Femoroacetabular Impingement 

…or FAI for short.

…or Hip Impingement, if you prefer.

…0r, it hurts to sit, to be accurate.

I was finally diagnosed in August with FAI.   Lateral impingement, both sides, pincer type and labrum tear in both.  Arthroscopic surgery is the only option after spending 4 weeks in PT just to make sure. 

Why does it hurt to sit? 

Simply put, the bone over growth in my hip socket pinches the labrum (cartilage) when I move my leg in certain ways like bending at the hips when you sit.  Over time, the labrum has become torn.  So, now, I deal with muscle compensation due to a loss of range of motion, tightness, torn cartilage and inflammation then you add pressure from sitting.  

As time has progressed, it has started to hurt when standing and laying down. The hips are getting weaker. 

How long have you had this? What caused it? Was it running? 

As far as I have read, there is no real answer as to what caused my FAI. It is a mechanical deformity. At this time, most people diagnosed are athletes. But, that could be because athletes move more and use a bigger range of motion regularly.  It’s also a fairly “new” condition so lots of people who had a hip replacement could have been FAI and just didn’t know it. 

I don’t know for sure how long I’ve had a hip impingemt or a torn labrum. If I reach back into my bank of old softball memories, I recall being 18 years old and asking one of my sister’s friends from our recreational softball team for a good stretch for the hip flexor because I had pulled it when running to third base. I have no proof, but I don’t think it was a coincendence.  

The next incidence was in the mid-2000’s when I started having tendonitis symptoms in my hip flexors. I sought treatment. I did not get a diagnosis, explanation, or relief. Treatment included orthopedic doctor and chiropractor.  Eventually, I modified my behavior and learned to deal with tightness in my hips. And, I quit wearing a belt. (The belt was not a cause of the problem but did press on inflamed soft tissue causing pain) 

More recently, a few Christmases ago, I had several days where, I thought, after eating too many Christmas cookies, I had gained so much weight that my pants were too tight thus by the end of the day it just hurt too much to sit another minute. 

Many nights I have gotten back up after going to bed to stretch out my leg muscles because the tension in my quads was just too much to let me fall asleep.

I can’t tell you how many times people  have offered me a seat only to be confused when I refused to sit down. Telling them I prefer to stand did not make sense to anyone.  It still doesn’t. 

Most recently, I was going through treatment for chronic achillies tendinitis.  I decided that all things are connected so I should be dillegent about resolving the tightness in my hips to make sure it did not alter my stride and aggravate  my achillies.   Eventually, this train of thought lead me to Dr. Komamduri.  

My first appointment with the hip specialist at MK Orthopaedics, Dr. Komanduri, was impressive. Before I was even seen by the PA or the doctor, they took five x-rays of each hip. 5! Then the PA came in to see me but could not identify the cause of my pain. She performed numerous tests but found no indication of the cause.

“It’s your back… no, it’s your hips… hmmm, it’s neither.”

She left the room and left me to contemplate yet another dead end and no explanation.

But then I heard a voice in the hall,

“She has pain in the groin and pain when she sits?”

Dr. Komanduri entered the patient room, requested I get on the exam table and immediately proceeded to place my leg at angle that nearly made me jump off the table in pain. 

“It’s a lateral impingement,” he said to the PA, ” only 10% of cases are lateral”

Color me impressed. Dr. Komanduri never asked me a question. He looked at my X-ray, read my chart and immediately replicated the pain that no other single person has been able to do.   

FAI.  Lateral impingemt both sides. Dr. Komanduri told me to go home and read up on it.  But, he was certain that I would agree that surgery would be the answer. 

He was right, I did.  I am now 7 days from having my first arthroscopic hip surgery. 

It’s been a long road.  Insurance is a pain and you learn that sometimes you have to be a pain also.  At this point, I can’t quite believe it’s happening. 

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Filed under Arthroscopic surgery, FAI, Femoroacetabular Impingement, Hip Impingement

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