(EDIT: Thankfully I've now found out a cure for the impingement as well I do have a tear, but it's very, very slight. You can read more about it here.)
Just got back from seeing Dr. Wagner, and after looking at my MRI he said I don't have a labrum tear, but I do have femoral acetabular impingement (FAI).
FAI is a what happens when your femur or hip socket is malformed, causing a friction spont in the joint. This friction spot can wear away the cartilige, and can lead to osteoarthritis and eventually a hip replacement.
This daignosis was nothing new, as that's what Dr. Johnson diagnosed in early August. What was new was what Dr. Wagner said I could and couldn't do. Unlike Dr. Johnson, Dr. Wagner said he wanted me to keep exercising (good), but I can't do high impact exercises anymore (bad). The conversation went something like this:
"So no more squats?"
"No, no squats."
"Deadlifts?"
"Definitely not, that's too much weight on you hip."
"Kettle bell swings?"
"I wouldn't do those, you can work your upper body though."
"So I can still do the Jerk or strict press then?"
"No, because you hip is bearing weight."
"Well, what other exercises can I not do?"
"No running either, maybe a little elliptical; cycling is iffy, just don't push yourself and use a recumbent bike. No exercise where you feet leave the ground, either, so no basketball."
"Can I swim?"
"Yes."
Hearing a doctor tell me I can no longer do the things I love crushed me. I knew there is a treatment (surgery), but the way he said it all I could do was focus on the idea of never being able to deadlift or run again, and it scared the bejesus out of me. Given Dr. Wagner's orders, the only exercise I can do is dips, ring rows, push ups, sit ups, Handstand push ups, and pull ups. This could work except for the fact that I'm still finding my limits with my shoulder. If I can't do these exercises until after surgery, I'm not sure how I will be able to crossfit....
I also don't know what to make of Dr. Wagner's opinion that I should no longer do load bearing exercises. Dr. Johnson is a sports doc, and after his FAI diagnosis he didn't seem to think I should stop exercising. Dr. Johnson is also well aware of what I do, I ended up showing him a crossfit video during our meeting.
However, Dr. Johnson never saw the MRI with contrast. Perhaps my hip is worse off than he thought. FIA leads to degenerative diseases, like arthritis, and working out will make it worse. My mother is having her first of two hip replacement surgeries next month, so it's possible this problem is something I've inherited.
Whatever the case, I will have to have arthroscopic surgery to fix this problem. I am going to have to make another appointment with Dr. Johnson, and start talking about my options. I'm not looking forward to having surgery, but it would be way better than a reduction of exercise. Also, from what I understand the FIA untreated will get worse no matter what, and it will only be a matter of time before I need a hip replacement. This surgery may be preventative, although they aren't totally sure about this.
So I don't know what I should do, should I stop crossfitting for now? I just don't know, I need some time to process this...
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7 comments:
Adam what did you end up doing?
I've been having a recurring rt hip problem and just going to get an MRI soon. I've been working with a phy therapist and doing all the mobility right, on 13.3 the problem popped up again. My pt told me What I explained to her was a labral tear. Man I hate to lose all theses gains I've had these past few weeks.
Phillip
Phillip for the laberal tear I ended up getting PRP injections, that seemed to help greatly for me. Just remember that the tear itself isn't causing the pain (your labrum doesn't have any pain nerves), it's most likely your muscles dealing poor mobility and improper mechanics. For example, my psoas was super tight/painful because it was trying to protect my unstable hip. The injections rendered my hip more stable, thus the psoas could relax, calm down, and no longer be painful.
If you're like most people the tear is just one part of the problem, so it's good that you're seeing a PT.
Have you read my article on what to do since being diagnosed with FAI? I recognize you are concerned with a tear and not an impingement but I imagine some of the therapies suggested in there could help you out.
There is one PT, Dan Pope, had hip impingement and a laberal tear. He didn't get surgery and is now crossfitting/ lifting heavy weights. I've linked to his hip articles in my more recent posts, so you can find his blog there. Perhaps he could help you out as well.
Hi Adam,
I was diagnosed a few years back with bilateral FAI, bilateral retroverted acetabulum, and labral tears.
I got multiple opinions. A couple docs said just modify your activities. At the time I wasn't doing crossfit and was just lifting weights and running long distances. So I stopped running long distances and really modified my weight lifting, which seemed to help with the pain.
One doctor recommended arthroscopic surgery and another recommended a surgery that completely scared me called reverse acetabular osteotomy. This is where they go in and cut the acetabulum and re-orient the joint to address the retroversion. This doctor said arthroscopic surgery wouldn't address my issues. This was about 1 year ago and I decided against it.
Recently I have been doing crossfit and loving it but the hip problems have started to come back especially with WODs that include deadlifting. I have been seeing a chiropractor for a couple weeks and I am not sure if that is going to do any good, but I have another appt with an ortho in May to see about scheduling arthroscopic surgery this summer. It is the same doctor who did arthroscopic surgery on my younger brother (who had FAI in one hip) so hopefully he can help me.
Let me know what you think about all this and if you are going to get surgery.
Hi Adam,
I was diagnosed a few years back with bilateral FAI, bilateral retroverted acetabulum, and labral tears.
I got multiple opinions. A couple docs said just modify your activities. At the time I wasn't doing crossfit and was just lifting weights and running long distances. So I stopped running long distances and really modified my weight lifting, which seemed to help with the pain.
One doctor recommended arthroscopic surgery and another recommended a surgery that completely scared me called reverse acetabular osteotomy. This is where they go in and cut the acetabulum and re-orient the joint to address the retroversion. This doctor said arthroscopic surgery wouldn't address my issues. This was about 1 year ago and I decided against it.
Recently I have been doing crossfit and loving it but the hip problems have started to come back especially with WODs that include deadlifting. I have been seeing a chiropractor for a couple weeks and I am not sure if that is going to do any good, but I have another appt with an ortho in May to see about scheduling arthroscopic surgery this summer. It is the same doctor who did arthroscopic surgery on my younger brother (who had FAI in one hip) so hopefully he can help me.
Let me know what you think about all this and if you are going to get surgery.
I ended up not getting surgery. For me, the mobility work fixed the FAI and the PRP seemed to repair the torn labrum. I still have poor squat mechanics due to the APT but am working on that and I project by the end of this year I'll be squatting heavy again.
....Your case sounds much more severe than mine, but if you're looking for options you could call/email Dr. Hauser in Chicago and see if he could help you. I've heard of RAOs before on hipchicks but have no personal knowledge of them or their effectiveness. ...I've been told that those with hip displasia should not get the FAI surgery. A friend of mine actually had the FAI surgery but ended up worse than before because the doctor missed the fact she had hip dysplasia.
Curious, who is it that fixed your brother's hip?
Thanks Adam, I would like to contact that doctor to get his opinion. It couldn't hurt.
As for my brother he just had the surgery in February on his right hip so he is still recovering. Not sure if it will be a success or not.
He saw Dr. Safran at Stanford. The doctor who recommended RAO to me is Dr. Safran's colleague, Dr. Bellino.
I saw you mentioned something in your blog about a Dr. Bruno. I saw a doctor by that name when I was in the Navy. Long shot, but just wondering if it was the same one.
The chiropractor I am seeing was recommended by my Crossfit Gym. He thinks he may be able to help me.
Hip pain is a tricky thing, all kinds of things can be off, like FAI, but actually not cause pain. I'm finding that the pain usually stems from muscles being either stretched or adhesions in the muscles. For example, I just met a girl with FAI, but is finding out that all of her pain is stemming from SI joint dysfunction. when she does exercises to put it back in place, she's pain free (albeit this is only temporary) Her pain has nothing to do with her FAI. The point of all of this is that a chiro might help relieve the pain, if nothing else you can find out if your pelvis is twisted and stuff like that.
Dr. Hauser's webstie is www.caringmedical.com, they seem to be responsive to emails and phone calls.
Dr. Bruno does work in the DC area, perhaps he was in the military, but I have no idea.
Hope the surgery works out for your brother. Lots of people report a honeymoon phase of like 3 months then things either get worse or go back to the way they were. So I'm really hoping he's the exception not the rule.
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