FAI and Hip Labral Tear

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Topic
April 17, 2020 at 11:45 am #40580

spencerwegner11
Participant

I’ve been dealing with a hip injury for about a year now. I found out several months ago that I have femoroacetabular impingement (FAI) and a labral tear in my right hip.

I tried extensive PT and rest for several months but that did not improve my pain and discomfort. I am now signed up to get surgery (which is delayed indefinitely, but might happen in early May) to repair my labrum and shave down the bump on my femur.

Unfortunately, I’m now feeling similar symptoms in my left hip and I can’t imagine having to get surgery on both hips. I can’t help but wonder if this pandemic is a sign that I shouldn’t get surgery after all.

What do you recommend to athletes who have this type of injury? What did they do to get themselves feeling better? What kind of tissue work, stretching, and strengthening did they do to make their hip healthy again? Did/do they have FAI?

I’m currently running about 20-30 miles a week and just dealing with the pain/discomfort. I’ve also recently started up my more PT exercises (namely the Myrtl routine and content from the FAI Fix) since I have some more time during quarantine.

I would greatly appreciate any ideas or help!
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Topic

Posted In: Injury & Rehab

Participant

Pete Dickinson MS,PT on April 18, 2020 at 6:11 pm #40603

Spencer,
I have seen good results from surgery for this when patients have failed conservative care. Treatments usually focus on joint mobility through mobilization, soft tissue work to the posterior hip structures to improve mobility and minimize load transfer on the anterior structures, and progressive strengthening. I often see symptoms shift to the other side as it takes on more of the load due to pain. Now is a good time to shift methods to less irritating movements, and pursue other avenues of fitness that will also help this…..core, core, core. I’m sorry you have to deal with this, as it is sure to frustrate goals and plans. I hear many stories of postponed elective procedures that couldn’t come at a worse time.
Pete

Moderator

Thomas Summer, MD on April 19, 2020 at 6:24 am #40639

Hey Spencer!

If you have FAI, properly diagnosed, and conservative treatment + rest didn’t make a difference, then it’s time for surgery. I have also seen mostly good results.
As Pete wrote it’s not unusual that symptoms also shift to the other side. How does the left hip look like in the x-ray?

Some thoughts on exercise and training:
– I would not recommend that you do a lot of mobility for the hip, because this can further damage the labrum.
– beside core, also focus on glute strenght
– stretch the hip flexors and reduce the tension
– don’t sit too much (only if you can ride your bike;-))
– and don’t try to tolerate too much pain while running. Discomfort is ok. But you should not limp. Because limping puts too much load on other structures.

I hope this helps!?
All the best and stay inside (…for core training;-))
Thomas

Participant

spencerwegner11 on April 19, 2020 at 1:50 pm #40650

Pete and Thomas,

Thanks for your responses! If nothing else it’s nice to hear other reassuring voices saying that surgery is a valid option after conservative treatment. I have been doing quite a bit of stretching and soft tissue work. I’ve also been doing core and glute strengthening work but I definitely have room for improvement.

Thomas, it’s a little hard to see on the x-ray because they focused on the right hip, but my left femoral head also has a slight bump like the right one. That means the same tearing is possible on that side.

I’m planning on reducing the activity that aggravates things which means more time for core work! I haven’t been limping when I run but obviously I’m compensating in some way to make the left hip angry.

Thanks for reassurance and muscle groups/exercises to work on!

Spencer

Participant

djcrusoe0929 on April 20, 2020 at 11:47 am #40689

Spencer,

Where exactly are your symptoms? Are they only in the front and more towards the groin? Do you have any other symptoms in your low/mid back (tightness or stiffness) or any where else in your legs (even if they are different than the feelings in your hips)?

How would you describe the sensation of your primary symptoms (and if you have other symptoms too)? What makes your symptoms worse and what helps them?

Anytime someone mentions symptoms on both sides I wonder if the spine can be referring to those locations. There is something that is called Maignes syndrome were the thoracolumbar junction (area between thoracic and lumbar spine) can cause hip pain. I’ve treated a couple of cases of this where conservative management had failed when the hip was the primary focus.

I’ve also found that even if I am treating someone with FAI that manipulation to the the thoracolumbar junction can help with hip pain (there is some nerdy science behind this).

Dan Crusoe PT, DPT, OCS, CSCS

Participant

spencerwegner11 on April 20, 2020 at 1:00 pm #40697

Dan,

My symptoms have varied in the past year as I’ve been dealing with this, but some I’ve had in the right hip include catching/pinching in the hip crease, soreness/discomfort in the hip crease, soreness up into the psoas, and soreness/mild sensation in the gluteus medius. On my left side which really just started in the past couple weeks I’ve only felt some catching/pinching, soreness, and tightness in the hip crease. I’ve also felt some light sensations in the gluteus medius.

I haven’t had any other sensation in my legs. My pain discomfort has varied quite a bit over time, but sitting for awhile or any sort of hip flexion movement (running, biking, even just walking/hiking for awhile) tends to aggravate symptoms. Downhill running tends to feel better than uphill running although I’ve felt varying degrees of discomfort on both. I will get some relief after I do some stretching, tissue work, and strengthening of the quads, hip flexors, and glutes. I got a cortisone injection in my right hip back in January and that got rid of my pain for awhile. In the last month or so the effectiveness of the cortisone has slowly reduced to zero.

I haven’t had any back issues or any pain or discomfort there during activity. In general though I am fairly tight in my low to mid back, especially on the right side. I’ve also been told that my spine is pretty straight where it’s supposed to have a natural curve.

-Spencer

Moderator

Thomas Summer, MD on April 23, 2020 at 8:37 am #40817

Hi Spencer!

your symptoms are quite typical for FAI, also that the injection removed the pain.

how is cycling?
and as Pete wrote: core, core, core!;-)

Thomas

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