[Stefan]

Hi

I have been diagnosed with FAI, including a few labrum tears and onsetting osteoarthritis in my left hip. I don’t have an MRI from my right hip, but the x-ray shows the same FAI-structure there. So far, I’m more or less asymptomatic in both hips, and I can run many hours without any pain- during and after. I have been told by three different orthopaedists, that I should reduce (or better: quit) running, as it will accelerate the cartilage degradation and basically speed up the inevitable: hip replacement.

I know the stories of people returning to ultrarunning post hip replacement. Still, I feel that keeping my (again, asymptomatic) joint for as long as possible, would actually be quite desirable. I’m 36 and would consider myself a recreational (mountain) runner and alpinist. I don’t do anything wow-worthy in this crowd, but being in the mountains is still a defining part of my life. The question I have been grabbling with ever since my diagnosis about two years ago, is this: should I keep running, because I enjoy it and it’s the perfect aerobic training, or should I look for some other ways to do my aerobic training and kiss those long running days in the mountains good bye? Will running really accelerate the cartilage damage in my hip joint and make a replacement necessary much earlier, or will forgoing running not buy me any significant time? I get that there are ways of managing FAI and reducing the impact to the joint while running (soft tissue work, running technique, strength training), but is this really enough to counter the high impact running has on the hip joint and the damage it can do to an already damaged cartilage?
Thoughts on this, anyone?

Topic

[Thomas Summer, MD]

Thomas Summer, MD on July 30, 2021 at 2:44 am #56062

Hi Stefan,

my first thought is: why did you get an MRI of your hip if you are asymptomatic? So it seems you must have some symptoms!?
To your questions: I don’t know your MRI and x-ray, but FAI is a risk factor for osteoarthritis. So your orthopaedics are making their recommendation for a reason. But is anyone of them an athlete? As you love beeing in the mountains, I would not stop that. But monitor your symptoms closely.
There are also some conservative treatment options. I would recommend to look for a good physiotherapist, where you can get regular appointments and a good strenghtening program.
Moreover there are surgical options for FAI. A hip replacement shouldn’t be the first (and last) step. These other surgical procedures have good return rates to sport. And even with a new hip long days in the mountains are possible.
I know someone who want’s to run 50km with 2 replaced knees. He is a bit crazy, but I’m sure he can do it!;-)

Hope that helps!?
Thomas