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:

Tuesday, 7 September 2010

Bad news from new consultant about retroverted acetabulum being significant.

Visited a new top hip consultant yesterday..
In short, after briefly looking at my x-rays and CT scan, he concluded that I do have retroversion and that it is significant.
That my hip sockets should be facing forward, anteverted, by 15 to 18 degrees, but instead are facing backwards, retroverted by 3 degrees. This is what causes the pincer impingement. A reverse acetabular periacetabular osteotomy (PAO) is the answer, except he feels that the results from such ops are entirely unpredictable, with success rates around 60 - 70% and that perhaps had I been 20, not now 40 then it 'might' have up'd my chances of success, however I am not!

Advice was to retry pilates and exercises to help adjust pelvic tilt to help minimize the retroversion and take pain killers.

One thing of note though was that that advice would've been the same a year ago, before FAI surgery.. however I do feel that surgery, whilst not 100% successful, was indeed worthwhile.

So personally I do feel that its not quite the end of the road.. not that I want surgery, I just feel I can arrive at a better place than I'm currently at.

On the upside, surprisingly I think that my right hip is actually improving still, even 14 months post op, which I did not expect at all! Yesterday I managed a 5 hr return trip to London, combined with several hours walking around the city and that after the previous day cleaning the house top to bottom... I thought I'd be on the floor by today, but surprisingly I have some achiness this morning and had a bit of groin pain and lateral hip pain walking about yesterday and today, so that's positive.

I still need to wait a couple of weeks for this consultant to have time to work out a number of angle measurements of my hips to confirm the facts.. so whilst feeling a bit hopeless during the appointment with the lack of a solution, I don't feel this is the end of the line. I suspect there is no point until the CT is analysed and I have accurate readings and therefore full facts.

I also think I just I have not yet encountered the right surgeon for me yet, its such a specialist area, with micro pockets of speciality even under the hip FAI umbrella.

I have not mentioned this consultant's name and will no longer do so in this blog.. as things didn't go brilliantly with Ernest Schilders and I found myself in a position where I had already named Professor Schilders in thanks for a diagnosis and along the blog, before I knew what the outcome would be. I do not want to compromise my honesty and so this is the obvious solution. How did Professor Schilders miss all this?

Thursday, 5 August 2010

Final consultation with Professor Schilders over disappointing outcome.

The meeting was very disappointing, because I can't progress if my consultant will not accept that my continued pain maybe down to remaining impingement of some kind. I held my consultant in such high esteem prior to surgery.

I am reluctant to go elsewhere for geographical reasons, as I find it hard to sit to travel still, but despite this, this last meeting had me leave thinking I have to get another opinion.

I think my protracted case may need another eye cast upon it and I have asked to be referred on because I believe, based on my symptoms and scan, that I have continuing impingement, whether that be remaining bony impingement, or scar tissue, I do not know.
I am also concerned about the extent of the retroversion, that caused the pincer impingement, been a significant issue in itself.

Not the hip journey I expected to be documenting...


Onwards and upwards then!

Sunday, 11 July 2010

Hippy 1st anniversary! .. hmmmmm

Well provided I take it pretty easy, I am a little improved... But today I went crazy, yes totally mad and did far too much, went bungee jumping, canoeing, then horse riding and... no, wait, sorry what I mean is I pushed the boat out, one year exactly post op, by doing 2 hours weeding! Which meant by lunch time standing, walking and sitting all really ached badly, muscles totally spasming and by the evening I had to lay down! Yes I know, super sociable for a Saturday evening with guests!

Its fair to say I am disappointed with this recovery.. I have been from the very early stages when I feared it hadn't worked.. I have regained some walking and standing stamina, though I am nowhere near as ok as pre-problem! But sitting is still impossible, I can just about drive from a to b and on a good day have a quick lunch with friends, but sit for hours, not a chance, no way!

I have no idea why my recovery had been so crap, I have rehabbed like a demon and educated myself ferociously, but all to no/little avail!

Now my left hip is going down too, regularly, in fact daily; and now I haven't a leg to stand on!! However Schilders will not operate on the left until the right is more stable or remedied.

I have another MRA due in 2 days to hopefully give insight into the problem holding my right hip back from full recovery.

Will it show another labral tear? Inflammation? Scar Tissue? ..a laughing gremlin? Not a bloody clue!

I also need a CT scan as there is still a question over whether the acetabular retroversion is a pain causing factor in itself.. ie over coverage on the front is one part of the problem and apparently been treated, the other possible part of the problem is consequential under coverage at the back, dysplasia causing hip instability, and so pain.

Schilders so far has refused this aspect of investigation, his reasons for this decision evade me.. But this absolutely must be addressed and clarified.

I have decided that if Schilders will not do the bone scan, that bar Villars every other specialist I've read about does, then I will be forced to seek a second opinion.

Anyway.. Monday should throw a few more answers my way, so fingers crossed I should get the results I need to see, whatever they are!

Sunday, 30 May 2010

All MRI's are not equal, getting the best

In short I'm having a pretty crappy time with regards to hips - both hips are down now! Same symptoms too on both sides, groin pain on walking and some movements, groin and bum pain on sitting, lots of muscle strain feelings in TFL, IT band, ab/adductors, hamstrings, the works with cherrries on top! The tipping point was moving house 2 weeks ago! The irony!!

I am now waiting on an MRI arthogram appointment for my right (post op) hip to see what gives. I will then see what the radiologist and my consultant say. If it is obviously scar tissue, then the course of action is simple, well, simple if I forget the fear of surgery and nightmare of childcare! If its not scar tissue, then.... then I'll cross that bridge when I come to it - huh, get me all Yoda!!

I also want a second opinion, either way, to make absolutely sure retrovertion of the acetabulum is not an issue, as I still obviously have concerns and feel I need that answered clearly, absolutely and NOT finger in the windly!!!

I need some resolution and I need it soon. I have had this diagnosis a year now (though symptoms coming up for almost 7) and I was pretty sure when the diagnosis was handed out to me by that by last Christmas, 09, that it would all be behind me (both hips)... but not one hip is resolved as yet, SUPER disappointing!

So, lets see what this MRI/A brings.

Also a tip, there are different strengths of MRI scanner, they ARE NOT all the same at all. They are measured in tesla strengths and that determines the level of detail which can be seen.

0.3T - might as well take your clothes off and ask them to see through you!

0.5T

1T - average

1.5T

2T

3T - best

I was scheduled a scan with a 1T MRI at the Yorkshire Clinic and have cancelled and phoned around the country and found a 3T MRI scanner. Ironically its not in a private hospital, or far away, but at Chapel Allerton, an NHS hospital in Leeds.
I am doing all I can to get that an appointment here, but its not easy as I am a private patient, but Bupa won't cover this NHS hospital, despite its superior facilities.
I had to explain all this to my GP, who I lost within the first sentence discussing the pros and cons of 1 verses 3 tesla MRI field strengths, God only knows what she writes in my notes nowadays?!

Anyway there's a lot to be said for determination and I figure no more messing about and no ones sticking a needle injections into my hip socket again for anything less than a 3T scanner!

Good luck hippies, the saga DRAAAAGGGS on as so often these hip-mares do!

Sunday, 23 May 2010

FAI hip bloggers please link your story to new facebook site.

Hi All,
Fellow bloggers please would you visit hip blogs (FAI, PAO, THR) on facebook and add your blog.http://www.facebook.com/group.php?gid=119530398085022

I've created a portal to link to hip blogs of all kinds on this page and if you go to: the "wall" where it says what's on you mind? ..and write in this box who you are and a v brief synopsis or you/your blog, then scroll directly below this box where it says attach, click 'link' just below where you are writing and write in your blog full address and click share all you will then have published your site on the facebook hip blogs link site to help others.

Blogs have helped us and I spent hours looking for blogs like yours, if someone can just come to this page and find loads of great hip blogs, it'll be so easy for them.
Thank you, much appreciated Louisa.

Ps this includes PAO and THR as they often overlap.

Thursday, 6 May 2010

fai hip pain

My hip pain has generally been better (could the op for FAI and labral detachment have actually worked??) Jury still out I'm afraid, as sitting for a relatively short period (1hr) flares the pain even now.. just like it did pre op...so I don't know..
I question further impingement, scar tissue and the acetabular retroversion, which I know I have, but the question I have to ask Schilders is:
' How can my retroversion be mild if my pincer is extreme?????' That make no sense to me..

Anyhow that rubbish aside, I am more gutted to discover that my daughter having been given the all clear last yr for hip dysplasia, after months of pavlik harness treatment.. actually still has dysplasia.. mild they're saying but dysplasia is dysplasia and I once remember reading someone's blog who said in her eyes there is no such thing as mild dysplasia, you either have a stable hip or not. WHY did I listen when they said she was ok, in my gut I thought a little longer in the harness and now can't forgive myself that I didn't stand by that!
The idea my gorgeously happy, 18 month girl may have to go thru all this crap is just awful.. I look at her and fear for her but have to paint a big smile on my face for her! SHIT!!

Sunday, 25 April 2010

improvement steroids or reality

Well, in general, I think I am doing better! Hurray!!

My hip held up REALLY well for me yesterday, during a 4 and half hour stint in a stately home and its play park on a hill (the things you do for your kiddies!) Frankly, I would've thought I'd have been a write off, after that amount of walking and standing! I was very aware of my hip etc, but no pain for a wonderful change and I had enough good sense to lay down for an hour when I got home!
I am really not sure if its the steroid (which typically takes 3 weeks to kick in for me always) or whether it could be ... that I am.. in fact.. SLOWLY... getting better???

The thing I am struggling with still is sitting and laying on my back esp, which brings on pain in the butt and sciatic pain! Possibly that is the hammies or some other annoying reactionary muscle group, though its still possibly ongoing intrarticular hip joint irritation.

My PT did loads of trigger point massage work on my tight adductors this week (OUCH!) and ouch for a good day after, but now fine. I think it could be that they, the TFL and Illiotal band, that are causing thigh and 'new' knee pain - peculiar pain patterns with hip problems.

Anyway in summary, whilst not out of the woods yet, I am also not saying 'ouch', 'shit', 'for god sakes', 'bloody hell' and 'leave me alone!' as much... So, on reflection, I would, say quite possibly, that I am improving now - only 9 months post op!! Grrrrr

Saturday, 17 April 2010

Answers from FAI expert

 I have pretty much copied in my latest correspondence between my Surgeon and myself, via his secretary..
I can't say I am too clear about where I am at, other than I'll probably be having another MRI soon.



Hi Louisa,

I have had a response to your questions from surgeon, as follows:

Q: What dose of anaesthetic and steroid was given and was this a “stronger” dose? - The two injections in the past have not affected the pain experienced when she sits down and this one did. Why? Also, why did the pain she gets when she sits down never go away after her hip arthroscopy?
A: 2ml Depo-medrol 80mg and 8ml of Marcaine. I wouldn’t call that a strong dose but a normal dose for a hip injection. I am not sure if Louisa is referring to the two previous hip injections that she has had in the past or to the hamstring injections. If she is referring to the hamstring injections then I would conclude that the hamstrings are not causing the problem. If I knew exactly why the original pain had never completely disappeared I would be able to treat it, but unfortunately her response is not a typical response that is seen in the majority of the hip arthroscopy patients with this type of pathology and therefore more difficult to pin down.


Q: Louisa’s range of motion is quite good. Would this be expected if she has developed scar tissue?

A: The number of patients that I have treated so far with adhesions post hip arthroscopy is very small. But in the group with this problem I didn’t feel that a reduction in ROM was the problem. Because we are talking about 1-2% of the hip arthroscopies as a group it is too small to see patterns and be able to identify possible causes for residual problems.


Q: The effect of the recent injection lasted no more than 4 hours. You said it would possibly last for 5-6 hours. Is this because Louisa’s pain is now so chronic and nothing will have a longer-lasting effect?
A: Each patient’s reaction to an anesthetic is individual. If I specify 5-6 hours then this means that this can be expected in the majority of patients, but it can last a shorter or longer amount of time as well and we have no way of knowing this with each patient. Chronic pain is unfortunately much more difficult to resolve because the permanent stimulus to the nerve roots telling the brain that there is pain might still continue even though the original problem has been solved.

Q: Louisa said that the injection took away the pain she feels when she sits down and was replaced by a sensation of deep-seated “itching” within her hip. Does this tell you anything?

A: It tells me that there could be an intra-articular cause which is at least partially responsible for her pain.


Q: Do you feel that Louisa has some residual impingement, or has she likely developed scar tissue?

A: That I can’t answer at this moment. As I discussed with her, if we felt that the injection gave her a positive response (i.e. blocked the pain), which I think she has had, at least partially, it would probably be a good idea to re-scan her hip.

I would say that the diary of symptoms over the past week is what could be expected from the effect of the local anesthetic firstly, and then subsequently, when the steroid kicks in, her symptoms start to improve again.


Q: Louisa has noticed that her gluteus on the right side seems to increase and decrease in size and she is able to induce “impingement” symptoms in the right hip herself in some positions. Can you explain this?

A: What Louisa is able to induce is pain, but there is no evidence at present that this is “impingement” and this should not automatically be assumed.

Q: Louisa seems quite convinced that there is some residual impingement remaining. Is this a possibility?

A: We have discussed in clinic how I treat a pincer abnormality and I have confirmed that she doesn’t have a coxa profunda, which is the more global-type of over-coverage.
I assessed the zone where Louisa had a wave sign and then decompressed the acetabulum in the area of unstable cartilage followed by a labral repair. Assessment of the impingement is done dynamically during the operation.

Can there still be residual impingement? - nothing is impossible; however her outcome scores and assessment do show that she is deviating from the pattern that the standard group of patients with this type of pathology follow (call it disproportionate symptoms) and we therefore have to start to look realistically at would could be achieved with further surgery if permanent stimulus to the nerve roots continues.



Louisa,

I hope the above information is of some help. If you are amenable to a re-scan I can ask the MRI department to arrange an appointment with you. I know you said that you were not keen on another arthrogram, but your surgeon would not consider a second arthroscopy without a scan, as the results of the scan will be important in deciding further appropriate treatment options if something does show up. I understand it is difficult and frustrating for you not to have a definitive answer, but I think he has been as informative as he can at this stage. If you have a think about things over the weekend and let us know if you would like an MRI scan arranging.


Thursday, 1 April 2010

Appointment with the consultant

Saw Professor Schilders yesterday.
Whats its not:
He thinks its not arthritis as on X-ray there looks to still be good distance within the socket and in surgery whilst there was a wave sign, the arthritis was categorized as grade 2, mild.
He says its not coxa - profunda? (big sockets) as I still have a teardrop sign. I didn't think it was though.
He says that there is retroversion because of the crossover sign, but says that its not, in his experience, the problem and that in arthroscopy he had a good view of my posterior socket and it was problem free. So the retroversion is mild.
He said it was not posterior impingement and I insisted on a physical test for that, which he did and it was pain free. He also said that again, during surgery no visible damage was there at the posterior hip capsule.

What it could be:
He said, according to his stats, pain could be caused by scar tissue. My only real bug bear with Proff Schilders, is that I feel he prefers to use his history stats, rather than listen to the individual. I'm sure he does both.. but I do feel like saying 'there's no point referring to your stats, as I'm never the average!'

I also showed one way I can illicit the pain, by laying on my side with my right leg on top, causing it to fall into an internal rotation. This made him say it was possible that there could be some residual impingement.

My question though its if its caused by scar tissue, which builds with time, why did the pain never go away and then return? It simply stayed, which has my money on residual impingement.

Alternatively the problem could be tendons etc.

So the inevitable arrived, the best test to rule in or out my actual hip socket was an anesthetic injection into my hip joint, yay! Actually for the 1st time in four of these, it actually hurt!

Anyhow, afterwards my sit pain disappeared, which I wasn't expecting, as once before I had the same shot and the sit pain didn't disappear.... so I wonder.. It could still be my hip causing all this pain. I could also more clearly feel other factors at play like a really tight, sore hamstring and a bit of discomfort around the SI, but these weren't that all encompassing pain and with that gone, I think I was able to distinguish other niggles. Does that sound weird?
Also where and when I would feel pain (like sitting) instead I simply felt like a deep itch that couldn't be reached, but not pain. I wonder too, if that's normal?

So this morning I need to know 2 things, could any anesthetic go into the local muscles, as that could skew the consequence of no pain on sitting after a hip socket injection and did he give me a stronger shot of anesthetic, so that this time it could stop the pain?
I feel a phone call to his secretary coming on!

ps The anesthetic should've lasted 5 to 6 hours, but felt to last 3 to 4 before the pain broke back through.

PPS We exchanged on our house yesterday, yippee so its legal and on May 10th I can move out of this stair hell, though lovely house, and move to my easy stair house!!

PPPS Note to self, the marker pen they use to draw all over your hip, prior to injection, doesn't just wash off.. not even with a shower.. and exfoliater. Might delay swimming, as it looks like I've been drawn up for liposuction!

Sunday, 28 March 2010

hip clicking again uh oh!

I am concerned that since the jolt or shunt type injury in the shop 9 days ago my hip has been far worse. Pain more constant and pain on weight bearing and as of last night it has started clicking again.. If I flex my hip and abduct (away from body) at the same time sometimes it clicks around the groin region (not painful). It did this prior to my hip arhroscopy for FAI and labral detachment, for years and only stopped post surgery. My left side also began clicking with the same action a year ago when the pain on that side kicked in and it also became symptomatic.
I also have a constant dull ache and increased pain on weight bearing and also since my one to one pilates my pain has increased.
All this pain feels frightening familiar!
But it seems or should I say seemed unlikely that I could have done so much damage just from a jolt 8 months post op surely??!

The disappointment and consequential exhaustion continues then!

Wednesday, 24 March 2010

and then I fell! 8 months post op

Well have been doing generally better (not out of the woods better, but reason for hope better,) hence my absence!
However, last Friday I fell/dropped down a stair, least I was in a shop walking and there was a stair dropping down into the changing room that bizarrely wasn't marked and instead it was actually carpeted over. So walking, I just happened to step into it and unexpectedly dropped 3 or 4 inches and ouch! It kinda shunted my hip upwards and immediately hurt the illiac crest area.. since then I have had much more trouble sleeping, feel dull ache in joint when I put weight on it and some spasm around the hip also. Really cross what a stupid thing to happen and I am sooo careful too! However that was 5 days ago and I'm hoping my 8 months post op joint can withstand that jolt and heel in the coming days or week.

On a positive note, as of today, I have started one to one pilates using a trapeze and reformer table to hold the weight of my leg and allow the pilates person to add resistance as I become able, so tailoring to my hippy needs.
Also I have an appointment with my surgeon. He knows I am disappointed with my recovery so far and I am curious what this next appointment will bring.

Happy healing out there!

Sunday, 14 March 2010

Hip CLUNK and the pain is gone?

Well the weirdest thing happened to my right hip last night. As I was standing, I shifted my weight slightly, my right foot slightly back of my left and there was an enormous CLUNK in the back of my right hip, that took my breath away. It was quite painful, but no sooner had the pain registered, than it was gone. Then nothing different until I lay down....
When I lay down the deep pain that is always in my right buttock had disappeared?????????? I was midnight, I was shattered, but lay there, suddenly wide awake and unable to sleep for an hour waiting for the pain to return.
Normally the pain is instant at worst and seconds to a minute away at best. After an hour I got a vague itchy, uncomfortable sensation, so I turned over onto my front, not wishing to push my luck!
I still woke in the morning with some hip pain (either arthritis or muscle fatigue pain is my conclusion with the achy side of night pain) But the urgent gotta tilt away from my right buttock, or change position because of a deep bum pain was gone.... after years, gone??????
This morning, still gone?! I've been laying on the bed, flat on my back/bum watching the clock testing it.. what the hell???????????
Still had some sitting pain at breakfast.. but no laying pain... how, whats happened?? One huge audible CLUNK and something has really shifted somehow.. but how? What? Where? WTF?????

Thursday, 4 March 2010

why the nightpain in the bum? 8 months post op

Does anyone know what causes night pain? I had an easy day yesterday and relatively pain free, but then night pain!? I only get this with the operated side and actually it started 6 yrs ago (pre-op) and was my first symptom that something was wrong. Six years ago I also lost the ability to sleep on my front.. but then unexpectedly post op, as from 7 months ago, I was once again able to sleep on my front and a little on both sides!?
I can't understand why anterior hip impingement would have stopped me sleeping on my front?? Any thoughts?

If I lay on my front now, I can get more hours pain free sleep. But after that my back muscles fatigue.
I struggle more now to lay on my back ironically, it was always also problematic and involved many cushions. Now though, the minute I'm on my back and I lean onto that side, so if I'm either flat or tilt towards that hip I get immediate pain in my bottom and it seems to also travel down my leg into my calf? If I tilt to other way using cushions, this is less painfuland how I had to sleep for 6+ years, but still painful.

I think it is the same pain that I get sitting also. So if I lay flat on my back or sit I get a radiating pain in my bottom and if I do it for any period it seems to antagonize the whole hip and flare up the pain.. My lefty side, the one that needs operating on, currently only gets irritated in the same way if I sit, which started last year, but not yet if I lay..
I thought I'd ask if anyone had any thoughts re this, as asking health professionals has them just shrug!?? Any opinions really appreciated :)

Monday, 1 March 2010

7 and a half months post a FAI op - anyones guess!

much to same, good and bad days.. but more bad days since last week when I woke with my leg/hip internally rotated and turn it into external rotation, as I did this I heard a VERY loud grinding noise... Also its still very stiff, wonder sometimes if I should lay off the exercises and see what happens. Still not convinced I am properly better..I wonder if:

1) Its possible my left hip that still needs an op can be affecting my right post op hip detrimentally?? Is that possible?

2) Hoping my fab physio is right and that actually its ongoing inflammation caused by the relentless stairs in this 3 story house, that I am due to move out of in the coming months.

3) The remaining pain is muscular, but then why does it have the power to wake me up every night? ..And I exercise my glutes all the time and in a targeted way too. My right glute though is still flatter, no mater what I do!?

4) Fearing that my surgeon is wrong and that my acetabular retrovertion is in fact the main pain causing factor that needs addressing. Without CT, I'm unsure how he can have such confidence it isn't. Especially given the poor view of the posterior of the acetabulum, via front portal arthroscopy when doing FAI surgery.
Also it concerns me that he insisted no-one suffers posterior impingement, when there is a clear body of evidence suggesting otherwise.

I wish I could be sure of my right's recovery, as my left is screaming out for the op. The problem is, until the right one is fixed, I don't have the confidence to address the left one, for fear it is the wrong op! I know its my hip causing pain, but which is the correct hip surgery, depends on the accuracy of diagnosis and due to ongoing pain, I have lost some confidence in that!

I'm banking on it settling after the move, though think that IS optimism. Still, until then, my head is planted firmly in the sand, unless pain dictates otherwise.

PS set up a 'How to move, improve and extend without going mad' blog, hence the alteration of 'about me'!

Friday, 19 February 2010

7 months post hip op and getting better!!!

I have been delaying writing this as I think I am FINALLY!!!!!! starting to improve, quite a bit - no idea why, not much different, unless the thought of not having to climb so many stairs, because of the immanent house move counts??!

I have continued to do the water exercises and included some of the Griffin video stretches from the last blog post, esp the illiac psoas stretch.. also doing a bit of the hip hiking exercise.
I saw a reiki healer twice and a chiropractor twice also, but doubt this can be the big change, as my left hip (good hip) is going down sadly.
I think I may just have needed more time post surgery, 7 months to be precise! 4 months over what I was told to expect! Initially I was told 3 months to recovery, when that didn't happen, I was told 6 months to recovery! ..and at 6 months I was told "well in some cases it can be a year or more"... The problem with that approach is when you're not better at 3 months you think "what the hell is wrong with me?" and then at 6 months when they start saying "maybe a year or so", you're thinking I don't believe you, I don't think I'll ever get better and you're moving the goal posts to try shut me up!

Expectation management for this op is a bit crap. I'm not an 18 year old professional footballer, so odds on I won't respond like one. I'm a middle-aged (ouch!), over tired, sugar loving Mum of two physically demanding very young children/baby.. so I can't spend hours and hours laying about, then training, then been psysio'd, massaged and drinking protein shakes! My hips aren't worth 25 gazillion pounds to a premiere league football manager!
My hips have to keep going or the family falls to pieces, I'd like to think I'm flattering myself, but I'm not.. My hubby runs a busy company, I have a four year old and a one year old, add crutches into the mix and its chaos!

I hope I am managing to express how myself and many other hip bloggers I read about are so hard on themselves and push themselves fiercely in rehab and physio and perhaps, partly because our recovery expectations are set unrealisically high.
Anyhow, that gripe over, or more to the point struggling recoverees hope that gives you hope!
So, yes I can sit for waaayyy longer, been driving about, eating meals in restaurants and just been to the cinema with my 4 year old and nothing horrific has yet happened! I notice also I can walk faster without groin pain, I caught myself overtaking someone on the path to school and suddenly though "woohoo get me!!"

The only bad thing that currently remains is my persistent pain in my bum when I lay flat on my back and its almost instant? But for now, with so much on, I have delayed the MRI neurography and consequential medical stress, for the burying my head in the sand approach! Its almost certainly nerve irritation caused by either piriformis or hip joint irritation.. as it stands I'm happy to delay further tests until after we have moved house in April-ish, and hoping that by then this improving malarky takes away the need!

Tuesday, 9 February 2010

FAI hip arthroscopy rehab exercises, video links

I have discovered an AMAZING website dedicated to post FAI hip arthroscopy recoveries. It is by one of the leading experts in the UK Professor Griffin. The fab thing is there's a flash video showing you every exercise repeatedly, so you can do some of the exercises whilst watching your computer and there less margin for error.
Also it shows exercises in the 1 - 4 stages of recovery, so it can be your best friend post op! Anyhow I think its fab and here is the link:


http://www.damiangriffin.org/rehab.html

I am sure this will be a huge help for many of you, esp those in the UK with little post operative support centres of excellence. Luckily if you're anywhere near Leeds in the UK there is a physiotherapy centre called Physiocure with a strong hip rehabilitation programme for hip arthroscopy and FAI patients pre and post op. There are water exercise programmes and classes, available for all recovery and maintenance levels, as well as hip physiotherapy and specially designed hip recovery pilates sessions to re-activated the core. Find physiocure at:

http://www.physiocure.org.uk/hip_physiotherapy.php


http://myfaihippain.blogspot.co.uk/p/exercises-for-hip-arthroscopy.html

Wednesday, 27 January 2010

hip arthroscopy non recovery - stairway to hell

Recovery from hip athroscopy for FAI leaves me exhausted like after flu or giving birth or something.. it must be the stress of all this non recovery and having to move out of this 3 story house too, to help my hips.
Well, if I do much then I have pain, if I do nothing, I have discomfort.
Still doing water exercises 3 x a week, plus some land stretches and exercises. Thanks those who have forwarded me some exercises, I am cherry picking those that don't flare up pain.
Right hip side glutes atrophy super quick if don't exercise for a couple of days, like popping a balloon. Obviously that's not normal.. I have an inflating, deflating arse!
Still seeing my PT still weekly. She is quite certain that the amount of stairs in my house are a factor, judging by her other hip patients.
I did a stair count one random day last week. I climbed up and down 442 stairs over the day/eve.. 260 of those were specifically because I live in a townhouse, so I would've climbed only 182 in a normal house. Maybe that really is too much???? Anyone have any thoughts on that one???
My PT thinks I need to start anti- inflams again and speak to Schilders about a steroid shot into my hip, I'm inclined to agree..
I have an MRI neurography to do also, though I feel too exhausted to deal with the travel and stress involved at the mo. Its not like me, but nevertheless its how I feel, utterly drained.
My PT thinks all my muscle spasms and entrapment's are down to inflammation within the hip capsule/joint, which in turn she thinks could well be down to all the stairs in my house.
I suspect she is correct, but feel so tired/bored/exhausted with it all, to think clearly at the moment.
Keep healing hipsters and any thoughts on stairs really appreciated.

Monday, 18 January 2010

6 months post hip arthroscopy she will recover she won't recover she will recover she......

As an experiment I did nothing Frid, Sat and with the exception of sitting for lunch on Sunday, nothing Sunday either... result = feel immeasurably better! ..And that is great, though I'm not sure I want to become one of those enormous people that live literally in the sofa and live on takeout, then eventually have to be removed from their house by the fire brigade, whist a reality TV show film it for one of those sad documentaries! "MAD HIP WOMAN TRAPPED IN HOUSE AFTER GOING CRAZY LAZING AND EATING HERSELF TO DEATH'
Today I had a normal day of activity looking after 1 yr old Izzy, small amount of food shopping and collecting 4 yr old son from school. Still I am careful, as in someone has to come look after Izzy whilst I do the shopping and collect Oscar from school, as I can't be lifting her in and out of cars, prams, etc without consequence that's for sure! I am currently ok. Still did some light stretches of the hip, psoas, pirifomis etc. Keeping thinking take it easy, cos inside I'm like a greyhound at the start gate.
SO we'll see can I do 2 consecutive days looking after the kids???

PS One tip I wanted to share I have discovered in my "hellish stair torturing townhouse that won't sell" that if I climb the stairs on my tip toes (or balls of feet) I can climb more consecutively.. I think it could be because it closes the gap in the hip less, not sure why, just is..but if stairs are a pain, possibly worth a try for you!


Tuesday update.
Pain started at 5am this morning in buttock and has antagonized all day. Currently wearing a heat patch. Wanted to go out with Izzy, didn't. Can't work out if its muscle pain or hip joint, or both.. hopefully neurography test will assist in that department.
I wonder if anyone else has had this at disability level for 6 years pre op? It started Sept 03 keeping me awake at night and by Feb 04 it was impossible to sit to work. Just wonder if anyone ever comes back from that, or is it too late?

Friday, 15 January 2010

hip arthroscopy non recovery 6 months disappointing response

My response to the letter sent in prior blog:

I'm para-phrasing as not sure I should reproduce the info verbatim, but in short (if it could be shorter!)

'Prof Schilders would like the referral address for the MRI neurography scan. Thanks.'

I am underwhelmed to say the least. On calling the secretary and questioning the brevity of his response, she said he would like me to make an appointment with him before or after after the MRI. I expected more from this letter and feel quite disappointed. Perhaps that is for him to physically assess me, but I don't feel heard and I don't see concern... and that concerns me.

Wednesday, 13 January 2010

hip arthroscopy non recovery 6 months - a letter for help

No idea why but am in loads of pain from my waist to knees! Hip hurts and have spasm in QL in back, illiac-psoas, tfl, piriformis, back and front of thigh.

I think FOR SOME REASON?????????? (and that is the question) my hip is irritated (as am I!!!) and that is causing muscle spasm and that in turn is irritating my sciatic nerve. Obviously that is a theory... but what more can I do, I can't 'not' think about it as the pain is screaming at me and also my theory is in the absence of a better diagnosis...

SO I have sourced something called MRI neurography, v new in the UK... it MRI's the nerves especially and can see which nerves are been irritated and why that might help make things clearer. There's a centre in Coventry and 3 in London, so I called them and I just need a specialist referral. It costs £750 plus 125 for dye injection, but apparently Bupa will cover it, I'm astonished and relieved.

Below is a copy of the email I wrote to my consultant Prof Schilders today, it explains where I am at at the moment..

Dear Professor Schilders,

I would like you to refer me for an MRI Neurography. This is a specific test to examine the nerves, under a specialised MRI, affected by muscle spasm etc. I have found 1 of 5 countrywide facilities that do this in London and they will do the MRI Neurography if you request it and to my surprise bupa will also pay for it (I was just going to pay myself).

I would like them to look for any obvious cause of pain and for them to also look in the areas I list which I would greatly like you to request from them.. They are:

1. A generic picture of the pelvis to see if there is anything obvious causing sciatic pain.

2. The piriformis for sciatic irritation, right side (though experience discomfort on both right and left)

3. The ischial/hamstring join for sciatic irritation, right side (though experience discomfort on both sides)

4. The obturator internus for pudential irritation, right side only

5. The psoas for inflammation right side.

Please, please ask for all 5 of these sub areas to be examined as its my one chance on this specialist MRI to get a very close look.

I 'think' that might cover all the bases I am aware of, the sensations of partial numbness, tingling and pain I get both down my legs and on the right side of my genitalia.

I already know the pain is not from discs or facet joints dues to a multitude of tests I have had in the past, but from the internet have learnt that irritations and entrapments can be caused by soft tissue also. I have to find out where this pain comes from.

My hip wasn't doing great though manageable, but in the last 10 days or so it has taken a step back and I am getting all the resulting muscle spasm I used to get pre op.. I now have my front thigh, glutes and half pelvic floor in spasm to name but 3 muscle groups. I am unaware of what I have done to provoke this.

As my left side deteriorates also interestingly it is following the same pain pattern as my right operated side, just to a lesser degree in pain.

My theory, for what its worth, is that I 'think' my hip capsule of hip socket is irritated and causing muscles to spasm and therefore to also irritate nerves.
I also wonder if my psoas is irritating the capsule, or if there is a chance you may have missed a bit of bone, or even if some bone may have grown back? I say this because I can make my hip click/clunk in the groin area. I discovered this by accident.. If I lay down, flex my leg to 90 degrees as if to do a hamstring stretch, then with a theraband adduct my leg inwards toward my other leg, at about the crossover point there is a repeatable cluck, I can't hear it, but can feel it. What do you think this could be?

I have groin pain on walking again, bum pain on sitting and massive spasm pains in the local area... I am almost overwhelmed with this less than successful recovery and at a loss to know what course of action to take next, but the knowledge that I must persist otherwise be crippled slowly.

I still have no chance of holding down a job with this sitting disability and my journalism career is now lost and equally distressing, I find it almost impossible to function as a mother to my 4 and 1 year old due to struggling to lift, bend, twist squat, pivot etc.. Our house is also on the market as we live in a three story house and I can't carry my one year old, 23lbs daughter up the stairs and struggle at times to climb them alone.

Please advise, my pain is in the groin, from the groin, but I can't get rid of it despite following all given procedures. As an expert in this area I'm pinning all my hopes on your ability to, pardon the expression, get to the bottom of this.

Please may I have this referral and please will you help me find the root cause, which I agree is my hip, but do not understand why I have made such a poor recovery.

Friday, 8 January 2010

hip arthroscopy recovery 6 months

This hip arthroscopy recovery is such a disappointment. A bad few days, after a good week!? Not sure what the problem is, I suppose I could be overdoing it! There's a surprise, seen as living like a normal person is considered overdoing it! Excuse my assumptions that LIVING might be ok to do SIX MONTHS post op.
Or it could be going back to the pool and doing the same intensity of exercise despite a 2 week break for a nasty cold? (pysio said I should've taipered down routine after 2 week break.
Or it could be that once again mercury is retrograde in Virgo? I'm now so bored of winging about my hip, I'm finding it quite hard to blog... 'how boring, she's still not recovered!'
I veer from its just I've been overdoing it, to my surgeon must have missed a bit or grade 2 arthritis maybe more of a threat to this recovering than predicted. I'd go on but I'm even boring myself.
I have currently pain in my groin, butt, side of hip and thigh - not sure which is direct socket pain or inflammation and also how much is resulting muscle spasm and or nerve pain.
Yours Annoyed.
ps Have worked out one defo pain trigger, pivoting when clothes shopping, I might as well play netball for the pain it can create.. what a bore!

Monday, 4 January 2010

hip arthroscoblah week blah?



Blah blah, bla bla bla hip pain blah, not bad blah blah... just seeing if anyone notices! Is there a key for giggling to myself?!
PS NO wine has passed my lips!
pps pics of offending GAP clothes.