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FAI in both hips

Jan 18th, 2018

I am a 37yo male amateur racing cyclist. I have FAI in both hips, with pain on the right that led to an arthroscopy op in july ’17 that included microfracture, repair to the labrum, and removal of the lesion. 7 months on and I am still doing physio which is now mostly lifting weights – single leg stuff, split squats, deadlifts – however, I am STILL getting pain in the right hip/groin area after cycling, particularly after any kind of harder efforts.

No pain in the left unoperated hip. I am keen for any advice on how much cycling I should be doing, the prognosis for my ‘racing career’, and whether it is a case of adapting my position on the bike to suit my physiology better.

Thanks!

ps I also have AS which causes inflammation of the SI joint after cycling, for which I take NSAIDS.

Jan 18th, 2018

The Guru Responded:

Hi Charles

Tricky!

 

You’ve had a good few things done to your hip – all of which are currently fairly controversial because pathology (i.e. what you’ve got or had) doesn’t necessarily equate to symptomology (what you feel).
Micro fracturing is pretty uncommon, and more common (but becoming less so) in the knee as one of the issues post op is pain and loading. How much, when for how long. The micro fracture is trying to give the surface of your joint some new cartilage, which is not as good as the old, original cartilage but it’s OK – the cartilage really protects the bone from (excessive) load. If you load the joint too early or too much you risk “sluffing” off the new fibrocartilage, potentially making the situation worse.

 

You’re 7 months down the road and this may well not be the case, and your OS should have managed all your expectations about time, recovery etc as he did the op. I definitely recommend getting a word in his ear to see what he thinks.

 

I’d also get someone who knows what they are doing to have a look at your spinal mechanics. Clinically I see a lot of “FAI” patients who have pain related to their spinal position, as this changes their acetabular orientation and load acceptance……

 

What you can and can’t do with regards to your racing career very depends on why and what is currently causing your pain – but needless to say anything which is non invasive, time respected and enabling you to move better (not necessarily move more) is going to be top of the list.

 

The Guru

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