Anyone squatting with femoroacetabular impingement (FAI)?

[MAG]

I've had some right groin pain for a few months now, and right hip pain for a year or so. Nothing too serious, just an ache every now and then when I push it. I've also noticed a tendency to externally rotate my hip whenever lifting my right leg to clean my feet or put socks on, an inability to lift my right knee above 90 degrees, and an appalling interal hip rotation compared to my left hip. It pops excessively as well.

 

I'm taking a punt based on my online research that it's FAI, or something similar. Regardless, I have an impingement in my hip that is painful when performing certain movements. Here's some info about FAI.

 

All advice I can see is to avoid bi-lateral squats, due to the pressure caused to the damaged hip when putting the torso at an angle less than 90 degrees with the femur. As far as I understand it, this is something that should be managed, not fixed, unless surgery is a consideration.

 

[EDIT: I had hoped to begin training for a powerlifting meet at some stage in the near future, but my long term health trumps my goal of competing. I already do soft tissue and mobility work, and play basketball year-round, and I'm open to the suggestion to switching to single-leg work. It's not like I was going to be competing at national comps when I'm starting at 30!]

 

Does anyone else here have this, or something similar? Are you still bi-lateral squatting? I look forward to hearing from anyone who can provide some anecdotal or scientific advice on this.

[FellowshipOfTheRon]

hey mate, for most of this year i have been fighting with hip pain which i've also diagnosed (self diagnosed, internet phd take it with a grain of salt lol) to be some form of FAI (initially thought it was ITB tightness, which is still possibility but symptoms suggest more of ball joint inflammation), or just my arthritis getting worse as i age.. it got particularly bad at one stage couple motnhs back where as you mentioned, couldn't even put my socks on without epic struggle because of the hip pain. i managed for a while with box squats, i was not ready to give up.

 

one major adjustment i made was changed my excessive foam rolling tendencies (ref : http://breakingmuscle.com/mobility-recovery/your-it-band-is-not-the-enemy-but-maybe-your-foam-roller-is). this is back when i believed the IT band to be the issue, i foam rolled that area so much and found it made the pain worse... stopped foam rolling it and done deep stretching of quads (not too much of hips, gave them some rest from stretching) and a bit of hams every couple days for a while.

 

funny you should mention basketball because i didn't notice this problem arise until i started playing exactly that not long ago. it got so bad at one stage that i couldn't even sleep because the pain so i know how you feel, gotta take it easy for a bit with alternative exercises. i don't intend to give up, but have taken a slight rest from that in my past 5-6 weeks while focusing on putting on mass/building strength for powerlifting (also intend to compete some point next year even if i'm still weak).... 25 yrs old, not far from 30, i think you still got a fair shot at becoming competitive just keep working at tackling your physical weaknesses in a smart way, see sports therapists and invest yourself into a good training regiment. my legs been giving me grief for the longest time and even stopped me from living out my dream mate, i still intend to thrash them for the remaining years of my life and make them my strongest asset regardless of the struggle.

 

 

long story short; deep stretching, taking a bit of a rest from things which worsen the pain (basketball games (is till go out for light training) and deep squats - still did box squats to train explosiveness etc.), stopped foam rolling so much. few months later i am back to proper powerlifting program and on the road to making gains for a lift meet next year. it almost came back when i was doing 1RM testing last week but luckily went away again because i didn't do anything to aggravate it.

[Riccardo]

What you are describing does sound like FAI, Your hip's strongest position is externaly rotated so squat with an upright torso and knees out if you want to avoid the pain.

 

Unfortunately, FAI will lead to a labrum tear, cartilage delamination, softening and potentially osteoarthritis in the long run. I suggest you completely avoid anything that aggrivates it untill you see an orthopaedic surgeon, I can recommend a couple of very good ones who specialise in FAI. Surgery is short (~2h) and minimally invasive, performed with an arthroscope (keyhole surgery).

[MAG]

long story short; deep stretching, taking a bit of a rest from things which worsen the pain (basketball games (is till go out for light training) and deep squats - still did box squats to train explosiveness etc.), stopped foam rolling so much.

 

Thanks for the reply. I didn't see anything in your post about reduced mobility - my major concern isn't the pain, it's the fact that I can't raise my leg or even move it in certain ways when sitting at my desk, getting out of the car, etc. Looking at this picture at kevinneel.com (not inserted since it's freakin' huge) shows the reason why the mobility would be affected, and why it pops so loud when I move it wrong.

 

Did you have similar mobility issues? I'd hate to try to work through retaining the range of motion, while simultaneously doing potentially irrepairable damage.

[MAG]

What you are describing does sound like FAI, Your hip's strongest position is externaly rotated so squat with an upright torso and knees out if you want to avoid the pain.

 

Unfortunately, FAI will lead to a labrum tear, cartilage delamination, softening and potentially osteoarthritis in the long run. I suggest you completely avoid anything that aggrivates it untill you see an orthopaedic surgeon, I can recommend a couple of very good ones who specialise in FAI. Surgery is short (~2h) and minimally invasive, performed with an arthroscope (keyhole surgery).

 

Your post backs up what I've read elsewhere - that untreated FAI will do some serious damage. I'm pleased you mentioned bi-lateral squats are still an option, though right now I've opted for rear foot elevated split squats to change things up a bit.

 

Have you had experience with FAI yourself, or are you just in the know?

[Riccardo]

Go see a surgeon dude, don't try and diagnose/treat yourself online, you're only going to make things a lot worse by continuing on, you don't want to end up needing a total hip replacement.

[FellowshipOfTheRon]

Hey MAG.To be honest I don't understand that picture but on the note of mobility, things like sitting down at desk were easy (albeit didn't sit my usual way), but standing up then walking after a couple of hours was hard. Driving/sleeping was difficult every time I had to raise leg to hit clutch but only because of that sharp pain as if someone was stabbing my hip flexors, the mobility it self wasn't reduced otherwise apart from the piercing pain - hence why I went for box squats instead of full range squats focusing on keeping torso upright as possible (only just learned how to brace core finally which has helped heaps with this). if i slightly forgot to brace properly and lean forward a bit on the squats now and do closer stand, i can still tell the problem is not gone just hiding. please note what i did is based on self diagnosis i might not even have same problem as you, what im doing is also irresponsible and to follow me is worse :think:

[Riccardo]

And I just happen to know a lot about FAI from the work that I do (medical field).

[MAG]

Go see a surgeon dude, don't try and diagnose/treat yourself online, you're only going to make things a lot worse by continuing on, you don't want to end up needing a total hip replacement.

 

Good answer. I wasn't attempting to treat it, just trying to get an answer from someone with anecdotal or professional experience that this isn't something to fork around with. This obviously isn't the same as a niggling elbow or knee injury - it sounds as though it's a serious issue and should be treated as such.

 

You mentioned knowing some surgeons who specialize in FAI - any in Dunedin?

[MAG]

please note what i did is based on self diagnosis i might not even have same problem as you, what im doing is also irresponsible and to follow me is worse :think:

 

Sounds like you've just been hit with some self-reflection! I'm going to see someone about mine, might not be such a bad idea to get yours checked out too in case you wreck it?

[FellowshipOfTheRon]

 

please note what i did is based on self diagnosis i might not even have same problem as you, what im doing is also irresponsible and to follow me is worse :think:

 

Sounds like you've just been hit with some self-reflection! I'm going to see someone about mine, might not be such a bad idea to get yours checked out too in case you wreck it?

 

yeah you're right i should! I just don't like how every time I go see a professional they are trying to tell me to stop training and just do light cardio to stay fit instead.. Riccardo, post up your contacts bro, any in Auckland?