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:

PLEASE ADD YOUR FAI HIP IMPINGEMENT STORIES HERE. any tips, advice, questions all welcome.

A page for FAI hip impingement/labral tear stories. Please ad your own using the comments button... the more we share, the more we learn!

262 comments:

  1. I fractured my illiac spine in December 2006 and have had problems ever since. I went from doctor to doctor to figure out what was wrong, returning home with no answers. I finally got referred to a wonderful surgeon who knew what was wrong with me. I had an FAI and since I'm such an active young adult, I decided to get open surgery to fix it. I got surgery in July 2011 and I'm doing great so far. I'm back to jogging, but no sprinting or anything. So far a successful operation!

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    1. This is incredible.. The EXACT thing happened to me and I thought I was just a weird case as a young adult having to get arthroscopic surgery on my right hip 2 years ago, and even then they had no explanations for me. I had all these tests done to rule out immune deficiency diseases, PVNS, and they even sent me to a rheumitologist! But like you, I had an iliac incident while in track and field in high school in 2001 and somehow the hip on my better side that was compensating up until now had so much wear and tear and got to a point in 2010 where I could not walk, stand, sit, sleep, and just be, without excruciating pain. I had surgery that year and just finished up physical therapy last month it was that bad. You are very lucky you found a doctor who knew what they were talking about as Ive had to do all the research myself to figure out what was wrong with me. I never even knew FAI was a common condition, and I could not be more grateful for finding this site and finally putting my exhausted mind (and hip) at ease, and knowing I'm not the only one. Thank you! :)

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    2. Lea you're welcome, where are you in the world.... have you, or do you know how to find a good FAI specialist?

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    3. I am glad that I have found this website, it is great to see that there are other people out there who understand how debilitating hip conditions can be.
      I have suffered from hip pain for approximately 10 years now. (I am in my twenties and was never really sporty and I did not suffer any injuries to my hips.)
      The pain that I started to experience in my hips and knees gradually got worse to the point where I would get stuck when trying to get out of certain seated positions. My hip would kind of lock and was extremely painful - had to pull my leg out of the locked position. Walking upstairs became tiring and my legs felt like they did not want to work anymore. I also started getting pain whilst walking. I ignored the problem for yrs hoping it would go away - but it got worse and worse.
      I decided that I needed help as I could not carry on the way I was.
      I had my first surgery two years ago on my right hip. They did a hip arthroscopy, shaved the bone that should not be there, took out dead tissue and repaired what they could. The second surgery was 4 months later on my left hip.
      I recovered well from the surgeries and noticed big improvements. However over the coming months the pain started to return until I was in the same position as before. I was sent for steroid injections which, believe it or not did not help!
      I am in my fourth week of recovery from my third operation which involved anchors into the joint for a torn labrum. I really hope that this operation has worked.

      Jo

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    4. Thank you so much for creating this website xxx

      Jo

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    5. After years of pain and getting no where fast I found a consultant who diagnosed Hip Impingement, he has referred me to Mr Maddan at Doncaster Royal Infirmary. So the big day is tomorrow my first appointment with him, fingers crossed he can help.

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    6. Paul woodward23 August 2012 09:38

      Hi all, after years of lower back and hip pain i had a back operation to replace my l5 lumbar disc in July 2011.Many month’s later still in pain got referred to physio by gp, physio diagnosed bi lateral hip impingement and after mri scans this was confirmed along with labral tears and bursitis.
      I live in Coventry and was referred to Professor Griffin who I believe has a good reputation. After a long wait i got to see him in June and he was very nice and operated in July 2012 which turned out to be nearly 5 hours due to me having a very tight hip joint which made access difficult. It turned out that I had a large cam impingement with a labral tear that was debrided, and the other hip had a steroid put into it. I am now two months post op but still have groin and buttock pain more so when sitting and i still get the feeling that the hip is still impinging on certain movements, which is a worry even though the proff said he airs on the side of caution on how much he takes away as you cant put back once its taken away. I get the feeling that it has not worked and will put my concerns to him next month when i have my follow up. Any thoughts would be appreciated. Thanks Paul

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    7. Paul I would not get too discouraged. I had a hip arthroscopy on May 15, 2012. It took 2.5 months for me to feel comfortable sitting for longer than 30 minutes. At 3 months I finally felt about 85% of normal and now at 4 months I feel about 90% of normal. I finally have hours that I don't think about my hip. I still see improvement each week, but it is slow. Don't be discourage, things will get better with time.

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  2. Thanks Shannon, great to hear such a positive story... good luck and hope you have a continued strong recovery.

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  3. hello,
    I was diagnosed with FAI in June of this year. It is hard to tell when exactly I first began having problems with the hip as I also have endometriosis and have had ongoing problems and procedures with that. any how, I finally got to the point where I couldn't walk and it was obvious I had a hip issue. 4 doctors, a bone scan, an MRI/A and a labral specialist later. I had Arthroscopic surgery on on the dang thing. I am 9 days post op today, and feeling pretty good surprisingly. My concern now is for the other hip. I haven't had an issue yet, but I'm told the two hips were shaped the same and I was wondering if you knew the likelihood that this would happen? thanks a lot, your story is inspiring!!

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  4. Hi Lizzie,
    I believe it is thought to be a 1 in 5 incident rate of bi-lateral FAI hip impingement. Sadly I am a 1 in 5 for FAI!

    Its not surprising the similarity between your hips. It is very possible your other hip may never become symptomatic, even with similar anatomy, as it may be a couple of degrees different and that could make all the difference, or you just may not used it as much.

    Please don't let it hinder you, as you have no issue yet and despite x-ray similarities, you may not have a problem for 10 years, or may never have a problem with it at all.

    Well done and good luck for a continued great recovery!

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  5. Hi Lizzie,
    I'm holly and I'm currently 17 years old. I have always been a very successful athlete, ever since I was little I have been involved in many sports and competitions.

    I was only 13 when I first discovered that I had severe back pain, hip pain, knee and foot pain. I would get this pain in all areas randomly, while going for a run or simply walking around a shopping centre. This pain would come out of no where and started to become uncomfortable and not normal.

    I first went to a podiatrist where I was diagnosed with high arches therefor would have to purchase orthotics to wear everyday. I was told that my feet were causing all my pain in all areas such as my hip and my back.
    After wearing the orthotics for a few months the pain in my back and hip had not changed. So mum decided to take me to a physiotherapist where I was just diagnosed with poor posture, I went once a week where I would be given excerises at home to strengthen my posture and undergoed massages and trigger points in my back. I went to this physio i for 3 months with still no improved or good results. The physio then referred me to a chiropractor where I was told again my posture was weak and that was all that was wrong with me and that my strengthening exercises would make me better. I was so determined to fix my problems, I did my exercises everyday.... Yet after another 6 months there was no improvement. I was sent to get x-rays on my back which showed no problems at all.

    I didn't bother going back to the chriopractor / physio for a while as they told me basically nothing was wrong with me apart from a weak posture. But my hip and back started to really interfere with everyday activities and I couldn't bear it any longer. Mum then took me to a normal doctor where she couldn't diagnose what was wrong with me and thought all my pain in the areas I was feeling was very abnormal, she was very concerned so she then referred me to a muscular skeletal person.

    I went to the muscular skeletal person at the start of this year, I brought my old x-rays which were a year and a half or so old. He looked at the x-rays and he thought that the x-rays had been misinterpreted and that he thought I had a slipped vertebrae disc in my back. So he then sent me for a MRI scan a month later where I FINALLY found out that I had FAI in my hip. He then referred me to a professional physiotherapist who works on the Queensland red football players, he insisted that I went to the physio twice a week for 3 months and he said that the physio would be very painful.... And he was right. I am currently still undergoing intense pysiotheraphy with this guy who has also now referred me to attend Pilate classes twice a week and I also have a home rehabilitation program. The muscular skeletal person said that if this non-surgical treatment does not improve me or work then I am to undergo surgery.

    Sometimes I wonder that all this treatment I'm going through is too much and that it may not be successfull. I think I would rather just have the surgery and improve from then onwards. It has been a very long and tiring process, it took 4 years to diagnose me with FAI. And I have had to cut back on physical activity which used to be such a huge part of my life.

    I would love some advice on what you think. Am I too young to have the surgery yet?
    What is the surgery like and how long does it go for?

    Thanks

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  6. HI Holly, where are you, you need a really good FAI surgeon. Your story makes me so cross, waisting your precious time. Tell me where you are and i will find out who you need to see. Its a typical story mishandled by ill informed healthcare professionals.
    Best wishes, Louisa

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  7. Hi Louisa,
    I appreciate you taking the time and doing that for me. I live in Brisbane. Do you think I should have the surgery ASAP as I am only 17? Or continue with the non-surgical treatment?
    Thanks heaps for your concern :)

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  8. Continue treatment but start to line up surgery, as there isn't really a non surgical route if you're very symptomatic, sometimes you can make the symptoms lessen but mostly by reducing activity levels, which I suspect at your age you don't want to do.
    Surgery is the only actual cure, but you must be careful who treats you as there are literally only a handful of surgeons worldwide competent at this. You happen to live in a country with one of the absolute best, but I'm not sure how much you can travel, whether you have private health or in fact how the health system works out there. Are you on facebook? ...if so, can you look me up Louisa Weeks Browning and I can put you in touch with 3 really nice young girls from Austrailia, only a little older than you who maybe able to talk you through the system and meanwhile the best surgeon, world recognised and very highly recommended in O'Donnell from Melbourne. I know he is some distance from you but please at least get his opinion, I truly can not emphasise the importance of having the best surgeon, as there are quite a few surgeons trying their hand at this now and the success rates can vary widely. If you only take one piece of advice from this, please take O'Donnell x

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    1. Hello Louisa,
      My name is Alina, I am 43 and live in Melbourne. I am going in for FAI surgery next week with Mr John O'Donnell, and also hear he's the best here and is training other surgeons.
      Wish me luck as I really want to get this problem resolved.
      My left hip has been pinching for a few years and have suffered lower back pain for a long time. Surgery to repair a torn labrum 5 years ago didn't make any difference, and earlier this year I went back to the same surgeon and he the diagnosed me with FAI which he wasn't aware of the first time. He then referred me to John O'Donnell who is an expert in arthroscopic hip surgery.
      Cheers
      Alina

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  9. Hi Louisa,

    Thanks for this site; i have been suffering lower back pain since July '11 and have yet to find an answer, though in the past couple of weeks my left hip has been aching tremendously, as well as strange pains in the groin area and pubic bone area (almost in my left testicle). The hip joint also clunks on flexion towards my chest and to the outside (though my right also does this to a lesser extent).

    It all started in July for after a run, and i carried on working through the London riots (i'm a 28 year old police officer) until the end of August, where a fall after arresting someone left me with lower back pain over the si joint and a totally numb left foot. I've had two back mris and a ct scan - all negative - been tested for MS, been told its psychosomatic etc etc, having ploughed about £5k of my own money into trying to get it fixed.

    Both my knees hurt like hell and now my left hip is extremely painful 24/7 - even lying down aches in the groin area. I still have full ROM, though it just hurts all the time. My back pain is worst upon sitting, though i have noticed that sitting on a hard surface (on your ischias - the bony protrusions in your buttocks - i think, rather than your thighs on a soft seat, is less painful). In the absence of anything else, i am convinced that this pain is all hip related and that the labrum is possibly torn, causing referred pain. Does this correlate with your experience of labral tears and fai, and if so, who can you recommend consultant wise (i am based in Kent)?

    I have gone from being physically active at the peak of my life to barely being able to wlak for more than half an hour, which i am struggling to cope with... It has basically ruined my life...

    Thanks for reading,
    Davo

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  10. Dear Davo,
    Everything you said I recognise. Do you a have private health care package?

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  11. Dear Louisa,

    Unfortunately not, but what i do have Is my house deposit to use... It's not ideal, but i'd do anything to get my life back...

    Thanks,
    Davo

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  12. Hey Louisa its holly again,
    Sorry I have been away on holidays and have only checked your reply then. I have been continuing with Pilates classes twice a week to build up my core muscles. I go back to my physiotherapist on Tuesday next week. Because I am showing little to no improvement, I have to get 3 steroid kind of needles in my hip. Is this the right thing to do? Did you ever get needles in your hip or heard of anyone else FAI stories who have had the needles in their hip?

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  13. Yes thats normal proceedure. You should have an anesthetic which is diagnostic and a steroid, all within the same injection. The anesthetic will hopefully temporarily remove your pain which is why it is used as a diagnostic tool and the steroid to help calm the site and give some temp relief.
    See this post on steroid injections for hip labral tears and fai, it should help. http://myfaihippain.blogspot.com/2011/07/hip-injections-for-hip-labral-tears-and.html

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  14. Louisa,

    Thanks so much for your blog. I am from the Unisted States. I've had pain in the hip since I was 18 (2008). For the next 3 years I thought it was overworked due to sport activities. Finally beginning of 2011, I began to seek medical attention ranging from Chiropractor/PT strenghthening, and 3 Orthapedic visits. The first did not find anything and said I just should just deal with in until I need "total" hip replacement. Then around June, I began to develop a really painful butt spasm in the glut area--this was unbearable. Because of this I went to see other Orthapedics and they diagnosed me with FAI. I had surgery 3 months ago it seems like the hip "popping" is gone but I still experience the glut/spasm pain. I strech twice a day and sit on a tennis ball. Although it helps, the pain is recurring. Any tips on what I should do with the spasm?

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    1. Tony see below Sues Q and A for your reply.. no idea why it has appeared there!

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  15. Hi Louisa,
    Such a relief to be able to read your blog. I was finally diagnosed with pincer impingement from having deep hit sockets, as well as labral detachment, paralabral cyst and cartilage damage a few weeks ago. I say finally because in April last year, my x-ray showed joint space narrowing, which the GP said was OA and to come back when I needed a hip replacement! Good job I didn't go away... Anyway, I'm waiting to see if the surgeon will operate for joint preservation or advise total hip replacement. From what I've read, the improvement rates after surgery aren't brilliant if you've already got cartilage damage and if you're older (i'm 47 and very active runner) but I'd be interested to hear what people say who've gone through the experience. Do you know of anyone else's experiences in this situation?

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    1. Sue yes I don know many in your shoes... DO you know how bad the cartilage damage is?? That is the key, though the full extent often can't be found until they open you up. How is you joint space in mills, can you post me your xray (however I am not an expert but have seen enough xrays to have some idea)
      Quite possibly your biggest issue might be that if your surgeon isn't very practised in FAI he may offer you all he knows how to do well like a THR, rather than whet YOU need most. Where are you in the country? I agree surgery rates aren't fantastic, but I believe much of that issue is there are surgeons out the pretty much practising on our generation of FAI patients so it is doubly important to get an excellant surgeon cast his eye over you hip scans. I would always choose joint preservation over THR, but if it fails revert straight to THR. Unless there are definate indications it is more likely to fail, eg severe cartilage damage, hyper-mobility or dysplasia. But again these are only my opinions. Let me know how you go and if I can help. If you tell me where you are I can find out who are the top surgeons in the area.

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    2. Hi Louisa,
      Good to hear from you. I don't have a copy of my x-ray and haven't been given a measurement! However, the arthrogram report showed coxa profunda (hence looks like narrower joint space on x-ray according to first consultant). Also, delamination of anterior superior chondral surface over 1.4cm, a 12mm paralabral cyst and an alpha angle of 55 degrees although no CAM lesions. I'm guessing the chondral delamination is the cartilage damage.
      I'm in the Somerset (Bath area) which seems to be a bit of a FAI black hole when it comes to information. My first consultant admitted he'd stopped doing hip arthroscopies and referred me on to Mike Rigby (Swindon/the Circle Bath), who specializes in this area. Interestingly, the 1st consultant said I've got hypermobility but last year when I had a bone scan (I'm at risk of osteoporosis apparently) that consultant said I wasn't hypermobile!! If you have any info on who's who in the Somerset fai world, that would be great!

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    3. Sorry Louisa. The anonymous person is me, Sue. Hit the wrong button!

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    4. I'll have to keep it brief as I am busy with work but I have taken reliable advice and would suggest you try get an appointment with a surgeon called Matt Wilson at the Exeter hip clinic, he comes v highly recommended. Good luck, do keep me posted.

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    5. Also Mark Ashworth who works at Mount Stuart hospital near Torquay

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    6. Thanks both of you for your suggestions! In the end, I decided to go with a recommendation for Mike Rigby in Swindon/Bath. I've now seen him and hip arthroscopy surgery is booked for the 27th March. He's made it very clear that the outlook isn't great because of degenerative changes and hip structure abnormalities, but the only other choice is to wait until it degenerates enough for a replacement. I'd rather have a go at fixing it. Whether or not it's the right choice of op or surgeon will remain to be seen... Will keep you posted!

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    7. I am pleased Sue, hope all goes brilliantly, keep us posted.

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  16. Tony I'm fairly certain that that glute and nerve pain is piriformis syndrome, not easy to treat, however I am hoping after surgery as the muscles learn they do not need to keep protecting the hip, that that spasm and so nerve pain backs off. If not, it looks like the options are an injection of botox into the piriformis muscle to see if that knocks it out. Surgery is controversial and hard to find the experts that do it (sound familiar??!) ALso there is an option of taking low dose (10mg) of amytriptiline to disrupt how your body feels the nerve pain. There are many stretches you can try from the net and I know they have worked for some sufferers. Keep me posted on how you go won't you.

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  17. So pleased to have found this blog and the info contained here.
    I was diagnosed with Coxa Profunda in both hips last year and maybe early onset osteo- arthritis by X ray I had taken.
    Only my right hip is causing me problems so had the diagnostic procedure with marcaine injection a couple of weeks ago, which did result in relief- although did still have some tingling in toes from related back issues. Going next week for MRI scan with the dye injection ( sorry can't think of the correct name just now) to find out in more detail what is going on. My specialist has indicated that I have a bony protrusion at the back of the hip socket which may need shaving off( according to X-ray) and also may have a tear/s in the labrum. After this we will be discussing which procedure I may need to have so good to find others that have gone down this route. Feel lucky that I am now seeing a specialist that has done lots of work with hip impingement.

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    1. Had my MRI arthrogram and had the results and yes I need surgery!
      Was offered a date in April but have deferred my op until beginning of June due to my teaching commitments ( I'm a peripatetic self employed music teacher working in schools). At least this way I can get a fair chunk of teaching in before my op, although I must admit I am starting to feel a bit down at times due to the pain and also the effect it is having on my sciatica! Just got to take it steady and try not to over-do things, but the garden is calling me and other jobs!!
      Good luck to others that are going through the investigative processes- hope that you find good specialists to see!

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    2. Ann good luck, only just found your message and I too have been on hols, I think you're taking the right route ... pace yourself before and after surgery too. Your case sounds more straight forward than most and as long as the cartilage has coped well you should do v well. Sciatica from this condition , in my experience, is normally caused by tight glute muscles, often the piriformis, reacting to inflammation within the hip joint caused by the original FAI... Don't expect that to disappear straight after surgery there is a good chance it will take many months as it slowly realises it no longer needs to protect the hip. I'm 5 months post op and it still plays up for me but is becoming less so. Patience is the best thing you can allow yourself with this condition and recovery. Good luck.

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    3. Thanks Louisa
      More info on what I need to have done in my op:- front labrum needs smoothing down, back labrum has tears so needs mending or removing if not possible, bone at back of hip socket needs grinding down where it is too deep -about 5mm or so. Also I have an extra bony growth on top of hip socket, which may or may not be accessible via arthroscopy. I am hyper mobile which may or may not make things easier but can also cause more problems- again won't know until in surgery. I also have several areas of bruising which I suppose is caused by the friction? I am a true pincer impingement case apparently.
      I have back/neck issues and suffered sciatica in the past before my hip caused problems, so will be interesting to see if that does calm down once the hip starts to mend. I know that I also have lower back issues so again will see if they are more manageable post-op but these have been on-going for years.
      Walking with the bad hip is certainly affecting my posture and an old knee problem has also started to re-emerge due to my walking gait. I had surgery on this knee ( same leg as bad hip) many years ago and had some of the bone removed.
      I am getting very tired with it now and lots of things are more of an effort, so having to pace myself to get through these weeks as don't want to miss any of my teaching that I have planned pre-op.
      Interesting that I will also be followed for up to 5 years due to government regs regarding impingement surgery. Got a long questionnaire to fill in and take with me to surgery as step one in this .

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    4. I am 3 weeks post-op today!
      Doing well although still have some restricted movement and get tired easily but it's still early days.
      My op went well, even got to watch part of it on screen whilst it was happening. I had sedation in my arm and then anaesthetic via epidural. The anaesthetist informed me pre-op that most people sleep through but some stir and can be put back to sleep unless they want to watch- I said if I stir I'll decide then! Only watched a bit as my neck and arm were at an uncomfortable angle so went back to sleep. Very interesting and wished I had seen a little more!
      From what I remember after seeing the os later that day the labrum was repaired at the front, bone at back of socket ground down by 5mm or so, but labrum at back was too thin and calcified when os was putting sutures in to re- attach. Labrum at the back also had a couple of tears. In the end he decided to fuse the labrum off at the back of my hip. I also had a bony growth above the hip socket, cause unknown, but os removed this as well. Fortunately I didn't need any work on the ball section so that was good news.
      Had a few issues with pain meds and low blood pressure in hospital so stayed for 2 nights but was home by Saturday afternoon at 3 following my 9am operation on the Thursday.
      Have seen the physio and have a few simple exercises to do several times a day.
      3 weeks today I go for my follow up appointment with the os, so will get a more detailed account then, and probably one I can remember better!

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    5. All sounds v good Ann, though you're a braver woman than me for being awake!! Hope all continues to go well for you.

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    6. Thanks Louisa.
      Watching the op ( or part of) was like watching TV, apart from the fact that the os was talking, I didn't equate it to being part of me due to the epidural!

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  18. Hi Louisa
    My name is Tina I am originally from the UK but am now living in the US. I like every one else who reads and comments on your blog have been misdiagnosed for years been told ( and thought ) I was crazy or just drug seeking . Thankfully like you I found a fantastic physio who had been through the same thing and referred me on to a fantastic surgeon ( he also reassured me I wasn't crazy). I am now a week post op from a right hip arthroscopy where he removed the damaged labrum (my surgeon doesn't like to repair them he feels it's too easy to re damage them plus mine was too badly damaged) and then did an osteotomy on my femur and acetabulum for pincer and cam inpingement. 24 hours post op I had a dose of radiotherapy to my right hip (which was fun btw) to help prevent heterotrophic ossification as I cannot tolerate NSAID'S. From reading all the various blogs and advice it sounds like I'm lucky as I had no arthritis or cartilage damage. Also it's also interesting to find the different recovery processes I am wbat on crutches but only as long as I need them not the 6 weeks every one else seems to mention I start physio today and my surgeon wants them to be aggressive with range of motion and get that damn hip moving. It seems like I have a good surgeon who came highly recommended (plus he is the only one in my state who does hip arthroscopy) But my question is how do I no he's any good how do you recommend Dr's Do you research them or is it just by word of mouth ?

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  19. Hi Tina, Isn't that a Q for before surgery? ;) Bit of both and mix in some gut feeling. I'd nowadays go by what other people say... Its all too easy to have a good PR team behind you and a slick website, not sure it means much... How did you find yours? It must've helped having a fab physio who'd been there already too?
    Not heard of radiation to hip for preventing heterotrophic ossification, doesn't affect your fertility or anything does it, though I can't imagine they won't have considered that.
    Go for it with the PT, but what out if you're a fairly active person also because if you resume activity after crutches and keep of a level of PT you could overdo it a little without realising. Coming off crutches is the painful bit really, if you're going to have one at all.
    Really please you got your diagnosis... thats what had me start this blog... I thought I CAN NOT be the only one and if just one person reads this and recognises these symptoms and it can bring about the right diagnosis for them, then job done! Enjoy the US, I'm envious!

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  20. Hi Louisa,

    Been a while since I posted here but i have had some investigations done on the my left hip, which showed up pincer impingement (3/10 severity) on xray and a labral tear on normal 1.5T MRI, albeit apparently a small one.

    I have excruciating lower back pain at the moment and really hope that the surgery will alleviate this, along with the odd sciatica like symptoms accompanying it.. I am in the process of getting a second opinion prior to proceeding, but it seems like it is a foregone conclusion at this stage, as I can't carry on like this. Anyway, I wanted to thank you for this site, as it has effectively allowed me to self diagnose my problem and seek treatment for it; without it, I would still be battling against the general ignorance of the medical profession about this problem!

    Here's hoping I can get my life back after the surgery...

    Thanks again,
    Davo

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  21. Thanks Davo, that is great news, will you keep us posted on how you get on? Good luck to you, hope you're feeling good soon.

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  22. i suffer from this hip conidition im 17 aswell and have just been diagnosed with ostero-arthritis because of it. my hip cartlidge is deteriating i have been to a surgeon in brisbane (where i live) and i have to go back to see him in april. he was talking about doing key hole surgery on me what are your thoughts?

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    1. Go and see Bill Donnelly at the Holy Spirit Northside Hospital PH 1300 236 663. He is a leader in hip Arthroscopy and Arthroplasty, both of which you may need. He repaired a Labrum tear for me about 7 years ago and the results were excellent.

      In the last year, I re-damaged the hip and instead of going back to Bill I went and had an FAI & Labrum repair with John O'donnell. The result has not been good and I am currently seeing Bill with a view to revisionary surgery.

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  23. Dear Anon,
    You have one of the very best surgeons in the world there called John O'donnell. Whilst he may not literally be on your doorstep, if there's any way you can see him, then please try.
    You're only 17 so your hips could do with saving, plus you already have cartilage damage, so you could be a tricky case. If possible see the best, even if only for a second opinion. I can't emphasise the importance of this enough.

    Details below:

    Contact
    Melbourne, Victoria, Australia
    John O’Donnell
    21 Erin Street
    Richmond

    Dr O’Donnell
    p 03 9421 6133
    f 03 9421 6144

    ReplyDelete
  24. Have you ever heard of Patrick weinrauch? That's who my surgeon is.

    ReplyDelete
    Replies
    1. Yes he just did my surgery .. March 14th. Have you had you surgery. I am 8 weeks post surgery and waiting to feel the benefits.. Still hopeful that my life will return to more ability.

      Delete
  25. I am a 49 year old female and am 5 days post op from hip arthroscopy surgery. I had a labral tear, 2 areas of impingement, synovitus and a cleaning and release of the psoas muscle. I was in PT and on a stationary bike the day after surgery and I feel like I am doing really well in the early stages. I was told that icing would play a big role in recovery so I purchased a cold therapy unit with a hip pad and it was the best investment!, it stays cold for hours and stays in place with Velcro straps. So much easier than hobbling to the freezer every twenty minutes and much more comfortable. I have suffered SI pain, groin pain and thigh pain for years until having a contrast MRI and a diagnosis of labral tear and FAI. I really did my research before choosing a surgeon...don't be afraid to ask tough questions and get a hip specialist with arthroscopic experience. This is very specialized surgery and you want the best team. I am in the USA and found a surgeon in Pittsburgh. I am a golfer and have done yoga and pilates for years. I am prepared for a long, slow, steady recovery but have high hopes of being better than ever. Good luck!

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    Replies
    1. hi what is the age limit for them to do surgery for hip impingement im 54 and have been given the run around for 10yrs started groin pain but come and went so didnt see about it but for the past 6 yrs been limping when walking a short distance,sitting and standing for about 15 minutes ive seen podiatrists, physiotherapists. sports medicine gps i get a sharp pain in groin its affecting me with everyday tasks ive tested positive to impingement test on internal rotation but they dont seem to want to take it further and told i might have to live with it im so frustrated and crying as im typing this i dont know where to turn to next

      Delete
    2. Dear 54yr old anonymous,
      Where are you and who are you seeing... I too was told this by 2 of the 6 consultants I visited in a quest for a good surgeon but since had surgery last november and I am doing well. I am 40 and I do not know if there is a cut of age for hip arthroscopy, more that if the cartilage damage is so bad the only option can be a total hip replacement, which isn't as bad as it sounds as it has fantastic success rates and I know of 20 yr olds who have had them. Your symptoms sound severe but have you had any exploratory tests like xray or mri-arthogram? Tell me where you are and I will do my best to guide you step by step thru this maddening situation. You can sort this out and you will be ok as there are solutions to your situation, you don't have to live with this much pain. Get back to me with your location and what tests you've already had and who you have seen hip related.

      Delete
  26. Anon Golfer, sounds promising, keep it steady, best of luck.
    Australian anon, no sorry I haven't heard of him, it maybe fine, but I would stand by my advice either way. Best of luck.

    ReplyDelete
  27. I'm a 45 year old marathoner, basketball player, mountain climber, soccer coach recently diagnosed with FAI. I had a nagging basketball injury that I could not recover from. My physical therapist requested x-rays and that is when the bomb dropped. I consulted with two different hip specialist in Denver, CO and they explained that I had a congenital, deformity in the structure of my hips. I have Femoral Acetabular Impingement. He said I had the cam form. The head of my femur is mis-shaped and doesn't fit correctly into the socket. He said the combination of this deformity and heavy activity don't go together very well.The cartilage has worn away so much that it is now bone on bone. Now I know why it hurts so bad. He said cartilage will not regenerate and the only way to correct the problem is total hip replacement. He says I'm pretty young for the procedure so he wants to try a more conservative approach. He thinks if I receive regular steroid injections into my hip and modify my activities, I might be able to hold off for three years at the most. That means no running, plyometrics or yoga and more biking, swimming and core strengthening. He says basketball a couple of times a week is okay if it is tolerable. I got my first injection a week ago and it feels a lot better and now I will have to redesign a workout program around the limitations of FAI. A new hip will relieve the pain and increase the range of motion but no basketball or running. I'm trying to come up with a good strategy for dealing with this unexpected challenge. Any tips or advice on how to handle this both mentally and physically would be appreciated.
    Thanks

    ReplyDelete
  28. Ultimately physically it is about what will allow you the most freedom for the greatest length of time... If steroids buy you time, it makes sense to use them, they can be very effective. If you're bone on bone then you're only operative choice would be THR at this point.
    At the time when your world shrinks further with the FAI/arthritis even when using steroids, then I think thats when THR looks like the rosier choice.
    Is there any merit in injections of hyloronic acid also to oil the wheels, so to speak, it might be worth googling and asking, could this buy you a little more time?
    Mentally, probably the harder question... it really is the cliche of 'keep calm and carry on'. Do what you can do but listen to your body and try to rest when it asks, as this isn't a pain to push through. Its a balancing act andit might be that you can have a more physically active day, if you have a lazier evening more often. The trouble is FAI, esp cam, hits the super active and sporty and by nature you may well want to be on the go all the time, so you will have to learn to prioritise and compromise. Its not going to be easy as you're only 40 not 60... but you're buying time to do the things you choose or love the most.
    Once you eventually need to have your THR it may not be as bad at all as it sounds, just be mindful of the recent problems with certain implants, metal on metal or de-puy's problems, choose carefully.
    You can always go for a second opinion, however if you're bone on bone thats not a great prognosis for FAI surgery, scope or open.
    One great thing is that THR is one of the most successful and life changing surgeries available and by the time you need it, I suspect you will be very glad of it. Best of luck to you.

    ReplyDelete
    Replies
    1. Louisa,

      I appreciate your response it really helps. I've seen two different specialists and they agree 100% on the diagnosis and treatment plan. They are both saying it is too late for arthoscopic surgery. I will definitely research the hyloronic acid. I will work on setting priorities and making compromises. I believe everything is going to be okay because I trust my doctors and I have good family support. If I learn anything of value I'll keep you guys updated.
      Thanks so much.

      Delete
  29. Hello Louisa,

    I am a 22 year old male who for the past 6 months has experienced hip pain, I am currently waiting to see a specialist. I have a suspect labral tear and was wondering if you could answer some of my questions and give me a bit of help.

    DO the NHS fund MRI arthrograms and hip arthroscopy (Like yourself I live in Leeds)

    What doctors would you recommend.

    Many thanks Luke

    ReplyDelete
  30. Yes the NHS do fund hip scopes from Leeds, we are very lucky and you can also chose to go elsewhere for that hip arthroscopy too, so you're not tied to having the op in Leeds, but you are tied to an NHS surgery (ie you can't go to a private hospital). However your biggest hurdle MIGHT be persuading a doctor that FAI is your problem, or in fact that FAI exists... their lack of knowledge can hinder your outcome.

    I would STRONGLY suggest you visit Louise Grant at Physiocure at Cookridge Hall in Leeds 16.... you are very lucky that you have a rare creature, an expert FAI hip physio on your doorstep. Google Physiocure and make an appointment with Louise because firstly she will be better equipt to confirm your FAI suspicions and secondly she will write to your doctor and be able to recommend the best course of action, tests etc to begin with, which he will take more seriously from a physio the diagnosis of FAI and basically you will be able to be guided and supported through every step of the way from diagnosis to recovery. Keep me posted, if I can help I will. Best Wishes.

    ReplyDelete
  31. I am a 47 year old female who loves to run and exercise 5-6 days a week. I've had hip pain since 2007 and was recently diagnosed with FAI. I'm scheduled to have open surgery September 5th. I chose to wait until after my son gets married september 1st. I am having quite a bit of pain from working out, but am determined to be in the best possible shape for my son's wedding as well as the surgery a few days later. My question is, do you think it's okay to continue working out at the intensity I have been? I've been doing a lot of squats and lunges in the group fitness classes I attend, I've been told they are some of the worst exercises you can do for FAI. I just don't want to do more damage or have my other hip flare up (dr. said it is the same but hasnt caused me problems yet). The nurse said I can exercise as tolerated, but I'm worried I'll cause more damage.

    ReplyDelete
    Replies
    1. Hello! I am a 44 year old female that also loves to exercise and walk several times a week. I had FAI, socket reconstruction and the removal of a bone spur on my femur 33 days ago. I was very happy that I had maintained my fitness schedule (as pain allowed) prior to my surgery. I really feel that it has helped me get around better on my crutches and will aide in my continued recovery. I have had an excellent recovery so far. There are good days and better days! Good luck with your surgery!!!

      Delete
  32. Hi Leana, Are you currently taking painkillers? If not, the you wouldn't be masking the pain and then I would be inclined to agree with the nurse and let pain be your guide. The only caviat to that would be for you to be aware some pain flares happen a day or so later, so your could be irritating the joint and not attributing an activity thats causing it. Personally I found it easier to do what people do with allergies... drop all possible irritants and then re introduce them 'one at a time' for a few days, so you can be aware of what causes you a problem with 'some' certainty.
    Also I think most of the damage will have been done over the last how ever many years anyhow. I would also add if you're struggling, that no matter what, with FAI less is more... it may not be one activity you're participating in that is the issue, so much as how active you are in general. Keep as fit as you can up to surgery, esp with core strength, it will all help post op... but if I were you, a week prior to your Son's wedding I'd drop activity down a notch, as its such a special occasion.
    Very best of luck with your surgery in Sept, let me know how you get on.

    ReplyDelete
  33. Hi Louisa
    It's been a while since I posted. I'm three days post hip scope now. Sadly, the OS found a massive labral tear (his op report words) that couldn't be repaired, so it had to be excised. He was able to shave off 5mm from the rim. There was also a large area of very thin cartilage at the rear of the joint, which he classed as grade III arthritis. No exposed bone though so no micro fracture done. He can't predict how much longer until it degenerates to bone on bone, but estimates 5 years is the best case scenario. I have to say, your day-by-day blog is great at making me realise that what I'm feeling is normal! Can't believe how much the anaesthetic and meds are making me feel grotty! Hope you're doing ok. Sue

    ReplyDelete
    Replies
    1. Hi Sue, Good to hear you're at the other side of your op. Now the recovery begins! You can never tell the outcome you might have and 5 or more pain free yrs before niggles and then pain returns seems a good exchange for a 3 month recovery.
      One thing the anesthetic absolutely takes it out of you, you're right, so rest whenever your body asks for rest. For future, I have now had one hip arthroscopy with anesthetic and one with spinal and sedation, which wins hands down everytime, if ever you're offered a spinal take it, I woke feeling fantastic and no weeks of feeling sick and moody, its been a revelation to me. I would've rejected it given chance as neither epidurals worked for me at my babies births but it was absolutely brilliant and I was out with sedation and out for them actually doing the spinal too, its brilliant stuff. Keep healing!

      Delete
  34. Hello i'm a 31 year old female who loves to run and really enjoyed spinning classes before my hip pain which started last June. Finally after two months of bad groin and buttock pain i decided to go to the doctor as i thought i had torn a muscle. From there i was sent for a x ray and ultra sound of the hip. When i went for the ultra sound the doctor saw my x ray and referred me straight to a hip specialist who diagnosed me with FAI impingement. I had my MRI scan last December and from that i've been booked in to have a left hip arthroscopy on the NHS for the 24th April. My surgeon is Mr Fern at Duchy Hospital, Truro, Cornwall. So far i am really pleased with the service i've got. Has anyone else been treated by Mr Fern?

    ReplyDelete
    Replies
    1. Yes I believe so I have heard his name many times over the yrs and people seem to hold him in high regard so I'm sure you'll be in good hands. Best of luck for the 24th April!

      Delete
  35. Hi Louisa,

    I am now just 50 and was diagnosed with FAI back in 2009 and was scheduled to have an FAI shave back in late 2009 on the NHS. Having been active in the martial arts for some 20 years I had become increasing restricted as to what sort of exercises I could perform however I could run ok and still go down the gym. My surgeon at the time made the diagnosis purely based on a XRAY needless to say this was on the NHS (cost cutting). Having read all the scare stories at the time I decided to give-up my beloved martial arts and pursuit a more leisurely pursuits.

    It is now 3 years later and I have started having trouble with my hips. Due to a change in job I now have private health care (what a difference to the NHS), I have had the CT and MRI scans and after seeing the initial consultant he told me (when I asked) that I have mile arthritis in my right hip and mild to normal in my left hip.

    Having read many of the published articles I think I have got a better understanding now, it is much better to have the procedure as early as possible. I am regretting not having the operation some 3 years ago.

    After seeing the consultant I was very apprehensive although he is a specialist hip surgeon he is not a specialist in this area. After discussing my condition with him he told me that this is a specialist area and he was referring me to one of the top specialist in this area. THE ADVICE HE GAVE ME WAS THERE ARE A LOT OF SURGEONS LEARNING HOWEVER YOU DO NOT WANT A SURGEON THAT WILL HAVE A GO.

    I go in for the operation on my left hip on the 19 April 2012 and am keeping my fingers crossed that I will be one of the lucky ones.

    Many thanks for all your useful info on the website and I hope your hip finally gets sorted.

    Mike

    ReplyDelete
    Replies
    1. Mike thank you and after a second op last year with an entirely different surgeon, I am doing very well. I think your surgeon is bang on as there are a lots of "L" surgeons out there messing with a major joint, its infuriating and it is a message I try get over time and time again. Word of mouth is key to recommendation, flash websites and boasting surgeons mean nothing. Good luck for the 19th and expect it to take more time and patience than you anticipate, but you'll get there.

      Delete
    2. Ha just noticed it is the 19th, best of luck for your hip arthroscopy today!

      Delete
  36. Dan from Denver15 April 2012 at 21:23

    Louisa,

    I just went in for my followup after a steroid injection into my hip. After about 12 days it really kicked in and my hip feels really good, although no increase in range of motion. Doc says that sounds good and that confirms the pain was coming from the hip. Unfortunately the relief is not going to last very long. I'm in week 5 and he is saying maybe another 4 to 6 weeks. When the injection wears off he says I need to decide whats next. I have three choices - hip replacement, another injection (probably not as effective or last as long the 2nd time) or live with it for as long as I can. I think I'll probably try a 2nd injection and try to hold off a little bit. I'm having a hard time with the morality of having my God given hip structure replaced with man made, artificial material. Maybe I'm supposed to just play the hand I was dealt. I understand a replacement can be a great, life changing event there is just something about it that is difficult to accept. In the meantime I'm trying to stay motivated to prepare myself physically and mentally for a replacement because it appears to be fairly eminent.

    ReplyDelete
    Replies
    1. Hi Dan, I bought time on steroids previously, I find it can work for months until I really overdo it and then you're back to square one, no-one can say how long they will last for you it depends on the level of inflammation within your joint and the cause, so it could be weeks or many months.
      The key question is how bad is the damage to your hip? Have you had the mri-arthogram and x-rays. If theres not much cartilage damage, why would you need a hip replacement? Find out the state of your cartilage/joint space and the exact condition and then you can make an informed decision.
      Steroids slowly destroy cartilage so be wary of having too many, especially if your cartilage is in fair condition, as you may force the need for a THR.

      Delete
  37. Hello, I am a 19 year old male who runs D1 cross country. I have recently been diagnosed (January) with hip impingement and torn labrums. The pain started only in last september during my first college 8k race- I felt the pain about half way through,and I struggled to finish. The pain only got worse after I collpased in a workout the following week. I currently have a meeting with my arthroscopic surgeon, but pain management has been a real struggle for me. I stopped running altogether, but I still have trouble concentrating on my schoolwork and managing a college lifestyle. I get so tired from some days that I need to take naps during the middle of the day. I tried taking over-the-counter pain meds like Aleve and Tylenol, and my doctor has been prescribing me anti-inflamatory meds. Nothing I take or do helps with the pain, and my doctor wants me to abstain from strong narcodics until I get my surgery done. I just wanted to know if there is anything I can do help myself keep motivated until I'm back to my old self again. I don't want to drop out of school to get everything done, but I also don't want to risk my grades falling from an inability to concentrate.

    ReplyDelete
  38. You need to go back to your Doctor and explain the difficulty you're having with your meds and managing your pain. ALso how long must you wait for this surgery? Are you seeing a very reputable surgeon with good experience both of this condition and of the hip arthroscopy surgery as beware there are many surgeons out there cutting their teeth on people like us. CHeck he is experienced, ask how many patients he has seen like you and what his success is, google him and look on hip forums like ones on facebook for testimonials, I have set up a group on facebook called 'Best hip surgeons - reviews" for just this kind of thing and its become quite active. Whilst you will feel quite isolated not knowing anyone with a similar condition (and that can be waring) there is a MASSIVE online FAI community on facebook and a yahoo site too full of people like you. Get support, the right temporary meds and a great surgeon and you will soon be on the right track. Keep me posted if you need any further help and I will do my best.

    ReplyDelete
  39. Hi, I'm a 47yr old female and have had chronic low back pain since 2001. Had all the usual mri scan etc but came back clear. Spent £££££ of my own money on every kind of treatment I could think of but had to stop work in the end. By this time I had given up on my GP. In 2004 I went to College to re-train and now have an office job. I'm now wondering if this has been a Hip problem all along as the pain sometimes would go to my bum and thigh. Nobody ever mentioned my Hip though.
    October last year I woke up with bad upper thigh/groin stiffness (not sure why it appeared over night though)..visit to GP over xmas and sent for x-ray, he said could be pulled muscle or hip wear & tear, x-ray normal.
    January the pain was severe and gone to my buttocks and knee, could hardly put my socks on, lift my leg to walk up stairs and getting into the car a nightmare, once in the car the pain was like a deep cramp like pain and the shooting pains would start. This lasted 2mths which by now I was refereed to see consultant, he though it could be hip impingement and would send me for an mri scan.
    Received an appointment but not for a scan but to see a specialist. By now the pain has eased but still have thigh/groin pain worse on walking or after sitting for a period of time but the pain is always there.
    Went to see the specialist yesterday, (ended up in tears). Had another x-ray which showed slight wear & tear. Specialist said he would refer me for physio and see me again in 6mths. He hardly examined me and didn't really give me the chance to explain history of my pain. He realised I wasn't happy when I said that x-rays don't always show up everything, he then said I might have a tear, but it might mend itself. He eventually agreed to refer me for an mri scan with injected dye, but not before trying to put me off the idea. He more or less said I've not been suffering long enough and it had eased to how it was beginning of the year.
    I'm now feeling a bit confused and thinking I'm making too much of this and maybe I should have just gone for the physio.
    Any ideas on this would be very much appreciated. I'm going to visit my GP once he's had the report back to see what he thinks, but really I've lost faith in them since 2001!! I'm really not sure what to do for the best.
    Thanks for your time in advance.
    Mair

    ReplyDelete
  40. Dear Mair,
    Sorry to take such a strident stance, but non of your health care professionals know what they are talking about! You have not had the relevant tests and the consultant is talking rubbish, clearly FAI is not his area as a labral tear can not be diagnosed using x-ray, nor can it heal itself.
    Even if you got him to agree with you in theory, you do not want this consultant anywhere near you with a scalpel! This consultant is not an FAI specialist, please avoid as even if he does your MRI-A, he has to be able to read it, if he and his radioliogists aren't 'in the know' with FAI you can be misdiagnosed and the diagnosis even within hip FAI vary massively. Please avoid this consultant.

    If you tell me where are you in the country and then I will do my best to guide you step by step to diagnosis and hopefully recovery! The correct consultant and a good GP/physio (physio's can refer too) is what you need. Also do you have any private health, I'm guessing not from what you say, its just worth asking as it can alter your choices.

    ReplyDelete
  41. Louisa,
    Thank you for your reply.
    No, I don’t have private health, there is an option through work but I guess it’s too late to start paying now and expect to use it for this, so I probably will have to put up with nhs as I can’t afford to go private myself. (I will ask in work though, just in case). Can I pick and choose a specialist myself though on nhs?
    I live in North Wales (Ruthin) so probably the options are not as good without having to travel far.
    I’ve made an appointment with a spiritual healer; she’s coming to my house on Tuesday and is meant to be very good. I’ll keep an open mind and hope for the best but from what I’ve researched is that if I have got FAI and it’s not treated/operated on it will only get worse and a hip replacement could be the only option in the end. Is this true?
    Thanks for your time

    ReplyDelete
  42. End game can be hip replacement, but if you're hips aren't bone on bone, then it could be another 10 yrs before you're allowed one.
    You need to find out 'if' your local pct fund hip arthroscopy in the first instance... if they do you can pick a surgeon anywhere you like as whilst they fund it, under patient choice you may pick any surgeon in the country. Choose wisely (PLEASE read fai surgery success rates on this site, it is very relevant to you.)
    I travel 200 miles from Leeds for mine, people in the states travel 1000 miles. If you're lucky you may have someone local thats very good, but if not I assure you its worth the effort of travelling. Nothing will rectify your FAI other than surgery, however Spiritual healing may well help with the stress and worry its causing you.
    Once you have got your head around what needs to be done, let me know and I'll help where I can.
    I have also put out a request to see if people know of a good surgeon in your area, I've not heard of one but its worth a try.
    You're current biggest question is whether your pct cover the hip arthroscopy op, your doctor may be able to find out for you or give you a contact number.

    ReplyDelete
  43. Mair read below, a few suggestions this afternoon from the best hip surgeons reviews site on facebook... will leave you to follow any up. good luck.

    anyone know of a good fai specialist near or on north wales? Not for me but for one of my hip pain awareness site readers?
    Like · · Unfollow post · 12 hours ago near Leeds

    Annick Hollins Hi there, can't answer your question, but it might be worth posting on the HipWomen Yahoo Group as well. Regards, Annick.
    12 hours ago via Mobile · Like

    Gail Mccomiskie oswestry hospital north wales has exellent orthopedic consultants check list
    10 hours ago · Like

    Deirdre Fulton think Freja went to oswestry and if from that part of the world so she might be able to advise
    8 hours ago · Like
    Louisa Weeks Browning thanks girls, deirdre who is Freja?
    36 minutes ago · Like

    Annick Hollins Hi Louisa, Freja is from the HipWomen site - I think she is Freja Swogger - if you join the site you can look up members and get their direct e-mail address. Hope that is of help! X
    10 minutes ago via Mobile · Like
    Louisa Weeks Browning yes thank you

    ReplyDelete
  44. HI

    Ive just been diagnosed with Hip impingement by Prof Schilders in Bradford. Hes not on the NHS any more.

    Could you suggest a surgeon on the NHS who specialises in this area?

    (Leeds/Bradford preferably, though would travel if the "choose and book scheme allowed)

    Thanks!

    David

    ReplyDelete
  45. The only good FAI surgeon I know of in this area is John Conroy. I hear he's very good and he works for Harrogate hospital on the NHS, as well as privately from the Dutchy in Harrogate also. Your pct should fund you for surgery in Harrogate. Have you got yourself a good FAI experienced physio also? Try do that in advance as it is stressful doing all that alongside recovery.

    Best of luck.

    ReplyDelete
  46. Hi, great blog spot. This has been very helpful to me already in the last 24 hrs.
    I am currently awaiting Ct arthrograms on both hips. Live in Jersey, Channel Islands.
    My symptoms started about three years ago. Unstable sacroiliac joint diagnosed by chiropractor, and a SIJ MRI showed inflamed r hamstring.
    Now I have progressed to hamstring tendinitis and gluteal tendons patchy on both sides. My most recent MRI showed a labral tear on r hip.
    Think I might be getting somewhere.
    I struggle now to sit down for any length of time, avoid the cinema and theatre, and driving.
    I also now struggle to exercise, as I am so drained from constant pain in my glutes.
    I have r hip pains I think, but have been diagnosed with endometriosis recently.
    Anyway, any feedback from people who have had successful arthroscopy on there hips, and also surgeon recommendations for southwest or London.
    Thansks claire

    ReplyDelete
    Replies
    1. Hi Claire,
      Your symptoms sound typical of FAI... recommendations, without a moments hesitation I would recommend Paul Jairaj at London Sports Orthopedic - Contact; 0844 561 7157 - his sec is Linda McFadden. Don't take my word for it, visit any other FAI consultant, then see this chap and you'll pick him.
      Best wishes.

      Delete
    2. Thanks Louisa, he also appears to run a clinic near Gatwick airport, which is really convenient for me. This is invaluable advice. Let's see what the arthrograms says!,
      Claire

      Delete
    3. Oh yes I forgot about that one and have no sense of geography, that is good news. Best of luck, he is very good!

      Delete
  47. Hi Louise

    My boss at work told me about your site after he was doing some research on my behalf after I have been declined funding from my PCT for my op. I am 44 and have been diagnosed with Cam Femoroacetabular Impingement and tear of the anterosuperior labrum after 18 months of struggling and numerous tests. I was referred from my hospital - Kingsmill in Mansfield Notts to see Mr Madan at Doncaster as my consultant did not want to do the op open surgery. Mr Madan informed me that he could do the op but due to the fact that I lived in Nottinghamshire and not Yorkshire he could not fund it and would have to apply to my PCT for the funding. After a further 3 months of waiting my application has been declined.

    As many people and yourself mention I am also struggling to do a lot of things which we take for granted. I can't walk long distances, sit for long periods, exercise and a good nights sleep is out of the question. Driving is also becoming an issue which is not good as I need to drive to get to work.

    I have looked into going private for the op and a surgeon local to me is Andrew Mankelow based at the Park, Nottingham. Have you heard any reports on him and if he would be able to do my op before I make an appointment to see him or would you be able to recommend someone please?

    I am really pleased my boss told me about your site because I feel a if I have been banging my head against a brick wall for months now trying to get help

    ReplyDelete
  48. HI Karen,
    I have not heard of him and if you're self funding the world, or UK is your Oyster! I strongly recommend Paul Jairaj at London Sports Orthopedic - appears to hide his light under a bushell to some extent, but he is the very best I have come into contact with! Contact; 0844 561 7157 - his sec is Linda McFadden.
    Don't take my word for it, visit any other FAI consultant, then see this chap and you'll pick him. The way Paul Jairaj does this hip arthroscopy surgery is done is the most advanced way I have encountered and the recovery is considerably faster as a result. If you choose not to go with him (though if you meet him you most likely will) then make sure you pick a top FAI surgeon, not one who is trying their hand at it and is a general hip consultant, or one that only treats FAI with an open surgery).
    Your should have done 100's and 100's. There is noone very close to you in Notts, however there is Griffin in Coventry and a very good one John Conroy in Harrogate. Villars another brilliant surgeon near Oxford... there are a few more well reputed, good FAI surgeons, but the one you mention I have not heard of so I am unable to comment, though that I have not heard of him isn't good. There are less than 10 good FAI specialist in this country and it is essential you pik a good one, I can't emphasize how important this is. Whatever you do go for an "FAI hip arthroscopy specialist" you want everyone of those descriptive words.

    PS What a lovely boss!, The Park in Notts is lovely, I used to live there 15 years ago!

    ReplyDelete
    Replies
    1. Hi Louise

      Thank you for getting back to me so quickly it really is much appreciated. I've got a consultation with Mr Conroy later this month so hopefully things will get moving. I will let you know how I get on
      :-)

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  49. Good luck Karen and I think you made a good choice in Jon Conroy.

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  50. I was so happy to find your blog. Thanks for your time and energy to stay connected to so many people who are suffering with this issue. I am 8 weeks post surgery and feeling pretty frustrated by my discomfort and lower back unpredictability after sitting at my desk or moving in bed. I had surgery on my right hip for a labral tear but they also found a 50 percent ligament tear. My surgeon suggested getting straight onto a exercise bike.. Walking and PT pretty much as soon as I left hospital. I spent no time on crutches. I have been doing physio 2 days a week plus low key Pilates.. Since reading others post surgery it seems many were on crutches for quite awhile. I would like to know if other women suffer more acute back pain and hip discomfort when they are at that time of the month. I find my back is like walking on thin ice with pain as I move to do things. I was feeling very down today but this blog has helped me understand what is going on and what can be achieved. Thanks TIff

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    1. Tiffany, just trying to piece together your messages... and will try answer each, if I can... re time of the month, yes I myself experience a peak in pain and know its something many other female FAI patients complain of, so don't be too alarmed by that, keep track of your cycle and anticipate the peak of pain. I think its the drop in hormones increasing general pain sensitivity and of course your hip is emitting pain.

      I am surprised you had no time of crutches post op, that is unusual not to protect the work he had done for just a couple of weeks... What I don't understand is why you haven't mentioned FAI removal?

      Who did your surgery? I am just wondering why you have had your labrum repaired and your ligamentum teres fixed without bone work also, if the bone work has caused the tear in the first place... unless you were in a serious accident to cause the tear? I don't want to alarm you but as a general rule these kind of repairs are prone to re-tear and give continued pain. Also were there any elements of cartilage damage found? Do you know your actual diagnosis, has anyone mentioned cam or pincer etc to you?

      PT and bike from day 1 isn't unusual, though personally having had 3 hip scopes now, I find that protocol a little unnecessarily aggressive, given overdoing it can cause the body to produce scar tissue also.

      With regards to the conversation between Claire and yourself re endometriosis, they can co exist yes and cause similar pains, though I wouldn't have thought endo would cause actual groin pain, that said I know little in this area and everyone has a slightly different idea of where actual groin pain is. eg above the pubic bone, on the pubic bone, in the crease next to the thigh, or under nearer the perineum etc...

      Claire I understand your symptoms have improved since taking the pill. That is great news and would either be tha that was causing that specific layer of pain, as you can have FAI and be a-symptomatic. I only developed pain at 33, no hint of pain prior to that age yet if someone had x-rayed me FAI was there... I think I developed pain only when the FAI started damaging the labrums and cartilage. Alternatively your pain could have coincidentally backed off for a while if you have by chance been less active, therefore not stressing the area so much.
      TIme might clarify how effective the pill is at curing the groin pain. That said, the other pains you are having, which are associated with FAI and a torn labrum, I would say are a clear signal that the hip is struggling.
      One of the jobs labrums do is stabilise the hip within the socket, once torn I think the muscles over compensate to cover the job and then in turn create pain by spasming due to overwork and becoming uncoordinated.
      Also once the labrum is damaged, the next area to suffer is the cartilage, once damaged your chances of a successful hip arthroscopy outcome drops .
      Consequently my thoughts are once the hip causes enough pain to disrupt your life and you have a clear clinical diagnosis, that is the time for surgery. You can buy time with anti inflammatories, steroid shots and PT, but ultimately if you're having to alter your life and activities to avoid pain, then one is merely putting off the inevitable and risking lowering your chances of a successful outcome.

      But as ever, I always say that currently, given that there are so few FAI experts around the world (15-20) then choose your surgeon wisely. For the sake of not boring you by repeating a message I feel strongly about (the good and bad FAI surgeons dilema) please read the post on FAI success rates. If I haven't covered everything, feel free to ask, I am still a bit hazy recovering form a hip arthroscopy on my left hip last Friday. All the best to you two!

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    2. Hi Claire , Louisa I went back to my notes from the MRI and they refer to there being no cam deformity or FAI. I am hoping this means my symptoms are from just the wear and tear due to signs of hip dysplasia. I am also concerned that not being on crutches for the first 2 weeks or so has caused the repair process to either go slower or to flare the area up more. I am still finding my leg hip is in discomfort but I am trying to correct muscles which have been overworked or dormant. I am still getting pain unpredictability and weakness in the lover back (again depending on how I sit or move.) I think I will ring up the surgeon to get some clarity on the healing process and find out if I have been misdiagnosed. The reason I started to read your blog was because it was like reading my own life at the moment. Maybe its still early days to be thinking it has not worked> Thanks Louisa. Tiff
      Ps my surgeon was Patrick Weinrauch

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  51. Hi Tiff, a fellow blogger! I have a labral tear in r hip, and awaiting ct arthrogram as I have also compensatory hamstring and luteal pain now on both sides. I have had r groin pain for at least 20 years , but it has cme more acute after the last two years in which I have been diagnosed fai and endometriosis. My Gp has put me on a contraceptive pill, which stops my periods , and this has also stopped the really acute groin pain, that which the sports consultant is saying is hip pain. Whether I have both problems on the same side is a further argument. But it has helped with the more acute pain, and may be a consideration in your recovery. Interesting to see what Louisa can add.
    Best of luck, early days, I am moving towards arthroscopy so would like to here how you get on.
    Claire

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    1. Hi Claire thanks for your response..yes I am due to test for endometriosis as well ( just add it to the list of 'to do's ). I will be booking in for this shortly but first could you tell me is there many side affects after the test. Were you needing rest or did you feel ok? I will keep this short as sitting on the chair is annoying but I wanted to let you know I went for a massage today working a lot of the ligaments and general tightness in my back, leg and foot. I feel heaps more peaceful as my body was still feeling post op stress. As for the arthroscopy it went well and I felt no pain only a feeling of peace afterwards as I felt a big weight off my shoulder. After the steroids wear off I started to feel similar discomfort to what I had before the operation. I am just finding out there is more to this than meets the eye and it is this 'FAI' still not clear on it.. Is it the same thing as wear and tear or an actual hip structural issue. I am worried that I will also have to learn how to live with it rather than thinking that this operation is my road back to normal life and comfort.. I have had a few emotional days as it feels like I am in a post op fog. I am planning to start going to the pool for some exercise to see if this help improve muscle support. I do know two other women who have their life back on track again.. being active, dancing etc. I am hoping to be this outcome as well. The operation runs smoothly and I hope you also get to feel the euphoric feeling I felt afterwards. Stay in touch to let me know how you go.

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  52. Dear Tiff, you are still in early days so fingers crossed your arthro has been successful. I expect recovery to take a while as a lot of my pain is compensatory so this will take a while to correct.
    I did not have a laparoscopy to confirm endometriosis, my Gp thinks symptoms are typical, and as pain has reduced by taking the pill, this confirms his diagnosis! I now have doubts though.
    He told me that laparoscopy was unnecessary as it may not fully treat the problem, and also as I am 43, once I o through menopause, it will no longer be a problem for me.
    Good luck with your next op though, facing the hip problems are predominating my mind at the moment.

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    1. Sorry, Tiff iPad froze!
      Would be good for you to hear from Louisa, I got the impression that people had a while on crutches after surgery. I have seen some really positive comments relating to arthroscopy on other websites.
      Have to say I get down too, as haven't exercised properly for about two years, and work is becoming a problem.
      But trying to stay positive. Good luck
      Claire

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    2. Just to let you know had surgery on my left hip Frid, normal service will soon be resumed, just feeling a bit icky, mainly stomach ironically! :)

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  53. ps I will be just 2 weeks on crutches after cam removal and treating a frayed labrum this time... they seem to be reducing crutch time, was 6 weeks for same surgery 3 yrs ago... although depends on the surgeon's policy, but as a general rule crutch time is reducing - yay!

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  54. Best wishes for a surgical success, had my first ct yesterday, not very nice.
    Claire

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  55. Thanks Louisa, I have seen it and very helpful, I have no doubt that I am on the surgery route, and I have taken your recommendations on board fully. Thanks for this.

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  56. So in April 2010 I was diagnosed with impingment and a labrum tear and opted to not get the arthroscopic surgery because if I missed work I would not get paid and could not afford to not pay bills. Now that I have disabilty insurance I have contacted a doctor in Boston to look over my MRI arthrogram. The main ocncern is Im a police officer and need to be close to 100% for work so recovery time is cruscial. I have one year of disabilty insurance for a specific reason and was wondering if that will be enough time?

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  57. So much depends on your surgery and surgeon. If he is a top FAI expert as opposed to a general hip specialist, that does FAI as a small sideline, that will help you.
    Then there is your condition, the extent of the FAI will dictate your surgery, but more than that and perhaps not readable from a '2010' MRI-A, is the state of your cartilage and labrum. If you need a microfracture to try repair cartilage damage that can slow and complicate your recovery, not to say it isn't work it, but just be aware. Then another factor will be your fitness level, specifically hip strength and core strength and your age - these are all factors that go into a mix to forecast recovery speed.
    I would say for a scope a yr is a good period of time and normal recovery should have you good somewhere between 3 - 6 months. Another consideration is how physical your job is, are you our crime fighting or at a desk?
    Just an example I had a scope on my hip in 2009 to fix a labral tear and pincer impingement, it took me '5 months' to climb stairs consecutively. I had another surgery on the same hip, with a better surgeon 2011 removing cam impingement and scar tissue, it took me '1 month' to climb stairs consecutively.
    I then had a 3rd hip arthroscopy 12 days ago on my other hip, bit less damaged with a frayed labrum and cam impingement and today, at 'day 12', I can climb stairs consecutively! Whats the difference, well firstly a better surgeon who caused less trauma to the actual hip capsule, secondly my left hip is less damaged and thirdly i do the hip rehab exercises in my sleep? ...What i'm saying is there is no black and white in this surgery as it is still very new. Find out the extent of the damage to your hip and weigh in the other factors, but personally unless you're unlucky, I would estimate 6 months to full functioning recovery.

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  58. Hi There,

    I've been reading your blog and learning a lot about FAI, I've been carrying out quite a bit of research after being diagnosed with cam type FAI and labral tear in my right hip.
    I'm a 40 year old fire fighter and this problem is threatening to end my career and there is not much chance of reducing the amount of acivity I do as I need to maintain a high level of fitness to perform my job..
    My trip into the world of hip pain started in august 2011 following a bicycle crash. I was hospitalised for 3 days with suspected internal bleeding and had x-rays on a suspected cracked pelvis, luckily there was no fracture. I was in a lot of pain for several weeks and had a bad limp. It took me 7 weeks before I could return to full duties but I was suffering every day. I managed to return to cycling as well and the pain started to ease off and this was the case for 2 months. At the end of December the pain started to increase and by February it was becoming unbareable. I had pains in my groin, lower back and glute. I went to the GP who said I could self refer for physio and I waitied several weeks for a reply. After a month I called to find out when I could attend and found that they had not reviewed my case but would have a look through my form while I waited. After I told them about my situation they arranged to see me within 4 days and, for the NHS, this seemed quick. At my first session I had the usual assessments including giving info on symptoms, cause of pain and tested for ROM. The physio told me that I could have torn the labrum and possible the glut med. She set me some exercises and set a follow up date. When I went back 10 days later she asked how the pain was before telling me it looked like I had a cam lesion as well as the tears and that I should be referred to a surgeon and suggested one she had worked with before. After ready several posts on the blog I feel I was very lucky to have the physio I did as she seemed to have a good understaning of FAI. Since then I decided to use the medical insurance through work to speed up the process. I have since had further x-rays, CT, diagnostic injections and MRIA and it was confirmed I have a cam FAI and labral tear. The surgeon said I have a small area that has arthritis that looks like it could have been accelerated by the crash. He said if I had nothing done then, within 2-5 years, I would probably not be an operational fire fighter, but if I had an arthroscoy then I would probably be good for another 15 years but would then probably need a THR due to the arthritis. I have currently been removed from operational duties by occ health due to the tear even though I was manging the pain. I currently have an op date of 6th August but work want me to bring it forward and have asked me to change surgeons to speed up the process. After reading your blog I think it's best that I stick with the surgeon that has been recommended. I do have young children, which will cause a nightmare to sort out the school run for if I am to be on cruthes for 6 weeks+ and I don't think the wife would appreciate me being on crutches for our holiday which are other thing to take into account with the op date.

    I will let you know what happens about changing the date of my op and how it goes as things progress.

    Thank you for the blog and keep up the good work.

    Mark.

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    1. Thank you for your comments Mark, A good surgeon is everything if you find one, hold on, his advise sounds sensible to me! I feel your pain I have a 3 and 7 yr old and am just coming off crutches for the second time in six months. Good luck keep at the physio and try be patient, its a real test of patience this recovery business! Remember to ask your surgeon what his success rate is and more importantly how many FAI arthroscopies he has done.

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  59. Mark, Never change surgeons just to speed up the process. Find a good surgeon that has a lot of experience in FAI surgery, handling labral tears and hip cartlidge clean up. Make sure he is using up to date RF probes, trimmers etc and that he has the skills to bleed and stitch the Labrum, if required. Also, just because you have some excessive bone doesn't mean that it is causing an impingement, look at the 3D CT scans yourself and judge whether or not you believe the neck and the acetabulum are clashing with certain limb movements and thereby causing cartilage damage. Some surgeons over react to bone deformity when the bone has not caused any damage and perform unnecessary surgery .

    Finally, the longest that you should be on crutches is about 2 weeks, if you require bone resection. Still, you can't run until about the 8 - 10 week mark and heavy lifting should be avoided during this time. Keep your hip out of the 90 degree angle for about 6 weeks if possible.

    I'm now 3 days into recovery from my third left hip arthroscopy. This one was mostly cartlidge clean up. Last July I had the full FAI fix, ligament teres etc. on this hip, by Dr John O'Donnell and it was a mess, resulting in this third surgery. Obviously, I got rid of O'Donnell and went to another surgeon who appears to have done an excellent job with a difficult situation. I will be having a Labrum etc. repair of my right hip in about 8 weeks time but in consultation with my new surgeon we have decided to leave the CAM abnormality alone as we believe that it may not be the culprit that has caused the damage. Remember, once you take bone or cartilage out you can't glue it back on, so be sure before you remove it! you can always take more off later if necessary.

    I hope some of this helps.

    Cheers

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    1. Thank you very much for this reply if I didn't know better, with your knowledge of RF probes etc etc, I'd think you were in fact a surgeon. Feel free to help out, if you so wish, as I am swamped by Q's left right and centre within this blog.
      ps Surprised to hear a negative on O'Donnell its the first I've ever heard, where have you gone to now?

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    2. Thank you for the info, any extra knowledge is a bonus.

      I decided to phone my surgeon and spoke to his secretary today to see if I could bring the op forward or look to find a diferent surgeon, luckily I got the sort of reply I wanted as she said. something like this, 'You are within your rights to change surgeon but there are only a handful of surgeons that perform this procedure and Mr Hussell is one of them, if you do wish to change then good luck finding someone who can help you' She then went on to say that there could be a cancellation appointment or she would see if the surgeon could gather a suitably qualifed team to assist him with the procedure at the end of one of his surgeries.

      I did get to see the 3D scans and there was a marked difference between the neck of femur on both legs and there was a clear section of extra bone on the right one that would quite easily cause an impingement so I feel it is right for the surgery to go ahead.

      I hope your recovery goes well and that your next lot of surgery works out well.

      Mark.

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    3. Hi Mark:

      The best way that I have found in finding the good surgeons for this type of procedure is to ask Orthopaedic surgeons that don't do it. This means, you need to ring or send emails to the receptionist of ortho's that only do hip replacements or only knees for example and ask them if they know of a good surgeon that does hip arthroscopies with labrum repairs and FAI issues. These people will normally know who the best are.

      If you can turn up anytime for the surgery let them know because there are last minute cancellations for this surgery all the time. Also, surgeons ask for additional theatre time, all the time and you might be able to get into one of those unallocated slots but you have to be immediately available. BTW, receptionist always say that there surgeon is the best and that they are one of a very few that can do this type of surgery, don't get sucked into this line.

      BTW, if the bone deformity is on the neck then you have a CAM impingement. You mentioned that your hip discomfort only occurred after a bike crash in 2011 and that you are near 40. My comment to this is that your CAM problem may or may not have caused your labrum damage and if it did it only did it because of a severe event i.e. the crash. I doubt that your CAM issue would be causing you damage in your everyday life otherwise the symptoms would have turned up more than a decade ago. but of course, I'm not looking at your scans.

      Good luck with the surgery

      Cheers

      Oz

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    4. Keep in mind mark that there is nothing. Like been in there with a scope to access what is really going on mechanically and this can change the surgeons course of action, cartilage can look ok on scan but be a mess when you're opened up and for example in my case 2 weeks ago thought to have cam and pincer, the pincer was not an issue only the cam, my surgeon was skilled enough to assess this, all damage was caused where the cam is and where the pincer was the labrum was attached and fine so was left behind. What I am saying is really that the key to this surgery is finding a good FAI specialist surgeon... And asking questions. It's isn't easy and I agree with Oz when he said all secretaries say their surgeon in the best, blah bilateral, I've heard the same over and over and pay no attention to that, I agree with Oz's recommendation on how to find a surgeon and also that you educate yourself and quiz the surgeon, I have been in consultations where I had to stop myself leaving midway when I realise they know very little about FAI and that could only happen because I read everything I could. I am not expert myself but thru necessity I have had to self educate. It shouldn't't be this way but at the moment it is. Good luck and apol for typos and other oddities I am on an iPad.

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  60. Hi Louisa:

    No, I'm not a Doctor but I do come from a strong medical family and have worked for a big Medical Device company.

    I started my Hip journey 19 years ago. After a year or two of suffering from a Labrum tear and a few medical procedures including a Colonoscopy, Xrays and an almost laparoscopic abdominal search mission, to identify the cause of my symptoms, I ended up self diagnosing my condition. I asked my GP for an MRI Angiography (MRA)with a request to look for a Labrum tear and the Labrum tear was found. The only problem at that time was that surgeons and the appropriate tools to deal with this condition did not exist within Australia, so I waited and suffered for until 2004 to have the condition fixed. I found a surgeon with enough skills to at least alleviate the condition, which he did, although I still couldn't run great distances at least I was pain free for most athletic activities and at rest. I was fine until 2011 and then the symptoms returned; playing Golf wouldn't have helped.

    This time around I wanted a full solution if possible so instead of going back to my previous Ortho Surgeon, because I didn't think based on his internet site that he was doing much of this type of surgery anymore, I went on a search for the best, hence my selection of Mr O'Donnell. For me, this ended up being a costly mistake and not only because I had to fly 2 hours and incur accommodation costs just to see him! I came out of the surgery with more problems than what I went in with. There appeared to be a twisting of the leg and nerve compression. I seemed to be walking on the inside of my foot. Anyway, my problem with Mr O'Donnell was more to do with his practice's focus on patient care. IMO, based on my experience, his practice is focused on money, the training of other surgeons and other O'Donnell issues and concern for the patient welfare is somewhere further down the line. Simply, although promised on at least 5 occasions over a period of 7 months by his administration team that he would call me to discuss the problems that I was having, he never did. Mind you, this was even though I was to have surgery on my right hip in 2012. The only time he did call was 5 days before my right hip surgery and I believe that this only happened because I hadn't called to pay them the money they required upfront to do the procedure. Luckily, I got sick a day or two before the right hip surgery and had to postpone the operation.

    Having time before my Right Hip surgery, I decided to look for another Hip surgeon to get a second opinion on what was happening to my left hip; I believed that my Femoral Nerve was compromised. I ended back at my first ortho Surgeons offices in Brisbane, Dr Bill Donnelly, who's contact details I mentioned in response to an earlier comment on this page. John O'Donnell and Bill Donnelly know each other well and both lecture on this hip condition. I found that Bill hasn't been keeping his internet site up to date and to ignore it, he was still a leader in this procedure. Anyway, we went through the MRA procedure, 3D CT scans etc and I sent a copy of the reports to John O'Donnell as well. We also asked John O'Donnell for a report on what he had found during his procedure and a copy of any photo's that he may have taken; we got back a report on what he did but nothing on the condition of the hip or any photo's.

    I called John O'Donnell's office to ask what his thoughts were based on the new MRA's, as I was concerned with the left hip and I didn't want to do the same thing to the right hip. Anyway, after waiting for the promised call over a three week period that never arrived I cancelled the right hip procedure with John O'Donnell and am now back under the care of Bill Donnelly.


    Cheers, Oz

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  61. Hi Louisa:

    No, I'm not a Doctor but I do come from a strong medical family and have worked for a big Medical Device company. I was always taught to self diagnose and question Doctors on their diagnosis. If a doctor doesn't want to engage with the patient on the diagnosis and recommended treatment, kick them to the curb and find another Doctor.

    My new doctor, who actually did the first operation on my left hip 8 years ago, is Dr Bill Donnelly; Holy Spirit Northside Hospital Brisbane Australia PH 1300 236 663. It's early days but it looks like he's done a good job alleviating me of the issues that I had after John O'Donnell's procedure. I should have gone back to him in the first place!

    Finally, my MRA's didn't show up that there was much of an issue, if any, in my left hip. In fact, I had to talk Bill into going into it again. Let's just say that he was shocked at what he found and we are now preparing for a future replacement of that hip. It's a shame John O'Donnell didn't provide any specifics or pictures of what he found when he operated on it. Anyway, the lesson here is that MRA's still aren't accurate and the only way to be sure is via an arthroscopy.

    My right Labrum repair will be happening in 6 - 8 weeks.

    Cheers

    Oz

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    1. Best of luck oz... Ive just discovered the minimal invasion technique (not a wide capsulotomy) is amazing it seems to mean by not cutting a huge L or T through the whole capsule they don't trash it, I am just 2 weeks out from cam removal and the usual and can walk and walk consecutively upstairs. I'm beginning to see what my new surgeon advised last year that this technique mean you keep muscle strength, propreperception and reduce the risk of scar tissue build up... He is cutting edge... And sure that other surgeons will switch to this technique within 5 yrs, mainly downtown the high incidence of scar tissue causing revisions.
      Having had 3 scopes now, 1st a disaster and a long recovery, as documented, last 2 by comparison in everyway a walk in the park!

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    2. Hi Lousia,

      LOL, I noticed that I double posted a couple of times yesterday. After waiting a few hours, it didn't look like my first comments uploaded on the blog, so I did them again and wrote them slightly differently.

      I must admit that I never really concerned myself too much about the capsulotomy. This might partly explain some of the discomfort that I have in the front of the hip from the second operation. As the devices they use for these operations improve, then so should the surgeons techniques in performing the operation. Scar tissue is always a potential problem when cutting is involved.

      Yes, once you've had at least a couple of these surgeries you know when things have gone well and when they haven't. The recovery from my surgery last week has been a breeze, so far.

      It's sounding like your CAM etc. surgery has gone well. Remember to avoid jogging on it for at least 7 weeks and longer if you can avoid it.

      All the best

      Oz

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    3. I will thank you, annoyingly I pivoted on it by accident yesterday and took it into extension and external rotation and its been throbbing since... these recoveries are a pain , long and fraught with anxiety.. grr...
      ps no worries re double post, few of my replies were coherent yesterday as I made the mistake of using my ipad, v flakey.

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    4. I hate that external rotation feeling! I do my best to guard against that one until my support muscles strengthen.

      I hit 7 days post op tomorrow. My thigh, lower back pain and bursitis symptoms have mostly gone but I still have some groin discomfort, which is the pain that I would most like gone. My hip is feeling more stable and solid once more.

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  62. Hi Mark;

    The best way to find a good Hip Arthroscopy Surgeon is to call or email knee arthroscopy and hip surgeons who don't do arthroscopies and ask for a recommendation. If a particular Hip Arthroscpy Surgeon's name keeps coming up, then it's a good bet that they are probably the person to look at seeing.

    If you want to get your surgery quicker you have to be available at anytime. If you can do this then tell the Surgeons administrator that you can be there at the drop of a hat if a cancellation comes up. This will move you up to the top of the cancellation list. Cancellations happen all the time with this surgery and you could get a call pretty soon.

    As for your hip injury. You obviously have a CAM issue. Based on the fact that your hip symptoms have only started since your bike accident and your age, it's probably pretty safe to say that the extreme nature of your accident has caused your Labrum tear and not the CAM itself. If your CAM was an issue, you would have been showing symptoms a decade or so ago. Having said that, I can't see your 3D scans so I can't be definite but still it would be a good question to ask your Surgeon.

    BTW, all Surgeon's administrators say that their surgeon is the best and that only a very few do what they do. Don't get suckered by this line.

    Good Luck

    Cheers,

    Oz

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    1. Hi Oz,

      Thank you for the helpful info, after reading your post I remebered that I actually know an orthopaedic surgeon who I cycle with, or used to cycle with lol. I sent him a message on facebook asking who he would use if he had the same symptons and I also asked if he knew the success rate of the surgeon I am seeing as they work in the same hospital.

      I would love to be able to attend surgery at the drop of a hat but it's hard to sort out the logistics when young children and childcare are added into the equation.

      7+ years ago I would regularly suffer from groin and hip pain while playing rugby, I put it down to the game being physical and taking knocks makes thing hurt. Then 7 years ageoI was involved in an accident and I ended up with a compression fracture of T7 with a T6/T7 bulging disc which impinges on the spinal cord. After I managed to get over this the pains in my hip had gone so I though nothing of it again until recently after carry out some research after my diagnosis. I don't feel as much pain in the lower part of my body since the accident so I'm thinking now that that's why the pain stopped. With all the trauna I've suffered over the years from rugby and bike crashes I think my body will end up being a total wreck.

      I'll let you know what info I get back from the questions I've asked.

      Mark.

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    2. It doesn't sound like you had a Labrum issue when you were playing Rugby. My first signs of a Labrum tear showed up when I was playing Rugby League. My symptoms were severe groin discomfort that reached into my private parts, low back pain, a bit of bursitis pain and an instability in the hip (sometimes it felt like my leg was going to pull out of the hip socket when I stepped). The other thing to know is that the pain from a Labrum tear will not go away with any amount of rest, physio or other non arthroscopic treatments. The only way to potentially get rid of the pain symptoms caused by a Labrum tear, is to repair or resect the damaged labrum. Due to a lack of blood supply in the hip socket, a Labrum can not repair itself.

      Finally, I have a 7 year old girl and a 4 year old boy. When I told the Doctor that I would turn up for an operation at anytime, as long as I had fasting time notice, he had me on the table in a week and this was after he originally told me that he could not fit me in until mid August. I packed the family up and we drove 2 hours to the hospital and got it done. When the pain and incapacity caused by the Labrum tear gets that bad you'll find you have coordination skills that you never thought you had. LOL

      Where there's a will there's a way.

      Good luck

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  63. Hello,

    My name is Holly, I am 18 and a student at the Rambert School of Ballet and Contemporary. I have been having problems with both my hips from about the age of 13 and have visited my GP who sent me for an X Ray showing no sign of impingement (this was an AP x ray). I have also seen a number of Physio's over the years and have never had a diagnosis. My symptoms are very similar to those I have read on various websites and forums, with pain in the groin and lumbar spine (particularly the Sacroiliac joint) and limited range in both hip flexion and internal rotation. Clicking in the hip and sharp unpredictable pain is present at times and a catching sensation in the joint. I have spoken to a specialist on the phone who is based in Leeds but am unable to get an appointment until the summer holidays. I was wondering if anyone has any advice regarding getting a referral or seeing a specialist in London, as this is where my school is based. I am seeing my GP again on Thursday, will I need a letter from a physio or specialist to be referred by my GP?

    Thank you for the advice on this blog it is very helpful
    Holly

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  64. holly are you private or NHS. If you are private and London is your base Paul Jairaj is the best I know, so much so I bet my own hips on it after quizzing 6 consultants around the country, he works magic. This is his contact0844 561 7157 and Linda McFadden is his secretary. He has people up and running in 2 weeks, he has saved my life frankly! If you need a referral there is a Physio in Leeds louise grant at Physiocure, she specialises in FAI hips and will be able to refer you directly to paul jairaj. Louise is based at cookridge hall and can be contacted on 0113 611999. If you need any further help facebookmrequest me as I could introduce you to louise through the help groups. Louisa weeks browning. Ps excuse all manner df typos as I am on a very flakey iPad 3 (kings clothes purchase!)

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  65. I am approaching this through the nhs and am concerned about how reliable this service will be in such a specialised area and the effects it will have on my training. Although the symptoms I am experiencing show sighs of FAI I have not yet had an official diagnosis and I am anxious to have the x rays that can confirm FAI. This is proving difficult through the nhs, do you have any advice on how I am able to get a referral, to see a specialist. Until I have one from my GP I am unable to see a specialist through the nhs or privately. I have spoken to Louise Grant and sadly will not be able to see her until the summer holidays.

    Thank you so much for replying so quickly and for your help
    Holly

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  66. Hi Louisa, hope your recovery is going well.
    I have now been diagnosed with bilateral fai, cam type, with adnesive capsulitis R hip, from ct scans.
    This has taken 3 years, but appreciate from others blogs that I have probably been quite fortunate.
    Now awaiting referral to Mr Jairaj following you and my doctors recommendations. Hoping I won't have to wait long.
    D you have any advice pre op, for exercises. I am struggling to walk these days.
    Regards claire

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  67. You honestly couldn't be in better hands, in my personal opinion. I had surgery with Paul Jairaj 3 weeks ago and I'm already walking normally and able to walk up and down stairs with no problems at all, his surgery is super cutting edge and I can feel the difference in the speed of recovery from a normal hip arthroscopy.
    Have a quick look at this link about adhesive capsulitis: http://www.livestrong.com/article/323613-exercises-for-adhesive-capsulitis-of-the-hip/ (you may have to cut and paste this link) it suggests keeping range of movement going, so my suggestion pre-op would be to use the Physiocure rehab guide as pre-hab (top right, under HIP ARTHROSCOPY EXERCISES AND REHAB FOR RECOVERY) and do the first couple of levels just to keep your ROM as adhesive capsultitis causes loss of ROM and if that causes you no increased pain, 'slowly' go up the levels to also increase strength, but as you're already in pain, take it easy as you do not want to increase inflammation. Let the pain be your guide and don't push through it.

    If you want to speed up the process, call Paul Jairaj's secretary, as you maybe able to collect the referral to just take with you, he may not need it in advance. Best of luck to you, keep me posted.

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  68. Thanks Louisa, I am giving this a go.
    Claire

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  69. Louisa,

    Glad to find your blog. I am 34 years old and injured my hip pushing a box at home in Jan. After going through 5 mths of therapy & several MRIs I went to go see a ortho hip specialist (FYI, I live in Dallas, TX). After I had a MRI arthrogram & additional X-rays I was diagnosed with a detached labral tear with mainly CAM impingement but also some slight pincer impingement. Because I still had sharp pain with certain motions, increased pain with sitting, and just had not been able to return to my regular lifestyle since Jan I decided to have a hip scope (done 6/4/12). Also I was going into nursing school in the fall so I wanted this taken care of beforehand. My surgeon anchored the torn cartilage back, shaved off some bone, & also ended up doing a iliospsoas tendon release. He has warned me my leg will be weak for 4-8 weeks.
    To give you some slight background I work for a ortho surgeon (not the one who did my surgery) as a medical assistant so I am on my feet usually 8-9hrs/day. In my head I painted a picture that after one week off work I'd be able to go back & work on crutches. Needless to say week 2 of recovery has passed and I have only done 3 1/2 days at work with each day ending in tears, a swollen leg, & increased pain. Although I realize my hip does feel better than week 1 I am still met with quite a bit of frustration. I do try to sit as much as possible at work, while putting my leg up and using ice when possible. I guess I just want to know things will get better and that I am not just being a big baby about everything. I still have to use pain pills, sometimes 4 a day and I didn't expect that. I read mixed stories of people who are great day 1 and some who it takes quite some time to get back to normal. Although I will force myself to sit more at work I can't help but feel upset both physically & mentally because I am not bouncing back as quickly as I expected. I am not the type of person who normally whines & complains (& I still don't, expect perhaps to you here) but I guess I just wanted confirmation from people who have been through the same experience that in time I will be back to normal. More tears have dropped these past 2 weeks than in the last 20 yrs & it's half from frustration & half from pain when I'm up on my feet for several hrs. Do you have any suggestions or even words of encouragement that in time going through the surgery will be worth it? I do appreciate your time and your website. It's comforting to read others stories. Thank you - Andrea Castro

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    1. Andrea I know the incisions are minimal on your thigh but you have had MAJOR MAJOR work done on a weight bearing joint!, I know few people who even THINK of going back to work within a month and many try at that point and then if there job is demanding (eg time on feet) take a further 2 to 4 weeks or more off. I don't understand why you weren't warned that you'd be likely out for the count for many weeks, most say don't expect to feel anything close to normal within 3 months, sometimes 6.
      ...And that is without a psoas release added on!

      Its not good to do too much either, as it predisposes you to scar tissue problems as it causes joint inflammation. Its not the kind of pain to push through, like a headache.

      I think you need to ask for more time off and to expect less of yourself for 3 months at least. With regards to comparing yourself tom others please bear in mind a hip arthroscopy for FAI or labral tear is a catch all for many different surgeries. The recovery for say a cam removal with no cartilage damage or torn labrum is VERY different indeed to what you have had done and then add in different ages and different fitness levels. Another thing is what people define as feeling normal can vary wildly and is ofte a brief snatshot and not always entirely accurate. It won't help you to compare as you may struggle to find someone just like you... but as surgery goes, lack of microfracture aside, you have had the works done and should really be alternating between rest and bursts of hydro and physio. Ask yourself how you feel at 3 and 6 months, after rest and rehab. Before and you'll torture yourself.

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  70. Thank you so much Louisa. I appreciate your advice (not what I wanted to hear but I already had a feeling I probably shouldn't be trying to be up on my feet. I have a post op visit with my surgeon Tuesday & I think now I will be a lot more clear-headed and realistic at that visit.
    - Andrea

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  71. Hello
    I have had a HA on both of my hips )right = Dec 2011 & left = April 2012). I am still in a lot of pain. The pain is right in the hip socket and also in my sacro joints in my back. I was told i also have synovitus in my right hip. I have had hip problems for 7 years now. I am basically house bound right now. I think its maybe just early days???? Seeing as i have had both done in the space of 4 months. I am 6 weeks since my left one being done. I have been so depressed, this has been the worst time of my life. I am 29. I am seeing a physio but progress is slow. I am still using the crutches when i do go out. Any help or chatting would be great, Emma.

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  72. Emma, it is early days, I had an op Nov 2011 and May 2012 so I am exactly a month behind you, are you on facebook? If so look me up and I can join you to all the existing FAI groups also. You can find people in similar situations and that will help as this is an isolating condition currently. I am concerned that you are housebound though and would like to know more... look me up its Louisa Weeks Browning.

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  73. Hi Louisa, i don't use Facebook so if its ok i will just message you here. Well i am house bound at the mo really because of the tablets i am on, i take codeine, paracetamol and tramadol. I am hoping to reduce my pills soon but can't do it at the mo. I am seeing the GP next week though to discuss a different type of painkiller. So because i am on the pills i cannot drive so i don't get out much, plus i've been depressed with all this, so i guess i've become a bit of a hermit. Its hard to find people to talk to about this who have been through it. Are you on painkillers? Or are you out and about more? my email is lydford_lady@yahoo.co.uk if you would like to email me

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  74. Louisa, in case you wondered i did have a look on facebook but decided against it, so maybe you could reply to me on here or email me instead. thanks, Emma.

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  75. Dear Louisa,

    Thank you so much for this website and invaluable source of information.

    I have been diagnosed with a labral tear on my right hip and I need surgery. As I know the choice of the surgeon is crucial, which one would you recommend me ; I live in Oxford. I am thinking of seeing Dr Damian Griffin in Coventry, after checking his website (http://www.hiparthroscopyclinic.co.uk/) and reading this article (http://www.dailymail.co.uk/health/article-1241913/Two-hours-ago-man-having-revolutionary-hip-surgery--Now-hes-exercise-bike--pain-free-last.html) Do you -or other people- have experience with him?

    Thank you in advance for your reply. Delphine

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  76. I know he has a good reputation and I also saw him and liked him very much, he is quite military in approach, thorough... but I chose not to go with him simply based on how difficult I found it to book subsequent appointments, which I had heard others say also on forums. I believe him to be very good, ultimately thought it important that I have fairly easy follow up access on what can be quite a problematic recovery. His secretary was always very friendly, but hard to get hold of and would say she would call and then I would not hear from her, in fact she's 'still' due to call me regarding an appointment that was delayed twice and was due Sept/October 2011! In the end I thought its not a good idea to pursue and as I was private I was in a fortunate position and so saw a good few surgeons until I met Paul Jairaj...

    I will always recommend Paul Jaraij at London Sports Orthopedics because of the way he does the surgery. He is the only surgeon currently in the UK that I know of to perform the hip arthroscopy using such a minimalistic technique, most cut open the hip capsule witha large T or L shaped but, Paul Jairaj makes 3 small holes... the significance of this is that the healing time is considerably less than the normal technique. Personally it meant 2 weeks crutches v 7 weeks crutches, 2 weeks before being able to climb stairs consecutively v's 5- 6 'months' before I could climb stairs.
    On top of that I have found him to be a really good surgeon full stop, but I think this technique, which is starting to become recommended in the states with some of their eminent surgeons, is behind the comparatively swift and successful recovery. Also this technique reduces the risk of scar tissue problems which in my experience are fairly common.
    Make of my personal experience what you will, I hope this helps. I think Griffin is most likely a very good surgeon, however I don't have a moments regret for travelling to London for my 2 surgeries with Paul Jairaj over these last 7 months. Very best wishes, Louisa.

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  77. Thank you so much Louisa for your quick reply. I think I will also try to get an appointment with this Doctor Raijaj, as London is also convenient for me. Do you know if he accepts BUPA insurance? And if I go private, do I still need a referral from my GP? Thank you again for your recommendation. Delphine

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  78. Paul Jairaj (pron J-RAJ) does accept Bupa, I know because I am in Bupa too.... Not sure whether you need a GP or a physio referral, but if you call and ask for Linda McFaddon who is his secretary she will be able to explain any ins and outs: 0844 561 7157.
    He does surgery in 3 location, the Lister in Chelsea, London Bridge and somewhere in Surrey I believe.
    Please do let me know how you get on, best wishes.

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    1. Thanks again Louisa, I have an appointment with Paul Jairaj this Friday. I tried with Dr Griffin, but as you said it is extremely difficult to get in touch with his secretary and she has not got back to me yet. Thanks again for your willingness to share your experience and help others. Delphine

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    2. Best of luck, are you aware Claire just next to this comment is also seeing Paul Jairaj and in going thru similar? Its always good to find a hip friend! Let me know what you think after seeing Paul Jairaj.

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  79. Hi Louisa, hope that you are doing well in your recovery.
    I am having bilateral hip blocks on Monday with Mr Jairaj, and likely progress to surgery not long after that.
    Can you recall if BUPA covered you for all your surgery costs, and whether there was a significant shortfall please?
    Just would like to be fully prepared!
    Thanks
    Claire

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  80. I did have a Bupa shortfall or approx £450 for his surgery, but that was it... unfortunately apparently Bupa has not updates how much it pays towards surgeons fees in over 10 yrs so... however I have a limited cover policy so your cover might cover everything. Everything else was covered. If you go for surgery ask for a spinal with sedation, I woke up smiling and chatting and made calls, after my first surgery with someone else I had a full general for the whole duration and woke upset and agressive and was frankly a little fruit loop for a fe weeks and inexplicably exhausted. I was afraid of a spinal as birthing epidurals didn't work for me but it was excellant pain relief and I was even unaware of having a spinal and asleep through the entire op. Let me know how you go. Goodluck with the block and hope it clarifies everything for you.

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  81. Dear Louisa,
    Thank you for letting me know, I had already seen a shortfall for the hip blocks so thought I would check, but frankly would rather pay to have someone I quote " who has done hundreds" by anaesthetist, than a surgeon giving it a go, recognising that this is a complex surgery. I have no doubt that my femur anatomy cam etc is my problem, but the hip blocks, buy me time, but also give me opportunity to do pre hab physio, as my glutes now pretty wasted. I want the best outcome. I have had all my treatments so far at North Downs Hospital, Caterham, as a traveller from Jersey , Spire Gatwick would have been easier, but hey, my first appt was a good time, easy by train, and it is a lovely place, impressed by the care I have had. Still struggling a it with what's happening to me, it its taken me three years to get here, and yes sadly the X-rays tell the story.. Rambling on, two days post hip blocks, cramps,

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  82. Sorry didn't mean to leave it there, but told hip blocks take a week or two to kick in. I saw comments above re delphine, I have joined hippy chick on Facebook, and open to chat.
    Thanks
    Claire

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    1. Hi Claire, how do you feel now that you had the block injection? And when are you due for surgery? I had a block injection 1 week ago with paul jairaj and was feeling much better until yesterday I decided to go for a 45 min bike ride and today the pain came back significantly. I was wondering as well if you do some pre-op exercices? Thanks and all the best Delphine

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  83. Theres understanding hip impingement on facebook, best hip surgeons reviews and hip pain awareness also. good luck. Good idea prehab and rehab is a long road after, follow one of the physiocure or griffin rehabs to prehab, as they're specially for fai.

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  84. Hey all Nate from the states (Illinois). I was Dx with FAI back in May of this year. I am an ER nurse, avid runner and amateur just for fun triathlete. I began to experience pain in Feburary after my runs and somewhat less after biking. My right hip was the area in question. I originally attempted to self Dx as tendinitis or bursitis. Well, that was a big NO! I first went to a prompt care for X-rays to insure I didnt show some late signs of stress fracture. X-rays were negative...........so I was told. Next day Recieved a call that an MRI was suggested. Dx was FAI...what is that? Long story short I did a ton of research and had my primary MD refer me to an orthopedic doc. I originally had seen Dr. Mauer's PA and was set up for an arthrogram MRI. A small labrial fray/tear was seen and further solidified the Dx of FAI.

    Dr. Mauer requires me to go throw the hoops of insurance clearance and spend undo money and time and have a steroid injection. That didn't work at all. I requested my information be sent to Dr. Byrd in Nashville TN. My insurance wouldn't cover me due to out of network issues. They directed me to Dr. Nho at Midwest Orthopaedics at Rush in Chicago IL (2.5 hrs from home). Wow what an organization. Things ran so smoothly! Had visit and he agreed I would be a perfect candidate for arthscopy of my right hip. Before I left his office I had a surgery date for July 5, 2012! That appointment was June 13, 2012.

    Well surgery went off without any issues. I have 3 small incisions and they removed a large cam lesion from my right femoral neck. No repair was needed on the labrum! (very happy for that). I was vomiting from post anesthesia and pain meds but pain was minimal post op. I had a rough 1st night due to swelling and to make matters worse I was staying overnight at a Chicago hotel as I didn't want to drive 2.5 hrs home right away.

    I am now 2 weeks and 2 days post op and feeling really well. I am riding my Tri bike on the trainer several times per day since coming home and advancing in PT so well that we are jumping ahead of planned therapy and making improvements every few days. I have decreased the use of crutches and leg brace. Weight bearing is easier too. Well I hope I haven't went on too long but I hope my story may be helpful!

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  85. Hi there,

    Thank you so much for this blog. I've been diagnosed with a CAM-type impingement and am booked in for surgery with Dr Mike Rigby in Bath, UK, this September. I've read a lot about people's painful experiences and what concerns me is that my pain isn't actually THAT bad. It was awful last autumn, but I've limited my activity and it has since improved a bit. I can't go on big hikes or cycle up hills and my hip is always a bit sore, but I don't have to be on painkillers for it.

    I've been told surgery is the only treatment option but also that while the surgery will fix the problem, I'll never fully recover from the surgery trauma itself. It also sounds like rehab is long and painful - so I'm terrified that I'll have the surgery and regret it. Is it possible to live with FAI without having surgery - and for that not to be detrimental? Or do I just have to grit my teeth and get on with having surgery?

    Thanks,
    Caroline

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  86. Ok Caroline, if you think that at the moment (fluid situation) that your hip is not limiting your life too much or causing too much pain, you do have other options, you could try steroid shots into your hip socket to reduce inflammation and work with physio on strengthening the necessary muscles. You could do this until either the pain or limitation becomes less bearable.
    The caution is to keep an eye on cartilage x-ray at the very least. The potential dangers are 1. you risk cartilge damage and 2 as your muscles adapt to compensate some will weaken. That said your progression maybe v slow and your surgeon doesn't sound too confident of success? I've not heard that specific warning itself nd wonder EXACTLY what it means? You don't HAve to do anything and that you are not sure suggests its not a bad idea to delay. There is no issue with delaying, it will have a drastic effect on your lifestyle within the first 3 - 6 months and career or family may dictate when you choose to have this surgery.

    Personally I think I would wait until it felt right for example the pain increases, life limited beyond tolerance and a suitable time in my career/ family life, meanwhile a sticking plaster is understandable and not a crazy whim. Come onto the facebook FAI sites and meet others, see what they think if that helps you, find me and I will happily link you up.

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  87. Hi Claire,

    Hope your hip block is beginning to work for you. I had one performed too under general anaesthesia (would have happily let them do it without, but that's the protocol apparently) and found that the benefits it brought were somewhat stealthlike. However, I went from being able to walk only 20mins at a time to being able to walk for two hours and jog almost pain free in the space of six weeks, so it certainly worked.

    If, like me, the hip block was a precursor to hip arthroscopy, then I would urge restraint with your activities once you have had the block and not to 'overdo' it too much. I had the surgery ten weeks ago and was surprised at how much synovitis and inflammation there was in the joint (probably as a result of an aggressive prehab whilst riding the effects of the jab), and I can only assume that the block masked some of the pain of this. This inflammation is proving to be very stubborn to shift and is, to be honest, causing real problems with my recovery now.

    As an aside, the block made me really flushed and red in the face for about ten days afterwards - much to the amusement of everyone else...

    As for Caroline, I would be advised that this is not a surgery for sissies and that the recovery period varies wildly depending on surgeon, individual, rehab and indeed damage in the joint in the first place. Given the paucity of your symptoms at the moment, I echo Louisa's comments above. It all comes down to whether or not you can live with it and how much of your daily living it is disrupting. With me, I elected for the surgery in the end as I was no longer the same person I had been six months earlier due to loss of all my physical activities and, moreover, the inability to do my job (uniformed services). I was given odds of 85% success, 10% no improvement and 5% could make it worse, so I thought I'd roll the dice and take the gamble of getting my life back.

    Recovery was a breeze until four weeks post op to the day, where it swelled up and the same deep rooted, nasty groin pain returned. I am now ten weeks post op and still pretty much disabled, still with fluid around the joint, so something isn't happy. But, I guess its still early days yet and I remain hopeful... If I'm honest, I don't think I was mentally prepared for how up and down the recovery from this is - and I had one of the better surgeons doing it (he was the only guy I saw whom I trusted to cut me...)

    I just hope I'm not in the 'do not pass go, proceed to THR or hip resurfacing' category...

    Mine was the result of a traumatic injury and I was suprised at how damaged the joint was (grade III on the outer edge of the cup) within less than a year of being symptomatic. I was told that the governing factor to success is early intervention as 'once its gone, its gone' pretty much sums up the issues with cartilage degeneration (yeah you can have painful microfractures to plug the holes, but who really wants that?) I suppose it's like a door that wont fit square in a frame - if you keep on slamming it, the frame's gonna get destroyed eventually...

    Anyway, this really is the best FAI site on the net, I think, so you are in the right place. Good luck with whatever you decide to do...

    Nick

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  88. Dear Nick and Louise,

    Thanks both very much for replying - trying to navigate all the info around FAI has been very confusing so I really appreciate your input.
    Louise, I think what the surgeon meant is that you never recover from the trauma of having surgery - the incisions, the traction, etc. Though like you, I've not seen or heard this mentioned anywhere else.

    I've managed to minimise the symptoms by becoming a slob - so, no big walks, no big cycle rides, no yoga - all things I used to do. I miss being active, which is why I agreed to the op. I have small children so the op will never come at a good time.

    Thanks Louise for inviting me to the FB group - I'll post there for more advice. Nick, I'm sorry to hear you've had such a hard time after having had the surgery. From what I've read, that kind of 'relapse' sounds quite common? Anyway, wishing you all the best for your rehab.

    Thanks again,

    Caroline

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  89. Dear Anonymous, thanks for your thoughts. At the moment the blocks have made a massive difference to my quality of life, but after physio two days ago, I could feel the pain! So I know I will be having surgery very soon. I have had pain for nearly three years now, so at extra month or so isn't going to make too much difference I think, but I take on board your comments re being careful. From following this blog and input from prefab physio I expect recovery to take 3-6 months, but suspect I may need micro fracture, which is going to make it tougher. My expectations aren't huge, at he moment would like to be able to sit down for more than an hour without pain, work is difficult, children's shows, cinema etc. and would be happy to walk as you say for more than 20 mins. Best wishes and thanks for your advice.

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    1. Hi Claire, how do you feel now at this post-injection stage? And when are you due for surgery? I had a block injection 1 week ago with paul jairaj and was feeling much better until yesterday I decided to go for a 45 min bike ride and today the pain came back significantly. I was wondering as well if you do some pre-op exercices? Thanks and all the best Delphine

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  90. Caroline,

    From personal observations, it does seem that there is an initial honeymoon period after the surgery. For the first month or so, I sometimes found it hard to believe that i'd had the surgery. Of course, part of this could be attributed to the steriod/marcaine shot that most surgeons put into the hip when closing up surgery which i guess can mask some pain.

    This, i think, can fool you into pushing things and then dealing with the resultant flare ups. A lot of surgeons will give you a three month recovery period, though i think this is wildly optimistic in a lot of cases (of course it varies dependent on work done etc) and my advice to anyone undergoing this is to take that figure with a pinch of salt.

    Anyway, at the moment, it feels like i have had a proverbial carrot dangled in front of me then snatched away again, which is pretty cruel!!

    Nick

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  91. Hi Caroline,

    I am now in week 14 of my recovery from my arthroscopy which included micro-fracturing. Having been reading the various blogs over a couple of years I was expecting the recovery to be hard but not this hard.

    My surgeon told me is was essential that I was partial weight bearing for 6 weeks and not to exceed 50% weight on the operated leg, and then only to increase to full weight baring over several weeks. Also it will not be until you have an x-ray at 6 months will you find out if the micro-fracture has worked.

    On the plus side I take a 40 minute walk each day, it has taken a lot of effort to get to this stage. In my case if I had the option of not having the operation again I would take it, however I only experienced pain whilst exercising.

    Best of Luck Mike

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  92. Louise,

    Hello again. I wrote to you a while back shortly after my left hip scope where I had "the works" done. I am pleased to say I am doing much better, but frustrated that I am nowhere near where I thought I would be. I am finally off all support (no cane or crutches...yay!). Today I am 9 wks post op. I'm still uncomfortable at the end of the work day & last week I dropped something, and on impulse went into a deep squat to retrieve it. Yikes! That was a bad idea. I went to see my surgeon a few weeks back, he said my left leg is extremely weak and he believes it is from iliopsoas repair. I cannot do a straight leg raise lying on the table which is frustrating me. In addition apparently both of my hips are extremely tight (they were prior to my left hip surgery but worse now). I'm a little nervous because my dr said if I wasn't careful I would end up with surgery in my right hip as well (it is believed I have FAI in that hip possibly?). I laughed and told the dr now that I know the recovery period I don't want to go thru this again.
    While I can say I am better each week, the process has been slow. I don't know that I can say yet that I'm pleased with my outcome, meaning I cannot say yet that surgery was the right road for me. I am still worse off than before surgery. I am looking forward to my 3mth post op period where perhaps I can look back & think otherwise.
    I did want to know if anyone had the iliopsoas repair/release done. If so, is there any insight on the recovery process you can provide? My surgeon swears this is what is holding me back and that in 3 mths after surgery my leg will be just as strong as my right leg. I'm frustrated because although several possible procedures were mentioned prior to surgery with a longer recovery time (ex. microfracture) but my iliopsoas was not mentioned. He showed me pics of the muscle, saying it was wound up tight and he cut approximately 50% (down the middle I believe). If this is what is holding me back is there any advice anyone can offer who has been through this? I start nursing school at the end of August & got this procedure done because I believed I would be fully recovered. I am nervous I may have limitations now but I am hopeful that things will be ok. I am pushing myself at physical therapy and trying to strengthen my leg in addition to doing stretches on both hips to loosen things up. Before this whole process I felt I'm young (34), in good shape, I'll recover just fine. Now I feel older after surgery and worry that things won't get back to completely normal. Perhaps I just put too much faith & wasn't as realistic as I should have been?

    Your thoughts & suggestions are appreciated.

    Thank You,
    Andrea
    Dallas, TX

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  93. Andrea, I have not had the psoas done, but I do know recovery can be hard and a good physio is key, are you in physio? Look me up on facebook and I will link you to the groups there, because you will find people in the same position as yourself and that in itself can be comforting! It is a long road and if you ad the works done think more in terms of 3 to 6 months. Look me up Louisa Weeks-Browning.

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  94. Thank you I appreciate it. I am in physical therapy right now, is that the same as physio?
    I sent you a request on Facebook, it's under Nikki Castro.

    Thanks,
    Andrea

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    1. yes it is and yes found you and glad the forums are helping you they're a good support for this as yet, lonely condition.

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  95. I am 5 months post-op from right hip and while I did get improvement (internal rotation & no more knee tracking issues) I'm far worse off currently than pre-op because apparently I chose the hip with the least problems first. I am now so tight on the non-op hip and so free on the op hip that I'm having huge imbalances and my non-op side low back is constantly killing me. My hamstrings & adductors on the non-op side are at least 20-30% shorter than the other side. All I can do is stretch all day long. Even at my last PT sessions at 3 months post-op we spent more time working on the non-op side than on the op-side... Before my op I was tight on both sides so at least there was some balance... now I'm feeling only half human. Must get that other side done ASAP.

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  96. I am currently in a bit of a predicament at the moment and I am not too sure what to do. Apologies in advance for the long story, but maybe yourself and some of the people here can help me with some advice.
    Basically, I have always felt a slight 'crunch' in my left hip when I move my leg in certain positions. It has always been there, but had never been painful. In the last year I had become far more active then I had been for some time (I used to teach Karate, but hadnt in about 7 years). I started training in MMA which includes boxing, kick boxing, jiu jitstu, wrestling etc. After a couple of months of training I started to notice the occasional pop in my hip, along with a dull ache. The ache wasnt so bad that I couldnt train, in fact even as I write this I still dont experience any sharp pain that stops me from running and training. But it is there, almost constantly, reminding me that something is indeed wrong.

    I went to the physio and told him about it. He performed some tests by checking hip and leg rotation. He ended up saying that this sounds exactly like a hip impingement/labrum tear, and that an MRI would show the extent of how bad it is. He also said that surgery should be able to fix it, and I can resume an active lifestyle..

    But herein lies the problem... I am currently in the process of becoming a police officer, something I have always wanted to do since I was a kid (I am 26 now). I have been working in IT for a long time now, and I am feeling completely over the 9-5 office work life. The drab office work life has been getting to me for some time, and it was this realisation that inspired me to pursue my childhood dream of being a cop. I begun the process December last year, and have passed nearly all stages of the recruitment process, including the exam, initial interview and medical (the doctor didnt do a hip rotation test and I passed everything). The only thing that remains is a fitness test, which is extremely easy-going and I expect to pass with flying colours.
    The only problem is my aching hip grows worse every day. It is still not so bad that I cant physically do anything, but it is getting worse and I now feel the ache every day. I worry that it will continue to get worse over the 6 months at the police academy.

    However, if I were to disclose I have this problem now I would certainly have my application cancelled, perhaps even permanently despite the fact that I would most likely be fine after I have recovered from the surgery. Obviously being able to stand, run, and chase down criminals is all part of the job, and someone with hip problems is not suited for it. This doesnt mean I wont be right for the job! I know I am right for it. As a matter of fact this decision to become a member of police feels like the most right decision I have ever made. The fact that my hip has picked this precise moment to start being a problem proves that indeed the fates are cruel. Even if it happened earlier I could have fixed it and then tried to join in a couple of years. As it stands now, the process takes about a year, and I am nearly at the end! Pulling out now would mean not only do I have to stay in my job (which I hate) for a couple more years, but I might permanently lose my chance to join the police.
    Again, apologies for the length of this, but I wanted to paint the full picture of my predicament.

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    1. At this point, informing the police doesnt seem like an option. Especially because I am still able to be active. If I thought that I actually couldn't do the job I wouldn't try. But my question is, how long could I leave it? My thoughts are to just grin and bare the ache for the moment, go through the academy as normal, and after graduation some time look into it. I know its not the most honest thing in the world, but no one would suffer for it. It would just mean I need some time off to recover in the future. I know I would be a great cop and the police would benefit from me being a member, I just want nothing more than to make helping people my job. I cant bare the idea of throwing this all down the drain because of this.

      I guess I am just venting, but if there is a question in all this (lol sorry, im all over the place at the moment), it's 'is leaving all this for another year going to cause massive problems?'. The physio said that I can in fact leave it for a bit, but i need to have something done about it eventually. I also dont think it is as an extreme case as a lot of you, as I am still able to do things as I used to, it is just an ache that wont go away.

      Anyway, I would love to hear from some of you. Any advice or feedback would be greatly appreciated. Thanks for listening to me ramble :)

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    2. The sooner you handle the problem the easier the recovery and the less imbalances you will create which are even harder to get rid of.

      You could ask yourself if a job is more important than your health.

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  97. Join up and go for the Police then, because you don't want to loose that dream, that much is clear. What is not clear is your diagnosis, by only a physio, not that the physio is wrong at all but wihout xray vision and scanning tools the severity will be hard to assess. How long before you might get the police job?
    You most likely 'will' need surgery and noone can say whether your hip will deteriorate within months, or years. Once in get an MRI but with an arthrogram (otherwise its pointless) then you'll have a clearer idea of hip status.

    Where are you in the country you have not mentions any FAI consultants. Once you further tests, doctors MRIs consultants etc then you will be in a position to disclose this to the police so can you hault untill accepted by the police. You're not necessarily choosing between a career you love and FAI being fixed, its about timing the surgery wisely. You won't be the first police officer to need to take time off for injury, if nothing else I imagine its an occupational hazard. I'm about to go on holiday but I will reply where I can.

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  98. Hi anonymous,

    I take it you are US based, but I am a serving police officer in the UK who has been unfortunate enough to deal with this injury. I am still recovering from surgery three months ago for a labral tear and cam impingement.

    I know where you are coming from, and for what it's worth, I think you have done the right thing by not declaring the injury at this stage. I agree with Louisa in that you still need further tests to ascertain what you are dealing with, and only then can you make a decision. If your police is anything like ours, the physical demands for fitness tests etc are not massive and you could probably tolerate them in the initial stages of your probation. (If you were applying for an infantry unit in the armed forces, then obviously things would be different!) In the meantime, I would be trying to get a firm diagnosis of the issue. Make no mistake that if it is a labral tear and FAI, then continuing to run on it and impact sports will not do you any favours in the long run, but I don't see why moderating your recreational activity as a trade off for getting the job you want can't be done. Lots of people in the job have some pretty horrendous injuries (backs mostly), but they are able to manage them and stay out there.

    As Louisa says, injury is an occupational hazard in our job - especially here in the UK where we aren't routinely armed - and I know this better than most, believe me. Kicking and MMA is probably the worst thing you can do for it if it is FAI, as the extreme flexion won't help.

    In any case, good luck with whatever you decide to do, but I really think you need to find out what you are dealing with first as hip pain could be any number of things...

    D

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  99. Hi Lousia

    Thanks for the blog. I'm in the early stages of gathering info on how to have my potential FAI investigated and fixed. I guess Im an active chap, based in London, UK. I always had tight muscles in my right leg, picked up a tibial stress fracture training for and running my only marathon in 2005. I turned to triathlon in 2007, hoping it would prevent future overuse injuries.

    Alas the pain from my right hip down has never gone, became a chronic knee, hip and ankle pain in December last year and following much research, I went through treatment for every muscle imbalance I could think of to stretch and strengthen my right side, including pilates, massage therapists, trigger point therapy, stretching, foam rolling, kinesiotaping, orthotic insoles, proper cyclefit...you name it, Ive done it! Only gluteal muscles strethening has seemed to alleviate the pain to a small extent. My right hip, knee and ankle just always feel out of line.

    So Im not on private health insurance, but recently splashed out and went to a top sports physio who deals in hip pains. In his opinion, my gluteal strengthening is a good short-term fix for counteracting muscle adapation which has occurred over a long time. This adaptation he believes is due to hip impingement on the right side (following positive hip impingement tests)possibly due to a cam lesion. It felt great to get a possible explanation for my pains over the past 7 years, and that it might be something I can fix rather than deal with what I thought was muscle imbalance, for the rest of my life. My dream of doing an Ironman race aren't completely gone now.

    So now I need to find someone for a proper diagnosis if it is FAI and help me sort it out. If I do need arthroscopic bone shaving, Id do it straight away. I have been recommended to see Mr Markus Bankes in London (based at Barts Hospital) and I see he does private and NHS.

    But I would be interested to know if you have any thoughts on how I might see someone like him relatively quickly or whether a GP-referral on NHS from a different PCT would even be possible. I live in Richmond, SW London, so not sure if you know of anyone local who might be as good?

    Im cautious of the NHS route as it took me a year of pain and trainee-physio's after my marathon to get a diagnosis of a tibial stress fracture. But if that the way to go I will do it. Any advice would be much appreciated.


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    1. HI some consultants accept physio referrals also, but GP is the norm. If you need NHS does your PCT cover it, it is different county to county.
      The best I know in London is Paul Jairaj at London Sports Orthopaedics, he gets people back up to sports level again, however he is sadly private only. Marcus Bankes is a name I have heard relating to FAI, but know nothing about him, nor do I know anyone who has been treated by him, so can't really comment on his skill in FAI. If you're in a rush the traditional speed up process is to pay for the initial appointment (which will be between £150-£200 on ave), but you may need to ask your GP how to find out if you're covered for NHS funding first. Other big names not a million miles from London would be Richard Villars and Damian Griffin. Keep me posted how you go.

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  100. CRITICAL FAI FACTORS

    1.Be fit and have strong hip flexors before your op. Therefore diagnose early so you are exercising (running etc) up to point of surgery or carry out intensive strengthening before. This is more importatnt than all the rehab tips you will ever hear.

    2.Post op. Have 2-3 weeks doing nothing but gently moving. Don't even try more even if you have no pain and want to show people how robust and fit you are. You will not allow bone to heal properly. 'take your medicine'. After this start to feel what your body wants. Start with cycling and step ups etc and avoid the pressure of running until around week 8-12 depending on how it feels. There are so many post surgery protocols ranging from braces to getting cycling on day of surgery. This paragraph is all you need in my view.

    Thats it.

    I am 45, had a bi-lateral hip arthroscopy, large bumps removed and labrum reattachments. I ran a half marathon (1hr 30mins) within 12 weeks of op and marathon 3.30 within 26 weeks of op.










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  101. Paul woodward23 August 2012 09:38

    Hi all, after years of lower back and hip pain i had a back operation to replace my l5 lumbar disc in July 2011.Many month’s later still in pain got referred to physio by gp, physio diagnosed bi lateral hip impingement and after mri scans this was confirmed along with labral tears and bursitis.
    I live in Coventry and was referred to Professor Griffin who I believe has a good reputation. After a long wait i got to see him in June and he was very nice and operated in July 2012 which turned out to be nearly 5 hours due to me having a very tight hip joint which made access difficult. It turned out that I had a large cam impingement with a labral tear that was debrided, and the other hip had a steroid put into it. I am now two months post op but still have groin and buttock pain more so when sitting and i still get the feeling that the hip is still impinging on certain movements, which is a worry even though the proff said he airs on the side of caution on how much he takes away as you cant put back once its taken away. I get the feeling that it has not worked and will put my concerns to him next month when i have my follow up. Any thoughts would be appreciated. Thanks Paul

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    1. Prof Griffin is known to be an excellant surgeon and if he admits he is cautious I suppose the Q to ask is if there is any merit in the theory that you still have remaining impingement? Another common issue post op is scar tissue, could that be an issue? ...but most likely he will say its early days and FAI symptoms dont so much disappear, as they do recede.
      Are you following the strengthening rehab? That said, our gut feelings can be correct and perhaps the way forward is to devise a step by step plan with him, as in if you still feel the same at the 6 month mark it might be time to reevaluate and have an MRI to look for new labral tears caused by residual impingement or scar tissue, though it regularly doesn't show, but there has to be a plan. You won't be allowed an MRI yet as its too soon after surgery and the images aren't accurate this early.
      Short term possibly you could ask for a steroid incase inflammation is the cause, which again I believe it often is... Its a VERY tough recovery. And remember if you don't get any satisfaction longterm and your symptoms continue there are other top FAI consultants, only a handful, but he's not the only good one.

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  102. Hello all,
    I have been following this blog for a while now but haven't posted before….

    Louisa- I just want to say thank you firstly for this site. You, without sounding dramatic, have helped a lot of people feel as though they are not going through this alone. So thank you! I am not sure whether you intended to become a hip pain guru but you have!

    So- my story is much the same as others who have posted. I started to get pain about 2 years ago in my left hip- which got progressively worse. Saw a fab consultant in Exeter who told me to get stronger through physio (I had severe back problems too) and then he would operate to remove the impingement. He did- and he was thrilled- he really was positive that he had removed the cause of my pain......however I spent 5 months on crutches recovering ....and just to make the story short- after 2 steroid shots and a year of post op physio- I am now 18 months post surgery and in a worse way than I was originally (oh and back on crutches- joy!).

    I am back on prescribed controlled drugs, back to having constant pain day and night....

    I was told today by another consultant (mine is on holidays) that there was nothing else they can do and basically I will have to live with this pain until I am old enough for THR. I am 38 and have 2 young kids.
    I don’t want to live with this pain for another 20 years....I know these operations aren’t always successful. I took that chance. I am lucky my PCT funded the operation and I am glad that I have had the opportunity to have surgery...but basically I was told to give up hope- and I don’t want to. I want to fight. I won’t accept that there is nothing else I can do.

    I have asked for a second NHS opinion (I will go private if I have to but will be self funding which won’t be easy!) so I hope they will have something more to say than live with the pain….

    Just felt the need to rant this evening- sorry!! Have a good night all x

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  103. Can I suggest you contact me via facebook so I can put you in touch with some people? Has your surgeon not responded to the fact you have slid off the scale of recovery? Who is he? Recoveries from this op are rocky but your recovery doesn't sound normal and you may need to be seen by someone, well, better? Perhaps more of an expert? Contact me and I will point you to people who may well be able to help. PCTs will fund you in different areas, so you maybe able to travel to an FAI expert out of your area, allowing you to see a better surgeon?
    Do you also know anything about your exact condition and state of your cartilage?
    Look for my name on facebook, its Louisa Weeks Browning.

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  104. i had been suffering with hip pain for about 9 years,id been going back and forth to the doctors for many years,ive had every scan from ultra sound because they thought it was my bursa,to CAT scans and x ray,mri scan..id had a little steriod injection done at the doctors,as they also thought it was my muscle.but to no joy,i was beginning to think the pain was in my head,they even sent me for intense physio,they told me it was my muscle in my bum,that i didnt exercise,mmmmmm ok..ive had 6 kids,so running around after them for 21 years,think ive done my fair share of exercise,so any way i got on with the physio,which really did shove me to the edge of pain,now bearing in mind at this time i was only taking co-codamols for the pain. so after 2 months of physio sessions id had enough ,went back to the doctors,i happened to get a very nice lady doctor,who looked at my notes and went oh you have been through everything,we will send you for a steroid injection which goes in to my hip...then if the pain stops we know its your hip....woohoo result..she also gave me some tramadol...which worked wonders.
    it took 3 months for the appointment to arrive..
    over the years my hips have stopped me from doing many things.walking upstairs,sitting,sleeping,sitting on the floor to play with my kids,if i stood for too long the pain would be too much,but i carried on like mothers do,doing my best,.
    the steroid injection was a short lived fix...but it was amazing,i could walk with out limping..take the stair 2 at a time,peel potatoes without having to sit down...but most of all i could sit on the floor with my kids...it lasted 6 weeks,i got a urgent appointment with consultant who thought there was nothing wrong with me as my pain was just in my hip,not my groin or my legs or my bum...but he relutantly sent me for mri with dye...and hey presto for the first time in nearly 9 years,i actually had a name for my pain,oh i was over joyed,labral hip tear left hip,altho pain is in both they would only do one at a time....i was literally jumping up and down,well ok maybe not literally but as good as,consultant,arranged op date, for 3 months after....
    since the months and years had pasted i was in more pain,the tramadol no longer worked,and i have now worked my way up to 50mg in the morning of zomorph and 5ml of oramorph 5 times a day and another 50mg of zomorph at night
    now like most ppl these days i did my research on the internet about hip arthroscopy,and was shocked to discover the statistics,we weighed up the pros and cons,and the amount of time id be off my feet etc.and decided to go ahead,my surgeon Mr kim is good at his field,i did check him up too.lol
    im now 3 weeks post op,and never been in so much pain,now my groin hurts,and my bum and the inside of my hip where the original pain was,

    mr kim said when i seen him before i went home from hospital that the tear was large between 12 oclock and 3 oclock ,and off he went...
    i had questions to ask him,like what caused it,as ive never done sports,was their signs of any other damage ?? i go back on 26 september 2012 to see him again

    is this amount of pain normal,im beginning to wish i hadnt had it done.
    thanks
    rachael

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  105. Has be just fixed the tear or also done bone work also?... can you look me up on facebook so I can add you to the forums, you'll get a lot from that? Where are you? Louisa Weeks Browning.

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  106. i have no idea .consultant just said about tear..ive added you on facebook thanks.i`ll have a look at forums tomorrow.im from manchester in the uk

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  107. Hi,

    I was wondering if anyone could help me? I have recently had hip arthroscopy and they shaved of some torn labrim. I had this on the 16th July 2012 and its really hurting nearly 2 months after surgery. I want this pain to end. They told me they had found my left hip rotating backwards which could have torn my labrum and they said the next thing is to bring my hip back down into place which I am aware is a big op, I am 24 I have nearly finished my masters and I feel my life is just going to be one big mess from now on. I didnt know who else to talk to as no one in my family/friends really undertstand this pain and half the time swear I am doing this on purpose and is not as bad as I am making it out to be. If any one has any tips/suggestions/experiences I would really appreciate it. Many thanks.

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    1. Hi Abs, I'm guessing you have version issues, or dysplasia and the op you talk of is a PAO. Please get in touch on facebook because not only can I put you onto some relevant to you groups, I can also introduced you to a number of people in your position, or at least they were, but are now living very fulfilling lives, the 3 I'm immediately thinking of, one (age 25) has just got married, one has just achieved her first post op 10K run that she would've said would've been impossible and one from Austrailia (age 20) has just been travelling America with a fellow 'hip friend' she made friends with, which is lovely. I'm not going to pretent your road ahead is easy, but I can assure you that you will come out of it the other end fine, if not stronger and you WILL be ok, but support is a key component, so please get in touch, Louisa Weeks Browning X

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  108. hi abs
    i feel your pain,mine is a month post op on friday,
    pain is worse than before i had it.least before i could actually do things,now im drugged up on morphine and have to rest all day...
    luckerly my family is great,which i am grateful for.
    i just keep hoping that one day soon i will wake up and my pain will be gone

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  109. Hi Louisa and Racheal,

    Thank you so much for getting in touch with me so soon. I do appreciate it. Louisa I think the one you mentioned PAO is the correct one. It is pleasing to know that life can get back to normal, I just feel like I am trapped if I am honest with you. This has been an ongoing problem for 2 years and it is only April/May this year someone believed me. I dont know how to express how I feel if I am honest with you, being pain free to me, at the moment is only in my dreams. I know that sounds dramatic or silly I dont know, but in my dreams I can be the person who I was before any of this. I had the arthroscopy on the 16th July, now I am back to normal anxiety of when the pain comes and how hard its going to hit. I see my surgeon on Thursday for a follow up so I guess if any time is right for it to happen this is the right one. I have an acceptence issue as its taking all over my life. I handed in my MSc dissertation on Friday, a moment I have been longing for and I couldnt even be happy becuase I had hardly any sleep due to pain and was doped up on codeine. I just feel trapped. its really hard to explain and I feel so far away from anyone and everyone. I will add you on fb and thanks so so much for your encouraging words. I really sincerely appreciate it and sorry to sound as though I am moaning. The thought of having to put up with this for the rest of my life isnt a good feeling at the moment I just feel so rubbish at the moment when I should be happy. Thank you both again, really appreciated, Abi

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  110. Hi Delphine,
    Apologies, I appear to have missed your questions, and I was just reviewing the blog.
    My hip blocks wore off after about 4 weeks, and now I am back at square one pain wise. Apart from the facti am having surgery next Thursday 20th sept, with Mr .jairaj in Caterham in Surrey. I am ready now, albeit it getting a bit nervous. Worried more about the rehab, than the surgery. How did your hip locks go?
    Claire

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  111. Claire just to say good luck with your surgery, don't expect to feel great overnight and I believe if you're surry based that he has an excellent physio there, so book her prior to surgery and she'll guide you. Good luck!

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    1. Hi Louisa,
      Just to say surgery went well, Mr Jairaj was really pleased. Had large cam removal and very significant synovitis, but no major cartilage damage, so early intervention and he expects an uncomplicated recovery. I am now just over a week post op and physio goes well . Seem to have quite a lot of numbness in outer thigh, but Facebook group seem to support that this is common. All in all feling positive and taking it day by day. Thanks fr your kind wishes and advice, will keep you informed of my progress. Claire

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  112. Hi Louise

    Thank you so much for such an informative blog.

    My problems started when I took a new job in May 2011. They gave me a desk for little people and a chair fit for a giant. As a result of this, I spent 40 hours a week with my knees far closer to my chin than I would like, and with my body leaning forward to reach my keyboard. Despite my complaints and request for a new seating configuration, nothing was done for seven months due to it being "too much hassle." For the last two months of my contract, I had the luxury of a raised desk and smaller chair. I felt better but nothing really went away.

    Some of the symptoms I’ve experienced are –

    Front of thigh pain when lifting my legs whether I’m shaving them. Also hurts when putting on socks or trousers and getting into the car, or when I take longish strides.
    Groin pain, mostly after I’ve removed said socks or trousers to partake in more fun activities of a naked nature with my boyfriend. I have no children, nor do I no longer have any desire to even practise at making any. It is also very uncomfortable to drive for more than 20 mins.
    Outer hip pain when sitting or walking for too long. It’s even worse on, say, a picnic bench or wooden chair.
    Catching pain every now and again that means my right stride is double the length of my left.

    I stopped running, and even working, for three months but to no avail. I'm now starting again as well as doing strength training, glutes and core work.

    I was diagnosed with bursitis then a hernia, followed by labral tear. I went straight from physio to an MRI with no x-rays. I wonder what goes on inside my body when I flex my hip. The MRI/A showed no sign of tendon or muscle damage, osteoarthritis or anything of concern other than the tears.

    I was treated with steroid shots which brought me around four weeks' relief on one side and, to date, twelve weeks' relief on the other. At my post procedure review the head surgeon said that there isn't enough to operate on and that my tears are within normal limits. I don’t know if he is being truthful or withholding treatment to save the NHS some money. I am now back to square one, albeit with more discomfort.

    Given that I've had an MRI/A, do you suppose I could present the image findings to another professional for a second opinion? My GP said that he was so sure the labral tears were to blame for my symptoms. I thought that a positive result from the injections meant that they had found the right diagnosis. What would you do in my situation?

    My next step is rheumatology and finally pain clinic. I'm 39 and don't want to be a childless, sexless spinster who can’t even sit in Costa for long enough to enjoy coffee and cake.

    You've inspired me to be less shy about standing up for my right to live a full and healthy lifestyle. I will do whatever this takes.

    Thanks for your time.

    Lisa
    Dorset

    PS – Sorry for the lengthy message. As you can imagine, I fear I have used up my friends’ patience!

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  113. I think you need to see an expert in FAI? Labral tears cause pain, your symptoms are consistant with FAI symptoms. But noone appears to have mentioned FAI or the cause of the labral tears (good chance FAI is tearing your labrum) there are other things that can cause labral tears also such as hip dysplasia and hypermobility, are you aware of having either of these conditions?
    I am assuming you do not have private medical care, so you need to be referred to an FAI expert who serves the NHS also and yes they can use your MRI-A, though will most likely they will also want to take a series of xrays, as xray is a great tool for showing FAI.
    Your biggest issue is finding an FAI expert in Dorset as there are literally only a handful of good ones in the UK, literally. I know of a chap called Matt Wilson, who comes highly recommended (Villars trained), but he is in Exeter hip clinic and I'm not sure if that is close enough for you? Why don't you come and join the group on facebook, Hip Pain awareness (FAI, PAO,THR) and you can chat amongst people like yourself and gain some support, but from what you say I feel certain that some hip pathology is causing your very recognisable symptoms and that most likely it is FAI...
    FAI is very common, but currently in the UK not well known and it is a bit of a fight to get your life back... but there are steps, procedures to follow and it is doable, MOST key is finding a good FAI surgeon. Come join us and have a chat! http://www.facebook.com/login.php?next=https%3A%2F%2Fwww.facebook.com%2Fgroups%2F119530398085022%2F (you may have to cut and paste as bog sites can be a little primitive)

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  114. Hi Louisa

    Thanks very much for your detailed reply. You are right in that nobody has mentioned FAI, at least nobody other than myself after reading your blog! The last thing I wanted was labral tear treatment only for the damage to recur. I was told I didn't need an x-ray as I'd already had the MRI-A and my femur is nicely rounded. I know that the rehabilitation must be immense but I felt as though I was half way there with the diagnosis, and I can't even begin to describe how I felt when it was taken away from me.

    My injury (al)most definitely started at work and, as a goodwill gesture, it may be that I could get a non NHS examination courtesy of an expert if I can track one down. If that's not possible then I will travel to Exeter for a definitive opinion.

    I don't know that I definitely have hypermobility but I do have legs with knees that lock out far further back than they should. I affectionately refer to them as my banana legs. Also, I can bend in half and touch my hands to the floor, and physiotherapists always tell me I'm incredibly flexible.

    Anyway, thank you again for your time. I have joined your facebook page and will have a good browse before joining in. I can't tell you how reassuring it is to have a new found support network, albeit at the expense of a lot of others' hips.

    Kind regards

    Lisa

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  115. You're welcome Lisa, glad to help... for anyone else looking for support please feel free to come to https://www.facebook.com/groups/FAIhip/ and if you're looking for an FAI specialist surgeon in your area, no matter where in the world you are, please come to Best FAI Hip Surgeons for personal recommendations, it beats fancy websites! https://www.facebook.com/groups/BestHipSurgeonsReviews/

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  116. I Have been to see mr Madan and Doncaster Royal Infirmary this morning and he has said there is a nodule of bone on and he will do the surgery to reshape it and tidy it up. So 75% chance of being pain free afterwards, Hell yes I will take those odds.

    You will all know how hard it has been to get this condition recognised, I have spent 24 years visiting surgeons, doctors, physios trying to get to the bottom of it. Over the last few years I have been told the the round mass was a fault on the xray and didnt actualyl exist, was inside the bone so wasn't a problem.

    I actually felt like such a weight had been lifted off my shoulders when I walked out the hospital this morning so a big thank you to Mr Madan, and everyone out there keeping pushing you will get there.

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  117. That is fantastic, this is a very complex surgery though with many "try their hands with a scope" surgeons out there. Just make sure you find out if he's doing an open or a hip arthroscopy, if he's doing a hip arthroscopy be SURE to ask how long he has been specialising in hip arthroscopies because if its less than a few years you could find yourself in the 15% fail rate... getting a diagnosis is 1/3 of the way, a very experienced surgeon to do your scope is another 3rd and good rehab the last 3rd. That aside, congratulations!!

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  118. Hello Louisa

    thanks so much for all the info here and on FB - and to others for your stories. They reassure me and make me worried at the same time as I can see how variable the interventions can be in terms of outcome.

    My first hip arthroscopy is scheduled for 2 weeks time and despite trying hard to get some info on risks / success rates, I just cannot get through to the surgeon (Mark Rickman, St George's, London). From the 10 minutes I have spent with him many months back, he seemed very knowledgeable, up to date (as far as I could ascertain with my v limited understanding of the subject) and approachable but I thought of all my questions to ask him afterwards!

    My main concern is, after reading some of the stories of how the surgery has left people worse off, I am struggling with weighing up the fact that I can live with the condition (had it for nearly 3 years) which fluctuates between pain at a certain point of rotation, with achiness / stiffness and my desire to know what is causing it and getting it sorted - versus fear that what if it makes it worse??

    I can see from what I have read here that the after effects can be very much caused by the surgeons skill / approach but how on earth do I go about finding this out about my surgeon and what are the best questions to ask to help me with this if I can actually get to speak to him before the day of the surgery?

    Do you know of him at all Louisa?

    Any thoughts gratefully received.

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  119. I have had lower back and si pain for almost two years last December my right hip began to hurt and i developed trochanter bursitis. After a few months of injections, therapy, and lots of Dr visits i diagnosed with FAI cam and pincer with labral tear. I had arthoscopic surgery with and found out after wards that the labrum had become partially detached and had a tear in another location. I was non weight bearing for 12 weeks. Initially, therapy went well but once i was off the crutches i started to experience more intense pain from my hip. After a second MRI it was discovered the labrum had not fully healed so a second surgery was required. When i woke up I found out that a second impingement had been discovered both cam and pincer in the vicinity of the labrum tear but not near the original impingement site from the previous surgery, so back to square one. I am off crutches again but still have pain but not as severely as before. I am wondering how this will effect my long term recovery and if anyone else has experienced this as well? I also have the same problem bilaterally and will require surgery on the other hip which is also symptomatic. Am I lucky or what?

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  120. I suppose that happened to me. I had surgery in 2009 to remove pincer, nerver fully recovered then had surgery 2+ yrs later and was found to have a missed cam and scar tissue, it made my recovery tougher and longer as had surgeon no.1 sorted it all out in the first place all would be gone and possibly 100%. Then 4 months ago surgery on other hip, whole different story, this time great surgeon and much better recovery. I guess I'm saying it makes recovery harder but not impossible, recovery from hip arthroscopy is rough anyhow. And this is all probably why I am so pro' find a good "FAI hip Arthroscopy specialist"' I can save you time at the other end of the surgery. You should be OK, your advantage is that it was spotted so quickly and dealt with, wheareas my original surgeon insisted he couldn't have made a mistake and refused to consider any residual impingement so I lost 2 more years. Make sure you rehad and watch out for inflammation as you hips been through a lot.

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  121. how long does the recovery typically take? is some long term/permanent pain normal or possible after the surgery especially after two on the same hip?

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  122. hi I have read the fai impingement awareness. and am wondering if you could tell the name of the facebook page. i have bi laterl cam impingement am 9 month pot op on my left leg. but my right is getting sore with certain things

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  123. Hi all,
    Just to warn you that I have just been in hospital for a week with pneumonia and I will be taking time out to recover, so not as omnipresent on this site. But if you would like help please look me up on facebook and I will attach you to FAI groups Or go to this site for support: https://www.facebook.com/groups/FAIhip/ and this group for surgeon recommendations: https://www.facebook.com/groups/BestHipSurgeonsReviews/

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  124. Well had my appointment with Mr Madan and he says thed boney lump on the ball joint is causing all the problems and he can do the surgery.

    I came out feeling a bit shell shocked, after 24 years of constant hip and back pain and being told there was nothing wrong, the bump on the xray was a fault on the xray and not really there, the lump is inside the joint so its not a problem right through to you might have cancer thats metastasized to the bones.

    I can't tell you how relieved I am, I am sure you will all know.

    Sound like surgery will be sometime in December.

    How are you all getting on, was the surgery worth it?

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  125. Hi All - I'm 1 week post-op YES! Looking fwd to walking soon and getting on with life :)
    I had left hip arthroscopic cheilectomy, arthroscopic acetabuloplasty, labrel repair, and a few other things. Things are going great. Very minimal pain and since there was no micro fracture I should be off crutches and out of this brace within 2 weeks.
    Here's my hip blog - I just started it to document my condition, surgery and rehab.
    Good Luck everyone!
    Scott
    http://fai-hip-surgery.blogspot.com/

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  126. Dear Scott Please join us here, I am struggling to answer individual Q's here as I'm recovering from pneumonia after drinking some dodgy water in Spain! Please link to our forum here: https://www.facebook.com/groups/FAIhip/

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  127. Hi Louisa
    I have just been told I have antero-superior chondrolabral junction tear and femoro-acetabular impingement. The MRI also showed trochanteric bursitis. The surgeon I went to see for the MRI referral actually ensured me I had no hip injury as my symptoms were not in line. How wrong he was.
    I am not keen to use him as my surgeon and was wondering if you could name a good surgeon in Sydney? I am willing to travel for surgery for the best of course, but Sydney would be preferable as this is where I live.
    I also am concerned by the fact I suffer numbness in my entire leg and foot as well as shooting nerve pain right down the leg from time to time, which I cannot seem to find anywhere as a symptoms of this!
    Could you shed some light? (I know you are not a doctor - but have you heard of this?)
    Thanks!

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    1. yes its not uncommon, though not a given, it seems to happen when the muscles supporting the hips tighten (as once you have a labral tear and/or some bone deformities these things cause instability) from my own and others experiece it is often specifically the piriformis muscle as the sciatic nerve runs right past the muscle and in 10% of cases the sciatic nerve runs through the piriformis. It is called piriformis syndrome but it is directly as a consequence of FAI. It is the reason many patients are misdiagnosed with back issues, as a slipped or troublesome disc produces very similar symptoms although the nerve impingement (sciatic ) is of a different origin. Best wishes, louisa.
      Come join us here to talk more https://www.facebook.com/groups/FAIhip/
      and for surgeon recommendations as there will be personal recommendations: https://www.facebook.com/groups/BestHipSurgeonsReviews/

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  129. I remember having lower back pain as a pre-teen but never thought nothing of it. At age 27 I began having a really intense pain in my lower back and groin. Truthfully I thought something was up with my testicles. I had many ultrasounds on that area but my hip was never thought to be the culprit. I had an x-ray done which led to having an MRI done and it was found that I had FAI in my left hip. In November of 2011 I had scope surgery to fix it. The surgeon said that I had some labral fraying as well and that was fixed as well. I did the physiotherapy but still to this day my hip hurts like it did before the surgery. Sometimes it feels worse. Maybe I had too high of hopes for the surgery, but it is disappointing. At age 32 I cannot play hockey anymore, cannot run, or even walk for a significant amount of time because if I do I get a burning sharp pain in my hip/groin area.

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  130. Ok there are 4 things most likely to cause this:
    1. Who was your surgeon, is he one on the "VERY FEW" FAI experts in the/your country? Anyone less can miss important issues, this is a very difficult op technically.
    2. Do you know the status of your cartilage from when the surgeon went in, as grade 2 and above can scupper your chances of a full recovery?
    3. Is there any chance you also have hip dysplasia (sometimes co-exists) and is sometimes missed?
    4. Could you be hyper mobile?

    I would order another MRI and ask your surgeon why? THEN seek a second opinion from a TOP FAI surgeon. You can find one on:
    https://www.facebook.com/groups/BestHipSurgeonsReviews/ on facebook.

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  131. The Surgeon I had was touted as one of the best surgeons in Ontario Canada for this type of thing. The last time I saw him for my one year check up he told me that I had some cartilage deterioration but did not say if it was present before the surgery. I told him that I thought I was going to feel "fixed" after the surgery and he basically said that I had had too high of hope most likely. He told me to start taking Glucosamine and Chondroitin for the cartilage and that he wasn't going to investigate any further. It has been really hurting a lot lately which is frustrating and am considering going to my family doctor to get a new MRI done.

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  132. The cartilage could be key, I wonder if you have the facility for cartilage quality mapping, its just arrived i the UK and Australia. Though he should also be able to tell you what grade he saw then, though this may have got worse since. I think recent research proved those supplements to not really be effective also.

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