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, 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.

53 comments:

  1. No suggestions, I just *love* the idea of an inflatable arse. People would pay good money for that!!

    Hope you feel better soon :(

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  2. Will try and remember to do a stair count tomorrow, will be interesting to compare, although I don't think I do anywhere near the amount you do!

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  3. Stairs are the worst!! I'm still so weak going up stairs, and oddly I have a clicking in my patella now, only happened post-op, but it's constant. Kind of worried now that it's going to cause problems in my knee. Those muscles have become really weak.
    Hope you get it straightened out!
    Vanessa

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  4. can you go up them consecutively Vanessa? DO you have stairs in your house, do you manage them well?
    Kate do, it could be a factor

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  5. How long have you had posterior (piriformis and/or glute pain)? Did you have any of it before the FAI sugery?

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  6. I honestly don't know which came first. I had an insideous start. 1st couldn't sleep on front, then couldn't sleep long in any position without butt like pain, few months later couldn't sit for any period, that went on for 4 yrs, then yr 5 and coinciding with 2nd preg started limping - why?

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  7. I experienced posterior pain with my right hip. No typical groin pain. MRI revealed CAM impingement and it was corrected by arthroscope, however, the posterior pain remained. In the end (I won't go through the details), I had an open procedure (same surgeon)and it revealed a posterior impingement. My greater trochanter was hitting my ilium and catching the piriformis and sciatic in the process (thus the posterior pain). They did a trochanteric transfer. My understanding is that this is something the experts are now really starting to look for as there are patients like me where they have done everything to correct the FAI, but the problem remains. Hopefully, it isn't your issue, but when I saw the "posterior pain/piriformis", I had to respond!

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  8. Thank you so much!!! Can this be seen on MRI or CT?? Are you in the UK?

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  9. also what is tronc transfer, could it not be address arthroscopically?

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  10. Dear Anonymous have googled but find nothing, please fill me in on cause, everything as this is what I thought right from day one but it was dismissed.

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  11. I am in the U.S. & unfortunately, it cannot be addressed arthroscopically. My greater trochanter needed to be moved distally (about 3 mm), so it wouldn't hit the ilium. The cause seems to be similar to FAI..anatomy just not formed correctly. I don't think it can be found on MRI or CT or at least wasn't found on my studies. I will ask this question next time I see my OS, but I believe if anyone would have or could have seen this on a scan, it would have been him! The surgeons actually went in to derotate my femur as this was believed to be the cause of the posterior pain, but then found (and Thank God they knew to check) the greater trochanter problem. Only one osteotomy could be done during the surgery (they didn't want to cut too much bone!), so they did the trochanteric transfer & corrected some remaining CAM impingement. Its looking like the femur may be able to be left alone based on how I am feeling so far. Also, the OS found that my posterior capsule was deficient & he said this still is one area of the hip that cannot be seen well by arthroscope.

    I forgot to mention that stairs KILLED me also...couldn't climb them! Fortunately, I don't have stairs I need to use in my home & I avoided them when I went anywhere.

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  12. Pleae would you ask him if he knows anyone in the UK aware of this problem? My surgeon suggested that he could see no labral damage at the rear, therefore no problem and that there's rarely ever a problem there, so to forget it.
    IS there a name for your condition?
    It sounds a nightmare to recover from.. what were your symptoms, how did it start?
    Can I just have a THR or will that still cause pain?

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  13. I will ask my OS about physicians in the UK. Actually, the surgery is not really a nightmare to recover from. An osteotomy of any type takes more time so the bone can heal, but the rest should be fine. Interesting question about the THR. When I google distal transfer of the trochanter there are many articles re: surgeons having to do it with patients who have THR because if the greater trochanter is not distal enough, it will still cause impingement (at least from the articles and book excerpts I read).

    My symptoms started about a year after a left hip arthroscopy. I had right posterior pain which was really sharp when I would sit. It also ached at times. We thought it might be due to compensating, but it continued. I actually thought I had a tear in my gluteus medius based on the location of some of my pain. I didn't have ANY groin pain. I had an arthroscopic surgery to fix the CAM impingement, however, posterior pain remained & about 6 months later, my psoas started to guard.

    My advice is to NEVER, EVER forget it! Again, from what I have been told, this is something that the experts are now looking at more moving forward. You know your body, so TRUST what it is telling you. If your OS really wants to "forget it" then move on to another opinion.

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  14. I really really appreciate this info thank you, even if only that I explore and confirm (please God) that its not this serious.
    Did your first arthroscopy change any symptoms?
    Is this condition anything to do with a retroverted acetabulum?
    What did they remove, you hip socket? Is the recovery 18 months?
    Sorry for deluge of questions just so few people to ask this stuff as is in its infancy.
    A very grateful Louisa!

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  15. I actually think the first arthroscopy led to an eventual worsening of symptoms because the hip then had more motion to impinge & also it probably was unstable because of the posterior capsule deficiency that couldn't be seen via arthroscope. I ended up having some muscle releases (known as sports hernia surgery) which included a pelvic floor repair. FAI & sports hernia are associated w/one another. I had the muscles spasm & become like cables & my ilioguinal nerve was aggravated (that hurt!). Due to the amount of guarding that resulted in the sports hernia the question of whether the hip was still not right remained & we went back to trying to figure it out. Yes, my OS is a SAINT!

    My right acetabulum is actually perfect...lucky me :). Nothing is removed. They actually cut the greater trochanter (I think above and below because it was in 3 pieces I believe) and move it distally and laterally so that it had clearance and wouldn't hit the ilium anymore. They then used screws and a plate to hold it in it's new position. Through the open surgery & dislocation, they were able to look at everything & in addition to the trochanter problem, fix some remaining CAM impingement and the posterior capsule deficiency.

    I'm happy to answer your questions. Again, I see the muscle, nerve & posterior problems and I'm having flashbacks of last Spring and Summer. Its frustrating when your body decides to throw curve balls & confuse the hell out of everyone!

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  16. Thanks so much for all this I will persue enquiring about the possibilities, please do let me know if there is anyone UK side (probably not!) and is there a way I could contact you email wise, should this become something they do pursue as it appears you are the only person in the world with this problem?!
    Also would you ask if they might've seen it on CT, did you have a CT?
    Many thanks again.

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  17. Louisa,

    You can e-mail me at pittmsw@gmail.com. I do know that there are other people who have had the diganosis (I made sure to ask if I was the only one :)) & I think like FAI, it will become more widely known about & looked for in people w/posterior pain in the future(although that doesn't help people dealing with it now).

    I did have a 3D CT, but it didn't raise any red flags.

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  18. Can I be clear, if I had a THR would I still have the same pain or would it be automatically moved away from the problem a fraction?
    How long was your recovery, My FAI was 6 weeks crutches (actually 8!).

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  19. I wish I could answer that, but I have no idea! I think the single most important thing for me was that my OS was willing to go the extra mile to help figure out what was going on...even when it seemed like there could be nothing going on because he fixed it. Your doing the right thing by pushing for answers.

    I was on crutches for about 4 wks for both FAI surgeries.

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  20. wow Louisa, sounds like you have another avenue to explore. Wonder whether the person's OS would recommend or know of someone you could see in the UK ? Just a thought...

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  21. Oh yes, I asked that.. Dear anon does your OS know anyone? And one thing I never asked how are you now??

    Dee how are you feeling? Bet you're glad of the net now you're laid up!?

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  22. I will def. ask my OS when I see him at the end of this month. I do know that there is a big Internationl Hip Symposium in Bern next wk & I looked at the faculty (many of the top hip OS) & there is an OS from the UK. You can go to http://www.hip-symposiumberne.ch/14586.html to look at the list.

    It looks like the original posterior pain is gone :). Thx for asking. I have a remaining psoas issue that should go away now that the joint is fixed. If it doesn't, they can do something w/it when the the hardware comes out.

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  23. An additional possible contact in the UK (it looks like he's also the President of ISHA): http://www.richardvillar.com/

    I found his name as one of the co-activity directors in the program from the most recent International Society for Hip Arthroscopy meeting that was held in NYC in October. The society was formed in 2008. This was another conference that brought together the thought leaders & best OS's for hip arthroscopy. You can go to: http://www.isha.net/downloads/ISHAbrochure_0912.pdf to download the program.

    The good thing is that he will be on top of the latest stuff & has all the contacts!

    I really hope this helps.

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  24. Richard Villar does have an excellent reputation. Doing really well thanks Louisa - best thing I've done for the hip in a long time - i.e. get it cut out and get a new one ! Extreme but hey it has worked for me !! Had a day of daytime TV today which is making me think I'll be working again by the end of the week...

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  25. Dear Anon, I've heard of this guy Villars and considered him, but heard good stuff about my OS too, so in the end stayed up in the north of England with Schilders.
    Thank you for your help.. please still check with your OS I'm hoping Schilders name comes up!
    I'm going to have to ask for a second opinion anyway if things don't improve and I receive no solutions.. ps what is your name?
    Dee are you saying that Jeremy Vile, followed by this morning and loose women and an late afternoon of Deal or no Deal and come dine with me isn't doing it for you???!

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  26. Wow! Thank you Louisa and Anon for all the great information. I was diagnosed with a labral tear and my surgeon wants to do arthroscopic surgery and shave the femoral head and fix the tear. Says I have early arthritis and some impingement. Most all of my pain if posterior and aching down the front and back of the leg. Second opinion totally disagrees with arthroscopic surgery, says the shape of my bones are fine, and I may have severe arthritis. I had 2 steroid shots today and got NO relief. The doctor there said he saw no bone shape problem, and no arthritis! I am in such a quandry and I guess I am looking for a third opinion. Never heard of the trochanter problem but I have some similarities to sciatica pain so I'm so glad you have discussed it. Feel free to shed any light on my situation :) Like you said Louisa, there is very little out there. Thanks!! Kandi

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  27. Kandi,

    Were the shots intrarticular? One of the main tests for an intraarticular problem is the lidocaine or marcaine followed by steroid into the joint. The lidocaine or marcaine only lasts a few hours & this is typically when you will feel relief. The steroid can take awhile to work.

    There can be posterior pain associated w/CAM and or Pincer impingements, however, it can also be caused by a posterior impingement problem like I had. In the end, the more the OS knows to check for, look for, the better. I can tell you that if my leg was fully extended & my foot was externally rotated I had severe pain in the posterior area. This is one test for posterior impingement.

    Are you in the US?

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  28. Kandi, yes we seem to have similar symptoms... if lucky it can be muscular as a result of impingement your body can make muscular adjustments and you can have pain in posterior due to muscles like the piriformis and those muscles can also irritate the sciatic nerve.. certainly I am in touch with a few sufferers of this alongside FAI. However some can't eradicate that pain, like myself and can't help but question if the problem is some kind of bony impingement in the posteria. My OS told me none exist on me or in patients in general.. anonymous is a god send as this is new info to me and I suspect many and welcome at a time when I can't eradicate my posterior pain despite an athroscopy for pincer and following ALL protocol afterwords.

    Did they inject into the actual hip joint.. the problem I've found is only some of my pain goes after this and that is because anonymous's problem still causes piriformis pain and that will not disappear with a shot into the joint. Steroid so far have reduced my pain in the fast thou.
    My advice is get the best OS, if you're in the states there are some good names with great results I am in contact with many success stories. If you're in the UK less so. But if you can get the best the only way they can tell for sure is to go in and see though MRI arthograms are pretty accurate at tear, you rely on the experts eye though for FAI and that's why you need the best.. further to that for treating a problem like anonymous's you may need a name from them in the states.
    Anon - I checked out the 2 names you gave one was Villars and the one on the list attending this meeting is Griffin, both of which I've heard of.. just sadly I don't know any of their patients.. yet.

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  29. Have just skimmed this & may have missed something vital (have to collect kids from school any minute) but I'm in UK & had a trochanteric transfer this year - Mr Kershaw in Leicester. Will post more when I have more time and read all comments!

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  30. thank you and me too.. I'm sure this is a great help to many, thanks for contributing!

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  31. Louisa,

    Yes, you are exactly right about the injection helping, but having soft tissue discomfort remain because of the piriformis and sciatic. I'm interested to hear what led to Clare's transfer & am happy that it sounds like there is someone in the UK that may have a different take on your problem Louisa!

    Also, the initial thought regarding my posterior pain (after it didn't get better after correcting the FAI, PT, injections) was that it was due to my femoral head being anteverted & more so the fact that my right femoral head was anteverted and my left was almost retroverted (I'm a pretzel). The anteversion may still end up being a part of my problem, but I'm optimistic & confident that based on how I am feeling, it won't be. Just another piece that I know that the experts are looking at w/patients.-Amy

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  32. Louisa:

    I have that same piriformis, sciatic pain. I have been diagnosed with tear and FAI. Offered arthroscopy but thought not. My marcaine injection did not help my buttocks pain. I am not sure an arthroscopy would either. Another hip doctor said I had mild acetabular dysplasia. Ugghh!

    Lisa

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  33. I have bilateral congenital dislocation of the hips (since birth) and a whole series of ops to correct this from age 3 to 10, then a while of hips being ok, then more surgery 7yrs ago on R hip (age 32) and last June was the latest on my left hip for a trochanteric transfer.

    The troc transfer was because the position of the greater trochanter was too high, so it was moved down in order to elongate the muscle attached to the iliac crest (I think!). I have a severe trendelenburg gait due to the short muscle, so this was supposed to help with this. I also have arthritis and this procedure was also meant to try and slow down the wear and tear to delay a THR, and to make the mecahnics of my hip better for when I do need the THR.

    Thing is, now I think the arthritis is carrying on as I have severe groin pain and referred pain inside thigh and knee, am taking tramadol every day, just to try and get through the day with 2 kids and the everyday things you need to do. Working is actually better for me, as I can sit down. It's being on my feet that is the worst and always has a delayed reaction of when the pain from activity is going to 'hit'. The gait issue is still there too, so I'm thinking of going for a 2nd opinion (Mr Witt at UCHL has good reports) re having a THR, but want to know if the THR will actually remove the pain. Mr Kershaw has suggested to wait as long as poss before a THR, but I need mobility now, not when I'm even less mobile than I am now.

    Sorry not much help with FAI issues, but my procedure was pretty similar to the one described here http://www.jbjs.org.uk/cgi/reprint/73-B/5/838.pdf

    Recovery from the Troch Transfer was supposed to be 6 weeks crutches - but took a lot longer - possibly because R hip not that good either to take the strain.

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  34. lol to the daytime tv comments Louisa... finding myself strangely compelled to watch heir hunters but can't stand loose women !! Managed to catch Angela and Friends yesterday which passed a good couple of hours... might have to wired into the dvd's soon but can't actually bend down far enough to put the dvd's in yet ! Prof Griffin also has a great rep - have you seen his website ?

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  35. Clare,

    My trochanter was too high also, but there wasn't any issue w/my muscles being too short. They moved it distal and lateral 3mm. They made the decision to move mine when they found that it was hitting the ilium and crushing my piriformis and sciatic in the process. They discovered it while moving my leg around during surgery to check for different impingements. I am still on crutches (6 wks) & will be for a few more weeks. I think I would be off if it wasn't for my psoas issue! My posterior muscles are finally starting to get used to being stretched an inch :).

    So, in addition to having problems sitting prior to the transfer, did you also have problems w/climbing stairs, extension w/external rotation?

    -Amy

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  36. Christ makes me think just hang on till THR! It seems the easiest and most successful approach by far... and yes they may only last 10 to 15 years but I too would value that mobility now and trade it for lack of mobility in my 50's or 60's! Claire so sorry to hear you're not right yet.. Its really hard with young kids isn't it, mine are 4 and 1, its not easy though so glad I have them, wanted a 3rd but can't see it now with all this hip hassle! I think given your series of op you are in a far worse place and that I should stop moaning, thou I am envious of your ability to sit.
    I am praying my issue is just residual pain from muscles due to inflammation not settling.

    Lisa it certainly does seem to be an issue the wildly differing diagnosis just from professionals alone. Are you stateside as you called steroid marcane?
    Amy as I have pincer and the crossover sign I also have retroverted acetablum, though not thought to be significant... of course as soon as they say "I can fix you' and then don't its hard not to wonder whether such avenues need pursuing further. I was also told grade 2 arthritis but that also is not a problem, but I know grade 3 is bad and wonder could am I grade 2 nearer grade 1 or 3... ugh yawn hard not to obsess on getting better isn't it. glad you're on the up though. Please do still ask your OS re UK expert in the know because just because I've heard of the other docs doesn't mean they know what I might need them to know.

    ps did you find stairs a pain?

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  37. Louisa,

    Yes, stairs caused a lot of pain so I avoided them, couldn't do them. I will ask my OS who the best person would be to see in the UK.

    Its hard when there isn't an immediate "fix". I've been one of those patients where if there is something unusual or unlikely that can happen, it will happen. When we discuss what "usually" happens, we figure I'll be in the opposite group. In fact, my left hip was what should have been the more complicated side & the right one looked like it would be a one and done, easy recovery situation...my body had other plans! I've accepted that this is a process & I take one step at a time. I know that there will be a finishing point with a positive outcome if I just stay focused & do what I need to do.

    I cannot stress enough the importance of a strong relationship and trust in the OS who is working through the process with you. The more pts they see, the more conferences they attend, the more dedicated to hip preservation they are, the better chance that they will be able to diagnose a problem up front and/or to fix one that happens later.

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  38. I did feel supported but I feel abandoned now as he appears not to seem v interested.. but I could be wrong.. I'm in your camp of the least likely thing will happen too!!
    Stairs are the bain?? of my life living in a 3 story house, but trying to sell, in fact I'm viewing a property we really like the look of tomorrow and if we like it and they accept our offer, we can then accept the offer on ours and finally move! YAY! Not the best time to sell and my criteria for house choice in bizarre, I have actually started to measure the depth of the stairs of the properties I view! It REALLY makes a difference!!

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  39. Well, there is only one way to find out & that is to have a direct convo about where his head is with this. He may just not know what to do & if that's the case you need to know that & get to someone who can take a second look at your situation. There are quite a few OS's out there who have the basics down when it comes to FAI and arthroscopy, however, they don't have the extensive knowledge of the experts who have TONS of experience & see the hardest cases. There is a group that lives, eats and breathes hips & are continuing to advance the preservation process. This same group is also the one that tends to see people that other people botched or couldn't fix!

    I wish you the best of luck tomorrow with your house hunt. I totally get the "criteria" for the house issue :)!

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  40. Louisa and Anon,
    The steroid shots were is the bursae and high on the thigh (for the groin). Still no relief today. Pain from the shots is a little better. I had an MRI with contrast in the joint, that left me hardly able to walk for a day and a half even though the immediate numbing medicine was supposed to help right away. I am in the US, San Antonio, TX to be exact. Still looking at doctors. It seems the ones who do hip arthroscopy are young and have very little experience. Plus, I hate to have surgery to see if whatever they decide to fix was the source of pain. I believe my pain is stemming from the labral tear and hope fixing that will help, but I was another doctor to agree with one of the other 3! The hip docs reccomended to me don't do arthroscopic surgery and I'd like an opinion from one who does. The stairs don't bother me, nor the straight leg test. Driving kills me. I've been working out 4 or 5 times a week, but haven't today and won't tomorrow because of the mega hip flexor pain from the shots.

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  41. Kandi,

    The top two hip arthroscopic surgeons are Dr. Marc Philippon at Steadman-Hawkins in Colorado and Dr Bryan T. Kelly at The Hospital for Special Surgery in NY. They are the experts.

    I can tell you that if you go to one of them you will get clear answers re: your diagnosis and the best way to treat it. Its worth the trip!

    I'd be happy to share more info if you want to contact me at pittmsw@gmail.com.

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  42. Yes Kandi I'll second what Amy says re the names out in the states.. also Byrd has a good rep out there.. You may be told arthroscopy isn't suitable or open isn't necessary, but beware as some will tell you what suits them, insofar as they can't do arthroscopy so suggest open and vise versa. If you can get to the best. Did you get any temp relief from dye injection into the hip joint, I'm presuming there was anesthetic in the injection for a short while.
    Amy I'm so excited to move its about 6 am here and I'm wide awake, almost waiting with that tape measure!!
    Amy I really appreciate all your input on this subject and its great this info is out there now for others to read.

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  43. Louisa/Kandi,

    Excellent point Louisa! Dr Bryan Kelly does BOTH arthroscopic AND open procedures based on the diagnosis. He will actually bring in an OS who is the top for osteotomies to work w/him. This, to me, is a clear advantage in that when you see Dr Kelly, you are not only getting one of the top hip arthroscopy experts, but also all the hip experts that come with him! This is because Dr Bryan Kelly is a Co-Director of the new "Center for Hip Pain & Preservation" at The Hospital for Special Surgery (formed this past summer/fall).

    The Hospital for Special Surgery is the oldest ortho hospital in the US. It is consistently #1 or #2 in ortho in the US (HSS & Mayo go back & forth), it has one of the most sought after ortho residencies & it has many of the US's leading OS's.

    The "Center for Hip Pain & Preservation" is the first of its kind in offering a multidisciplinary approach to hips. The Center has 17 OS's who are leaders and treat the spectrum of hip disorders. HSS does the most arthroscopic hip surgeries in the US, however, as I pointed out earlier, they also do open procedures.

    I have experienced the multidisciplinary approach first hand & it is what has made the difference in figuring my diagnosis and treatment. These OS's have e/other to share info & to collaborate on challenging cases vs being on their own in an independent office. Again, I see this as an advantage for the patient.

    Louisa--good luck again w/the house :)

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  44. Just don't know if I can travel to see a doc. Thanks for the names though. I'll think about it. I did not have any relief from the MRI injection or the cortizone injections in the first 24 hours. That seems impossible. The anesthesia should have made it feel better. In fact, the first 24 hours both times were the worst by far. Every doctor kept saying you will get some immediate relief, but not me. One thing I meant to say was that I read that a torn labrum mostly has pain up front, and mine is on the side and back and down the front and back of my leg. Have any of you been diagnosed with a torn labrum and where was your pain?

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  45. Sorry for the repeated questions, digging through all the narrative each time gets confusing.

    Anon, you had anterior impingement issues first, and then posterior impingement on the other side, right?

    and Louisa, you have been dealing with this for 5 years, but not had any surgery? Is that because of the public health care or you just don't know which surgery to have?

    Thanks guys

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  46. Kandi my symptoms are very similar to yours. Pain in the groin yes, but more pain in the butt and also pain in the side and down the front side and back of thigh, I used to say I wanted to rip my leg off, also sciatic pain and pain in sacro area. Infact for full list page one of blog explains... but I am learning that A LOT of my pain has been muscular spasm reacting to joint inflammation and is equally painful to joint pain and can even be worse.. so symptoms can be misleading.
    Anon I had symptoms for 6 years and was repeatedly, mistakenly diagnosed with a back problem for a few reasons, all experts insisted I was too young for hip pain (33 at the time) knowing what I know now, its ridiculous! And 2 they all said back pain can refer into the hip, but not the other way around (again utter rubbish) and actually 3 I think the sciatica misdirected people and now I think about it 4 I was quite flexible considering.
    What saved me was last yr my daughter was born with hip dysplasia (fortunately the pavlik harness fixed her, though I still have a very watchful eye on her) and this made my new PT think more towards hip possibilities, plus she had just updated on a course for labral tears and sent me off to a hip specialist for an MRA. This specialist said labral tear but no visible cause, so I researched for top specialist in area and found the very reputable Prof Schilders. He took one look and said labral tear and obvious cause of FAI, infact right hip extremely impinged and in worse 5% of pincer FAI, so I went ahead and had it fixed.
    Kandi also btw my labrum in the end was detached not torn, dunno if that may cause a vaguer pain.
    My ROM is very good now, but pain still comes and goes and persists if I am active and its hard not to be active because its my nature and I have two v young children.

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  47. Kandi/Louisa,

    Left Hip: ALL anterior groin pain & it started @34yo.
    Right Hip: ALL posterior pain & it started @36

    I had a dislocated L hip at birth and was braced for 9 mos. & never had a problem, was always an athlete. At 32, my R medial meniscus tore working out (bounced right back) & then a yr ltr, the L medial meniscus tore in my L knee working out (ended up needing a Carticel procedure w/tibial osteotomy). In the end, my hips most likely caused the alignment issues which led to the uneven wearing of cartilage in my knees. I'm being re-built and plan on a FULL recovery w/my improved anatomy.

    Kandi, if you don't mind me asking, what is your hesitation re: travel to see someone? I ask because I, like many people, had hesitation as well years ago. It seemed inconvenient & costly, however, then I had a surgeon & radiologist miss my diagnosis w/my knee which led to a wasted procedure & complications after it happened. I also made a similar mistake w/my hip initially. I've talked to quite a few people who have had the same experience. In the end, travel to the best saves time,money and headaches. The top OS clinics are used to out of town patients so they are efficient. You typically go in the night before & any tests that are needed are done so that when you see the MD, a diagnosis and treatment plan can be made. Even if you just travel to get an accurate diagnosis & treatment rec to start. Maybe you'll be lucky & your situation requires trying a specific PT protocol to see what happens. That's the other great thing about the experts, they won't do surgery just because they are surgeons. They are able to offer specific treatments to try if they think it will help. Its refreshing. Just something to think about.

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  48. Thanks guys. I'll go to my follow up next month, then probably look for another doc.
    Thank you for all the answers and your time :)

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  49. Anytime Kandi, good luck and thanks Amy for all your pointers, appreciated more than you know.

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  50. Good luck Kandi. Louisa, I will get back to you after I see my OS & try to get a name of someone in the UK for you. Hang in there...things will get better! -Amy

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  51. i have just had hip arthscopy, due to a labral tear and impingement. i am 4 weeks post op and still have groin pain....is this normal??

    thanks is advance

    Martin

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