Hip impingement/femoroacetabular impingement questions

[Andreas Collberg]

Hello,

 

I first experienced some pain in my right hip last year, thought it was something temporary and went on with exercising. Capoeira, skateboarding, GST training and some running. Sometimes after exercise I could feel a sharp pain in the right groin area of my hip, the pain was often there for just a couple of hours after working out and then went away. 

After some time I decided to visit a Physiotherapist and took an MRI on both of my hips. The difference was clearly between my left and right hip. The physio suspected hip impingement on my right side. He gave me a couple of exercises in order to build up strength in the glutes and around the hips and told me that surgery was the last option. After some months with these rehab exercises I could barely feel any difference at all, the groin pain was still there, especially when rotating the hip inward. It's really frustrating because of the limits in range of motion I have on my right hip. Sometimes I can hear a snapping sound coming from the femur and it doesn't sound god. I'm in the thoughts of having surgery because I feel there is not much that I can do to make it better myself. Tried foam rolling, stretching and different mobility exercises for the hips. When i'm for example stretching for middle splits, specially the frog stretch, I can feel a sharp pain in the right groin area.

 

So now to my questions: Can impingement in the hips be treated with stretching over a long period of time? 

Anyone else here on the forum dealing with the same or similar problem?

Have anyone done surgery? If so, how long was the recovery time and how did you feel afterwards?

 

Thank you.

Best regards

Andreas

[Hubert Häggman]

I had the surgery for CAM type femoroacetabular impingement about a year ago. After the surgery I had to use crutches 3 month and it took about half a year that I could do any sport I wanted.

My hip is now better than it was before surgery but it is not as good as the healthier side. I had some minor labrum tear and little cartilage damage and I guess those will not heal completely ever. In the surgery they took some bone away from the caput of the femur to make it match better the acetabulum and helping with the impingement. 

I still get some symptoms in the extreme ROMs like stretching the hip flexor, side splits and deep squats but not very much. I can pretty much do any sport.

[Andreas Collberg]

Thank you Aydrian for sharing your experience with FAI.

[Mark Collins]

Can you post a summary of the MRI findings?

[Andreas Collberg]

Yes,

 

The MRI summary is written in Norwegian so will try my best to translate into english:

 

Examined the whole pelvis with coronal T1.

Right hip examined with coronal PD with and without fat suppression. Axial T2. Oblique sagittal PD with fat suppression.

 

Somewhat higher amount of liquid intraarticularly.

Suggested flattened lateral contour of femoral head.

Pathological signal changes anterosuperior along fastened acetabulare labrum at least 3 sections. No paralabrale cysts. Very suspected labrum rupture.

Otherwise generally normal findings in bone marrow in produced skeletal structures.

 

Normal hamstring joints.

Normal findings in symphysis area. 

 

Normal sacroiliac joints.

 

No pathological masses in the small pelvis.

 

Normal iliopsoas muscle.

 

R: Something increased amount of fluid intraarticularly in the hip joint. Strong suspicion of rupture changes anterosuperior in the acetabulare labrum.

Some lateral contour of caput and femur neck.

[Mark Collins]

I am always impressed with Norwegian's english. Especially translating an MRI.

Considering your lack of improvement with Physiotherapy I would have a consultation with an orthopaedic surgeon to discuss surgical options. Otherwise with MRI results like yours I would expect some hip symptoms such as you are describing for the rest of your life.

The stretch series would be good to do if you are not already doing it.

[Andreas Collberg]

Thank you Mark.

[Joseph Blazuk]

Did they inject contrast into your hip prior to MRI?  In all likelihood... find an orthopod who specializes in FAI/labral repair, don't go to one who 'does a bit of everything' - ie, does a lot poorly and nothing really well.  Definitely worth a trial of 1-2 months of conservative care to see if hip stabilization will help relieve symptoms, but most labral tears in younger/active folks get referred out to surgeons and there's emerging evidence suggesting true FAI may precipitate earlier onset hip OA.