Hip Clinical Pearls: #8 Femoroacetabular Impingement, FAI |
|
Clinical Pearl #8: Femoral Acetabular Impingement, FAI
Now that we’ve talked about some of these diagnoses and various related factors, let’s talk more about the impact of these findings. With FAI, our bodies do a spectacular job of laying down extra bone, or callus, as a result of stress. While this is a normal phenomenon, how much isn’t always “normal”. How this extra bone affects motions over time may not be “normal”. And, this “abnormal” amount of bone commonly contributes to someone with FAI to have an accompanying torn labrum. Whether you have repetitive abnormal movement, or direct impact at the joint creating abnormal movement, they each create shear forces which contribute to the labrum tearing. While people can live with a torn labrum for many years, the loss of the function of the labrum can negatively impact the articular cartilage health within the joint. The bad word of osteoarthritis comes into play if the articular cartilage health degrades, and joint space lessens.
My Experience
Just because someone is diagnosed with FAI and a torn labrum, it doesn’t mean that surgery is the only potential solution when an exacerbation occurs. I am a non dysplastic individual with FAI and a torn labrum. At this point in time, I’ve been able to avoid surgery for many years, but I am also very knowledgeable in this area. Has my hip been pain-free my whole life? No. Have I been able to manage it through exercise of choice, alteration of activity level and home program maintenance? Yes. And, my joint space is very good for a female my age, and I will continue to monitor this because I recognize that I am in the age range where degradation of the joint can occur fairly quickly. Knowing what I do, I am willing to monitor and continue with conservative treatment due to the sporadic pain intensity and frequency. I can continue to monitor this, and make changes in the future. Does that mean it’s going to work for everyone, or that I recommend this choice for everyone? NO.
Patience is a Virtue
Every individual body is different and needs to be treated individually. In addition, conservative treatment doesn't mean that only after a period of a couple days or weeks of doing exercises that you’re going to anticipate any of the pains that you’re having going away. If you are truly trying to address movement patterns, muscle function and/or firing patterns, and change them, these things TAKE TIME AND PATIENCE! There is no quick fix for some of these issues. In today’s world, whatever the fastest thing to “fix” is typically the choice for many. For many patients, I encourage taking a comprehensive approach with time and exhaust conservative measures based on the body's reactions, provided the surgeon and objective findings with diagnostic tests support this as well.
Now that we’ve talked about some of these diagnoses and various related factors, let’s talk more about the impact of these findings. With FAI, our bodies do a spectacular job of laying down extra bone, or callus, as a result of stress. While this is a normal phenomenon, how much isn’t always “normal”. How this extra bone affects motions over time may not be “normal”. And, this “abnormal” amount of bone commonly contributes to someone with FAI to have an accompanying torn labrum. Whether you have repetitive abnormal movement, or direct impact at the joint creating abnormal movement, they each create shear forces which contribute to the labrum tearing. While people can live with a torn labrum for many years, the loss of the function of the labrum can negatively impact the articular cartilage health within the joint. The bad word of osteoarthritis comes into play if the articular cartilage health degrades, and joint space lessens.
My Experience
Just because someone is diagnosed with FAI and a torn labrum, it doesn’t mean that surgery is the only potential solution when an exacerbation occurs. I am a non dysplastic individual with FAI and a torn labrum. At this point in time, I’ve been able to avoid surgery for many years, but I am also very knowledgeable in this area. Has my hip been pain-free my whole life? No. Have I been able to manage it through exercise of choice, alteration of activity level and home program maintenance? Yes. And, my joint space is very good for a female my age, and I will continue to monitor this because I recognize that I am in the age range where degradation of the joint can occur fairly quickly. Knowing what I do, I am willing to monitor and continue with conservative treatment due to the sporadic pain intensity and frequency. I can continue to monitor this, and make changes in the future. Does that mean it’s going to work for everyone, or that I recommend this choice for everyone? NO.
Patience is a Virtue
Every individual body is different and needs to be treated individually. In addition, conservative treatment doesn't mean that only after a period of a couple days or weeks of doing exercises that you’re going to anticipate any of the pains that you’re having going away. If you are truly trying to address movement patterns, muscle function and/or firing patterns, and change them, these things TAKE TIME AND PATIENCE! There is no quick fix for some of these issues. In today’s world, whatever the fastest thing to “fix” is typically the choice for many. For many patients, I encourage taking a comprehensive approach with time and exhaust conservative measures based on the body's reactions, provided the surgeon and objective findings with diagnostic tests support this as well.