Hip Arthroscopy FAI Surgery Round Two—All Done!

[benne68]

How did things go today at the new job, @Sammy-Am? How's the hip tonight?

 

[JusticeRider]

The doctor thinks that my hip flexor tightness and tendinitis are what’s causing my persistent pain.

Standing Hip Flexion (3 sets of 10)
Straight Leg Raises (3 sets of 10) and
Straight Leg Raise + (3 for 30secs)

@Sammy-Am, I can’t help but think that these exercises are just going to continue to aggravate your inflamed hip flexors. You might consider just doing the stretches and giving your hip a rest for at least a few weeks. Only my opinion of course, but it seems like continuing to work them when they’re aggravated may be counterproductive.

On another note, congratulations on your new job, that is so exciting! I hope it goes well and you thrive there And maybe being able to be upright more of the time will help your hip flexors to relax a bit too!

You’ve been through a lot lately and I hope all these new beginnings will come together in the most positive way for you

 

[Sammy-Am]

The doctor thinks that my hip flexor tightness and tendinitis are what’s causing my persistent pain.

Standing Hip Flexion (3 sets of 10)
Straight Leg Raises (3 sets of 10) and
Straight Leg Raise + (3 for 30secs)

@Sammy-Am, I can’t help but think that these exercises are just going to continue to aggravate your inflamed hip flexors. You might consider just doing the stretches and giving your hip a rest for at least a few weeks. Only my opinion of course, but it seems like continuing to work them when they’re aggravated may be counterproductive.

On another note, congratulations on your new job, that is so exciting! I hope it goes well and you thrive there And maybe being able to be upright more of the time will help your hip flexors to relax a bit too!

You’ve been through a lot lately and I hope all these new beginnings will come together in the most positive way for you

Hi @JusticeRider,

Thank you and @benne68! The new job went well today, but was very chaotic. I started working for a local school district and just found out today that I’m working as a 1:1 aide! It was an interesting sensation being on my feet all day, my hip was quite angry this morning, and I’ll have to find a way to accommodate things like getting down on the floor, sitting in smaller sized chairs, etc.

I think the logic of the physical therapist is that my hip flexors are overstretched because of sitting—I’m not at the strength I need to be. We’re hoping that gentle strengthening of the hip flexors will help everything to not feel as “tight,” as the “pulling” of my hip is a big complaint. At the moment stretches actually seem to aggravate the hip as opposed to relieving it.

I’m exhausted atm, but I’ll try to update everyone again soon.

 

[JusticeRider]

Sammy, do let us know how it goes! Also, if the stretches aggravate the hip, maybe don’t do those either? As long as you listen to your hip, you should do well.
I always look forward to your updates

 

[Sammy-Am]

So far everything is going great! This is my first year in this school district and my first year working as a 1:1 aide, so I’m a little uncomfortable (I always am in new environments) so hopefully I’ll adjust soon.

The little girl I’m working with has primarily physical limitations. She alternates between a wheelchair and a walked and as I mentioned yesterday, being in an elementary setting I have to squat down, get on the floor to help her with her leg braces, and of course, walk the ENDLESS school hallways . I’ve been doing okay so far, but didn’t really anticipate the physical load of the new job. I have to speak with my PT at my old job to find the best ways to meet my student’s needs, but also keep my body and my hip happy.

Throughout the day, I mostly have a burning/achey pain in my lower groin/abductors. This is an ongoing issue for the right hip. I had similar pain in my pectineus muscle last year, but this doesn’t feel like necessarily the same issue. I’m still very sensitive to rotation as well.

After eating, I spent a few minutes doing a “Janu Sirasana”/QL (quadratus lumborum) stretch. You’re sitting in a wide legged fold with one leg outstretched and the other leg bent in towards the thigh. You lean over the extended leg and feel a stretch in the side of your back/obliques. (Sorry, I over explain )
Anyhow, I noticed the inner thigh muscles of my right hip were very tight, and when twisting towards my right side, my right hip bone was a little aggravated.

I’m probably going back to my retail job within the next week or two to supplement my income. I have to see how the bills work out (being an aide and requiring health insurance really doesn’t pay well), but that will determine how many more hours I’ll take on. It will probably be close to 30, curse NY state taxes, but at least I’ll have more flexibility with sitting and taking breaks when I need to.

I’m definitely missing being at the PT office and having hot packs at my disposal . But, who can even think of hot packs when you’re sweating your tail off in a sweltering school? Not me! LOL

 

[benne68]

I noticed the inner thigh muscles of my right hip were very tight, and when twisting towards my right side, my right hip bone was a little aggravated.

That's not surprising. Your muscles and soft tissue have been through a lot and it will take time for your body to find a new normal.

Ease into those stretches -- if something causes discomfort, back off for a week or so and then try again.

You are doing great!

 

[Sammy-Am]

Good Morning,

Hope everyone is doing well on this beautiful (and shockingly mild!) Fall day! Welcome to October!

So I made a big (and probably premature) leap back into yoga today. I did my first yin class since before my surgery. While the doctor and I have yet to discuss my return to teaching and practicing, I had a great feeling in my hip walking around work. My pain was limited and I decided why not try one class to just give me an idea of where I’m at.

The focus of the class today was upper body management. With yin being primarily seated and reclined, I had a little bit of trouble being so low to the ground and positioning my hips where the right hip wasn’t pinching. For my fellow yoga friends, my hip LOVED practicing frog’s pose and a reclined eagle variation. I was actually shocked at how much my left side body has tightened up—everything is so rigid.

I had a decent amount of “burning” in the quad and I’m not sure what was just angry soft tissue or my lingering tendinitis. I will say though, that stopping physical therapy and not sitting all day has helped DRASTICALLY. I still struggle with rotation and extension, but the joint (while still angry) seems to be moving better.

I was a little surprised about this “burning” under my butt cheek that seemed to wrap around to the lower abductors. I don’t find this yoga specific, but it’s making me question if it’s abductor tendinitis or something else. The soft tissue discomfort and any burning eased as the class went on and I really focused on just doing “enough” or even less than, instead of really pushing or stretching.

Anyhow, I follow up with the doctor on the 19th of this month. I’ll mention everything to him and see what his stance is on stretching (yoga) and or doing 1x a week PT. So far, just moving with work has been enough, but I would like to see how else I can take the pressure off my hip, pelvic floor muscles, etc.

On that note, I’m off to rest and have an easy Sunday. Enjoy!

 

[Hippie Chick]

Enjoy your Sunday!

 

[Sammy-Am]

Hi Friends!

Gosh, what an exhausting morning! After what felt like an eternity, I finally had a 6 week follow up with my surgeon. I know I haven’t posted on the forum for a while, but unfortunately my hip is still giving me problems. I find I have the most trouble in the mornings and with things like stairs, extended my leg to walk, and just simply being unable to do a lot of activity with my hip. Since my left hip’s recovery was drastically different, I was super eager to see the doctor this morning and get some answers.

So, I had to wait about a half an hour to see the doctor and when he came in, we talked for a little bit and then he examined my hip. He sent me for an X-RAY (my first one post-op) and was happy to see that I didn’t have any arthritis developing as a result of the surgery. He said that the residual pain could be a result of long-standing and pesky inflammation and talked to me about either trying an anti-inflammatory like Meloxicam again, or going for a more aggressive approach and trying a cortisone injection into the hip. We decided on the cortisone injection and decided to do it today to get me some relief and the day off from work LOL.

When using the ultrasound for the injection, the doctor and tech were both surprised to see a giant ball of fluid in the anterior part of the hip. Yay me! Luckily, it looked like the fluid was right outside of the hip joint, so the doctor didn’t think the buildup was anything to worry about in regards to the labrum and what he did in surgery. I asked what the buildup was likely from and he said he couldn’t be certain, but that it could be bursitis. We decided to continue with the injection into the joint and if I’m still having pain at my next follow up, we’ll aspirate the hip to see if that gives me some more relief.

I’m very happy I was able to get some answers today and make some progress with my doctor towards finding relief. I’ll pop on with any new updates after a few days.

 

[benne68]

Glad to read that you may have an answer, @Sammy-Am . Here's hoping the injection works!

Keep us posted.

 

[Layla]

Hi Sammy,
I hope the injection brings some speedy and lasting relief.
Please keep us posted and have a great Sunday and week!
@Sammy-Am

 

[Sammy-Am]

@Layla thank you!

So far, I haven’t had a lot of relief from the injection. I think the front of my hip has calmed a little, making the pain in my groin more noticeable. I forget how long it took the last cortisone injection to take effect,

 

[Sammy-Am]

Good Morning All,

I haven’t posted in a little while and am feeling a little blue. My right hip has been a bit of a mess lately and I’m not sure exactly where to turn.

To start, I think I got at least a couple of days relief from the cortisone injection, but it took at least a week or two to kick in. I don’t follow up with my surgeon until the 30th, but I might call the office tomorrow to see what guidance I can get.

I do feel a slight difference in pain since the surgery. A lot of friends comment on how I’m walking better and how my foot appears straighter. For the last month too, I’ve even wondered if it was my hip at all causing my pain. Working the two jobs, my low back has been killing me. I even made an appointment with the PT for Thursday to have my back evaluated.

But, I took two yoga classes this weekend, one Level 1 class yesterday morning (mostly seated) and a yin class this morning. Now, this isn’t my norm at all, but my mind has been very low lately and I just needed something to stretch my back and pull me out of my depressive state. Anyhow, my back feels AMAZING and my hip still feels like **** .

I’m 5 months out from surgery now and nothing feels “normal.” I know recovery is a year and a half to two years, but my hip just doesn’t feel like it’s improving. Flexion is still the worst, along with groin and front of hip pain.

The doctor and I were discussing draining the hip at my last appointment. Apparently I have fluid right outside the joint that may or may not be bursitis. I’ve even noticed a popping sensation when walking and straightening my leg, but in terms of understanding what’s going on, I’m really at a loss.

I’ll keep everyone updated as the days and weeks progress. I know the days are still very early for me.

Sending you all lots of love and light

 

[Hotchocolate]

I hope when you see the doctor again, they're able to provide you with an option that actually helps :(

 

[Sammy-Am]

I hope when you see the doctor again, they're able to provide you with an option that actually helps :(

Thank you. My surgeon is actually quite helpful and responsive. Cortisone just doesn’t work for some people

 

[mature mama]

Thank you. My surgeon is actually quite helpful and responsive. Cortisone just doesn’t work for some people

I agree. I have had cortisone in both knees and hips. Even with sonogram guided placement of the shot, only half the time or so was it effective .

 

[springs12]

@Sammy-Am I just got back on here as I just had my other hip replaced 11/16. I'm so sorry to hear you are still struggling! I know this has to be so hard at the age of 32. I'm 45 and feel I've missed out on the past four years of my life. I know I have a long road ahead because of the many compensations my back and pretty much every muscle head to toe has taken on.

Sometimes I wonder if cortisone shots don't always work because they don't address the root of the problem and the body just says nope. Hopefully it is some form of bursitis and they can drain the fluid and that will help.

I went back and glanced through threads, even what you and I wrote so forgive me if any of these are repeat questions. These are my thoughts to investigate IF the aspiration doesn't reveal much and give relief.

• What led to your arthroscopies? I am assuming torn labrums (as one signature indicates).
• Are you a bendy person? I'm sure having done yoga for so many years you have been quite flexible, but I mean overly bendy and hypermobile.
• Is your doctor a hip preservationist or an orthopedic surgeon? I ask bc I have mild dysplasia (I guess had now that I have two hip replacements. An OS did not see the mild dysplasia. My hip preservationist ordered a 3D CT, and even on that the radiologist did not make note of the dysplasia (I had an anterior pelvic tilt that made the angles misleading). The hip preservationist reviewed them with me and explained that I had mild dysplasia. Basically, I had in both hips mild dysplasia, cam impingements, osteoarthritis, and labral tears. All of this to say, I'm asking because if there are shallower sockets, it can make it harder for your muscles to work because they are trying harder to keep you together.

I just am throwing out some other thoughts because you are young to have had this. I know labral tears are common, especially in athletes. I also know that hip problems at younger ages are often due to avascular necrosis, hip dysplasia, and/or injury.

Sending good vibes your way!

 

[Sammy-Am]

@Sammy-Am I just got back on here as I just had my other hip replaced 11/16. I'm so sorry to hear you are still struggling! I know this has to be so hard at the age of 32. I'm 45 and feel I've missed out on the past four years of my life. I know I have a long road ahead because of the many compensations my back and pretty much every muscle head to toe has taken on.

Sometimes I wonder if cortisone shots don't always work because they don't address the root of the problem and the body just says nope. Hopefully it is some form of bursitis and they can drain the fluid and that will help.

I went back and glanced through threads, even what you and I wrote so forgive me if any of these are repeat questions. These are my thoughts to investigate IF the aspiration doesn't reveal much and give relief.

• What led to your arthroscopies? I am assuming torn labrums (as one signature indicates).
• Are you a bendy person? I'm sure having done yoga for so many years you have been quite flexible, but I mean overly bendy and hypermobile.
• Is your doctor a hip preservationist or an orthopedic surgeon? I ask bc I have mild dysplasia (I guess had now that I have two hip replacements. An OS did not see the mild dysplasia. My hip preservationist ordered a 3D CT, and even on that the radiologist did not make note of the dysplasia (I had an anterior pelvic tilt that made the angles misleading). The hip preservationist reviewed them with me and explained that I had mild dysplasia. Basically, I had in both hips mild dysplasia, cam impingements, osteoarthritis, and labral tears. All of this to say, I'm asking because if there are shallower sockets, it can make it harder for your muscles to work because they are trying harder to keep you together.

I just am throwing out some other thoughts because you are young to have had this. I know labral tears are common, especially in athletes. I also know that hip problems at younger ages are often due to avascular necrosis, hip dysplasia, and/or injury.

Sending good vibes your

Hi @springs12!

Congratulations on your new replacement—so happy for you! How are you feeling?

I’m doing okay, to be honest. I’m incredibly exhausted today after working a long Black Friday shift. My hip was very sore yesterday and this morning I forgot my phone, had to turn my car around, and for whatever reason, decided to sprint back to my apartment. Needless to say my hip was killing me for a few hours this morning! But truthfully, standing at the register for most of the day today, I really wasn’t in too much pain.

Anyhow, I noticed last night that external rotation and even squatting feels mostly fine. It’s really just internal rotation and flexion that still bother me the most.

I appreciate all of the questions that you posed. I’m not sure why the cortisone injection didn’t work. I think my surgeon and I are beginning to realize that hip flexor tendinitis isn’t the “main diagnosis” and might instead me a subset of whatever we’re dealing with, which I feel is still impingement related. We’re not sure if the fluid is bursitis or not, but from my understanding we’ll investigate that more when I see him on Thursday.

To answer your questions:
- I have bilateral femoral anteversion. Given my age, my doctor didn’t recommend a de-rotation. I had labral tears and cam and pincer impingements in both hips. I had wonderful success with the left side and nagging front of hip pain and hip flexor pain with the right hip. The groin pain has mostly gotten better, but is persistent in the iliopsoas region.

- I am a bendy person. I wouldn’t say that I’ve ever had “hyper mobile” hips, but my joints have definitely suffered over the years from yoga, lack of strength, and testing my limitations.

- My doctor is an orthopedic surgeon who specializes in hip arthroscopy. We didn’t get a CT scan and didn’t measure the exact degree of version as my intoeing was pretty obvious that abnormalities were present. So far, there hasn’t been a conversation as to me seeing a hip preservationist. I’ve researched the idea somewhat myself, but don’t see a lot of symptoms that resonate with my hips.

I’m not sure what the game plan for Thursday is. I think we might do the aspiration, but I’m not sure what else my surgeon will say. We did an X-RAY last visit that didn’t note any joint degeneration or OA.

Thank you for your guidance and I’ll be sure to update after my visit.

 

[springs12]

Congratulations on your new replacement—so happy for you! How are you feeling?

Thanks! I'm overall doing well. I do not have the intense pain in my rectus femoris tendon that I had with my right, nor do I have the intense quad pain. I still have soreness and tightness from that surgery back in June, but it is improving. The left has honestly been much less painful. I rented a game ready so I am babying it for two weeks with ice and compression every 30 minutes. My surgeon has all his patients walk with a walker with no wheels for two weeks and is pretty strict about us not doing a lot. We have bed PT exercises for circulation, but that is about it. I think I will definitely be doing PT around 6 weeks to take care of all the muscular compensations.
I am bored. Haha.

Good for you for working so hard and trying to get back to life. I'm glad you can get through many things, but it sucks to still have pain. Prior to this surgery, I had a weekend of yard work with my husband where I got 16,000 steps two days in a row. I could not believe it. My left hip and back let me know they were not happy. My right hip's soft tissues were aggravated but they recovered over night.

To answer your questions:
- I have bilateral femoral anteversion. Given my age, my doctor didn’t recommend a de-rotation. I had labral tears and cam and pincer impingements in both hips. I had wonderful success with the left side and nagging front of hip pain and hip flexor pain with the right hip. The groin pain has mostly gotten better, but is persistent in the iliopsoas region.

- I am a bendy person. I wouldn’t say that I’ve ever had “hyper mobile” hips, but my joints have definitely suffered over the years from yoga, lack of strength, and testing my limitations.

- My doctor is an orthopedic surgeon who specializes in hip arthroscopy. We didn’t get a CT scan and didn’t measure the exact degree of version as my intoeing was pretty obvious that abnormalities were present. So far, there hasn’t been a conversation as to me seeing a hip preservationist. I’ve researched the idea somewhat myself, but don’t see a lot of symptoms that resonate with my hips.

I think I recall the femoral anteversion. My sister had dysplasia caught as a baby, but she also had the anteversion I believe, and they corrected it. It is all very complicated. My hips were excessively bendy from my dysplasia so I could never stretch how incredibly tight all my muscles were. I can tell you that I did not have the typical dysplasia symptoms (although I do have the tight pelvic floor, had hidden hernias, as well as FAI: all caused by my dysplasia). My doctor went on intuition with me. He said I was a "complicated case". I hope your right hip subsides and you get relief soon, as well as answers with your doctor. I share my "complicated case" to encourage you to keep on keeping on. If no answers are discovered, it might be worth talking with another hip specialist that works with the younger population. My doctor sees kids as young as 16 and works with mostly a "younger" population.