Monday, April 13, 2015

FAI: lead up to the surgery

I haven't posted in a long time. I'll write another post catching everyone up, but the long and the short of it is that I tried to run a marathon, but after my final long run, I started experiencing sharp, somewhat random pain in my hip. the pain started about 4 days after the run, and got worse quickly.

I went to a doctor, and he did x-rays, which showed that I did not have a stress fracture. He suggested I have an MRI with contrast. This is when they give you a shot of light sedation, and then stick a large needle into your hip joint to insert the contrast. this feels very strange. They give you the shot with a live x-ray, so you can watch it go into your joint. I am pretty squeamish, but I thought this was awesome. The rest of the day it feels like you have liquid in your hip- it's like there is extra pressure in there. It doesn't hurt, it just feels uncomfortable.

The first doctor I went to was a shoulder doctor. He and I knew he wouldn't be the final doctor I'd see, but hips and shoulders are pretty similar in the ways things go wrong. He said the MRI showed some fraying of the labrum, but noting too serious. He tentatively diagnosed me with femoral acetabular impingement (FAI), but didn't seem concerned since he saw so little fraying. This was disappointing, since it left me wondering if the sharp pain that was keeping me from running was coming from something else. He prescribed me physical therapy, and I began going twice a week. My PT at the time was very into muscle release through massage, or, as I liked to call it, she pressed into me really hard wherever it hurt. This PT was pretty non-aggressive in her exercises, though. For instance, I never did anything more strenuous than leg raises on a stability ball. This got annoying quickly, especially since I was going from such an active lifestyle to one that was pretty still. I've since changed PTs to Jackson Clinics, which I have really enjoyed. Half of each session is spent with my PT, while the other half is spent with a personal trainer, working on specific exercises.

My first doctor said that if it still hurt in December, to make an  appointment with Dr. Andrew Parker of OrthoVirginia. I had the surgery today and am in pain, and even under these conditions, I would definitely recommend him. The one downside was that it took a really long time, like 2 months, to get an appointment with him. He is the doctor for the Redskins so he's a little busy. He is calm, patient, and knows FAI backwards and forwards. He's done FAI surgery thousands of times so he's seen it all.

He reread my MRI and showed me where my bone was shaped unevenly, which was causing the labral tears were. He said he understood why it was causing pain and that he was confident he could fix it through arthroscopic hip surgery. This diagnosis felt so freeing, since I finally understood where my pain was coming from. He spent a long time with me going over how FAI occurs, how I irritated it, and how he could fix it. If PT doesn't work to "fix" FAI (reduce the symptoms, since you cannot actual fix the impingement), arthroscopic hip surgery is the next option.

I told Dr. Parker I really wanted to ski in Vail with my in-laws the first week of April. He was really supportive of this- he said I wouldn't be able to do any damage that he couldn't fix up in surgery. His understanding of my need to continue to be active, even though it hurt, was something I really appreciated. I scheduled surgery for April 13, and went about life until then.

Before the surgery, I focused on strengthening my core and glutes, hammering out planks, leg raises with resistance, and squats as much as I could. In the end, I think this really helped, since after surgery, you can't use many of your muscles at all.

Next post: Surgery Day

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