UKC

Any climbers out there with femoracetabular impingement (FAI, essentially a mis-fit of the hip joint so it cams out at certain angles) and what did you do about it?

Just had a diagnosis on hip problem - specialist is 90% sure its this from 1st x-ray, needs an MRI for a better diagnosis. Had aches around that hip for a couple of years now but rapidly getting worse, it takes a few days to get over a hard wall session these days to the point where I'm starting to limp. I get sharp pain when I do a wide bridge move and can't do open-hip moves.

Options seem to be intensive physio vs keyhole surgery to remove bone growth and re-shape the hip. Outcomes after a year from both are about 80% but they don't know beyond that point. Keen to hear from anybody that tried either option and how it went from a climbing perspective.

I'm pretty nervous about the idea of surgery on a joint at this age (early 30s) as any work has to last 40-50 years. On the other hand FAI is connected with early arthritis and there is a history of that in my family. Some specialists will describe it as a "mechanical problem with a mechanical solution" whilst standard NHS practise is physio.

As it happens I've been presented with the option of joining a clinical trial where they follow outcomes of both routes. Problem is its randomised so I don't get a choice of treatment but I do get fairly intensive monitoring over time.

I'm 50% thinking "get this sorted now so I don't get arthritis and can keep climbing" but the other half of me thinks "avoid surgery if at all possible". Anybody who has had similar problems might be able to give me their experience.

In reply to petellis:
Hi,

I had a hip arthroscopy in July of this year following hip pain from FAI for about 18 months. I tried about a years worth of physio before getting referred to a surgeon and wish I'd done it earlier. I'm 28 and was doing a lot of running, climbing and netball before my pain started.

Physio didn't really help the worst bit of my hip pain (the horrible pinching pain deep inside) at all prior to surgery, but did help the pain that was caused by the pinching pain (i was very sore in my lower back, piriformus and the outside of my hip).

My surgery showed no labral tear thankfully but some cartilage that was flapping around! They shaved a bit of bone off and sorted out the cartilage. I was on crutches for 3-4 weeks and was back at work at 4 weeks post-op. The recovery has felt slow at times, but I'm a bit of a perfectionist!

I still have some residual pain sitting around for too long, but I can now run (a bit) and I'm climbing better than I was pre-op (5 months ago). I was able to start climbing again about 10 weeks after surgery, though stuck to sport and trad climbing as the impact of bouldering if I fell off was a little too much to start off with. This is totally fine now and like I said, my climbing has come on leaps and bounds. I started climbing whilst my hip was just starting to become an issue. Hopefully there will still be improvements as im still building up my strength again and ensuring that I build up my glute strength and my core (my pelvis is a bit too tilted forwards).

I'm really glad I got surgery, but it is a very personal choice!

In reply to nic_nac_doodle:
As I understood it, physio can't fix the problem but I could be wrong.
I had surgery for fai about 5 years ago, shaved off some bone, repaired a labral tear and removed some cartilage that wawas too damaged toto repair. I still had a similar pain after 6 months of rehab so they realised they hadn't removed enough bone. I had a second lot of surgery 3 years later (due to nymy circumstances I wasntwasn't able to get it done sooner ). And it has been greatgreat ever since.

In reply to nic_nac_doodle:

Thanks for the reply.

Sounds like you had the same symptoms - I get discomfort most of the time at the top of the outside of my thigh but if I provoke it I get the pinching nasty pain in the actual joint area by lifting my leg out to the side (e.g. getting on a bike).

A month off work seems like quite a commitment and your 6 month re-hab sounds hard work but if it were to fix it in the long term that would be good.

ck85:

My (private) physio was saying the same: "if its bone shape problem I can't help". Interesting to hear from somebody who has had it done a while back. Been great ever since sounds encouraging!

I think the problem i have is that the reading I have done hasn't been convincing for surgery, essentially they talk about the procedure but don't give statistics on outcomes. But this is probably because (in the UK at least) there hasn't been a longterm study done on outcomes.

In reply to petellis:

I definitely could have been back to work in 2 weeks but I have to drive for my job so needed to be off crutches!

It has been hard, but the amount of pain I was in was far worse. It would keep me awake at night and made my day to day life unbearable, even with pain killers. The pain got worse over time because of all the compensating my body was doing.

You're right, there's very few studies on outcome. My surgeon (I'm from Newcastle) does about 50 a year and said that generally there's an 80% chance that the op will help, but my physio at that the time agreed that there was nothing that physiotherapy could offer. When I posted about this a few months ago (I was concerned about when I could get climbing again!) there were a few people who had had the same surgery too with good outcomes. You're young and fit, so that always helps!

Get the mri and see what they say. It may be that surgery isn't even indicated. Only then can you make a real informed decision.