T Nation

19 with FAI


#1

I went in to see a doc about sharp pain in my right hip I've had for 3 years. After an X-Ray and MRI, it showed I have a hip impingement (from what I understand, excess growth of bone causing loss of motion), a torn labrum (apparently common when you have a hip impingement), and arthritis of my hip joint. Theres an arthoscopic surgery that helps (similar to what Alex Gordon or Alex Rodriguiz had, not exactly though), but the doc said insurance usually will not cover it and the surgery will not cure/prevent further arthritis.

Basically, im 19 with arthritis in my right hip. Pretty demoralized right now, I love lifting and squats, but now im not sure what I can do again.

My question is, what can I do to help slow down/help the arthritis? Like supplements to use/exercises to avoid. Will doing something like squats worsen the arthritis? Im fine with living with the current pain from doing squats, but if squats/leg presses will worsen the arthritis I will stop.

On that note, are there hip friendly exercises for the legs? I can only think of leg curls and leg extensions, not exactly as fun as squats or RDL's or deadlifts.

EDIT ON JUNE 6th: Changed title of thread to "19 with FAI", more accurately reflects my condition and treatment. Im hoping I can actually change the title, I've never tried before. The arthritis is a technicality, this thread is now about FAI and my treatment, recovery, and any issues I have along the way. Im using it to help other lifters with this problem because I have found very little on the web about people who had it and their recovery, especially for lifters and active people. Feel free to ask questions or give your own experience with this condition, im always wanting to help others and hear their stories.


#2

I am 40 and am having a hip resurfacing done in January. I have arthritis in both hip joints along with bone spurs. I have had hip issues for years but over the past year it has started to affect my quality of life and at this point, I can no longer squat or run at all. The doc said mine is genetic and probably started when I was in my early teens in that my hips, etc didn't ossify correctly. I basically have the hips of a much older person. I have zero internal rotation on one side and about 5 degrees on the other along with external rotation issues as well.

The only way to slow down or prevent arthritis is to do nothing, literally. Lie around. We know that can't be done. Inflammation (arthritis) is a response to what we do to our bodies. Unfortunately, some of us are predisposed to certain things and we have to deal with them.

Anything anti-inflammatory (fish oil, curcumin, etc) helps with the bodies reaction to stress. There was an article on the main page a couple days ago about inflammation.

My advice is do what doesn't hurt or cause pain later. You also answered your own question, you will squat until the pain gets so bad you can't.

Can you run sprints? I've never seen a sprinter who didn't have good leg development. Do lighter weights in the squat affect you or only heavy ones? If lighter weights don't bother you as much, maybe look into high rep sets of squats, they will pack muscle on your if coupled with the correct diet. Can you deadlift? One legged squats with just bodyweight will suffice and then you can find a way to add weight.

Hope this helps.


#3

Im sorry to hear about that.

I don't know much to advise you on you situation but supplements wise it might be of use for you to try fish oil as suggested above, glucosamine and chronditn, try a search of osteoarthritis on the board im sure you'll find more better suggestions than mine.

Also do a search on alflutop/adequan - again just what Ive heard/read myself.

Best of luck, chin up.


#4

Thanks for the replies. I've scheduled an appointment to get a 2nd opinion as my dad flat out refuses to believe its arthritis since im 19 and he is very against doctors and surgery in general. I don't believe the arthritis is as bad as the doctor thinks, but I think if nothing is done the impingement/torn labrum will cause it to worsen significantly.

I will say that I was running in the summer and had no noticable pain, but that these last few months I have been lifting lower body 3x a week (no squats, leg presses though), doing incline walking 3 times a week, and running about 1.5 miles 1-2 times a week so I definitely was working my hip so that explains why the pain got so bad.

After zero physical activity the past 2 weeks the pain is virtually non-existent in my daily life. Not a long term solution but something I've noted and has given me hope that surgery may not be necessary at this point, assuming I can alter my lifting and cardio. Maybe switch to lower body 1x a week (only did 3x a week anyway because I couldn't lift arms due to wrist surgery) and do swimming/biking for cardio, as much as I hate the exercise bike.

I will look into those supps. Sprinting is something I love, but I have always pulled or strained my right quad/hip flexor when doing it no matter how much I stretch or warm up. After getting the x-rays and mri and discovering the impingement I feel that explains why, so I don't think sprints are an option right now.


#5

I used to pull/strain my hip flexors too. If you have the funds, get yourself a prowler or sled or something similar or if you know a welder, have one made. I could still push my prowler walking without aggravating my hips unless I took really long strides. You can load one of those up and get a great lower body workout that will positively affect your conditioning too.


#6

Thought I would post a update in case anyone else ever searches hip problems. My doctor referred me to another hip specialist who is qualified to do the hip arthroscopic surgery, apparently he is one of 3 in my state who is allowed to do it due to the difficulty of the procedure. I have Femoroacetabular Impingement, both Cam and Pincer. Basically I have an excess growth of bone on my femur head as well as excess bone on the socket on my pelvis. When I move certain ways the bones hit against each other causing pain and pinching the cartilage.

Surgery is likely and something I want right now. Apparently the insurance company hates paying for this surgery so it will take a few months to get them to agree to it. In the meantime I was told I can do everything I want except squats/leg press. As for arthritis, I honestly do not know anymore whether I actually have it as of yet. I think the first doctor was jumping the gun a bit because this new guy did not mention that I had arthritis yet. He said that doing this surgery is no guarantee that it will prevent arthritis later. From researching online people have not known about this condition long enough to have collected significant research on long term outcomes. I personally believe this surgery would help long term prevention just because two bones hitting against each other repeatedly can't be good.

I'll try and post an update in 6-ish weeks on whether or not the insurance company agrees to cover the surgery and what the long term outlook is.


#7

This is going to sound silly and probably moot, but here goes:

I had terrible knee pain in both knees when I was 16-18. I was 5'11 and 130 lbs. I was running a lot and wearing Vans and Etnies sneakers, no warmup or stretching. Total idiot. I saw a specialist who told me my patellar tracking was off and could not be corrected without surgecy. The X-ray looked brutal; obvious bone-on-bone contact ... I thought I was doomed. All it took was adding some muscle to legs and a more sensible approach to training. No pain since.

Maybe it's worth just mentioning that if you focused on hip rotation exercises to get your legs the way they "should" be, it would make some kind of difference. Perhaps it will help keep you motivated in the meantime.


#8

I had this surgery performed in both of my hips but I did not have the accompanying labrum tear. It alleviated the vast majority of my pain. The only remnants of the surgery are hips that click and pop a little bit more. They have to release the hip capsule slightly to get it to open up and make room for the arthroscopic tools.

Rehab is a breeze really; you just move as much as you can and strengthen the muscles surrounding the hips. I can squat/legpress, deadlift, and lunge just fine. My doctor billed it as something different on the insurance to work around the restrictions. I wish you the best.


#9

@njrusmc - I asked the doc if there was any exercises that could help allievate the condition, he said no. No matter which muscles I strengthen or stretch it will not effect my hip enough to alter the collision when I squat/hinge my hip. That said, I am doing some stretches that logically could help.

@arcadiafades - Well at least I know someone else who lifts and has this surgery. I was told I would be on crutches for 3-4 weeks after surgery and meds for that time to help ensure the bone does not re-grow back. How long was your rehab process? Like when could you return to upper body lifting, squats, deadlifts, and running? The doc said I should be able to return to all activities no problem, though he did say there is a chance it will not eliminate all my pain. He said he performed this surgery on a Division 1 basketball player and the guy has about 80 percent pain reduction, which I think would be worth it long term.


#10

Oh and he said that people usually wake up with numbness in their leg after the surgery due to a nerve that is very close to the area they are operating on. Usually goes away in a couple days, but he did have 1 patient (a very small, thin woman with little fat on her to protect her nerves) that had long term numbness. That kind of freaks me out, but the odds are not likely that will happen to me.


#11

Yeah, my left leg is still numb in one small patch on my upper leg. It doesn't bother me at all and the muscles work fine. It's actually a blessing to me because I'm getting it tattooed anyway and the numbness will help me sit longer.

You will have a longer recovery due to the labrum repair but its really not that bad. You have to wait at least a month before running or jumping on it. You don't want to chance injuring the bone or possibly developing a stress fracture. You could return to upper body lifting without driving your legs into the ground for presses pretty much immediately.

You're going to have some discomfort with flexion though so sitting will be uncomfortable for a little while. Honestly, the worst part is the location of the few stitches they put in. They rub and get caught on stuff. I remember I rolled over in bed one night and the stitch got caught and it felt like someone held a flame to my skin. It sucked.


#12

Glad I did a search on here!
I have just been diagnosed with FAI as well and I am struggling with the decision to have surgery just the same.

I am personal trainer/coach and my job pretty much requires some sort of squatting movement, hip flexion and extension, etc. Not to mention I am a competitive drug tested bodybuilder and was just getting in to powerlifting when this pain started.
The pain has gotten so bad that it wakes me up multiple times throughout the night, it hurts when I walk, sit, bench press, plank, pretty much in pain 24/7.

Just wondering if this is consistent to how you are feeling?

There are definitely ways to train around the FAI, with the research I have done you can treat it like anterior femoral glide syndrome, focus on strengthening the glutes but no deadlifts/cleans from the floor and no squats beyond 90 degree flexion.

I feel like the FAI is taking over my life.

So, any other advices on the surgery and post-op lifestyle would be much appreciated.


#13

Just get the surgery.


#14

@arcadiafades - When you say I'll have discomfort with flexion, is that just for a few months post op I assume? Or are you talking long term? It will suck since I am a student and in class a few hours a day, but discomfort with sitting im not too worried about. Right now if I sit up with good posture I have discomfort/tightness in my outer groin area (hard to explain exactly) or when I try to push my knee toward my other knee. Did you have this as well before the surgery? I think its from the FAI and I plan to ask my doc in 4 weeks if the surgery would also fix this. Not a huge issue, but one that would be nice to correct. How long ago did you have the surgery?

@B_rock - that sucks man. My pain got really bad (similar to what you were describing) after about 4 months of 3x a week lower body lifting plus 5 days of cardio. I couldn't move my leg without a sharp pain. Once I stopped all activity for a few weeks most my pain went away. I've restarted activity again , 1-2 times a week lower body lifting (nothing that puts me in full flex like leg press, squats, RDL's) plus 4-5 days cardio (2 days of running on track) and on an anti-inflammatory called Morbic my doctor gave me while I wait for news from the insurance company. After 1.5 weeks the pain has not returned yet, but I can still feel the "oddness" in my hip so it doesn't feel normal. So if you are able to, take a break from leg work for a couple weeks. Or at least alter your lower body lifting to avoid full flex movements. I always had (and still have right now) what felt like a cramp in my hip when i did seated calf raises or leg extensions. Also, from everything my doc has said and arcadiafades has said makes it sound like assuming the surgery goes well, long term outlook is pretty much a normal active life with some minor pain if you work your hip too much one day.

Due to mobility issues im pretty sure I have some FAI in my left hip, but after talking to my doc he said if it does not develop into pain then there is no reason to do surgery on that hip.


#15

fisch,
You'll be fine. I was in college when I had the operation performed. I ditched the crutches in three days. You will have more discomfort than I did, but you will still be able to sit. It might just take you a little longer to sit down. The pain from the operation will subside in a couple weeks. I did a lot of walking to get my hip rehabbed quickly. The pain you describe is consistent with FAI symptoms. I had my left hip done in February 2009 and the right hip done in May 2009.

Your hip will hurt and click for a while, perhaps up to a year, but the majority of your pain should be alleviated if you test positive with the FABER test. Flexion, abduction, external rotation. It should feel like a knife in your groin.


#16

Thanks man I really appreciate the time you've taken to respond to all my posts. Im coming off a 1.5 year part-layoff due to a torn cartilage in my wrist and I have lost pretty much all my muscle, so I am not in the best spirits then this news hits me. As long as the insurance company will stop being dicks I plan on getting the surgery, hopefully over spring break so I can spend the first week of rehab with my parents to help me. I know after my wrist surgery I was unable to move much for the first 4 days due to pain/inflammation.

Funny thing with the FABER test. My left hip has less range of motion then my right and some pain in the test, but has no pain symptoms in all my activities.

I'll post an update when I go back to my doc in 4 weeks.


#17

Sorry for the hi-jack, just after some advice.

Just returned from my ortho appointment, I've got mixed FAI with a labral tear, some insidious pain over the last 12-18 months. Had X-rays and MRI, but surgeon wants to do CT scan before considering arthroscopic procedure. I'm reluctant to have the CT due to the radiation exposure. Did anyone here get a CT in addition to other imaging? Thanks.


#18

I know exactly what you're going through. I had federal BCBS PPO and they had to bill it under something different to get it done because it was considered an experimental procedure. The majority of the discomfort you feel is probably due to the labral tear. I had a lot of stuff go wrong within a short period of time. It went something like this:

Sep. 2008 - L5-S1 herniation
February 2009 - Dislocated right sternoclavicular joint
March 2009 - Surgery on left hip for FAI
May 2009 - Surgery on right hip for FAI
May 2009 - One week after the hip surgery I had a bilateral hydrocelectomy. Look it up and feel my pain if you don't know what it is.

Why did all of this happen in such a short span of time? I was about to turn 22 and get kicked off my parent's insurance. It was sort of like trial by fire.


#19

Damn man thats a lot in a short time. I looked up the hydrocelectomy and yeah that doesn't sound like much fun. At least thats all behind you now and you know what real injuries are like, not just some soreness or stiffness. Thats one of the only bright spots in this ordeal for me is I realize how important health is and I plan on making it a focus from now on. I might be 19 but im not invincible.


#20

That's true but don't dwell on the idea and don't limit yourself. This wasn't your fault and it wasn't caused by faulty programming. Your hips simply grew wrong and predisposed you to all kinds of potential hip problems. I'm almost glad that I endured those other injuries because they gave my life direction. I'll be taking the MCAT in two months and applying to medical school this year.

As an aside, there's something neat you might notice after the surgery. They basically put your leg in a jig, clamp down on your lower leg, and pull your hip half way out of the socket so they can fit tools in there to work. They have to release the capsule a little bit in order to do this. I found that after surgery I could relax my leg completely and actually use my other foot to traction the leg and I could feel it pull away from the hip socket slightly. It actually felt great and increased my mobility, however I did not have any labrum issues so I wouldn't mess with it if I were you. After I healed up, I was unable to do it anymore. You may also feel some initial discomfort in your knee due to the traction they put on your leg during the surgery. It goes away in a few days.