Fai +1

[Bruce K]

I know this topic was discussed a bit in the Fit section but I think it is worth discussing here.

So I went to the orthopedist today to discuss my hip issues - dull ache after riding and discomfort when sleeping on my side.

One of our members had recently been diagnosed with FAI and suggested that I mention it to my MD.

They took 3 images before I ever met with the MD. I then met with the PA who put me through a series of flexibility and strength tests. He mentioned arthritis and ridiculitis (sp?) but said that the specialist would be in after taking a careful look at the pictures. he was skeptical that I would be able to treat whatever was going on without getting off the bike for a while.

A bit later the MD walks in and starts decribing this reptitive motion injury that is causing my femur to contact the edge of the pelvic bone, irritating the femur and causing it to build extra bone in the area of the irritation.

I asked if this was FAI and he said "Exactly".

It is apparently quite common in cyclists.

The treatment will be a course of steroids, PT to retrain some of the muscles to pedal straighter as apparently the body's reaction to this type of injury is to pull your knee to the outside to alleviate the pressure (it is maximized when your knee is pointed towards the stem when pedaling), and then to basically live on Advil, Motrin or some other anti-inflamatory for the rest of the season.

Cycling does not have to stop but I will have to watch out for over doing it or pushing too hard in my pedal stroke and irritating the hip.

The MD was also very glad I had just gone through a refit as this type of injury is more prevalent when riding positions change or bikes aren't all set up the same.

I guess the upshot of all this is to keep a close eye on your fit and to not ride through hip discomfort that goes deep into the joint.

Good luck to all this season.

BK

[thwart]

Sorry Bruce... what exactly does FAI stand for?

[Bruce K]

Femoroacetabular Impingement.

As I said, basically it means your femur is contacting your hip/pelvis when you pedal.

It is the shaft part of the femur just below the ball end and it hits the edge of the socket.

The more toe in you are, the more likely you are to develop this from what I understand.

BK

[gone]

At the risk of performing a "self-diagnosis" via the internet, I think I might have the same thing. I'll try to describe it in more detail so that others who've already had a confirmed diagnosis can say yea or nay.

Just forward and above the point of my left hip there is a "burning" sensation, somewhat sensitive to the touch, definitely exacerbated by sleeping on my right side with my left leg stretched over my right putting pressure/stretching that area. This has been pretty consistent for about 6 weeks now. Haven't really noticed any correlation between long rides and more pain (I've done several centuries and 200k's in the last 45 days). It's not been painful enough to this point to cause me to go see an ortho but if it progresses a bit it will be.

I haven't had any bike changes or refits but obviously I've been ramping up the miles here in the frozen north since January.

Sound similar to FAI?

[Bruce K]

Try some anti-imflamatories and see if it eases up.

That might be a hint.

BK

[ultraman6970]

Interesting, because a pain like that just showed up in my left leg a few weeks ago the 1st time I went out in one of my bikes (my last built), I was using an old time impact, it was weird like the junction of the femur and the hip was super rusty specially when standing in the pedals, while seated was ok. In the last overpass like 1/2 mile from home I stand up and the left leg in specific that area felt so weird that I could not stand the pain, it was simply working wrong. Then like 2 weeks of pain like you guys, could not open the leg that much because of the pain, had to force it a few times to stretch it. After like 10 days the pain was almost gone.

Yesterday was the second ride, changed the pedals to a pair of rxs i have in my other ride, the leg felt better, in special that area, the junction of the femur and the hip. Standing in the pedals was almost 100% ok.

Today went out again and i really forced the mileage, like 60 and the last 10 the femur and the hip junction started messing around again. Now it is kind;a sore and it hurts.

One of the things, one of the medications i'm taking is for cholesterol and one of the side effects is pain in the articulations, it could be that or could be something like what the op says, i remember read about it before in another posting.

About the pedals, the impact has a closer q factor than the rxs and that looks like was the root of my initial problem, the issue is that probably i forced it too much and I messed up the articulation or is something else.

[yodelinpol]

At the risk of performing a "self-diagnosis" via the internet, I think I might have the same thing. I'll try to describe it in more detail so that others who've already had a confirmed diagnosis can say yea or nay.

Just forward and above the point of my left hip there is a "burning" sensation, somewhat sensitive to the touch, definitely exacerbated by sleeping on my right side with my left leg stretched over my right putting pressure/stretching that area. This has been pretty consistent for about 6 weeks now. Haven't really noticed any correlation between long rides and more pain (I've done several centuries and 200k's in the last 45 days). It's not been painful enough to this point to cause me to go see an ortho but if it progresses a bit it will be.

I haven't had any bike changes or refits but obviously I've been ramping up the miles here in the frozen north since January.

Sound similar to FAI?

Could be one of many things or a combination of things. Yep I wouldn't diagnose yourself or have others diagnose you over the net. The hip can be a funky area and there are so many common symptoms in different dysfunctions... I'd go see a doc before you try to self treat. Some kind of sports specialist would be best of course.

[gone]

Could be one of many things or a combination of things. Yep I wouldn't diagnose yourself or have others diagnose you over the net. The hip can be a funky area and there are so many common symptoms in different dysfunctions... I'd go see a doc before you try to self treat. Some kind of sports specialist would be best of course.
It seems to be in a bit of a holding pattern, not getting worse but not going away either. If it gets worse, I'll go get it checked out.

[firerescuefin]

http://forums.thepaceline.net/showthread.php?t=87812&highlight=FAI


I think I am the member Bruce is referring to. Bruce is the 3rd member of the forum that I know of that has been diagnosed since I posted the above. 2 contacted me directly to discuss symptoms before they received a definitive diagnosis. As Bruce said, it's very common in the cycling/active adult community, but outside of a specialist, is not going to be known of/diagnosed by most general practitioners. Most times, FAI is congenital, not developed. The manifistation development of the injury occurs because the overlap (pincer type) or femoral cyst (cam type) does more damage to the cartilage the more miles (figuratively and literally) that are put on the hip. That's why it is most prevalent in active adult populations.

[Ahneida Ride]

This is why I like Frogs ...

Tons of float .... do I need float ...

[Bruce K]

Float is a plus according to my Orthpod. I have been using zero float cleatas for years.

In my case, the cam type of injury, the pedaling motion while forcing my knee inward is what has caused contact between my femur and pelvis leading to additional bone growth and the formation of the lump.

The bodies natural reaction is to also pull your knee away from correct alignment at the top of the pedal stroke putting stress on the ITB, hip joint, and knee joint.

I strongly agree with firescuefin that if you decide to see an expert that you make sure they understand cycling and the biomechanics of cycling.

I am allowed to continue riding but limited to 2 -3 hours or until ache gets too big while I do a course of steroids and PT. The PA who did the inital diagnosis before the orthopedist came in to see me was talking about taking several weeks off from riding.

Guess who I am listening to...

BK