Hip rehab


Instead of going under the knife, I’m trying this colourful collection first. 🙂

In the early evening of 12 December 2016, I got up from the couch to have a look at the jam I was cooking, when suddenly I had excruciating pain in my right hip area. Hunched over holding on to the couch, I knew that something was badly wrong. Even just breathing had me in agony, and with gasps and involuntary tears in my eyes, I found my way back to the couch. Several hours later and with the help of a handful of pain pills and Voltaren, I could manage to get myself into bed where I promptly faded into a deep sleep hoping that everything will be better in the morning.

During the months of August and September, I went through a set of tests and scans and was diagnosed with cam FAI (femora-acetabular impingement) in my right hip. I was told by the surgeon that it can be fixed by grinding away the bone that is impinging (NZ$20k) and/or to consider a different sport.

Dumbstruck by this diagnosis, my daily exercise, which had been steadily declining since the end of July anyway, came to an abrupt halt. And then the weirdest thing happened – where I previously (while still running roughly around 40-70km per week in the months leading up to the diagnoses) only had pain around my ilium crest, it had suddenly moved down to my groin and into the whole hip joint area, and also extending down into my right leg to my knee. The ilium crest pain was still manageable while running, whereas what happened after I stopped running, was debilitating. Maybe it was coincidence and the shift in pain would have happened anyway? Either way, my hip was in shut-down mode and I was hobbling everywhere I had to go.

This caused me to doubt the FAI diagnoses. Yet again, cynic that I am, I question the whole field of medicine. There are too many variables and it is fair to say that most diagnoses could be any number of things with similar symptoms. In this case, it may as well be dormant butt syndrome, or ischiofemoral impingement, trochanteric bursitis, trendelenburg sign, snapping hip syndrome, and so on. Yes, the MRI showed otherwise, but the fact the every second person you speak to suddenly has deformed hip bones and therefore FAI problems, makes it sound like a bit of a fad. Almost like the “ITB snip” was a few years ago. I know I will get a lot of flack for saying this, by why is it then that my left hip is presumably fine? The left hip being the one that has been making a very deep and loud clicking sound since I was about 19 years old? My right hip only started making a very soft clicking sound after I’ve been diagnosed with FAI. Is my mind playing tricks on me?

Ever since the original pain/niggle that got me going to the physio in the first place, was unlike the symptoms of FAI, I starting searching for alternatives. Is the bone deformity really the problem? Is it tight muscles? Or muscle imbalance? Because let’s be honest here – I don’t really put much effort into stretching and this may well have impaired my mobility. Is it fascia? Is it a nerve pinching? The pain of 12 December certainly did feel like a nerve pinching somewhere. Bone rubbing against bone can’t feel like that, can it?

That was when I reached out to Dr Google again. I had to start somewhere, and therefore searched for non-surgical FAI treatments, when I stumbled upon The FAI Fix. On 19 December 2016 (NZ time) I subscribed to their self-help treatment plan. I know I haven’t been good at stretching and strengthening and thought I’ll start there. However, being the silly season and making plans to go hiking for five days (yes – probably not a good idea), I didn’t get to do anything about it for another few weeks.

Upon our return from the hike (which went very well, thank you, with a fraction of the hip pain/discomfort I experience on a normal, sedentary day), I slowly started to incorporate the exercises into my daily routine. As with everything, it will take time. For starters, just to do the quad-roll, you have to spent a lot of time in a planking or reverse planking position which is very hard if you don’t have the muscle strength. Any amount of rolling and sitting on a ball proved a challenge. So, instead of spending an hour or so to get through all the exercises in one session, I tried to slowly incorporate them throughout the day. Initially, I could only manage two of the tissue work exercises a day and one stretch. But I’ve gradually gotten better at it and stronger so can do a few more now. It will probably take a few months of dedicated effort before I can do all the exercises they recommend.

And so far I’ve managed to move the pain around. Sometimes it is in my groin. Other times it is in my hip. Every now and again it is back on my ilium crest. Most of the time it still extends into and down my leg. It still feels as if something is pulling my knee out of its “groove”. But overall there is definitely some improvement and much less pain. If only I can figure out what exactly is the cause of the pain I feel running from my hip and into my knee, and what to do about it, things will improve even more.

For the foreseeable future, these two sites will be my go-to for self-help treatments, until things are either better, or I’ve proved myself wrong and have to get the operation. In which case I don’t know what to do, as we simply don’t have the money.

Just by the way: FAI is usually associated with sports such as ice hockey, horseback riding, yoga, football (American), soccer, ballet/dance/acrobatics, golf, tennis, baseball, lacrosse, field hockey, rugby, bike riding/cycling, martial arts and mixed martial arts, deep squatting activities such as power lifting, surfing, rowing sports (kayaking, sculling/rowing), car riding, flying in an airplane (deep seated position, bucket seat position), and not necessarily running.

Bottom line is, yes, I have hip dysplasia, yes, I have growth on my femur – can’t get away from that fact, but is the only solution an invasive operation? Is it not manageable through tissue work, strength training and stretching like The FAI Fix guys suggests? Only time will tell, I guess.

4 thoughts on “Hip rehab

  1. I agree with you that there are too many variables to get stuck on one diagnosis. And surgeons (obviously) are ready to operate to correct the symptom. But, the pain/discomfort/niggle is a symptom of a problem and the problem needs to be corrected, not the symptom removed.
    I broke my foot a number of years ago. One physio told me to put on a moon boot for 6 weeks and forget about running comrades. Another therapist said let’s treat for full range of motion and see what happens, anything is possible. I comfortably finished comrades that year.
    Have a read of this http://thelynomethod.com/what-is-causing-your-hip-pain/

    • Thanks Staci. It is fantastic that your foot situation could be sorted, to allow you to still run ultras! You doing it again this year?
      I played a lot of badminton as a student (and after) and even then I could see a huge difference in my groin muscle development. The one was short and tight while the other was a much longer muscle. Wish I can find a physio that can assess everything and relieve fascia and muscle tightness where necessary.

  2. Pingback: The Greatest Virtual Run – Jog around the Blog

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