Femoral Acetabular Impingement

Say that title five times in a row......

I generally stick to riding topics but this affects my riding so I guess it applies. I also hope that maybe it will help someone who is going through the same thing as me. 

I have had back pain since I was a kid. In my teens it was a biproduct of figuring skating. When you slam into the ice 50+ times a session learning a new jump a sore back isn't much of a suprise. I traded that for diving head first into the ground off horses and my chiropractor got to stay in buisiness. Six or seven years ago I was falling much less but decided to have a gravity squall off Bre mid jump. I got back on but when I got off I couldn't put weight on my right leg without feeling like a tiger was tearing into me. (I did however drive myself to the ER)

I spent six weeks on crutches without a diagnosis from kaiser. 

Ever since then something has been off w my hip. My back pain flares up and I can hardly function. My right hip is permantly crooked. My right leg also happens to be my landing leg from skating days (and side most likely to get wrenched in bad landings). I tried to get it figured out but Kaiser kept saying nothing was wrong. My new line of work meant new medical providers and I thought maybe someone would listen. First doc (a resident) says "we can't really do anything for back pain anyway". Went back mid flare up hoping them seeing my symptoms first hand would help and got the "go get an xray, rest, and come back if it doesn't resolve." If it hasn't resolved in 6 years and is steadily getting worse what makes you think it will now? He even had the nerve to call back and say my xray was "normal." He did agree to send me to PT which has made me worse. 

Funny thing about that xray. It wasn't normal. I read the radiology report. I have extra bone on my femoral head that predisposes me to something called FAI. Do some armchair google diagnosing and I find out that people with FAI can have pain for years that and never be diagnosed. One of the problems is that pain is often in the back, groin, or even abdomen so no one catches a clue about the hip. 

Last week I finally found a primary care doc accepting new patients who happens to be certified in sports medicine. She listened to my stories of being shrugged off. I told her how I went from being active to avoiding hiking excercise due to the pain. Horses are all I have left and giving that up isn't an option. I told her that my last PT round helped my back but I now have round the clock hip pain. 

She listened! I was prepared to bring up what I thought might be going on and fight with her over it. I didn't even have to go there. She said what she thought I had (FAI) before I did and showed me where the problem was in my xray. She came up with a plan for PT first, if that doesn't work joint injections, followed by surgery. It was amazing to have a doc listen and even have a clear plan that makes total sense. Surgery might be in my future but at this point I'm ok with that. I've been struggling so long anything that helps will be a relief. 

Basically FAI means you have bone in your hip joint where it shouldn't be. People are usually born that what and it becomes a problem when the bone damages cartilage inside the hip joint. If you're like me and have been dealing with random low back pain of unidentified you might want to have your hips looked at. One of the websites I found listed horse riding as a risk factor. Go figure. 

Here's a normal happy hip:

Here are some hips with extra bone in unhelpful places (cam impingement is what I have)

If you're interested this website gives a nice overview:

http://orthoinfo.aaos.org/topic.cfm?topic=A00571