So you might be reading the title and wondering what the heck is FAI? FAI is short for femoroacetabular impingement, a condition where there is abnormal impingement in the hip joint where the acetabulum meets the head/neck of the femur and causes non-arthritic joint pain.
There are people that have this and it never bothers them, but very active individuals tend to find out about it sooner than most since their active lifestyles can bring about hip pain. FAI isn’t caused by exercise, but exercise can exacerbate it and cause flare ups. FAI is actually a deformity in the hip joint itself that usually occurs during bone growth and development in childhood.
There are a few different kinds of FAI: cam impingement, pincer impingement, and a combination of those 2. I have pincer impingement in both hips, with a bone spur in my left hip joint.
I was officially diagnosed with FAI last summer when I was having increasing pain, aches, and stiffness in my hips after doing lots of PiYo. I was doing PiYo nearly every day preparing for my upcoming class, and I was really working hard at increasing my flexibility. During my practice and classes I was really pushing into my hips. Bad idea.
I misinterpreted my limited hip mobility as a flexibility problem and didn’t realize that it was really a mechanical joint problem. Pushing through my hip stretches made my hip joints hurt and ache! My physical therapist was the one that figured out what was going on, and recommended I get hip x-rays. Sure enough, I had FAI as she suspected and if I had continued to push myself I could tear the hip capsule cartilage (labrum) which requires surgery to fix.
Finding out I had a joint deformity was rough at first. I felt so limited in what I could do and mentally I was frustrated to find out I had a permanent hip disorder. I cried, and felt powerless and frustrated. I thought for sure I was going to have to give up PiYo and yoga completely.
I really enjoyed teaching my fitness classes and loved that I was getting better at PiYo, getting stronger and more flexible, but my hips posed a problem. My increased hip pain spread into everything else I did: squats and lunges hurt, rowing was painful, and bike riding grew uncomfortable even though those activities posed no problems before I regularly started PiYo. Sitting for lengths of time then getting up to walk was painful. I started limping around and people noticed.
I didn’t try to keep my health problems from my students: I had to modify my moves or quit, so I provided my class with modifications that I was doing and why I was not able to do certain things. Everyone was super understanding and very gracious! When I got sore or stiff, I told my students I wasn’t moving as well that day and I would be moving slower.
The doctor was going to give me cortisone shots in my hips but I decided against them. I decided to try and help my hips myself and get a second opinion if things would not improve. I modified my PiYo moves and I stopped doing so many squats and lunges until the inflammation had gone down considerably.
I can keep doing PiYo and yoga as long as I watch the deep hip-hinge poses
I also started taking more anti-inflammatory supplements like turmeric, quercitin, and tart cherry extract to manage the inflammation in my hip joints. The doctor had said he didn’t see any arthritis in my hip joints, so the pain at this point was mostly mechanical so I could manage the inflammation in my joint.
Since being diagnosed with FAI last summer, I had to make a conscientious decision to really watch the hip-opening yoga poses and deep hip-hinging poses like low lunge, 3 point balance, single leg down dog, etc. I started using a yoga block in low lunge and that really seemed to help. I also had to make sure that I was using my muscles in each position instead of simply sinking into my hip joints. I cut back on how many days a week I did PiYo and yoga so my hips had a chance to rest. I also started using a TENS unit so I could help my hips recover better.
So far, have been able to manage things pretty well! It has taken months to heal, but my pain and stiffness has finally subsided and I didn’t have to get cortisone shots. I may eventually have to get surgery on my hips if bone spurs continue to grow and impingement increases, but we are hoping to avoid surgery. I have never had surgery before yet (knock on wood) and if I can make it through life without having surgery I’m all for it!
And I have had to come to grips with the realization that I simply cannot do things like everyone else: I can’t squat below parallel, I can’t do a great pistol squat, I will never touch my nose to my leg in 3 point balance… BUT I can do other things and I need to focus on what I CAN do instead of the things I CAN’T do!
Resources and info on FAI:
- Henry Ford Health System Orthopedic Surgery
- FAI Joint Preservation Guide (Rothman Institute)