Hip impingements are a pain in the arse  

I started this post back in 2016 and never got around to finishing it, probably because I was so hacked off with what is such a frustrating injury. I picked it up again in 2020, again never got around to publishing but as it’s now the eve of my operation to have a total hip replacement, think it’s high time I get this out there, as much for anyone else suffering with FAI (Femoral Acetabular Impingement) as myself.

Hip impingements aren’t so much of an injury, more of a “condition”. What’s more, there seems to be little consensus about the cause and even less consensus about the treatment.

My struggles with FAI started back in 2012. I was coming off my first season of Triathlon and had got the fitness bug big time, so much so that I was regularly cycling or running into work. Having conquered Olympic distance triathlons but not being particularly fast, I had found my niche for longer endurance events and had my sights set on Marathons and beyond. It was on one of these commuting runs one April morning that I felt/heard a horrendous snapping/popping in my right hip.

I didn’t know what had happened (torn labrum) but I did know that I could hardly walk, much less run.

I hobbled in to the office, figuring I’d maybe pulled something and that in time, with rest, everything would be fine.

It wasn’t fine. I went to the GP and was told the usual, rest and ice and stop being an idiot running into work. I did as I was told (couldn’t do much else really) but although the initial pain resided, as soon as I attempted to resume any activity a dull burn would creep in and everything would seize up.

I’ll let 2016 me give some insight (two years on from eventually getting arthroscopic surgery on my right hip in 2014)…

pain manifests itself all over the place, radiating out into the glutes, thighs (IT band, quads etc) knees and even back. Sometimes, like this week, I find myself wanting to give up, what’s the point? Just settle for a life as a couch potato and say goodbye to all the biking and hiking that I love. But I’m not ready to do that, I love being outside, exploring and pushing myself, just that this damn thing really does make that hard to do. Don’t get me wrong, I count myself fortunate that I can do the basics, walk and generally live the majority of my day to day life largely pain free. Some people have it a whole lot worse so I’m not trying to martyr myself but it’s essentially something that can’t be fixed (save for a hip replacement) so not a minor gripe…

After two solid years of research and badgering my GP, he finally relented and sent me to see a consultant in 2014 (after first informing me that this type of thing is very rare so he’d be surprised if it was indeed impingement!).

The text above illustrates my mindset in 2016, two years after surgery on my right hip but by now starting to get similar issues with my left. I guess I knew what was coming – the long battle to convince the medical professionals that there was an issue whilst trying to manage the pain in the meantime.

I often half joked that I’d have rather broken my leg, at least it would have been visible (sympathy points!) and relatively straightforward to diagnose.

The issue with FAI is that outwardly you can appear to be functioning normally and often even manage sport but the cost would inevitably be due once you stop moving. Many times I’ve been waiting in Orthopaedic consultant waiting rooms, surrounded by people with obvious breaks and injuries yet jumping and striding forward when my name was called, feeling guilty at my lack of obvious symptoms.

Writing this now in August 2020, over 8 years on from that initial “pop” that April morning and I could never have anticipated a near decade long struggle to get this issue sorted out.

I had arthroscopic surgery on my left hip back in December 2017 and despite promising signs initially, I’m now awaiting the results and follow up appointment with my consultant following a recent MRI and CT scan on my left hip.

The hip flaired up last summer and despite settling on and off hasn’t ever really been right since. So I’m back popping the Naproxen and trying to remember to do my strengthening exercises (which actually do help!) whilst waiting to see if more surgery is on the cards and if not then what…?!

But, despite all that I am managing to get outdoors, both hiking and on my bike. I’ve even managed some pretty big rides this year, creeping up towards my pre surgery distances. I’ve done back to back days and managed some bikepacking trips. I dabbled with a return to running for a while and despite managing a couple of trail half marathons decided the punishment on the body just wasn’t worth it.

I guess then that the point of this post was firstly to get this whole bullshit scenario off my chest but also to maybe offer a glimmer of hope to anyone else out there suffering with this particular issue.

Whilst it may not be life or death, having a constant background pain can really drag you down but stay positive and maybe try to use the downtime from running, riding or whatever your sport to try something new and gain a new perspective outside.

One of the biggest frustrations for me has been weight gain. I’m not very disciplined with my diet and would often use exercise to combat my food excesses. Walking just doesn’t cut it compared to running or cycling.

Ironically, cycling with this condition is a catch 22. Whilst it puts far less stress on the joints, it also causes flexion of the hips which can aggravate the impingement.

I remember watching a video of American ultra runner Anton Krupicka talking about his numerous injuries and lamenting that he was “so limited by his body, I just break down all the time”, something I could sympathise with and a notion that frustrated me immensely as Doctors and Social Media told me I should lose weight, be active, all that bollocks.

Yea, I’d say, never mind your couch to 5k, or those walking the London Marathon, I wanna be running ultras and bikepacking the length of the country. Unfortunately, whilst the mind was willing (and arrogant), the body wasn’t.

Still, surgery is booked in for November. It frankly scares the crap out of me. Apparently they want to do an epidural so I’ll technically be awake (although doped up) during the procedure. Yikes. The alternative is a full general anaesthetic which is a little too close to death for my liking. It’s a lot of stress, risk and concern for a non life threatening injury. But it is a life limiting injury so I guess I’m willing to accept the risks at this stage.

I’m still not sure what the replacement will allow me to do. By some accounts it’s a one shot miracle cure and I could be back running and biking as if the last 9 years never happened (assuming my right hip holds out). My consultant however is, understandably, a little more cautious.

I’d settle for biking over running. Although nothing beats the simplicity of lacing up your shoes and hitting the trail, no mechanical parts or punctures or bike cleaning to worry about, I accept I have to be mindful of my own mechanical parts, even if some of them will be man made in the future. To be decided I guess…

A few things I’ve learned (if not always adhered to) to help whilst dealing with FAI:

Clams – do your damn clams. I find strength work hellishly boring but it works!

Diet – wallow in chocolate and pizza and crisps if you must but try to focus on being ready. Every extra pound of weight carried won’t help your hips much so try to keep the comfort eating to a minimum.

Focus – as the old saying goes, if you can run, run. If you can’t run, walk. If you can’t walk, crawl. Perhaps look at other ways of enjoying your outdoor fix. Take up photography, adjust your goals accordingly. Try to do what you can.

Believe – as Mr Krupicka himself proved earlier this year (yes I have a man crush) it may not be today, tomorrow, next month, next year or even 5 years but comebacks are possible. Fingers crossed…


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