What is FAI? Learn the truth about femoroacetabular impingement.
ฝัง
- เผยแพร่เมื่อ 15 ก.พ. 2014
- Been told you have femoroacetabular impingement? Been told surgery is the only way to deal with FAI? Learn the truth about femoroacetabular impingement.
Detailed hip impingement training program: bit.ly/thefaifix
Labral tears: uprighthealth.com/blog/hip-la...
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ABOUT THIS VIDEO
Matt introduces alternative ideas about hip pain and the relatively new medical diagnosis of femoroacetabular impingement (sometimes called femoral acetabular impingement or just FAI).
He discusses some ideas for exercises for femoroacetabular impingement as well as alternatives to surgery for FAI.
This is the first video in a long line of videos on femoroacetabular impingement. For more updated information, please see the helpful links for research on FAI below.
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NOTE TO COMMENTERS
Please, before engaging in angry verbal attacks, read the articles below and watch the rest of the FAI playlist for detailed research on femoral acetabular impingement. Recent research has very clearly called the conventional understanding of femoroal acetabular impingement into question.
While doctors currently believe that bones are the cause of the hip movement problems, there is no strong evidence this is true.
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HELPFUL LINKS
FAI: what you need to know and what your doctor won't tell you: uprighthealth.com/blog/femoro...
Playlist of videos on FAI, including practical exercises to improve hip mobility and reduce discomfort: • All things FAI
Research refuting basic ideas on femoroal acetabular impingement
1) FAI bone shapes are common as anatomic variants and are not indicative of a disease.
•Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study. Link: goo.gl/achTPA
•The prevalence of cam-type deformity of the hip joint: a survey of 4151 subjects of the Copenhagen Osteoarthritis study. Link: goo.gl/AA1EZX
•Radiological Assessment of Femoroacetabular Impingement Morphology Using Computed Tomography in an Asymptomatic Young Population: goo.gl/JHg9Be
2) Cam and pincer impingement do not lead to arthritis.
•Predictors of progression of osteoarthritis in femoroacetabular impingement: a radiological study with a minimum of ten years follow-up. Link: goo.gl/nc3pBV
•Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study. Link: www.ncbi.nlm.nih.gov/pubmed/23...
3) Labral tears and other joint pathologies exist in high numbers in individuals without any pain or hip symptoms.
•Identification of acetabularlabral pathological changes in asymptomatic volunteers using optimized, noncontrast 1.5-T magnetic resonance imaging. Link: www.ncbi.nlm.nih.gov/pubmed/22...
•The prevalence of acetabularlabral tears and associated pathology in a young asymptomatic population. Link: www.bjj.boneandjoint.org.uk/co...
4) Surgery for FAI often fails to meet patient expectations.
Fulfilment of patient-rated expectations predicts the outcome of surgery for femoroacetabular impingement. Link: www.oarsijournal.com/article/S...
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MORE RELEVANT FAI RESEARCH
Problems with FAI hip impingement - www.uprighthealth.com/blog/fe...
Special test for femoral acetabular impingement - www.uprighthealth.com/blog/FA...
5) Prevalence of FAI in CT scans of young asymptomatic population: www.ajronline.org/doi/full/10....
6) Is a Positive Femoroacetabular Impingement Test a Common Finding in Healthy Young Adults?: www.ncbi.nlm.nih.gov/pmc/artic...
7) Does FAI cause arthritis? This 2010 study gives a resounding NO: www.bjj.boneandjoint.org.uk/co...
8) Does pincer impingement lead to arthritis? This study also says NO: www.ncbi.nlm.nih.gov/pubmed/23...
*This content is not a substitute for individual medical or health advice. It is intended to educate and inform.
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If your major gripe with the perspective in this video is that it's not being put forth by a doctor, you may find these physicians' written opinions helpful.
Sports Surgery Clinic - Dublin, Ireland - www.sportssurgeryclinic.com/growth-hip-surgery-ireland/
Michael Reiman, Physiotherapist - Femoroacetabular impingement surgery is on the rise - what is the next step? www.researchgate.net/publication/303739484_Femoroacetabular_Impingement_Surgery_Is_on_the_Rise-But_What_Is_the_Next_Step
PDF: www.muscleuppt.com/FAI%20on%20rise%20%5B1%5D.pdf
David Rubin, Radiologist - Femoroacetabular impingement: fact, fiction, or fantasy?
www.ajronline.org/doi/full/10.2214/AJR.13.10913
thank you for this. the things you said on this just blow me Away I have the same symptoms . I wanted to know if can i get in touch with you? i was resigned and just go into sergury but I saw this and maybe there is hope. please reply thank you,🙏🏽
Diagnosed with FAI. Was told Femoral head was misshapen with osteoarthritis. Limited range of motion. Dont wanna do a hip replacement. Cant sit butterfly/indian/lotus style. Would love too. What can I do to get back to being able to sit like this.
@@gambinored81 OA may slightly charge this. OA and FAI are linked but nothing the same thing....
Everyone considering surgery something to think about: I had FAI surgery on my left hip when I was 17. (Also had FAI and torn labrum on right hip) My bone was shaved down and my labrum was repaired. (Surgeon said it was the most bone he’s ever removed from FAI surgery) Yes, it relieved some pain, I could finally sleep on my side again without the uncomfortable pinching. Was very diligent with my rehab and returned to football about 4 months later. It felt better but never great. Eventually the same pain creeped back, there was still popping after surgery and all of that. I ended up playing D1 football at Virginia tech but was forced to leave due to my hips. I had MRI’s done on both hips and my left hip labrum was torn again and my right was torn as well. And I was diagnosed with FAI again and recommended to have corrective surgery for both hips again. FAI just doesn’t make sense to me. How could I re-tear my labrum if the “structural abnormalities” were fixed. Why could I still not move how I wanted to? My mobility is awful and FAI just seems like an excuse. My “FAI” pain was never fixed because surgery wasn’t the answer. I never fixed my muscle imbalances and I can keep getting the surgery over and over but if I don’t fix the muscle imbalances nothing will ever change. For everyone saying you can’t stretch bone, yeah I get where ur coming from and that used to be my excuse but there are some very interesting links that are provided at upright health’s website that make FAI not make sense at all. There are so many people with “FAI” that have zero pain, zero symptoms and perfectly fine ROM. How is that possible if they have these structural issues and you can’t “stretch bone”. Yet, they’re perfectly fine and have normal hip mobility. Sounds to me the source of the problem is the muscles surrounding the hips and not the hips themselves. I don’t have the answer but FAI is a newly research “condition” that doesn’t add up. If the bone shape is really what is causing all this pain and problems then how did Matt get better without surgery? How do people with said FAI have great mobility and no pain? Something to think about if you are considering surgery. It’s at least worth a try to avoid surgery and fix ur muscle imbalances first. I’m 21 now and I’ll be honest, I want to fix my hips because living with this pain is not living at all. But I’m not trying to fix the problems, im not working on my muscle imbalances everyday like I should. I keep putting it off because it’s hard and one of the hardest parts is figuring out what excel uses actually work for you, because each person is different. But before I can honestly say I really tried these exercises and trialed and errored myself then I don’t think surgery should be considered again until I make an honest attempt. I’m not recommending to or not to get surgery but I think you should definitely try to avoid it. Lastly, I don’t think a lot of PT’s understand FAI so the stretches and exercises they recommend may not work at all. Because I’ve been there, I go to PT and it’s: some simple stretches, glute bridges and that’s about it. That’s not going to cut it. Matt has some really sound logic and what I’m saying is, you should at least try and put in an honest effort before going the surgery route because I was back to where I was before surgery within a year.
Hey man how are you now?
Thats the conclusion of Dr Sarno, pain its actually TMS pain, and not due to structural abnormality
After dealing with FAI and deciding not to get surgery, I decided to really strengthen all the muscles surrounding my hips. I had overly tight hip flexors, especially on the impinged side. The leg with the un-impinged hip felt "shorter" than the other leg. I was also told by a chiropractor that I had APT. I came across a few articles detailing glute amnesia, and once I really started strengthening my glutes, especially on my un-impinged side, my symptoms became better immediately on the contralateral side. Most people think they have strong glutes (I thought I did, I hike all the time) but it was really a glute strength imbalance that seemed to be causing my problems. This is completely anecdotal, but if you have FAI symptoms and hip flexor strain, do some serious glute work and see if there are imbalances there.
Hey thx for story. How is your hip doing now, in 2022?
Very true!
Which exercises?
How is it going in 2023?
I just had surgery for this. My X rays showed very clear dents from my pelvis hitting my femur and the size difference between the problem side and ok side was very clear as well along with a torn labrum from the wear in that area. Being a rower and runner, it was very important for me and now I have very good and even flexibility on both sides whereas before, my leg could not go above 90°. The surgery helped me. Everyone's body is different so not every body will get problems from it and some will get worse problems.
How are you doing 5 years later, and how did it start for you? I'm fighting this now, it started after an injury to my hip (my leg got yanked back) and now I get pain at night and my range of motion is very limited. The Dr. diagnosed it as FAI. I've not had surgery yet and curious to know if you got your range of motion back and are you back to normal?
@@8180634 My range of motion is the better, especially because I stretch as much as I can everyday because of martial arts as exercise for me.
My orthopedic surgeon at the time examined that the way my joint was was that it essentially grew incorrectly. I did rowing and due to the motion of rowing with your legs, it caused my femur and pelvis to grind and impact each other. The surgery was to reshape my joint.
The only signs I have of ever having surgery are 3 dime sized scars on my hip and sometimes it will feel tighter than the other hip but all I need to do is stretch it for a moment and I feel and move fine
@@thepurespartanify great thanks for the info! Where I'm at now is I have much reduced range of motion and it will painful at night after say a good mountain bike ride or if I run intervals, or motocross kills it. Can't sleep without Advil. Watching the surgery and seeing them grind away what looked like smooth parts of the joint made me scared it might lead to arthritis down the road, but it's good to hear it was a improvement for you still years later.
if you have impingement you need the surgery if its damaging the labrum, this guy is not a medical doctor nor a expert. you made the correct decision
@@8180634 is your labrum torn? or bruised? it wont get better unless all you wanna do is walk aroudn for the rest of your life. get it done sir
I am a ballet dancer and I dealt with/tried to improve my excruciating hip pain for four years before I finally sought out medical help. I had fai and a torn labrum. I went trough months of physical therapy (which is typically required before hip arthroscopic surgeries so people are exposed to/try non-surgical techniques) and had steroid injections into my hip. Even after my physical therapist told me that I had loosed up, I was strong, and my range of motion had improved, none of my symptoms/pain had been alleviated. I had an arthroscopic hip surgery to repair my labrum, correct my impingement, and I had a capsular repair to improve joint stability. The surgery is minimally invasive, they do not “cut you open” and you would no that if you knew how arthroscopic hip surgeries work. I’m sorry but most people, especially young athletes, don’t have three years to dedicate to trying to improve their hip function themselves, and according to my physical therapist my joint function was actually good, despite the fact that the pain was terrible. My orthopedic surgeon made it very clear to me that for SOME people surgery was not necessarily the solution and we exhausted all the non-surgical methods, but ultimately surgery was the answer for me, and I’m very greatful that I had the surgery. In my case, the impingement was also linked to osteoarthritis, so do not tell me that they two are not linked because I am living proof that they are. I do not think that you are in any position to be telling people what they should do in circumstances like this because medical advice should be given by DOCTORS. Also, if people are in a great amount of discomfort they SHOULD seek professional help and they should not have to feel bad or guilty about it because some guy on TH-cam said that it was unnecessary because for some people it is very necessary. May I also point out that you said you might have fai, you weren’t even formally diagnosed and fai does require a diagnosis by a doctor. So you are literally trying to give medical advice on something you weren’t even diagnosed with and you did not go to medical school for. While I don’t believe surgery is the answer for everyone, I do think that surgery is A solution to this problem, as I have experienced it firsthand, I don’t think you should be making blanket statements about fai, because it is very personal and different for everyone and they need to work it out on a personal/individual level with their doctors and therapist.
The link between supposed FAI bone shapes and osteoarthritis is very weak. Additionally, this appeal to the authority of doctors is problematic. It doesn't take a medical degree to see that the theory of FAI leading ostoearthritis is not well founded. Overall I think it's good Matt is bring attention to this issue supported by studies with large numbers of participants with FAI bone shapes who aren't symptomatic and not only personal anecdotes.
The guy who posted this video is an idiot. He is not qualified to be giving any medical advice and it is irresponsible of him to be giving this type of advice on TH-cam. I and many of the comments below seem to be calling him out. DELETE THIS VIDEO!
@@NozPortfolio You're a fool. This guy is not a doctor. Hopefully you can understand that he is giving advice on an alternative to surgery. In addition, no surgery is approved before PT and other modals have been tried.
Any statement about FAI is just that. It is fact-based statement about the hip joint. When someone has trained and learned about the hips and he is giving his advice, he is providing a wonderful resource to all of the people out there with hips, which is most of us. Please stop being a Karen trying to shut people up with INVALUABLE information!
@@jamesmedina2062 clearly. He is not a doctor. Just a guy with a TH-cam dispensing advice on a subject he knows nothing about.
The sad thing about the misinformation in his video is that it may lead to further joint deterioration in people who may need to actually speak with a medical professional.
I can relate to this video 100% and have started doing some of the stuff you've talked about here. I found the video hugely beneficial. Thank you.
I'm so glad I found your channel. You do a better job of describing what's going on with me than any of the doctors/chiropractors I've been to.
I love how you explained the economics involved in decision making process. Why worry about surgery if you have not tried simpler treatments? Treat the simple conditions before the complex.
Great video. I've played hockey for 30 years almost, have been suffering with these pains for over a decade and was just was referred for surgery this morning. I'm glad I found your site and will hopefully find some good exercises on your channel!!
Be sure to check out the FAI playlist, and happy skating!
Thanks for this video. I am currently in my senior chiro year and what you are talking about makes sense. Really appreciating the fact that you are posting all the relevant articles to support your findings on this! I have a patient with complaints like these and I will be using your video and all the articles to complete my writeup.
Regards,
Ziko Bull
Happy to be of help!
Bruh... so practical yet so logical! Love it!
Brilliant makes sense stuff! Laugh at this .... I was diagnosed to have an fai fix by my lovely consultant- turned out though they’d scanned my left leg and I’d gone Re pain in right leg - so they’d diagnosed the wrong leg ! They backtracked and ended up operating on the right leg - guess what it’s no better in fact worse - so to me everything you say is proven correct by my case x I’m finally following your advice and am already feeling improvement THANKS FOR ALL. YOU DO XXXX
These options have made a huge difference for me! Ty so much!!
This is so true with so many ‘ailments’. I love Matt!❤️😊💪. The fact about the images showing FAI with no pain, images with no FAI and have pain. I’ve heard this many times not just about FAI. If ur on the fence about what they are telling us. What have u got to lose? Get stronger, do ur homework folks. Not easy which is why ppl go for surgery.
Tell the muscles to shut the hell up😂
Really enjoyed the video. It was funny and informative. Thanks for including all the links also
What would be REALLY great is if you could do a video of people sharing their symptoms, to demonstrate how differently people experience FAI and how it can relate to the soft tissue imbalances that surround this issue. I say that because there seems to be a set of symptoms that are hard-coded to this diagnosis, but a lot of people experience additional symptoms that aren't covered in the literature. It's not necessarily just groin pain and snapping, a lot of people (myself included) feel pain in their lateral hips and glutes, their psoas, etc. I also have learned, by discussing this issue with dozens of men and women, that there seems to be gendered differences in symptoms... which makes sense, because male and female hips are quite structurally different, and medical literature seems to focus more on men. Ultimately, as you stated in your video, there may be cases where surgery is necessary. And it sounds like you're not refuting the diagnosis... you're simply stating that FAI pathology is, in most cases, benign until soft tissue imbalances give the pathology an opportunity to do damage and cause pain. By addressing those imbalances, you may revert the joint back into an articulation where bone spurs aren't grinding and causing pain and damage. It never hurts to try a conservative route first.
Sounds like you have been through a journey of investigation, experimentation and discovery, exactly what I am in the middle of right now with my left hip and back. Every now and then I get a lightbulb moment and my progress takes a step forward, usually after reintroducing a forgotten exercise, stretch or release, creating a new one, or after watching a video from a like minded person such as yourself. Thanks for the knowledge 👍🏿🇬🇧
Hey! My boyfriend has this problem and he really wanted a video showing the correct exercises so he could be just like you haha no pain, no more of this femoral acetabular problem. Thank you!
How is he doing?
You make such a difference in my life doc. I’m a martial artist have done most my life, had a couple years off from 18-20 and when I went back to training I was so tight and I had so much hip pain. I thought something had to be wrong with me because I tried everything so went got a mri i have hip inpingment or femeral head deformity. Actually messed with my metal health as I’m a person who lives and breathes fitness and pushing my body and if I can’t even pistol squat am I even a athlete? Like it was embarrassing I was this fitness guy but was so unbelievably tight and inflexible. Ever since I found you I feel like your talking to me. Everything you talk about in these series of videos on fai is amazing. There’s no info about it you my friend are a legend and impacted my life so much
Very informative! Good stuff!
I just wanted to say how glad I came across Matt and his videos. I’ve had excruciating pain in my hips. I saw an orthopedic dr and he said I had a underdeveloped acetabulum, so it doesn’t cover the ball all the way but I don’t know how that can be a big problem when my cartilage is good. I also had a small bulge in lower lumbar region. When I looked up my condition I stumbled on all kinds of therapists and w Matt, his philosophies made sense. I was ready to go at it as a plan of attack w an open mind and dedication. I accepted the work and have followed several of his strengthening videos and I have come out w about 80% fix to the pain I was feeling. I’ve also started yoga as a gentle strengthening balance and yoga is so good for all of us. Do not say yoga is too hard or following Matt might take too long. You have to start somewhere and I was willing and determined to fight this pain properly w no surgery. I give him much credit. Thank you Matt! I’ll continue to learn and stretch and think MUSCLES!! ❤
What's up Matt! I have been listening and doing the exercises you have been doing and they have been helping me for sure. I tried ice-pack on the top of left leg muscles for about 20 minutes then switched around to the bottom of my left leg and iced it for 20 minutes and it did help with the pain for a short time but did see some relief. I just want to finally get rid of this pain when I put all my weight on my left leg to throw my 16lb bowling ball down the ally and get strikes like I used to. Anyway I do want to thank you for all your videos because they have helped me with my pain. Keep them coming they sure do help.
hey thanks for the videos. I have tried so much these last 2 years in terms of different exercises, different programs, and yup I am stuck with all the symptoms today that you have described in your video. I would appreciate it so much if you could maybe provide some specific exercises and stretching protocol to try before opting for surgery. Thank you, god bless and all the best.
Please check out the FAI Playlist: th-cam.com/play/PLfKNSz5BBcBH4lL9pn4XUX9ef0OyZPFtj.html
Also check out thefaifix.com
Keep up with all information. I'm following
Interesting, but missing a lot of the important information. Yes you are correct about hockey players and the higher instances of occurrence. Medical evidence suggests that the human body will distribute calcium to areas of the skeletal body that are under more stress (head of femur, cam impingement and pincer impingement to the outside of the acetabulum). Medical studies have shown that these are a combination of both genetic, and activities (sports) played during developmental years.
If you truly suffer from FAI, you will tear your labrum while performing certain types of motion. If your labrum has been torn, the only way to repair it is with surgery, at which time the will repair the impingement(s) as well. If you have a torn labrum the impact on acetabulum while performing physical greatly reduces micro stability in the hip, and increases the wear on the cartilage in the acetabulum. According to the scientific study published by J Biomech in August, 2000 the wear on the joint is increased by at least 92%. Another issue that is then caused by this is Synovial fluid breaking through the acetabulum. Synovial fluid is known to dissolve calcium and create bone cysts, which can greatly weaken the bone structure, even resulting in collapse and fracture.
Exercises, stretches, and injections can not correct true FAI, and many people are mis diagnosed. The range of motion you site is a correlation as well, and not an indication of FAI, but a common occurrence of it (in which the range of motion is restricted due to soft tissue issues surrounding or in the joint).
I would highly recommend that you attend one of the many orthopedic conferences that feature highly notable lectures on FAI. While I am not a doctor, I have spoken at more than 5 of them in the past 4 years, and I have not seen you at a single one of them. The latest this past August in
Your information might be helpful to someone that has a very slight impingement, but not a full impingement (in which motion does tear the labrum). I think that your post on this is potentially dangerous, and will make some think this issue isn't as serious as it could be. If the MRI does not show an elongated or torn Ligamentum Teres, nor a torn Labrum then your advice may help. Surgery is the only solution proven (study presented in Vail, CO by Dr. Marc Philippon August, 2015 at the Vail Scientific Summit) for patients that show either of those conditions along with torn or worn cartilage, or the presence of Synovial Bone Cysts. Two options of surgery are available, arthroscopic which includes the repair of FAI, or Total Hip Replacement.
I don't know it all, but I find this discussion video to be potentially very detrimental to some patients lives, and feel that overall it best leaving this up to the true experts to deal with the patients on a one on one level.
+rehderj4 , you sound like someone I'd love to speak with. Could you get in touch via email? There are a great number of very recent studies that seem to greatly undermine the criteria used for FAI diagnosis and for the underlying theory in general, and I would love to have a more in depth discussion with you about them.
I agree that this could be misleading to people with true FAI. I have dealt with this since I was 13...The first things they noticed in my MRI/arthrogram and surgeries were bone cysts, torn ligamentum teres (torn on left and right side), severely torn labrum, etc. I've undergone a total of 7 hip surgeries to repair this because I tried alternative things to "repair it myself". I'm 23 years old, I do not have a labrum in my right side, I'm constantly growing bone cysts, my pelvis "drops", causing lumbar pain, moderate OA, and my only option is replacement at this point. I've had reconstruction surgeries to put a hamstring in my hip to act as a labrum...There's a huge difference between someone who thinks they have this, someone who has mild FAI and people like me who experience more than just a "clicking or popping" sensation.
Very well stated. His non medical advice is simply wrong and could put some individuals down the wrong path. If a patient has FAI and a labral tear that is painful surgery unfortunately is the only solution, no amount of pt or stretching will fix the issue.
@@Daniel-tv9tb yup, I just finished about six months of physical therapy and it helped a bit, but not as much as I would have liked it to. But for me and the therapists helping me, it was a waste of time on both sides.
Dude! Your video just blew my mind! I appreciate you!
I got the surgery last Friday on 5/31/19 and am posting updates on my page.
My physical therapist moved my leg out to the side like 45ish degrees yesterday and to my surprise, my hip didn’t lock!
My leg has only ever been able to go out to the side more than about 35-40 degrees-no matter how much yoga or stretching I did.
Even when I was 11-13, my side kicks in karate never got as high as the other kids because my hips would lock. Looking back, it was definitely because of FAI.
Overall, this defect destroyed my quality of life to the point where I couldn’t do yoga, skateboard, snowboard, ride a bicycle, or hike without pain. Nothing helped! These past few months, I went from very active to total couch potato and walking with a cane some evenings.
I’ve dealt with chronic pain for over 6 years now and I’m pretty much 100% sure it was due to FAI. This year, it became unbearable.
After the operation, my surgeon said the labrum was torn pretty much all the way through.
My left hip is okay at the moment since skateboarding and snowboarding are the main things that caused problems and they’re asymmetrical sports, but it will probably need the surgery in a few years as well.
I believe this surgery will help a lot just based on these first few days post-op. No amount of stretching or soft tissue work would have fixed this issue.
FAI is a real condition. If you’ve done everything you can like yoga, physical therapy, and getting exercise in general, but nothing seems to work, then surgery is probably a great option.
It’s fucking rough and feeling helpless for a couple weeks really sucks, but it’s better than chronic pain the rest of your life!
It’s been 2 years how’s it going with your hip ?
@@xToymachine1031 Right hip is still great. Got the left done last year (May 2021) and it went okay. I don't recommend surgery if you have other ailments that could affect that area though.
I broke my back (T12 compression fracture) and roughed up my sacrum by landing on my ass snowboarding off a jump in 2020. The combination of the leftover scar tissue and aches from those injuries did not mix well with the second surgery.
Overall, still doing better than before. It just took much longer to get back to normal this time around and there were more rough patches. Still not quite 100%, but starting to see the light. Probably back to somewhere between 80-90%. Just now starting to skateboard and do more active things again.
Also, the last bit of my friend circle collapsed right after my second surgery, so my mental health was suffering. It wasn't until my mental health got better that my body really started to as well.
@@quikboarder93 Thanks a lot for sharing with a long term update...I have a hip arthroscopy scheduled soon! Definitely scared but like you described prior to your surgery, I can't do much anymore without pain, also tried PT and when it didn't help (got worse actually) they eventually had to give up and send me to a specialist. I have X-Ray confirmed femoral neck cam deformities and MRI confirmed labral tears in both hips. :(
@@carsdankandchicks How is it going on now, 1 year after the surgery?
Being a patient of of two hip arthroscopic surgeries due to FAI at age 15 and 16 I can assure everyone that this is a very real diagnosis and can be treated properly with surgery. ( I am a former soccer player currently in my senior year of high school). In my injected MRI (dye was injected into my hip joint to create a clearer picture) I had a clear indication of impingement and was treated accordingly.
I tried stretching, extensive physical therapy, icing, resting, "taking it easy" and nothing relieved the pain. So I got the surgeries a year and a half apart, recover in about 5-6 months first time as in playing soccer again. And I was playing again on my second surgery after 4 months.
Although my hips are still not 100% they are significantly better than what they used to be. This is because my right hip had certain complications to it that made it improper to shave the ideal amount of bone off, an open surgery would've fixed that but with open surgeries comes much more risk and recovery time. I have always considered myself reasonably flexibly being 6ft. Everyone's diagnosis is different what is apparent to me is that his was just not a severe case. I had similar symptoms as him like the locking and popping of the joint when driving(mainly the same motions as driving that he described). But in addition I experienced pain( yes pain like it hurt) when just walking after waking up in the morning. I was not physically capable of walking after I hyperextended my leg during a game (worst pain I have ever felt in my life even pain during first few days after recovery of he surgery wasn't as bad). I tried stretching and physical therapy but the thing is I went almost 2 years by knowing what was wrong which did include other treatments such as stretching and pt 1-2 times a week. Making a claim as large as he did just isn't something that should be said.
Would like to add my labrum was damaged in the on both sides seen from both the MRI and the surgery itself
Hi Eddie, glad to hear your surgery went well.
One major point of this video and that is clear from your story is that that the surgery is most definitely not a guarantee of successful outcomes. Recent studies on patient satisfaction do not show fantastic results. More than half of patients not having their expectations met for return to sport or improvement in daily life. Only 64% in a recent study were satisfied with the surgery after 2 years. Both studies are discussed here: www.thefaifix.com/surgery-guarantee-improvement/
This video is an interview with a guy who had bilateral hip impingement surgery and ended up with the exact same pains. Even though he had tried physical therapy before, he started doing things the way we propose in the FAI Fix. He found the way he was doing things before surgery wasn't frequent enough or targeted enough. As he's learned the anatomy and worked with his muscles, he's been getting motion he never thought he'd get back AND he's gotten rid of the pain: th-cam.com/video/Hw3i9H6JrI4/w-d-xo.html
Bonnie, a client of ours, is a medical professional whose story is particularly inspiring in that she was able to completely avoid surgery for FAI and get back to playing hockey: th-cam.com/video/b4KnQ7OCEOQ/w-d-xo.html
There is a lot of variation in what people experience. We are in a unique position to hear lots of people's stories about FAI, and it's clear that the diagnosis is being placed on a huge range of hip issues. While it may be possible there are situations that absolutely require surgery, there does not seem to be a strong case that the surgery is addressing what actually needs to be addressed for all the people that are getting surgery.
A really great article to check out from a medical professional with some very similar concerns as brought up in this video is here: www.muscleuppt.com/FAI%20on%20rise%20%5B1%5D.pdf
Folks, This is one person opinion. The frustrating thing is that there are sometimes no definitive solution. As suggested, exhaust all pt options first before surgery. Also, in my opinion this is not an easy surgery to perform or recover from. I think the video is very educational and the constructive dialogue is positive and insightful. If you disagree, that's fine but do it in a positive way if you want any credibility. Lastly, be cautious of know it all people, this incises doctors too. Thanks for the video and your ability and willingness to remain professional.
Thanks for your comment, John Doe. Our goal is to help people make decisions for themselves with balanced perspectives and good information.
you have a really really good channel i am suprised you havent had more followers , great videos absolutely amazing and very
educational.
Wish I saw this three years ago, although I am stubborn and may not have listened. Had FAI surgery a couple years ago and now my hip feels worse. Would give anything to go back and redo it. Not only do I have impingement but a burning/aching sensation. One thing to note, I feel like many people watch a video like this and don't take the advice as "legit" simple because it's not an orthopedic surgeon or physical therapist speaking. While I don't wish to get in any internet debates, and while there are many great surgeons and physical therapist, just because someone has an MD or PT attached to their name doesn't mean their word is the law and no one else knows what they're talking about. One thing I wish I knew back then was that injured tissue does not always equal pain and pain does not always equal injured tissue. And even if there is "injured/damaged" tissue, that, in and of itself, is not a bad thing. In particular for "chronic" conditions. Yes, if you get your ACL torn by a 300 lb lineman, surgery is probably the answer.
Another thing, loved the "I am not a doctor, but this still doesn't make sense" thing. It really, truly, doesn't. Many of the top neurologist/pain researches give numerous examples of many people that have FAI, bulging discs, torn rotator cuffs and yet have zero pain or malfunction. They offer the likely explanation that these are "normal" adaptive changes create over years of moving (playing golf, hockey, baseball, lifting weights, simply being alive), and that these changes are so slow and small that the brain doesn't process these minor tissue damages (that we all have) as a threat, thus no pain is created.
Pain is a very complex issue and the human body is a very complex system that's always adapting. I don't have all the answers and I don't believe anyone has all the answers. Just keep in mind that surgeons get paid to operate and are taught that when they see something "wrong" or "abnormal" their first instinct is to go in and "fix" it.
For anyone interested in learning more I'd recommend Explain Pain by Lorimer Moseley and David Butler. I certainly learned a lot. Todd Hargrove also just put a book out about Movement and Pain that I thought was really good. I'd recommend trying to learn as much as possible, because at the end of the day, it's your body and no one will ever has as much invested in it as you.
Derek Ingui Thanks for sharing your view on all this. Those books listed are wonderful educational resources. As you noted, observable "tissue damage" does not equal pain. That's an acknowledged, well established fact that has only slightly begun to penetrate the world of orthopedic medicine and has only barely begun making it out into public knowledge.
A more detailed summary of the research that demonstrates much of what Derek has referenced can be found for free at thefaifix.com
It's your body! Invest wisely.
Mat the Cat. I feel your observations are Correct. I am at the bottom of the hill, moving up. I am motivated because after reviewing the x rays, doctor says i need a hip replacement. Yin and restorative yoga and some of your content has helped. Ht. ave gone from Stump leg to walking w a normal gait. Tho' i cannot take on weight. Your logic and deduction: Stabiilzing the femur thru the whole range of motion is the RIGHT WAY. ( i hope) Keep up the good work!
FAI is real. I'm 36 and have had both hips resurfaced. After 10 years of trying everything some hips are just not built for high level impact.
But I agree, strong muscles and surrounding mechanics will help everyone else preserve their hip movement.
Balls Deep I can relate being on 17 having both hips resurfaced as well I had to give up soccer but not sports all together. I know am part of track doing high jump instead of soccer which does take the stress of my hips
Stretching is not high level impact.
@@eddiegonzalez3325 are you 17?
Hows life after resurfacing? Pain free? I've been avoiding it for years and years. I'm 45 and had a severe labral tear when I was 16.
I have subscribed just for this video. Love and respect my friend
Oh I so WISH you were right! Unfortunately for me your approach on the matter is exactly the approach I took when I started having trouble. I didn't even think it came from the hip, I believed fully that it was only a "tight inner thigh muscle"-problem and so began a comprehensive stretching program and got sports massages on a regular basis for months and months.
Guess what? It only worked very momentarily and over time the problem accelarated instead. So I went to see a physical therapist about my "muscle problem". She did the posterior FAI test and sent me to ortho instead of treating me.
I went to have an x-ray truly expecting it to come out blank and fine, but noooo... HUGE pincer and some CAM - this means that no amount of stretching in the whole world could fix my problem. You can't stretch bone away and I had bone catching on bone, unabling me to straddle my horse, run fast, change directions rapidly etc. etc. (i.e. no fun sports available anymore).
Had my surgery 10 weeks ago and guess what? I can now do lots of the movements I simply couldn't do before. So for me when you say "I don't buy FAI" is like saying "I don't believe in x-rays" and "bone spurs can be stretched away".
Sorry for the late reply but better late than never, right?
Because FAI is added bone growing in your hip you need a scope surgery or the problem will remain and can cause damage to your cartilage that is permanent.
For more information check out fb FAI awareness groups and you will find many others in the same situation.
Be careful not to work out in ways that trigger the problem. Make sure you don't get too sedentary at the same time.
Even though stretching won't fix the problem, it is still good to keep your mobility and core strength up until you can have your scope done.
Best of luck!
***** Read the latest article now linked in the video description. Your locking and popping in the hips is a real phenomenon, but the FAI explanation is based on very shaky assumptions. Standard physical therapy protocols for helping generally focus on the wrong muscles. In addition, you need to learn to activate the posterior and lateral hip muscles on a regular basis to minimize locking and popping in the groin.
Frk, while the surgery and the recovery time may have seemed to help you, that does not validate the diagnostic criteria. The second link in the video description covers a study done in 2011 that very strongly calls into question whether the diagnostic criteria and the supposed disease process make any sense. The data is pretty shocking.
Altering the bones may make a difference to how your joint feels, but many FAI surgery survivors can tell you that the bone cutting approach makes no difference for them. If the theory behind FAI were right, success rates would be much higher, and you would not see the unfortunate cases of patients needing to go back to "revise."
Glad your hip feels better, though. Count yourself lucky!
Upright, I would love to agree with you, but how can you say that the outcome rate is bad when all the latest figures show at least an 80% success rate for FAI scopes?
And also you are avoiding the question of how stretching and exercise could in any way, shape or form have helped ME as my pincer growth on the acetabulum hit and locked with my CAM bone growth, destroying my labrum bit by bit?
I am sure there are cases where maybe the x-rays do not clearly indicate FAI or where the bone growth is not so severe where the problem could be eased by what you're suggesting. I might even go so far as to saying that IF you catch it in time it COULD help prevent the bone growth even if I'm not sure how much I actually believe that...
But I still think it's downright irresponsible of you to give people in the same situation as me the advice that you do here.
Had I seem your video before seeing a doctor I would gladly have given it a try (who wouldn't rather work out and stretch than go into surgery??) and all that would have accomplished would have been to give my pincer more time to grow...
In my opinion YOU are the lucky one to have caught your problem in what might have been just in time.
I only hope your hips will continue to be fine in the future too. 😊
Frk Långsam Show me a study with an 80% success rate, and I will show you heavily massaged statistics and a "success" metric that is faulty.
Re: your pincer growth, I direct you again to the studies re: the radiological evidence of FAI and whether or not it is indicative as a cause of groin pain. Both links in the description directly address this. Studies show that radiological evidence of cam and pincer impingement has no correlation to symptoms of groin and hip pain. People can have "FAI" in an x-ray and have exactly NO problems. That's an established fact.
Right now x-ray is used to diagnose FAI, but all signs indicate that "FAI" on an x-ray is a coincidental finding and does correlate (let alone even *cause*) FAI. So blaming the bony misgrowths makes no sense.
This is the same pattern of cut-first-THEN- study is exactly what happened with back surgeries in the last 20-30 years (e.g. unnecessary and costly spinal fusions with grossly overestimated success rates for back pain ultimately turning out to be based on x-ray evidence that turned out to be of no predictive quality).
We are both lucky! My hips continue to get better, stronger, and more mobile even as I age. One of these days I plan to get x-rays and MRIs done on my hips to see how terrible they look in radiological reports...because between hockey, snowboarding, and martial arts, I know I've "wrecked" my hips for x-rays. :-)
Edit: just want to add that sports massage generally won't do the trick and all P.T. protocols I've seen so far make no sense for helping with the problem. Massage will not have a lasting effect when you're as far gone as you were (sounds like where I was), and typical P.T. stuff for it aggravates the problem. That's for another day.
Enjoy your sports and all your fun activities!
Man thank you so much for this video. You inspired some next aspects of my mobilization routine I’ve been missing out on. Can’t wait to do some more stretching haha
You are very informative sir with good sense of humour as well.
You are such an inspiration...I am now able to do that pose now that both puns from both my hips have successfully been removed......i have a whole new happier athletic flexible life
Hi Matt! Thank you thank you for sharing the truth about this! Ive had this off and on for a few years now. Xray showed no calcium build up. Then it went away and I forgot about it. But lately its been very problematic. Always dull pain and stabbing when I move just right. Not able to bend over without displacing my hip to accommodate. The inner thigh and glute stretches are working and fast. You were right pt is what would be prescribed for starters anyway. Im so grateful to you! Moving without pain has been such a relief! ❤️👏👏👏
Great video! thank you for sharing valuable content! are you a physical therapist?
Nice work man. Simple and to the point :o)
Seriously mate, this is the best video I have watched on the subject of Hip Impingement. My story is literally your story. I am on the road to recovery but I felt so frustrated in the beginning about being misguided with diagnoses of Hip problems, arthritis, osteophytes - I've heard it all. When in fact for me it was as you say. Really weak messed up Glutes and over tight flexors. Trying to regain the balance with excercise and strethches. Well done mate
Glad you've been working on it and making progress, Gregory!
This is 100% me thank you so much for giving me something to look at it, I have an ankle issue while walking which I am sure is from this (it has baffled a tonne of foot/ankle specialists)
I agree 100%... work on improving what you have first - surgery is NOT the best option. I'm an ex downhill ski racer. Very few people have had the level of joint abuse I have had (not bragging, TRUST ME). I had severe hip impingement on my right hip in 2005, I was recommended for surgery, instead, I did one prolotherapy treatment with Tom Ravin in Denver and its been flawless ever since - no issues. The left hip had a severe labral tear almost 30 years ago, its a mess (you'd think I took a bullet in the labrum), I have some serious issues with it but still no surgery. I work on joint mobility and stability almost daily. I can hike and mountain bike and lift (squat and lunge) with the best of 'em, and pain-free. I'm 45 now and just trying to make it last until an age where a resurface gets me some longevity until a total replacement. Prolotherapy was a game-changer for me. Be smart about it, consult with more that just an ortho - cuz they're gonna walk you down the surgery path.
I have been dealing with the hip pain for a few months now and been diagnosed with Labrum tear and hip impingement. I am doing physical therapy, pilates core strengthening, gentle stretching and self massaging, seeing chiropractor but still not satisfied as I feel my hip in my groin area all the time. I just purchased the FAI Program...will definitely share the results. I am going to watch the videos and Upright Health recommendations, giving myself two weeks to start seeing results. My orthopedic doctor said he does not want me to do the surgery. There are no guarantees.. My physical therapist said that as long as I am not in professional high impact sport, I should learn to move correctly, become stronger and more flexible and I can heal.. it is worth trying to me.
great video. thanks for the clear presentation
you're welcome!
I had verified fai on X-ray and mri on both sides. My left side was symptomatic and my right wasn’t. I was doing Breakdance since 97 and my mobility was good in both hips but decreased through out the years! So in the beginning of 2010 my mobility was so bad and the pain was just awful! No stretching or workouts will help you... 2012 I decided to do the surgery on the left side first and decided to do it a year later on the asymptotic right side! After that I was able to dance again and my mobility improved. The pain is gone. The only thing he is right about is strengthening the butt will definitely help you. But trust me it will only help you after the surgery!
I have been dealing with internal snapping hip since I had a minor fracture in my L-4 three years ago. I have been to many PT's and Chiros, stretching and strengthening my hip flexors with no help. Can FAI be the reason/fix for this? Thank you.
Could you do show some FAI exercises that worked well for you to build up strength? I’ve done a round of PT but am looking for additional ideas for things to do at the gym.
Hey man, do you have a video on how to perform your own research? You are very thorough and I feel like this is a skill you could teach in and of itself.
Thanks for spreading this information. I was worried because I had developed this pain after pushing my legs a lot recently. I had identified it as FAI after maybe a few days in a week of research on google. I looked at the treatments and started getting scared. Surgery?! I found an article which linked to this vid. And I started playing around more and its exactly as you put it. It's a misblancing of my muscles which is probably rotating my leg incorrectly which was probably started because I tired out the lesser muscles in the outer and butt area muscles. And relied too much on inner thigh muscles.
I tested out using just my outer thigh and not tensing inside and wow. No clicking or pain. its like its not even there. So I'll continue to work on it. Thanks for the information! It's not inuitive for most people and you've made it easier to locate an answer for at least me. thanks!
Glad to have set you on a surgery-free path. Good luck!
Hi there. Thanks for sharing your experience. I'm a 33yo motorcyclist who is experiencing first inner thigh then C-shape pain around the hip joints. The pain becomes excruciating after half hour riding on track (a lot of hips openings required). I've had initial FAI diagnosis (no radiology done yet). However, I feel strongly that the condition can be dealt with by other means and would probably not decide to have an op even if recommended. The condition is only evident on track and no other parts of life.
Just finished watching this video, as someone who suffers from femoroacetabular impingement SYNDROME (the syndrome means every few months something gets inflamed in my hip and I'm essentially immobilized with almost no range of motion and excruciating pain). I have been trying to understand the relationship between muscular strength/flexibility and its impact on joint mobility. When I would think about stretching/strengthening muscles around my hip joint, I couldn't really understand a way in which this could increase the mobility of my ball-in-socket joint. This completely changed when I heard you talk about how muscular engagement can help keep the joint in the proper place when going through the range of motion. I am unsure how I was never able to connect this dot before. So basically if my glutes are strengthened, they can help keep my femur joint pulled back into the right place, so it does not come into contact with the front of the acetabulum. I also know this to be true, because when I try to pull my knee to my chest, putting a band around my hip and having it pull my femur back makes my mobility on that movement much better. So since I can use a band to hold the joint in the right place to increase my range of motion, it only makes sense that posterior strength of that joint can do the same thing and hold it in the right place.
Thank you for making this video. When you gave solid evidence for your skepticism of this whole problem (the fact that the MRI can say you have it, when you really don't, and visa versa), it really gave me hope. This problem has been messing with me for years and no physiotherapist could give me any information that 5 minutes of googling didn't already tell me.
are you still battling with pain? i bet its not getting better 100% right?
@@jackaro0343 not 100%, far from it, but quite a bit better
@@rightofleft6280 but if you do sports etc it flares up right? is your labrum torn? sounds like you need the surgery there is no way of getting around the bone spurs smashing into the labrum. have a look at images of what fai looks like you'll see what i mean
I am an x-ray tech, and generally a proponent of less is more when it comes to what doctors prescribe. I think there is a very specific group that may benefit from this course of treatment for FAI. However what you're missing is that FAI and the associated labral tears it causes are extremely conditional from person to person. The pain isn't necessarily from muscles or instability but rather from the torn cartilage itself. I have a torn labrum that for whatever reason is extremely vocal and does not respond to strengthening. I can't sit or walk without having pain. I've done the physical therapy, p90x, and even tried the stretching/strengthening you describe. None have helped even the slightest. I think the physiology of cartilage itself and the location of the tear (i.e. directly at a nerve ending) are what make this such a difficult condition for people to agree on. Again, I actually agree with you about not having surgery when exercise will typically fix most structural problems (I advise every person I can to NEVER have back surgery). But there are some situations, especially when cartilage is involved, where it hits exactly the right spot and can cause debilitating pain no matter what you do. Such a highly debated topic. Good video!
Exactly! My pain is in the bone, U can feel it every movement I make. Its not muscular.
Hi. Are you still alive? Why do you advise against back surgery?
@@igorjesus2121 back surgery is just a very complicated thing because of how sophisticated the spine is. There’s a lot of risk to back surgery, like paralysis, infection, nerve damage, etc. if anything gets messed up in your back even something like a pinched nerve could cause problems somewhere else in the body.
Hey Matt. Thanks for the video, I'm a physio student in the UK so your video really does give a good perspective on the subject. Piers
You mentioned exercises to rectify the FAI issue. Where do I go to see those specific exercises that you had mentioned?
I get great relief by hanging upside down on an inversion table. I believe my problem originates in my sciatic, and the gentle realignment works wonders!
I absolutely had to get the surgery done in order to keep playing baseball. I'm in college and I played this last year with Mixed FAI and labral tears in both hips. I went to physical therapy twice, had trainers put me on work out programs, but it only got worse. Stretching was extremely painful, I couldn't bend over to put on or tie my shoe, Back pain would never go away no matter what I do. I couldn't do any core workouts because crunches and twisting would pinch my hips and planks would make my hips ache. Now that I'm 1 month post op from my left hip, I can already tell there's a difference in my range of motion and certain movements don't cause pain anymore. I can also compare it to my right hip (which I'm getting done in a month). I'm happy with the surgery to be honest. It so far is not nearly as bad as I though it was going to be. Obviously I still feel a bit of pain, but it's slowly getting better each day. Physical therapy is a little rough, though, like as in hard because your muscles are weak from not walking for 3 weeks. The first 5 days are the hardest but it gets better from there. Just thought I would share my story with FAI and Labral tear surgery
Great talk. I agree with everything. A video with some excercises would be appropriate. Most people have no clue.
Check out the playlist: th-cam.com/play/PLfKNSz5BBcBH4lL9pn4XUX9ef0OyZPFtj.html
I have a hip impingement and a labral tear (documentent on MRI). I did a lot of squatting the last years and never had problems. But I was looking to improve my squat for perfect depth with still good posture. I started doing these stretches for the adductors, like you showed , split streches, tactical frog, and so on... THATS how I damaged my labrum, it always felt a litte strange but I thought it's just the streching pain.... But suddenly I had a sharp pain in my groin while doing adductor stretches...
I just want to tell you that not all hips are the same, and only if it worked for some, it will not work for others, maybe it will even get worse...
+Hans Jörg Did you have an MRI of your hip that showed no labral issues before you started feeling pain? Given the high prevalence of labral tears in asymptomatic people, it would be very hard to say what specifically tore your labrum, as 60-90% of the general asymptomatic population can have labral tears and have absolutely not idea. While you may have hurt yourself with the stretches, the pain may be caused by a number of factors besides the labral tear that you see on an MRI, but the only way to know is for you to do some heavy-duty, in depth experimentation on yourself.
You're right that everyone is different, so everyone does need to be experimental and mindful.
+Upright Health The crazy thing is I really have that MRI that shows no labral issue before... It's because I had some back problems before, went to the doctor, and while looking at my Xray from my back, he said: oh your hip looks like there could be an hip impingement or something worse, why not taking an MRI? First I thought this guy is crazy, but for some reason I did the MRI (back than I never had any hip issue), there was no labral tear detected, but he said my hip anatomy is not perfect... 2 years later, with a couple of weeks/months of stretching to get better at my deep squat I suddenly had this "stingy" pain, when I did an abduction of my right leg, or when I went skating (on skies)- also abduction of the leg, or if I did this exercise called "tactical frog" or almost any exercises with abducting my leg...
If I would do the stretch you do for example at min: 9:40. and than rock back and forth a little this gives me a sharp pain in my hip! But if I do a deep squat without abducting my legs (knees go forward or only a litte bit to the outside) than I have no problems...
So it just seems that with my hip all the hip mobility exercises made it worse!
binge in progress. ... good stuff man... thanks
I thought I had FAI, I had pain in my left leg when I did stretches, turned out my left leg muscles got weak over the years standing with the weight on the right leg, muscles got weak went into a spasm & it got extremely tight, especially the glutes and it affected the quads & adductors. I thought I was the most inflexible person on earth, so I stared strengthening, massaging, stretching,muscle rehab, pelvic rotation with resistant band etc. Massive improvement on the glutes , pain is gone, adductors next stop. In some cases PERSISTANCE cancels out RESISTANCE & MOTION IS LOTION : )
I have FAI and was diagnosed when i was 12, I have had many operations (both hips have been shaved) and I have done all sorts of physiotherapy with only minor pain relief for a minimal amount off time. Unfortunately I have a mix of Pincer and Cam in both of my hips but since all my surgeries I do have full range of movement but I do regularly get stuck with the cracking and popping.
I struggle doing the basic daily tasks but do still exercise to keep my muscles and everything else moving and strong. Its sucks being told I need two hip replacements at the age of 24 as I would prefer not to go through any more surgeries but would love to see an exercise routine of what you had done and also read your blog.
Casey, we've put things all together in the FAI Fix at thefaifix.com
Hopefully you find info in the program helpful!
Just an update, I've been told that I have a torn labrum, PVNS disease, and bone on bone arthritis. It honestly felt like a groin pull then maybe an adductor strain.. Today I was told to get a total hip replacement.
At age 37 I'm pretty disappointed and plan on postponing my surgery as long as possible.
Going to the gym now and gonna train hard and be ready for whatever life throws at me!
On my, that a scary diagnosis. I hope you will research further before getting a complete hip replacement. You are way too young to hear someone say that. Good luck to you.
larry this is so old but how are you doing!?
I’m 21 I’ve been in pain for 1 1/2 year I had to quit my job due to not being able to work I’m scared of surgery I’m thankful for this explanation and I will stretch everyday I hope things go well for me and again thanks for the explanation!!
I've been watching all your videos and you didn't have a FAI diagnosis? I have verified FAI and it's agony. A new paper came out that after diagnosis you want surgery within six months or it's worse outcome. But your videos give hope, although finding out you were not diagnosed it's new info
Interesting. Which exercises should we be doing exactly? Is there a video for those?
I have a had a slight hip-impingement all my life and only regognized it when I started doing much more sport (bouldering 3 times a week). X-ray and mrt have proven this. Even though I am quite strong I can't stretch well. But I still don't understand how stretching can avoid the damage being done by the joints not fitting perfectly.
The point is that the damage is not being done by the joints not fitting correctly. Please see the video description for relevant research links. All recent research points to the fact that the bone theory of hip impingement is highly, highly questionable.
so … great video. Always fabulous to find someone preaching retraining over surgery.
Switch off the over tonic and stimulate the inactive. Stabilise stabilise stabilise!!!!
I had a tailbone injury at 10. (Moshed at the bottom of a slide by two bigger kids)
Any kind of glute flex was excruciatingly painful while the injury healed. I think it took around 4-5 weeks for me to start walking normally, and even then I did not AT all engage my glutes or any kind of posterior musculature.
Recently I've begun flexing my butt A LOT, or yet even more emporingly I HAVE RECLAIMED MY BOOTY. (I'm 27)
This video really helped me understand what needs to be done and why.
Thank you.
Very intrigued by this video +upright health. After 18 months out of my sport and unable to do much aside from trunk and core work I just had the FAI surgery on my R hip. Interestingly the one area that I am super tight in is my groin/adductor region. I also had hamstring issues on the very same side. The pain came out of nowhere and it was after overdoing hill work involving a lot of fatigue and repetitive high knee flexion. This matches with my areas of tightness and your belief regarding this injury.
My only gripe with your video is the way you talk sarcastically about magical lumps appearing on your bones etc when this is very possible, bone spurs, calicification etc from constant friction.
+Therightfit PT , sorry about the sarcasm. The sarcasm is not intended to be directed at the possibility of that happening. It's meant to be directed at the notion that those are identifiable as the generators of pain and disability. In study after study, there is simply no demonstrable correlation between the bone spurs/bone shapes and actual symptoms. This appears to be true of the knee, shoulder, spine, and hips.
At the time of filming I found it very hard to believe that bone abnormalities would be blamed after decades of spinal surgery research showed that bone and joint abnormalities are widely over- and mis-interpreted as pain generators.
It certainly would have been better if I had left sarcasm out entirely, so for that I am sorry, but hopefully the major message is not lost.
Dee Brown how are you feeling now?
In relation to the disparity between pain and MRI evidence of FAI, I attended a talk presented by Orthopods discussing how there is even poor correlation between pain and evidence of Osteoarthritis on X-Ray. That is, a hip that exhibits evidence of osteoarthritis on an X-Ray may not be painful to the patient, and conversely a painful hip may not exhibit OA on an X-Ray.
Thank you!! I had a hip infection which left me with FAI and dealing with the pain sux!!
love it. I needed to hear this.
What are some of the exercises or stretches that you did ?
Hello, I have a question about my hip pain. Here is my situation:
I am a very flexible person and I have a good squat form as well as strenght ( I can perform 100 bodyweight deep squats in a row, with good form ).
However, about a month ago, I was casually squatting and, accidentally I did a “bounce” rep and I hurted my hip.
Now, the front of my hip feels very uncomfortable ( I did a test and I feel pain when I do external rotation and when I perform deep squats ). It is not a horrible pain because I still do parallel squats and lunges without pain.
What exercises should I do in order to get back to the ass to grass squats pain free? Note that I only have the floor as my equipment, so no resistance bands, foam rollers, tennis balls or any other recovery tool. So I only have my bodyweight to help me.
I suffered from this for almost 30 years on my right hip because of either parkour or taekwondo...after doing the 90/90 and the deep squat for 2 months ( which i coudn't do with this restriction) 50-60% of the problem is solved for me...don't let go guys
What is 90 90
@@Tristan-fh5ui bro, just tap 90/90 stretch on google or youtube and you will get it...it's a stretch where you put both knees in 90 degree angle
this is great info, im facing this due to kick start of motorcycle, i have spent alot of money and time and i didnt give in to surgery, i just concentrated on stretching. Im just ok
This matches other research I’ve done into this. I didn’t even go to my doctor yet, went straight to my PT because I know they’d recommend strengthening supporting muscles and correcting imbalances. He did tell me he thinks I have impingement but none of the growth part of it. Just that I was overstretching and not working my glutes enough to support some of those deeper positions. After not exercising and spending way too much time sitting at work and in a car I started dancing and doing yoga in deep hip openers. I have pretty flexible hips, am pretty double jointy and used to feel great in pigeon pose etc. This did happen after I stopped lifting weights and doing glute exercises. I’m really hoping I can power through and do glute exercises / fix this on my own. In the meantime this is extremely frustrating and painful! The one thing that used to be flexible and never have pain for me was my hips and almost overnight I’m feeling them in pain every day and having muscle spasms in my psoas.
Hi Hanna, im having the same problem (dancing, stoped, work, weight etc.), since 2015, how are you doing 8 months after your comment?
@@itsjes3d i hate to say this but I’m still in the same pain as before. I haven’t been as consistent with the therapy as I wanted to be but most of the stabilizing workouts havent reduced the pain, at least for me. I do think its still worth going down this route. Everyone is different but im about to explore other options/ doctors.
Thank you for asking! Wish you the best of luck with your pain.
@@hannah22banananai hope you the best too! i recomend you to see a hip specialist doctor as soon as possible. im seeing one, but im gona try to work out my glutes as well, and see if it gets better. Thank you for shearing! Kisses from Argentina :)
@@itsjes3d kisses!!! 🙏
Hey man i have recently been diagnosed with CAM hip impingement, after pulling my hip when i was doing a deadlift max a year ago i i felt pain in my hip joint ever since. During crossfit training i did alot of squats and deadlifts and i was told i have very poor hip mobility and im not all that flexible. When i was younger i played baseball and hockey and now i only play golf. I was advised by the doctor to have surgery, specifically open hip surgery where they can clearly clear up the excess bone on the neck region of the bone to restore proper movement in the hip joint. I believe an open hip surgery is too invasive and i would have to sit out and do nothing for 6 months. I wouldnt mind doing an arthroscopic surgery to improve the condition but after watching some of your videos im not sure what i want to do. The hip hurts every night and i would really like to find a solution for this. I love playing golf but the golf motion involves the hip and i do not want to keep damaging the soft tissue in that area. please help!. Thanks.
Ok so glute medius and to a lesser extent maximus exercises work very well to relief my pain! But when I do this stretch for my inner hamstrings, I feel a very tight bone-on-bone feeling in my femur- hip socket, like its gonna pop or snap or grind if I go further. Should I just maintain the stretch despite this sharp tension?
Good stuff - completely agree on role of weak buttock muscles tight v. tight adductors. Pelvic position is also key to muscular balance, and tucking under is an almost universal mistake these days. See Esther Gokhale's work on this. Scoliosis and/or Pelvic rotation is also a cause of uneven hip action and problems.
Hey Matt, I've been doing the FAI Fix for about a month or so now and I'm starting to feel better, one thing that is persisting is knee pain when cycling and sometimes hiking more than 10 miles or so. I think probably doing a tissue work and stretching routine before and after might help and I'll try that next time but do you have any advice for this?
The knee pain is on my right side which is the side that I have the hip impingement. Been there for awhile and flares up during activity.
Ditto on the left side.
Yes. I've had this for over 10 years. Reason I stopped running. The most frustrating pain ever. Like something is pulling the side of the knee. Only recently discovered a hip tear.
Hey dude! I think you're onto something with glute amnesia, but what's also unlocking my hips is working on my complete lack of internal hip rotation!
Hopefully this helps you develop more effective treatments! :)
Thanks!
Any experience with labral tears? I have a tear and a cam impingement. I am very active and I totally understand waht you mean by retraining your muscles especially strenthening glutes can be beneficial. but will this help with a tear?
I have a diagnosis and I am in and out of pain, sometimes no pain for weeks then it strikes .. normally a flexible person but it gets harder and harder, I am 33years of age but your video is very good and helpful! Thank you!
Good video.
But what stretches do you recommend?
Please see the FAI playlist.
Question. You speak about loosening your adductors in order to fix hip issues. For fai, do you focus on one leg or do you focus on loosening the adductors on both legs? Thanks
If both are tight, you do both. This can vary wildly from person to person.
4 weeks ago I had FAI Surgery for Cam AND Pincer type impingement in addition to a Labral tear repair/reattachment.
I am going to be very frank with you. The advice you are giving here can be dangerous. It's not wrong, but in some cases your advice will only damage the health of the joint more. You do all of this "strengthening" talk and blame "FAI" on muscular weaknesses.
pre-op @ 158lbs I was able to...
Conventional deadlift 425lbs
Sumo deadlift 385lbs
Squat 300lbs to around parallel
How do your lifts compare? I'm curious to how much "stronger" you believe your hips are. It's pretty hard to deadlift ~2.4x your bodyweight without firing your glutes and hips!
I couldn't even lift my left knee to 90 degrees of hip flexion without running into a "WALL" where my bones were making a sandwich out of my Labrum. THIS HAS BEEN THE CASE MY ENTIRE LIFE. It's Genetic. In the Surgical images from inside my Hip joint, my left Labrum looked like cotton candy. It was mauled. I've suffered numerous hip injuries even when I lived a mostly sedentary lifestyle. I always believed it was simply a "flexibility issue" and stretching/strengthening only made it worse.
HOWEVER, you are right in that you can have bone deformations without any issues. I have "FAI" on both sides by X-RAY. I have the same deformation on both side, but the right side it is located in an unrestricting location. My right side passes all mobility tests while my left side failed on all levels miserably.
The operation and recovery process has been entirely pain-free. I'm not saying the recovery is easy. You essentially have to learn how to walk again and your leg muscles quickly atrophy and forget how to fire.
3 weeks post-op I was cleared to walk without crutches for short distances. 1 Crutch for longer distance.
4 weeks post-op I only need to carry my crutch with me just in case. (I dont use it)
Pre-op my hip flexion was rated at -1 (1 degree under 90)
4 weeks post-op I am at 13 degrees (103 degrees) pain free. I have never in my life been able to flex my hip to this range of motion.
The worst case scenario is someone POSTPONES a surgery (an idea I address in the video). Best case scenario is someone finds a way to help remove the issue and avoids an unnecessary surgery. The dangers you talk about are only hypothesized by researchers and are only marginally proven by research.
You yourself already have seen that FAI in an x-ray doesn't mean anything necessarily. That is a point that is NOT communicated to the general public and one that can lead to MANY unnecessary and unsuccessful surgeries. So thank you for making my point! In your case, you may have had an issue that needed surgery. Maybe there were things you could have done besides surgery but nobody thought to try. Maybe the approach was jsut a tad off (I've seen LOTS of P.T. stretching and strengthening regimens do things that would actually make it worse). It's a moot point because, you're better, so enjoy it!
Great strength numbers, but we're not talking about ability to powerlift. We're talking about meeting a minimal level of strength and neuromuscular coordination to ensure proper joint motion.
Upright Health
I wholeheartedly agree with you that people shouldn't rush into the surgery. This is not a minor procedure and the recovery period is long. I won't be cleared to go back to normal training for around 2-3 more months. People really need to educate themselves on something like this before taking the leap. Not just about "FAI", but about their own bodies. I firmly believe that if someone has no knowledge of the biomechanics of their own body, that they should postpone this type of operation while they educate themselves. A healthy strength base is also recommended as I believe your muscles will bounce back more quickly. I have read articles of people claiming to still have pain 10 weeks in while I experienced barely any pain throughout the entire process so far.
In agreement with Upright Health, you should not go into a Surgery like this without a decent strength background and you should exhaust all other options beforehand.
do you mind if I ask who did your surgery?
isabel hall www.methodistorthopedics.com/john-seaberg
Would you be willing to fill us in on how things are going now that you're a couple years post-op?
I appreciate your videos, I was considering surgery but after I watched your videos, I tried stretches instead. They're working, I feel less pain already, and I don't hear the popping sound as much. Thanks!
I don't have FAI but just impinged hips and anterior glide of the femur. After much work with PT's I found a person who diagnosed me with a long Psoas Major which is causing the femur to not get pulled anteriorly but the other dominate hip flexors. Have you ever heard of this Matt? Everything else you say is correct about weak glutes (the lower fibers though) and tight hip flexors (Rectus Femoris and TFL) but the Psoas was overlooked and just mixed in with the other hip flexors which I've learned is not correct. What do you think about this?
Thanks a lot! Very, very helpful!
Yeah, I find this video very interesting. When I was in my 20's I could sprint, play basketball 2x, lift heavy as weights. I DID NOT have a desk job at the time.
Then in my 30's I took an office position and this certainly played a BIG part with my hip pain.
All this sitting + weight lifting + hard cardio and limited soft tissue work/stretching really did some damage.
My inner thigh muscles are super tight not to mention my outer thigh muscles.
Some of you may know David Goggins but when he was all FUCKED up from the military he would stretch 6 HOURS A DAY for YEARS.
He does Ultramarathons again. Remember this guy went through navy seal training 3 times! He came out of the military all messed up!
These days I do a lot of massage work either by myself or get the massage therapist. And see the chiropractor. I know this is a long road to recover.
I was diagnosed with FAI this past week. I'm 39 ..play basketball and softball. I've been having progressively worsening pain in my right hip. Feels like sharp stabbing pain and stiffness. I agree with your premise of strengthening around the hip joint...but if I've already caused damage to the hip labrum!? Strengthening the muscles around the hip joint won't correct the torn cartilage in my hip. Believe me...I want to agree with you...
I think you should get it fixed now before worstening the damage. Don't be scared of the operation either I'm reading more and more about quick recoveries without pain meds. (the symptoms are worse than recovery) I'm getting both of mine done after i get my back fixed lol and im a 25 yo ex collegiate athlete. my 2 cents
I hear ya...I'm not afraid of the surgery. I just don't have the luxury of taking 2 -3 months off from work ( I'm a truck driver) . It's a catch 22...
Josh Martins
ahh I hear ya. Well I wish you the best and hope it all works out for ya
Thanks. If you have surgery post back let me know how it goes. I admire the premise of this video. However I just think it's misguided. I'm not a Dr...but imho stretching and strengthening does nothing to change torn cartilage or a misshapen hip socket. I can literally feel the spur at top of my femur digging into my hip labrum.
I went through 3 months of p.t. for my slap tear and partial thickness r.c. tear. I strengthened my shoulder muscles. My range of motion improved..but guess what? I still have pain and stiffness in the shoulder. Just like my hip
Matt,
I gotta know, do you still experience hip pain frequently and are you limited in your activities? I am a young active guy who, after ~4 years of hip issues, was recently diagnosed with FAI. I have pincer impingement on the right hip and mixed impingement on the left hip. At the time my doc didn't think I should look into surgery yet b/c I guess it wasn't too bad, and the type of PT I would do post surgery is pretty similar to what I can do now. I've been at it for ~6 months. Although it's only been in the last 2 months that I cut out running (my main form of activity) and have been sticking to elliptical/bike/swimming for cardio and doing more weight lifting with emphasis on glutes
My range of motion is pretty good but I still experience pain anteriorly on the left hip (especially when sitting,) right SI joint, apparently I also developed a mild sports hernia on the right side (something my doc said frequently coincides with FAI.) Are these other symptoms something you experienced or seen with clients?
Really I'm looking for a frame of reference about what I can expect for a non-surgical approach and what I can/shouldn't do. I bought you Healthy Hips book and have incorporated all the stretches into my routine. Additionally many of the exercises I was already doing or doing something similar.
Is there anything else you can recommend?
What is your opinion on biking? Does it involve too much hip flexion?
What about squatting deep? Good for ROM or too much and potential stimulus for more bone growth?
I completely understand this was a long comment and you are a very busy man. But, any advice you can offer would be most helpful. You're videos have given me hope that there is a light at the end of the tunnel and I just want to keep my momentum heading there.
Thank you,
Charlie
***** I play ice hockey as a goalie again exploding into the (almost) splits, squatting deep on the ice and in the gym, and trail running. It took a long time to get my hips back to this point, but the only thing that bothers my hips is very long periods of sitting, as that just weaknes and tightens up the muscles that cause hip problems. My friend and partner on the FAI Fix was unable to tie his own shoes before due to hip problems. He is back to olympic lifting, gymnastics style exercise, and he just accomplished the full side splits for the first time in his life recently.
You can see more about the truth about FAI on thefaifix.com where we've laid out the research that shows that x-rays and MRIs to "pinpoint" cam or pincer is, by and large, totally pointless.
Pay attention to the muscles, not the "cam" or "pincer." Don't shortcut any of the stretches in healthy hips I. Read carefully and make sure you are actually doing everything as described and feel all exercises as described.
***** To clarify, the long periods of sitting "bothers" my hips, but proper stretching and exercise resolves it. I don't want you to think long periods of sitting is a debilitating thing. If you squish any muscle for 4 hours, it's not going to be happy.
Upright Health Matt that's really great to hear. I'm sorry it took me so long to respond, youtube got put on the back burner for a while. From where I'm at now it's hard to imagine life without the pain, or the worry of pain. Right now it seems that running, and enjoying activity without trepidation, has been taken away form me. But, deep down I believe this can't be then end of the road. Thanks for offering your advice and, most importantly, hope. I'll look into The FAI fix for further direction.
I get sharp pain when doing hip stretches, should I push through the pain? I fear I am causing physical damage. Even after massage and foam rolling I get pinching with stretches.
No, you should NOT push through pain - especially pinching pain - in stretches! Stretches should be felt in muscle bellies as a stretch. It's rarely ever a good idea to push through sharp pains like pinching.
Did it ever get better dude I have pinching in my hips do when I do lunges or knees to chest it sucks
@@jonthebeing knees to chest gives me pain at the front of the hips too, not on lunges though
Powerlifter for years man and thus impingement wasn't working its way out/ after everything I could possibly try standard healthy hip function was not achievable. I went in today and just got my right head shaved and the 6mm labral tear stitched up in there. Big time mega painful but I'm optimistic about the recovery and having a proper shaped healthy hip
I really hope you answer questions on here regularly. My left hip has been uncooperative for years now. It started shortly after squatting. I've been told I have a functional leg length discrepancy and misaligned pelvis. The hip flexor on that side feels resistant to stretching, and the IT band might be tight. The left leg also wants to veer outward too.
captainunload did you fix this?
I think this makes a lot of sense.
If the adductor muscles are too tight, or the gluteus(abductors)are too weak, then hip movement becomes a problem
Was just told I need hip replacement at 45 do you have a gym on the east coast you work out of ?