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:

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.


  1. Without wanting to sound harsh (because believe me, I feel for you dreadfully!)... from an outsider's perspective, he gave you what you asked for. In your letter, you made it clear that you have done your research and asked for xyz - he is going to give you what you asked for and then discuss the results with you. The other reply option would have been for him to dismiss your concerns and say that it couldn't possibly be the nerve - but instead he is going with your theory. See what the scan shows up - he can always investigate other options afterwards.

    BTW, about the clunking you get, could it be a tight ITB or hip flexor? I had similar symptoms in the past, after upsetting my ITB through poor gait. I'm sure you've investigated this already, but have a look at snapping hip and see if it fits: http://en.wikipedia.org/wiki/Snapping_hip_syndrome

  2. Thanks Briony, fair enough.. I think I just hoped that he might offer some answers as to why he thinks my recovery's not happening though and I only saw him 4 weeks ago. Otherwise I would've written a v short letter simply requesting MRI only.. but you have a point, perhaps his response might've felt more appropriate had the email from his sec requested more than the MRI address.. I only know he wants to see me bacause I rang and said of the email "is that it?"
    Maybe in part I also see great communication between other patients and consultants in the States.
    Thanks for the pointer on snapping hip, I suspected that and have requested they look there as part of my MRI... I'm probably fed up of research and wish the docs would take over, no docs had even heard of MRI neurography here! Its lonely been the only one interested in fixing me. I read Noell's blog and Phillipon is utterly amazing with her. Anything wrong and they investigate and fix! ..and she's not the only one receiving that level of care. I have to somehow work it all out myself and plead for tests! Anyhow thanks and apologies for downer! Are you recovered then?

  3. Louisa,
    Honestly all but one (not Byrd) surgeon I've dealt with come in and out in a flash of lightning and it feels I need to handcuff them to the door to get any quality time, lol. I think most surgeons give the shortest possible answer.

    The thing that makes Dr Byrd great is he has these wonderful nurses that treat you like they are your mother and really listen to you. They spend time and then give him a debriefing before he comes in. I also get a lot of help from the PT I work with in his office. Does your PT work with your surgeon? I think that helps a great deal.

    Sorry for you this is going on. I know you are frustrated!! Good luck, maybe you are on the right path with your theory.


  4. oh, and another thing...if you're considered it is muscular or nerve, could you try seeing another type of doctor and then having them talk to your surgeon? Maybe worth a try.

  5. I've had a lot of exposure to that environment over the years, both personally and professionally, and sadly (at least in the UK) consultants tend to be technicians - especially the professors, as they are high-level academics and concentrate on their research. If your surgeon reviews the results and finds them to be neurological, as Vanessa says, it may be worth having him refer you to a specialist in that area. Equally, if it turns out to be ITB or similar, it would be physio first, to lengthen the tendon, followed by a different type of hip surgery if that failed.

    As for me, I only met my surgeon once, on the day of my op, and he had different ideas to his registrar. Consequently, I ended up having a mini-open op instead, due to the amount of bone work that was required, so they have had to do both hips separately - 8hrs on the table would not have been sensible. 2nd op should be in Feb. Despite this, I was off crutches and driving within a week after the first op, so there is no question to my mind that you have other issues that need attending to! Very best of luck in finding them.

  6. I would be disappointed too Louisa, but just go with it. Send him, the address, get the scan and them see what he has to say. Hes not the greatest communicator at the best of times as you know, but I think its actually the sec that has been abrupt as she was the one who sent the email.
    I think sometimes because we are so consumed by our hips 24/7 and are constantly looking for answers we build up the communication with the OS too much and want the same response from them, but we are only one in god knows how many to them. I am guilty of that anyway and always come out of any consultation a bit deflated and thinking "is that it" after weeks of counting down the days hoping to get a positive plan.But we have to play by their rules and keep plodding on hopefully chipping away until we finally get there.I am already putting all my hope into my next consultation which is still three weeks away and probably won't be any wiser after it!
    Good luck with the scan, hope it shows something
    Kate xx

  7. Hi Louisa, I do agree with what Kate says in get the scan done and then see what happens. It may also be that he was very busy when he got your message and didn't have a lot of time to respond. I also think that on the whole surgeons in the UK are much less accessible than in the US in terms of getting feedback, calling patients etc and also perhaps less used to patients being their own advocates.

    Fingers crossed to having the scan asap - will the results be sent to him or will you get a copy too ?

  8. Wow Briony that is some recovery! Was it pincer, cam, bone spurs?? I take it you're an ice skater I wonder if been super fit helps, that's amazing, 1 week crutches!!
    Thanks Kate, In fairness he is always generous with his time in appointments.. I dunno maybe its living in a 3 story house antagonising the hip joint, causing bad local spasms.. I'll let you know on the scan when I can muster the energy... all this up and down and trying to juggle babies has really got me down and I'm totally lacking in energy, not like me at all, but hey, thats the deal at the mo sadly!
    Thanks Dee, I intend to get my scan results too yes.. your ops soon isn't it? How are you feeling?

  9. Gosh Vanessa, sorry.. yes its a logical path and I listen to others who have similar complaints, I think Its a relatively predictable pattern, one which in 10 yrs may be better known.
    Hope you've recovered from spin class!!

  10. I haven't seen my surgeon since before the op, so all I know at the moment is what my scans said - cam impingement and labral tears. I have my follow-up on 25/01, so I should find out then what the actual damage was. Being fit must help, but I am also lucky to be a fast healer with a high pain threshold.

  11. Louisa, not sure if you use the yahoo hipwomen group but one of the girls there has set up a new facebook type network for us hip girls (not on facebook but a similar idea). The address is
    http://hipchicksunite.ning.com if you fancy a look.


  12. Fabulous! How clever! Will do tonight as soon as the rug rats asleep!