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  1. #26
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    FAI Diagnosis- post op recovery time

    anyone gone through the surgery yet? I spent 3 months working with a physio to avoid surgery with no improvement- only decline in that time period.

    I just want to know what the post op timeline is like for activities. I was a porfessional cyclist until this season when the muscle tightness, fatigue and pain in my hip flexor, inner leg, and outside of hip kept me from training or being strong enough with that leg.

    will I be able to swim right away? trainer? walk? hike?
    any information would be appreciated.

  2. #27
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    Hi, sorry to hear of your situation.

    Yes, i have had the Arthroscopic procedure, had the bone debrided and the labrum re stuck back to the pelvic joint.

    I would question what a physio can do to remedy a physical/ structural problem, yes you can try and ensure the femoral head sits right, but if the bone is rubbing the labrun because its deformed ( cam ) or the joint is overreaching and causing an impingement ( Pincer ) then its needs surgical intervention IMOP.

    I had my procedure done on Apr 4/ 07, I was swimming 4-5 weeks after ( no frog kick ) and was playing tennis ( lightly ) in June. No limp after about June and I was back on the bike again in Aug from memory. I managed the steps on the great wall of china with crutches in May, its after the op that the Pysio comes into play.

    Good luck if you go with the procedure, pick your surgeon carefully.

    Jez

  3. #28
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    Quote Originally Posted by sorehip

    I just want to know what the post op timeline is like for activities. I was a porfessional cyclist until this season when the muscle tightness, fatigue and pain in my hip flexor, inner leg, and outside of hip kept me from training or being strong enough with that leg.

    will I be able to swim right away? trainer? walk? hike?
    any information would be appreciated.[/COLOR]
    I'm in a similar boat. Trying to decide between doing surgery now vs. after ski season (I care more about skiing than mtg - I know that's sacrilegious here). I have a bone spur on my left femoral head which is what's causing the pain for me. If I were to schedule surgery today, it would probably happen sometime in September. Will I be strong enough to ski by December? Will I have to wait longer? Hmmm.

  4. #29
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    I'm bringing this thread back up. I had FAI arthroscopic surgery on Dec 31st on my right hip. I was off crutches in 10 days and am in the middle of PT. I'm shocked by how good the recovery has gone and I'm back riding the stationary bike.

    Like many of the others that posted I had both cam and pincer impingement, labral tear and arthritis. My problems started after a crash in 2000 training for the Leadville 100. During the race I started suffering in the first few miles and struggled through the race. The next day I couldn't walk and have been the whole PT, Chiro, route. I had two cortisone injections that got me through the last two years of biking. Finally got it properly diagnosed a couple of months ago. Like many of you, i have the same problem in my left hip as well but don't have the labral issues and arthritis yet. I will probably put that off another few years.

    I expect (hope) recovery continues to go well and I'm back on the bike on the trail in 3 months. I had never heard of FAI until i was diagnosed. I had the same pain as others - lower back, groin, IT band and knee. The change already is tremendous. I highly recommend the arthroscopic procedure but strongly recommend researching for the right doctor. I'm fortunate in that I live close to NYC and could go to the Hospital for Special Surgery that is world renowned.

    Good luck to those of you recovering. I would love to hear an update on your progress and any challenges.

    Barry

  5. #30
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    Argh... I'm in the same boat and a bit nervous

    So for the past 10 months now, lower back pain, outside of the hip pain (IT band), diagnosed with a disc and bursitis etc.

    Finally, pushed for a MRI which found a labral tear.

    Diagnosed with FAI and they want to do surgery with a scope at U of Michigan.

    However, I guess I'm a bit skeptical/scared.

    First, I'm pretty positive that this started when I almost crashed my road bike and got my left leg caught to the side and then quickly behind me. This would explain the tear.

    I had no problems on the right side until 8 months after the original problem which I attribute to compensating.

    If both femurs look the same and both acetabulums do also, then really the only thing different is the tear, and the only side with real problems is the left.

    I'm really tempted just to have the labrum tear fixed and see if everything else clears up.

    The first surgeon almost seemed to come in with a preconcieved notion that the FAI was the only way to go, wants to shave down the femur, clean up the labrum and possibly shave down the socket. He also suggested an IT band lengthening and Bursecomy at the same time.

    My MRI (both) clearly stated no bursitis seen? So, I felt this guy might have just been way overaggressive.

    Am I wrong to feel like both sides should have the same problem if it is the FAI, after all the bone structure is the same, but my tear is on the left only and I think I know when it happened?

    It's been extremely frustrating, lots of money spent and time both on and off the bike lost.

    I have a second opinion lined up this week.

    Furthermore, the FAI board on Yahoo really doesn't seem all that positive, lots of post-op problems, many without getting better etc...
    "The thing is, Bob, it's not that I'm lazy, it's that I just don't care."

  6. #31
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    Fai

    You are correct that FAI is most likely present in both hips. The impingement can be seen by specific x-rays (Frog-leg or internal rotation). I also know exactly when my labrum teared, it was on a run. The pain wasn't even in my hip, it radiated to a part unique to the male anatomy. So the first doctor I saw was a urologist.

    Since both of my hips had FAI I opted for surgery on each, even though only my left hip was symptomatic. I figured with my active lifestyle the other hip was going to have trouble down the road, so I might as well do some preventative maintenance and sure enough there was some labral damage in the joint when the doctor opened me up.

    Your first doctor does seem aggressive, especially with the IT band, which will probably resolve itself once the FAI is addressed. And you do make a valid claim about Yahoo. But realize a lot of people tend to post negative comments looking for answers as opposed to the success stories, who have the peace of mind and time to partake in other activities. The success stories that I have noticed tend to occur with the more athletic patients, who have enough muscle mass and physical therapy knowledge to minimize the rehabilitation process.

  7. #32
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    Green Giant,
    My situation is similar to pro-gravity. If you are getting scoped for the labral tear, they should fix the bone as well. You are right in that you could be asymptomatic in the one hip and the other one could have been injured in a crash. That is exactly what happened to me. Both hips have the deformity which is normally in white, athletic males (according to my doctor) and occurs during growth spurts. I had mild lower back issues for years but nothing I attributed to my hips. It wasn't until a hard crash that I tore the labrum in my right hip. That is the only one I've fixed for now although like pro-gravity, it may be a good idea to fix the other one before too long.

    When the doctor went into my right hip for the 90 minute procedure, it took 4 hours. The damage is not always apparent on MRIs and xrays. I saw cool pictures of how shredded my labrum was and there already was a ton of arthritis. But like I said in an earlier email, it is already much better. Of course while I'm limping around on my right hip, my left hip is starting to have issues.

    There is a racer who has a blog of his experience that is still active with postings (you'll see one from me) at the following website:
    http://505live.com/?p=187

    Hope that helps. My own inclination is to get the arthroscopic procedure but I would be skeptical of the other IT bank/bursectomy "repairs".

    Best thing is that insurance is coming around to covering everything. I have Aetna and my total out of pocket was only like $400. I heard that just a year ago, FAI was not a covered procedure so check it out before committing.

  8. #33
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    Quote Originally Posted by CrashCanipe
    Green Giant,
    My situation is similar to pro-gravity. If you are getting scoped for the labral tear, they should fix the bone as well.

    --- I'm considering getting the labrum fixed and seeing how it goes, and if it happens again getting the bone done. It just seems to me that the injury caused the tear, not the impingement

    Both hips have the deformity which is normally in white, athletic males (according to my doctor) and occurs during growth spurts.

    --- I've been 5'9" and change since 8th grade, I'd kill for another growth spurt so my height and weight would be more "in line"

    When the doctor went into my right hip for the 90 minute procedure, it took 4 hours. The damage is not always apparent on MRIs and xrays. I saw cool pictures of how shredded my labrum was and there already was a ton of arthritis. But like I said in an earlier email, it is already much better. Of course while I'm limping around on my right hip, my left hip is starting to have issues.


    ----Fortunately both MRI's and the XRay show zero arthritis for me. I'm going to get the labrum fixed here sooner or later. I'm going to another surgeon this week and I'm only giving him the MRI pictures and x-rays. Not the report from my first surgeon as I want a "clean" diagnosis. The first surgeon I was referred to by another guy in his group. The first guy asked me what I thought I had, and I suggested FAI as I had read about it. I was asked VERY few questions, given the referral etc. When I saw the second guy he asked no questions, just came in talking about FAI surgery for my groin pain.. AND the IT BAND surgery for that pain. He said I had two issues.

    >>> Now here is my issue. 90% of the time I can live with the groin pain. It is the outside pain and aching (presumably IT band) that is causing 90% of my problems. IF I could elminate that pain, the groin pain is tolerable. Now it's possible I need to stretch out that IT band and that aggrivates the groin pain, that I buy. My confusion now is if that labral tear can cause that outer hip pain as the surgeon focused on groin.


    Best thing is that insurance is coming around to covering everything. I have Aetna and my total out of pocket was only like $400. I heard that just a year ago, FAI was not a covered procedure so check it out before committing.
    The insight is good though, this just really feels like a procedure that I want to research in a big way before going forward with any bone shaving.
    "The thing is, Bob, it's not that I'm lazy, it's that I just don't care."

  9. #34
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    Crap. I was just diagnosed with this.

    I had the best season ever last year. ~4500miles, mostly road, with two centuries and two doubles. No pain anywhere except my low back, which is typical for me.

    Over the fall I took it easy and then started base training with some running, yoga, swimming, and kept my cycling miles pretty low. My weight was down and I was in the best shape of my life.

    Then the hip pain started in December and continued to build into January. Dull pain only after riding. Started to keep me awake at night. I took two full weeks off, but stupidly continued doing yoga/stretching through the whole incident.

    Went in to the ortho (well respected sports med guy) and the X-rays show pretty clear FAI. He said he couldn't rule out a mixture of iliopsoas tendonitis/bursitis, but the physical exam also supported FAI.

    Not sure whether to write this season off and do surgery or take a steroid injection and try to gut it out until fall.

    Depressed. Maybe I'll just sell my kit.

  10. #35
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    beats being a couch potato

    It's been a few years since i had both hips scoped at the UofMichigan to repair my FAI (repair torn labrums and reshape the femoral neck so the damage wouldn't recur). I had my two hips done 6-8wks apart, which was a mistake, in that i was demanding too much from the first leg while recovering from the second. impatience is evil, as i then pushed right out of PT too quickly and had some minor issues for the eyar following.

    now i am all good. the surgeries were the best choice (if the door is rubbing on the frame, eventually the hinge breaks). Committed and patient PT is crucial. it's just a few months (3-5), and better than living with the pain/causing more damage-arthritis.

    I recall my first diagnosis: i was told if i was a couch potato, i'd never have become symptomatic. i choose life!

  11. #36
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    Sorry to bring this thread back to life. I have started riding a lot more lately and have had some recurring pain as described above. I stopped riding for a few weeks and it has not gone away completely. Kind of wraps from my groin around my hip and down the back of my leg stopping at the lower hamstring before it gets to the knee. Not a horriffic pain, just bad achyness/soreness/tightness in that region. There is one spot on my inner/front thigh near the groin that is particularly tender though. I know you guys are not doctors, but do you think that it could be this FAI stuff or something less serious? I am only 29 and am not doubled over in pain, but it does pretty much hurt all the time except for when I have slept/rested for a while or have not walked up/down stairs for a while. All started when I had to do a takedown/restrain on someone who was disturbed and went down onto my right side. Then I did 12.5 miles offroad on the new bike over 2 days, and I think I might have made it worse...

  12. #37
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    I'm no doctor, but you may want to take some additional time off, rest and anti-inflammatories and then start back slowly.

    I've been riding with a nagging hip pain for the past year. Thought it was ITB, finally went to see a PT for it - he figured out the issue immediately. After X-rays, an MRI arthrogram, and a trip to the hip specialist orthopedic surgeon, I'm scheduled to get my hip scoped in 2 weeks.

    So, don't ignore and ride through those nagging pains, they may be worse than you think.

    I'll post back after surgery. Hopefully back on the bike before end of summer.

  13. #38
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    Could be, but your symptoms don't sound specific for or against.

    From what I've read, the pain can radiate various places, but one thing that consistently makes the pain worse is flexion of the hip past 90 degrees (like when you sit in a chair and bend forward). Part of the treatment for FAI is behavior modification to avoid repeated over flexion (raising your chair at work, adjusting your bike minimize the head of the femur bashing into the pelvis, no deep hip stretching like some yoga poses).

    One exam test they did in the clinic was to lay me on my back and push my knee toward my chest past 90 degrees and then rotate the hip by pulling my foot away from midline. As they rotated the hip and pushed it toward my chest it recreated the pain.

    But the diagnosis was a combination of consistent history, the exam and the Xrays that showed the bony prominence.

    I suggest you go in and see an ortho who specializes in sports medicine (not just surgery). My pain got (at least temporarily) better with a steroid injection and this helped confirm that it was the joint and not a muscle/tendonitis. So far the steroids are allowing me to have something of a season on the bike.

    Once I had the diagnosis, he referred me to a specialist who does the arthroscopic FAI surgery and I'll consider it in the fall if I can't ride strong throughout the season. Right now, 2 months after the steroids and with behavior mods, I still have mild nagging pain during rides but it hasn't slowed me down. I may even have another steroid 5-6 months after the first. I'd rather have surgery in the fall/winter.

  14. #39
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    I'm 2 weeks post-surgery for FAI in my right hip. Surgery went well, and the hip feels good - no real pain issues now, although I'm not using the hip much. I'm on crutches for 2 more weeks before I can start PT, or walking. I'm really encouraged by the lack of pain so far.

    What's somewhat concerning is that my left hip/groin is now bugging me due to all of the time on crutches, using only my left leg.

    Does anyone know the statistics related to having this in both hips? If this occurs in 1 hip, are you much more likely to get it in the other? Hopefully, this is just muscle pain, time will tell.

  15. #40
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    no pain from FAI

    I just got diagnosed with FAI. I have no and have had no pain in my hips. I went into get stitches removed from my hip (mtb crash) and they took x rays just to be safe when they noticed I have FAI. The doctor said there is a chance it could never be an issue but said he needed to give me the low down in order to CYA in the case down the road I have issues. After doing research, I'm a bit freaked out. I also read that using pain as a guide can be misleading. Anybody out there like me diagnosed with FAI but still are riding without pain and confident they are not shredding their insides while riding?
    www.24hrBikeShop.com 10% of your purchase price is donated to the trail organization of your choice!

  16. #41
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    Anybody else post-op?
    Last edited by tanchris; 08-13-2010 at 02:44 AM.

  17. #42
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    I'm 3 months post op on my right hip now. The right hip feels quite good. It's better than the left hip. I do still get some soreness/achiness on the right hip if I go big on the bike. But, it doesn't seem to last long.

    The left hip has been hurting since about 3 days post op on the right hip. It started with groin pains. I had an mri arthrogram on it this week - looks like another labral tear, with mild arthritis, and a cyst. Here we go again. I'm planning to have surgery on the left side before the end of the year.

    For those considering the surgery, the worst parts of the recovery for me were:
    - CPM machine for 2 weeks. Really difficult to fit in 8 hours a day for this.
    - crutches for 4 weeks

    I'm still having hand pain from the crutches. 4 weeks on crutches is a really long time.

  18. #43
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    I just had surgery this past Friday (3 days ago) to correct FAI in my left hip. I had a tear in the labrum cleaned up and some of the femur shaved down to correct a CAM impingement. I feel much better than i thought I would. The day after I was on the trainer for 20 min to get my range of motion back. (docs orders) I will be having my post op appt on Wed to get the stitches out and will be starting PT this Friday. I will try and keep up with posting about my recovery.

    I was back and forth for a while on whether or not to have the surgery but it got to the point where I couldn't run for more than 20 min without having pain. It was getting worse and worse, and I am glad I decided to go through with it. I am pretty optimistic about the recovery and would like others to share their recovery stories if possible. I am hoping that I can start working on my base after a month or so. I can begin swimming again after 3 weeks, so that is another way I can get some cardio in.

    My background - I am a CAT1 mtb and also do xterra's. Hip started hurting 2 years ago mainly when playing hockey. Progressively got worse to the point where I couldn't skate anymore and running was almost unbearable. Biking however did not bother me at all, but I enjoy cross training to much to be limited to only the bike.

  19. #44
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    One Week Post Op -

    Feeling much better than anticipated. Starting PT today, up to 30 min daily on the trainer with no resistance. Also down to one crutch and honestly I don't even need it. I am just trying to do what the doc says. When I went in for my post op appt on Wed - the doc was amazed with my range of motion and what little pain I have.

  20. #45
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    Fai

    Hello again fellow FAI sufferers! It's been nearly 4 years since I first posted to this thread complaining of hip pain, and diagnosed with FAI. After many sleepless nights, painful hikes/rides and 3 intra-articular hip injections, I finally had my right hip arthroscopy on Wednesday (12-14-2011)!
    Though it's only been 3 days, I feel GREAT! Actually I've had very minimal discomfort since day one. I needed to have a labral repair done with the cam/pincer osteoplasty, so I am only 50% weight bearing on the operative side for the next 2 weeks. After that I'll be back to spinning!
    As I mentioned 4 years ago, I've been an operating room nurse for 18 years, specializing in orthopaedics and spine surgery. The doc I chose to do my surgery (Dr. John Knight- San Francisco East Bay area) started doing these hip arthroscopies about 5 years ago, and I was part of the team that assisted on his very first case. So, for the past 5 years, I've been silently watching and waiting while Dr. Knight perfected his skills. When my mountain biking become more painful than enjoyable, I decided I had waited long enough!
    My advice to those with hip pain: get X-rays and see an ortho doc who is familiar with FAI. If FAI is confirmed on X-ray, try to have the arthoscopy done at your earliest convenience. Delaying the procedure will only prolong the pain, take some of the fun (mountain biking is still fun even when you're in pain!) out of riding, and possibly (probably?) lead to a labral tear which will delay your recovery!
    Five years ago FAI was a term unknown to many orthopaedic docs, now it is one of the fastest growing procedures performed. In the right hands, it can add many, many years to your passions!

  21. #46
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    10 days post op - no crutches. Feel great. No pain meds, and barely walking with a limp. Had my first day of PT on Friday and I was doing things that "normal" people don't do until 3-4 weeks post op. My PT thinks that I could be totally unrestricted by mid Feb. I am not getting my hopes up, but that is great news considering going into the surgery I was told at LEAST 3-4 months. I am only doing what they tell me and not rushing anything, but I am up to 40 minutes on the trainer at the lowest resistance with absolutely no paid. I am still using flats and will continue until I get cleared to add so resistance.

  22. #47
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    3 weeks post op - started swimming wed. Sat was so nice out I couldn't take it anymore. Just did my first outdoor road ride for a hour. Nice and easy and felt great.

    If anyone is questioning whether or not to do this surgery - I would say go for it. My only issue is now my fixed hip feels better than my "good hip."

  23. #48
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    fai

    After 40 years of cycling on a regular basis I have had to give it up. I developed hip pain (groin area) on the right about 15 years ago. A work up by a well respected orthopedic surgeon found no problems. Being a physician myself, I decided to "heal thyself." I stretched frequently and continued cycling but with some pain all the time that eventually got much worse. At age 61 the pain would no longer allow me to cycle or do much of anything without constant pain. I was diagnosed with fai-a diagnosis virtually unknown when I began having pain 15 years ago. By this time my joint was pretty much shot and I had to have a hip replacement. I felt I had a good result and started riding again a few months later but developed increasing groin pain. Turns out I developed heterotopic bone in my hip flexor (iliopsoas) tendon). Had surgery to remove a 3 inch piece of bone that grew in my iliopsoas muscle and tendon. Felt better after this second surgery and tried to return to riding but pain on my operated side got worse and then developed similar fai symptoms on the unoperated side. Decided to stop riding since the pain wasn't worth it and I didn't want to accelerate the damage on my good side. Eventually will probably require hip replacement on the other side as well. There is some controversy regarding surgery to fix fai. Many doctors believe the bony abnormality will just grow back. Lots to consider for you riders who continue to ride in spite of pain or return to riding after fai surgery. Good Luck!!

  24. #49
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    FAI information

    Hello! I stumbled upon this forum about FAI and I wanted to comment and share my new blog post. I recently underwent surgery for CAM impingement, torn labrum and torn cartilage in my left hip. Before surgery I was a competitive triathlete and ran half and full marathons.

    I am 7 weeks post-op and doing well so far. I still have some hip flexor pain, but I no longer have the hip pain I used to have. I am cleared to swim and bike for about 20 minutes and can do the elliptical and stair master along with some strength training. I had my post op appt. yesterday and the physician said I can jog in 3 weeks.

    Anyway, I wanted to share my blog post because I interviewed my surgeon (Dr. Peter Maiers at Methodist Sports Medicine) and his physician's assistant. They answered some general questions about FAI that might help those of you who are wondering if you have FAI and if you do, what the next steps or options are. I was misdiagnosed for almost two years so I am trying to spread the word about FAI.

    I tried to submit my post with the link to my blog post, but am unable to link to my website unless I post to this forum 10 plus times. The website is called Fitness Is Delicious and you can google it to find the name. The url is fitnessisdelicous dot com.

    Best of luck everyone with their recovery and decisions moving forward!
    Ashley

  25. #50
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    Surprised to find so many fellow FAI ninjas!

    Apparently my years of mandatory running ignorant of my FAI chewed on my labrum a bit. Fortunately I was diagnosed correctly on my first civilian orthopedist visit. Lots of previous posters in this thread deliberate on postponing the fix, but I saw one doctor respond with his cautionary tale of the risks of manning up. My doctor apparently agrees, and told me that if I did not fix my impingement now I might need bilateral hip replacements by the time I was 45. I had the right hip done this past April and will have the next hip done later this year. If any of you suspect FAI you'd be wise to go get checked out. I'm glad that I did.

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