin, you are my supporting Angels's thank you in different ways for different things, but thank you both all the same and luck and hugs back to you both, thats a lot to digest x

  6. Louisa - The article I referenced on my blog was published on Hipwomen today ... message 21154. Terri