Understanding FAI: For friends, family, caregivers & co-workers

"Living with hip pain no one can see or explain is difficult on an emotional level, maybe even shameful. When you break your leg or are involved in a car accident your suffering is validated. When it is invisible, you suffer alone..." -first paragraph of my first blog entry.

There is a common thread among those diagnosed with FAI. We are a community of people whose life, leisure and identity are tied to athletics. Now, take that away and replace it with chronic pain and limited activity. If you are the caregiver or loved one of a person with FAI listen up. It's a long and painful journey, filled with grief, exhaustion, fear and pain. But with your help it can also be full of healing, hope, love and self-accomplishment. But one thing is for certain, it cannot be traveled alone.


Who Does FAI Typically Affect?
-Active adults, most of which in their late twenties to mid forties but can be earlier or later in life including runners, cyclists, yogis, football and baseball players, golfers, paddle sports enthusiasts, dancers and those involved in martial arts. High range of motion activities provoke the onset of symptoms most often.

-It is common for pregnant women or mothers of small children to suffer from FAI. Bending, squatting, carrying, etc., the activities of a new mom are not kind to those with FAI.

What Are the Symptoms of FAI?
--Aching joint pain deep in groin. Pain associated with osteoarthritis in particular may be worse at end of day and evenings.

--Catching, locking or grinding sensations in hip that are continuous and painful, often stopping a person in their tracks. This is often caused by loose debris in the joint as a result of torn cartlidge and tissue, etc. A patient might complain of a "bone on bone" feeling.

-Pinching pain felt in the hip flexors when bent past 90 degrees or when engaging the hip flexors in certain movements.

--Pain with internal rotation of hip.

--FAI may cause lower back, buttock and knee pain. Also pain while sitting is very common. Sitting at a desk or in a car for long periods of time may cause terrible pain.

How Does A Person Develop FAI?
The cause is still unknown, but it is believed the bony abnormalities that cause the damage (hip impingement) were either present at birth or developed over time due to certain activities such as dancing, kicking or running, especially at an early age.

What Causes Pain Associated With FAI?
When the bony abnormalities on either the Femoral Head or Acetabular rim, or both make contact with the labrum and cartlidge, tearing may occur. The result of a torn labrum or cartlidge damage is painful and may very well lead to an early onset of OA, Osteoarthritis.

What Are the Treatment Options for FAI?
Good news! Although research and technology for diagnosing and treating FAI is still relatively new, there are treatment options available with high success rates. Finding the right Orthopedic Surgeon who is knowledgeable and experienced in treating and diagnosing FAI is key.

Treatment Options Include:
--Conservative Treatments (should be encouraged first) such as NSAIDs and Physical Therapy.
--Arthroscopic Surgery
--Open Procedure

How Can I help Someone Who Has FAI?
Be sensitive, available and patient. Understand this person may be grieving the loss of a dream. Many professional level athletes have suffered from FAI, but even for a new mom whose release comes from her weekly spin class, to her that loss is devastating. Acknowledge and validate their pain. No matter how hard they try, they will not be able to "suck it up" or "push beyond the pain". Chronic pain is a monster far more powerful than you can imagine if you have not faced it yourself.

Help out more than you think you should! Daily activities such as climbing stairs, loading the dishwasher, driving a car, etc can be exhausting beyond belief. To keep up with life despite the pain, it takes much more energy. After a long day, they might be achy, frustrated and tired.

Be supportive in the decision making that lies ahead. Conservative treatment options such as NSAIDs or Physical Therapy should be tried first, but if they fail and the pain continues surgery may be on the horizon followed by anywhere from 1-8 weeks on crutches followed by months of hard work to reach a full recovery.