19 with FAI

Training Injuries
41

I just had this surgery last Wednesday in Nashville. What they thought was a bone growth on my femur turned out to be a huge calcium build up that was rubbing against my labrum. They were able to shave that down and reatach the labrum as well as clean up the joint. They gave me a disc of the surgery, it is pretty crazy. There was a little arthritis in there but they didn’t have to do a micro fracture so I was happy about that.

So far the recovery is ok. Painful but not as bad as I thought it would be. If you have the option I STRONGLY suggest getting the Game Ready ice machine. I have only had to take the pain medicine once a day while using it. Good luck.

42

I had the surgery on May 3rd, so 2 days ago. It took 3.5 hours to do because there was more cartilage damage then he anticipated. The bone was shaved down, part of the labrum was reattached and some was removed. I am on crutches with no weight bearing on my leg, I go back for a post op appointment on May 15th (12 days post op). They emphasized repeatedly that I should stay on top of my pain meds and that I could use 2 pills every 4 hours if I needed, but honestly the pain isn’t noticable if I just stay in bed with just 1 pill. It is sore/stiff when I get up on my crutches to move, but it is not bad at all. Way less pain then I anticipated, especially after all the warnings from the doctor/nurses.

Obviously too early to tell how successful the surgery is, but right now I am happy I did it. I’ll post again after my post op appointment to log where I am at and what the recovery plan is.

I encourage anyone who has this surgery to make sure someone is around for a few days to help you. I could probably do most things myself, but it is really nice to have food made for me and help in and out of bed the first day.

43

fisch I was diagnosed with this on Monday, Saw a specialist on Friday. The specialist has done over 600 FAI surgeries and 1000’s of other hip surgeries. He has 23 years of experience, and I was referred to him by the doctor that did my shoulder surgery. Both of the doctor’s have had this surgery themselves.

I don’t have arthritis in the joint, and I don’t think I have a labral tear. The hip specialist was getting pretty aggressive with the testing and I had no pain, so that’s a pretty good sign. No MRI, but he wants a CT scan done.

My left hip is the one giving me issues, I also have it in my right hip, but with no symptoms at all. I’ll be following this thread, keep us posted, and best of luck with your recovery.

44

I said I would post an update after my post op appointment so here goes. I had the appointment on May 15th, 12 days post op. Stitches were taken out and I was told I can start weening off my crutches over the next 1-2 weeks. Right now I walk with one crutch, and the only issue I have is the stiffness in my hip but that should go away within a couple weeks. Could probably walk crutch free but I don’t like how stiff it feels afterward. I start light physical therapy on the 29th, which is basically stretching and some light strength work. No running or anything high impact. I go back in on June 19th to see the doc again and see what restrictions are lifted.

My rehab will likely be slightly complicated because I have opposite foot issues/inflammation and have had it for 9 weeks now. I go back to see the foot doc tomorrow and see if he has any new ideas. Hoping to get it fixed before the June 19th appointment so I can start jogging if I get the clearance.

ucallthatbass - I responded to you in the other thread, though I will add it seems like you have a great doctor. I don’t know how many FAI surgeries my guy had done but I know it was not 600+, though I still trust him alot. Let me know if your doc recommends both hip surgeries or just the one giving you issue. My doc has told me repeatedly that unless the other starts causing pain it is not recommended to be operated on, but I would love to hear another docs insight.

I wish I could change the title of the thread because while I “technically” have arthritis it is only because of the FAI caused cartilage damage. It is not typical arthritis and I do not have any idea how much lasting issues will be because the cartilage damage. Im guessing my hip will likely be stiff/sore for much of my life after hard physical activities.

45

[quote]fisch wrote:
I said I would post an update after my post op appointment so here goes. I had the appointment on May 15th, 12 days post op. Stitches were taken out and I was told I can start weening off my crutches over the next 1-2 weeks. Right now I walk with one crutch, and the only issue I have is the stiffness in my hip but that should go away within a couple weeks. Could probably walk crutch free but I don’t like how stiff it feels afterward. I start light physical therapy on the 29th, which is basically stretching and some light strength work. No running or anything high impact. I go back in on June 19th to see the doc again and see what restrictions are lifted.

My rehab will likely be slightly complicated because I have opposite foot issues/inflammation and have had it for 9 weeks now. I go back to see the foot doc tomorrow and see if he has any new ideas. Hoping to get it fixed before the June 19th appointment so I can start jogging if I get the clearance.

ucallthatbass - I responded to you in the other thread, though I will add it seems like you have a great doctor. I don’t know how many FAI surgeries my guy had done but I know it was not 600+, though I still trust him alot. Let me know if your doc recommends both hip surgeries or just the one giving you issue. My doc has told me repeatedly that unless the other starts causing pain it is not recommended to be operated on, but I would love to hear another docs insight.

I wish I could change the title of the thread because while I “technically” have arthritis it is only because of the FAI caused cartilage damage. It is not typical arthritis and I do not have any idea how much lasting issues will be because the cartilage damage. Im guessing my hip will likely be stiff/sore for much of my life after hard physical activities.[/quote]

My Doc said the same about operating on both hips. He basically said the following:
“Unless you have symptoms, don’t bother. You know what if feels like, and know the early signs. If you have any abnormal pain or stiffness for an extended period of time, or clicking and popping come back in.”

The only plus with this condition is that most of the damage occurs to the labrum. Though it sucks that it gets damaged, the labrum has a rich blood supple and can be repaired and heal. I’m not sure if a removed portion of the labrum will ever heal 100%, I know that some tears can heal on their own. If this condition is left to run its course then you can damage to the articular cartilage which has no blood supple.

46

[quote]ucallthatbass wrote:

[quote]fisch wrote:
I said I would post an update after my post op appointment so here goes. I had the appointment on May 15th, 12 days post op. Stitches were taken out and I was told I can start weening off my crutches over the next 1-2 weeks. Right now I walk with one crutch, and the only issue I have is the stiffness in my hip but that should go away within a couple weeks. Could probably walk crutch free but I don’t like how stiff it feels afterward. I start light physical therapy on the 29th, which is basically stretching and some light strength work. No running or anything high impact. I go back in on June 19th to see the doc again and see what restrictions are lifted.

My rehab will likely be slightly complicated because I have opposite foot issues/inflammation and have had it for 9 weeks now. I go back to see the foot doc tomorrow and see if he has any new ideas. Hoping to get it fixed before the June 19th appointment so I can start jogging if I get the clearance.

ucallthatbass - I responded to you in the other thread, though I will add it seems like you have a great doctor. I don’t know how many FAI surgeries my guy had done but I know it was not 600+, though I still trust him alot. Let me know if your doc recommends both hip surgeries or just the one giving you issue. My doc has told me repeatedly that unless the other starts causing pain it is not recommended to be operated on, but I would love to hear another docs insight.

I wish I could change the title of the thread because while I “technically” have arthritis it is only because of the FAI caused cartilage damage. It is not typical arthritis and I do not have any idea how much lasting issues will be because the cartilage damage. Im guessing my hip will likely be stiff/sore for much of my life after hard physical activities.[/quote]

My Doc said the same about operating on both hips. He basically said the following:
“Unless you have symptoms, don’t bother. You know what if feels like, and know the early signs. If you have any abnormal pain or stiffness for an extended period of time, or clicking and popping come back in.”

The only plus with this condition is that most of the damage occurs to the labrum. Though it sucks that it gets damaged, the labrum has a rich blood supple and can be repaired and heal. I’m not sure if a removed portion of the labrum will ever heal 100%, I know that some tears can heal on their own. If this condition is left to run its course then you can damage to the articular cartilage which has no blood supple. [/quote]

Cool, thanks for the feedback. Keep me posted on what route you decide to take and how it goes, especially how your surgery and post op is if you do go that way. From what I understand from my doc it takes 4+ months until “athletic moves” such as cutting while running are allowed, though from reading online people don’t feel normal every day again until at least 6+ months.

47

At the moment I don’t know which route to go. It’s not debilitating, I can run, jump, twist, squat and leg press. I just get aches afterwards. I work a desk job and the sitting is what’s killing me. I can literally feel the pressure on my hip from sitting. I get tight, stiff, and sore until I move around.

Everyone yells “Your hip flexors are tight. Your quads are tight” But there aren’t. Mt physical therapist ran me through the paces and said I wasn’t tight. I can do the kneeling hip flexor stretch, squeezing my glute hard, and still have the heel of that foot touching my ass. If I do cossack squats I can go ass to ankle on the right leg, but once I hit parallel on the left I impinge.

I don’t have much pain, but I know something is definitely wrong. I have a cyst in the joint which the doctor says is caused by the constant irritation and friction. Its more of a constant stiffness, minor clicking, and a dull ache after sitting for long periods. Family members I talk to are 50/50 on doing surgery and thinking I’m crazy. I’m almost 30, my wife thinks I’m nuts for wanting to go under the knife. My train of thought is to minimize joint damage now, and avoid a hip replacement later.

I’ve had more orthopedic issues than anyone I know. Broken hands, feet, shoulders, knees, and hips.

48

[quote]fisch wrote:

Cool, thanks for the feedback. Keep me posted on what route you decide to take and how it goes, especially how your surgery and post op is if you do go that way. From what I understand from my doc it takes 4+ months until “athletic moves” such as cutting while running are allowed, though from reading online people don’t feel normal every day again until at least 6+ months.[/quote]

I had a rough shoulder surgery. It consisted of an anterior capsular shift, rotator interval closure, and a bankart repair. I was in a sling for 7 weeks. My range of motions was reduced about 90%. I couldn’t reach my arm high enough to touch my chin, or rotate my arm further than 6 inches from my belly button. PT was a brutal 2 months, of stretching the shoulder capsule back out to normal. No weights over 5 pounds until month 3. Back in the gym deadlifting 225 by month 6, but I still couldn’t bench and empty bar.

It took about a year before I could do a still painful pushup, much of which was mental. PT is as much a mental game after something like this as it is physical. You need to get over the hurdle of thinking you are going to re-injure yourself. The most important thing is to get range of motion back. Honestly don’t worry about strengthening until you can move without pain, discomfort is fine, pain is not.

If you try to strengthen while still in pain you will just enforce incorrect motor patterns.

49

hows recovery going? i am 12 days out of having my second hip done, with the first one 8years post-op. very happy with the results, but im not sure heavy squatting is in my future. we’ll see… flexibility will eventually be much greater, and the pain will be gone, but they haven’t been doing these long enough to know long term implications. as in, some early arthritis might happen… i’m personally going to avoid limits in rom while loaded and do sled stuff more unless someone clears it.

50

Recovery was going great, but literally the first day I was allowed to do upper body work (June 2nd) I had an incident. It was the end of my workout, decided to do some incline BB bench, only some light weight work nowhere near failure. Well since I haven’t lifted in forever was doing a couple reps with 95 lbs when all of the sudden my muscles died.

Like I did a rep, normal speed no issue no sign of weakness, then the next rep couldn’t get it off my chest. No warning at all my muscles were tiring. No spotter because my friend couldn’t make it that day, and the weight wasn’t anything that should’ve gave me problems especially since I planned on avoiding failure.

Had to push the weigh down to my hips, then I stood up with the 95 lbs in my hands/against my hip. Didn’t feel a pop or anything, but walking hurt a little and after the car ride home it hurt to move my leg out of the car. I have no idea if I damaged the cartilage by basically doing a 95 lb squat, or if its just a bunch of inflammation because I did something waaaay different then what my hip is used to. This is 5 days later though, and the uncomfortable feeling and slight pain when I lift my leg is still there.

If anyone knows the likelyhood I damaged my hip structurely I’d appreciate some insight. I’ve been very freaked out and anxious ever since Saturday, my hip doesn’t hurt when im sitting but it just feels uncomfortable. I have pain in the joint if I pick up my leg with my leg muscles, but not if someone lifts my leg with my muscles relaxed.

The PT said it’s possible to damage my hip by doing a twisting movement with weight but this wasn’t a twist, just a squat basically. Called my doc a few minutes ago and left a message with the nurse, hopefully she’ll call back soon and I can get some assurance.

I am very freaked out, if I damaged the cartilage again I really don’t know what I’ll do. There is no way to convey how nervous I am, I actually took a painkiller leftover from my surgery just to try and relax myself and get the uncomfortable feeling to go away, didn’t work.

51

Nurse called back, basically told me what the PT told me. Said that I did something very different from what my body’s used to and that the pain lasting past the night of the incident is letting me know I went too far, which wasn’t news to me. Told me to take anti-inflammatory’s consistently throughout the day and ice it a lot, maybe use my crutches again for a few days. Basically do everything I can to relive my leg of work. She’ll talk to the doctor once he’s done with surgery today and call me back tomorrow with any news of what he says. I have another post-op follow up appointment on June 19th, so I should be back to “post-op normal” by then if nothing is structurally damaged.

The only reasons im so freaked out is I have that uncomfortable feeling back in the joint, an the pain when I move my leg isn’t in my hip flexor anymore it feels like it’s in my joint itself. Before saturday I didn’t have that uncomfortable feeling and I had pain when i used my muscles to move my leg but it was mainly in my hip flexor, not the joint. Im not very familiar with inflammation pain and what it feels like. If anyone can describe it at all I would appreciate it, to see if my symptoms are similar.

Still nervous but for some reason a little calmer. I think just talking to a doctor/nurse and having a plan of action is reassuring, even though it’s very “hands-off” and I personally HATE waiting.

Im still interested in anyone else’s progress, results, or issues they have.

nschneid when you say you aren’t sure if squatting is in your future, is that because of what your doctor said or just how your hips feel when doing a squat or some other reason? Im obviously way away from being cleared to do a squat (reinforced by this stupid incident) but pre-op my doctor said I should be able to perform them again at some point.

52

sorry for triple post, but realized I didn’t post about my actual recovery before this incident.

Started PT on May 29th, the PT watched me walk, evaluated ROM on both legs, and said he thought the right hip issue (one that had surgery) was caused by my muscle imbalances, tightness, and weakness in my left leg. PT consists of moving my right hip and trying to improve ROM, plus doing a lot of exercises to teach my body how to activate my hamstrings properly, especially my left one. And strengthening the inside of my left leg and teaching my body to use that muscle. Seriously, the first exercise to activate my inner left leg was the hardest thing I’ve ever done. After 2 sets of 15 second holds my inner left leg was cramping and just dead. I couldn’t even do the last set for more then 5 seconds. The day after PT my left hip and inner leg was stiff and sore, kind of surprised me.

PT generally takes an hour to do, I go 2x a week because I only get 20 visits a year for insurance and the PT wants to see me for as long as he can and help be there when i start transitioning into normal exercise again. I have home exercises and movements I do 2x a day, basically ROM and activation though I was given one exercise yesterday that is meant to strengthen my right hamstring.

I was supposed to be able to start walking through belly button high water tomorrow (June 7th) but after the bench incident im going to hold off on that for another week or so. PT wasn’t very happy when I told him about the lifting incident.

Again sorry for the 3 posts in an hour, but hey it’s my thread right? :slight_smile: plus the first 2 were me scared out of my mind and this one is the normal log of what recovery is like and what im doing. Much more helpful for anyone else with this condition who is curious about the recovery.

As always, feel free to ask questions about anything.

53

[quote]fisch wrote:

nschneid when you say you aren’t sure if squatting is in your future, is that because of what your doctor said or just how your hips feel when doing a squat or some other reason? Im obviously way away from being cleared to do a squat (reinforced by this stupid incident) but pre-op my doctor said I should be able to perform them again at some point. [/quote]

Well the reason I needed the labral repair/bone shave was in large part because i have bi-lateral retroversion in my hips. This, combined with thick femur necks, caused a cam impingement on some soft tissues (particularly the labrums but also apparently a ligament) in the hip.

See the retroversion makes the femurs actually sit differently in the socket. There’s an angle that’s considered normal, and back and forth from that is considered anteverted or retroverted. Until I know the mechanics behind it, I don’t want to push my hips to full ROM, because while i full ROM squats for most people are a purely flexibility issue, for others you’re actually impinging the joint to go full ROM. My doc told me that my flexibility in some directions is bad not because I’m inflexible, but because I’m hitting bone on bone and there’s no more flexibility to be had in those directions.

This isn’t to say that you can’t get awesome leg workouts using other lifts, but when you hear people say that some people weren’t meant to do certain lifts, this is what they mean. Not everyone’s skeleton is the same, and even the way the bones fit together can be different. Apparently I am not meant to do ATG squats. It’s a challenge to work around, but its not really a game changer unless you let it be.

54

[quote]nschneid wrote:

[quote]fisch wrote:

nschneid when you say you aren’t sure if squatting is in your future, is that because of what your doctor said or just how your hips feel when doing a squat or some other reason? Im obviously way away from being cleared to do a squat (reinforced by this stupid incident) but pre-op my doctor said I should be able to perform them again at some point. [/quote]

Well the reason I needed the labral repair/bone shave was in large part because i have bi-lateral retroversion in my hips. This, combined with thick femur necks, caused a cam impingement on some soft tissues (particularly the labrums but also apparently a ligament) in the hip.

See the retroversion makes the femurs actually sit differently in the socket. There’s an angle that’s considered normal, and back and forth from that is considered anteverted or retroverted. Until I know the mechanics behind it, I don’t want to push my hips to full ROM, because while i full ROM squats for most people are a purely flexibility issue, for others you’re actually impinging the joint to go full ROM. My doc told me that my flexibility in some directions is bad not because I’m inflexible, but because I’m hitting bone on bone and there’s no more flexibility to be had in those directions.

This isn’t to say that you can’t get awesome leg workouts using other lifts, but when you hear people say that some people weren’t meant to do certain lifts, this is what they mean. Not everyone’s skeleton is the same, and even the way the bones fit together can be different. Apparently I am not meant to do ATG squats. It’s a challenge to work around, but its not really a game changer unless you let it be.[/quote]

Oh okay. I knew that some people had bone on bone when doing a squat (I had that before the surgery), but I figured the FAI was the only limiting factor and surgery to correct that would make it so squats would be an option. I wasn’t aware there was another hip bone condition that could effect others like this.

The flexibility thing I know about. I can’t internally rotate my legs, especially the left one. But that is due to the FAI. At least thats what my doctor said.

55

Had a doc visit yesterday (June 19th). Pretty pointless, it was a 5 minute appointment with his assistant and all he did was ask how it feels, then examine the range of motion briefly, then told me to come back in 2 months (August 14th). My physical therapist wrote up a note for the doc stating my ROM and strength levels as of now:

IR: 30 degrees
Flexion ROM: 90 degrees (only if pt lifts leg, if I use leg muscles to it’s less due to pain/discomfort)
External: 0-5 degrees
Abduction: 35 degrees

Weakness of glutes/adductors/abductors.

Therapist notes: ROM great, strength increasing, pain levels diminishing, small slip up of lifting weights 2 weeks ago (my little freak out incident) but now knows not too

That’s it. Doctor thinks I’ll hopefully start transitioning back to athletic stuff another 3-4 months from now. The PT doesn’t really want me running for a while, but I can start water walking and biking for 10-15 minutes each day. Hip is sore or hurts pretty often right now, never bad but it’s noticeable. Mostly from the new exercises im given from PT.

On a side note, ART is the shit. It fixed my entrapped nerve from my wrist surgery (which my surgeon said was impossible). Im also having the ART guy work on my right shoulder (same side as wrist surgery) because I’ve had some weird impingement/snapping in it due to the full arm cast from the wrist surgery and lack of PT. If anyone’s doc ever says “PT is a bad idea” tell him to go screw himself. Great surgeon, but my god he’s horrible for post op recovery. 1 year later and im just now getting everything sorted out.

56

Had my 3 month post op visit with my surgeon. Looked at my hip fro 5 minutes then I asked some questions. Im able to start jogging for brief periods now (though my left foot is still jacked up so I can’t yet, got a cortizone shot in it 4 hours ago so maybe that’ll fix it). He said once im able to jog for 40 minutes straight (I won’t ever get to that point honestly, but it’s a good reference) I can start sprinting. I can do all lifts weighted except squat, lunges, and deadlift. Those are about 2+ months away. So is playing basketball.

Otherwise, my hip doesn’t bother me much during my regular non-gym activities. I pushed it and did 40 mins straight cardio (bike and elliptical) and my hip hurt afterwards and the next day. Still too early to tell if the surgery fixed me, I won’t know that for another 6+ months once im healthy enough to resume normal lifting and get some strength back.

Doc said the main cartilage healing process takes over 6 months, after that it still heals a little. He warned me that there’s a good chance at some ends of ROM i’ll still have stiffness and pain even after full recovery since the cartilage is damaged and partly removed.

Still a long recovery to normal, though if it wasn’t for my foot and shoulder I would be pretty happy with my health. As always ask questions if you have any, otherwise I’ll post another update around November 11th when I go back in for my 6 month check up. With luck I’ll have started light squatting and I’ll be jogging like a marathon runner

57

Fisch how is the rehab going? I just had my fai surgery on 10/1

58

rehab seems good, i finished at the PT in August (not by choice, but because insurance only covers 20 visits) but by that point (3 months post op) I was basically good for everyday activity anyway and was still working on getting comfortable running/lifting. I can do elliptical 35 mins no problem, I jogged 20 mins on the treadmill and felt discomfort afterwards but nothing big. Doc still wants me to work up to 40 mins of running at a time, way more then I’ve ever done at any point in my life.

I’ve mostly stopped PT exercises at this point outside of bodyweight lunges/squats, the band holds and walks are useful but at this point it seems more like a waste of time. I do use the abductor/adductor machines on leg days right now, and a lot of my original PT work was on strengthening those muscles

Doesn’t hurt during the day, if I sit up with good posture and try to push my knees in I still get tightness/discomfort, or if I try to internally rotate my leg when my knee is bent.

I actually was involved in a bicycle/car accident last week and have some injuries there, so I can’t keep my running up (elliptical seems fine though). I am leg pressing, leg extensions, leg curls without much issue though I am careful not to go too far ROM where the hit starts bothering me.

Squats and lunges (at least weighted) are still on hold for another 1-2 months. I can do bodyweight though, and im encouraged to actually by my PT.

Foot still messed up, another MRI done I get the results on Tuesday. Doesn’t prevent me from running though.

Right now again im not able to say it was a great success or not, im pretty much at the point I was prior to surgery but obviously the goal of the surgery wasn’t just to get me back to the same condition, it was to improve me.

For most of the day I don’t think about it, so that’s a good sign. It’s a longer process, but after the first few months it seems to improve a lot. That first month isn’t going to be a lot of fun mentally, but it seems to get exponentially better after the 2 month mark

59

Good to hear. I’m almost a week out now and am amazed at how little pain I have. They shaved my femor, hip socket, and did a labral repair. Crutches for six weeks but I can already do all the at home pt exercise for all sets and reps three times a day. I over did the walking yesterday, I bought a house so I was up and down stairs and in and out of the car a couple times. Overdid it and I’m sore today. Only needed the perks for 3 days.

When I did my shoulder 5 Years ago I was on perks for a week then advil for another three. Once pt started I was taking like 30 advil and 3 perks a day for 2 more months it was horrible. I’d do my hip 10 more times before I ever do a shoulder again

60

Yeah I was the same, 3 days of pain meds then done. I was told to start weening off crutches after 2 weeks, and I was completely off after about 3.5 weeks though there were a couple days I jumped back on them cause I was hurting. You’re given at home pt exercises already, I wasn’t given that til 4 weeks out but im sure starting earlier will be good for you.

You’re going to have a lot of days you feel sore. I still feel sore/hurt after doing a leg day or going for a run, and im 5 months out. Doc said it’ll be like that for up to a year.

It’s unbelievable how up and down the recovery was/is. There were days it hurt a lot, then days where I would feel normal walking around. Could go all week feeling normal, then wake up and walking hurt. Seemed random.

Also, when you get off your crutches it’s going to take a while to not be uncomfortable walking. I could walk after 3.5 weeks but it took another 4-5 weeks to be consistently walking around without discomfort. Since your already doing PT exercises maybe you’ll fare better. My hip was incredibly stiff.

And that first day you’re cleared to walk normally, you’re going to want to throw them away instantly and spend the whole day without them. Don’t do that. Walk around without them for awhile, but then start using them again for the rest of the day and see how you feel the next day. Inflammation can be a bitch. Though im sure you’re doc will tell you the same thing mine did: go from full crutches to walking with both crutches supporting you, then walking with one crutch helping, then walking with none. Just reminding you that going slower then you want can make the process smoother.

Though im sure you’re experienced enough dealing with rehab to know most of the things I mentioned. Main thing is to remember this surgery is usually 8-12 months until normal, there will be bumps along the way.