Exploring Hip Pain: FAI Dysfunction

May 01, 2012

Fitness Forum

I had femoroacetabular impingement (FAI) and recently had the labrums arthroscopically repaired in both hips. Contrary to the article written by Chris Gellert, PT, MPT (February 2012), I had no limitations in flexion, extension, or internal or external range of motion prior to the surgery. What I did have was pain; specifically with internal rotation and 90 degrees of hip flexion. However, the pain masqueraded itself as muscular tightness. I’m a cyclist, and I had been racing a lot at a velodrome. The hyperflexed [racing] position along with the anatomy so well described by Mr. Gellert is what caused the labral tears. There had been no acute trauma; the injury was purely a mechanical one. However, hip flexors are frequently tight on cyclists so this is what I suspected it was. After X-rays, two MRIs with and without contrast, consultations with seven different doctors and a ton or research, I had the two surgeries.

Although the protocols for [FAI] rehab recommended crutches for 3 weeks, the surgeons I consulted recommended weight bearing as soon as possible. Hence, I was on crutches for only 3 days after each surgery. As the article states, it takes about 3 months for full recovery—when you can start to really train hard. My current rehab doesn’t consist of a lot of strengthening exercises. My hips don’t lack strength or power. In the repair stage, it is more important to keep the muscles firing to allow for the bone to heal, collagen to form and the tissue to regenerate. My current rehab consists mostly of aquatics to encourage gentle movement, cycling for blood flow and stretching to restore range of motion. There is always adaptive shortening when tissue is cut.

It is very difficult to diagnose this condition without an X-ray or MRI because it is caused by abnormal structures of the femoral head-neck junction. However, like most athletes, I “pushed through” the pain. Prior to the MRI, I spent 4 weeks resting, massaging and stretching torn labrums. None of that was going to mend torn connective tissue.

The takeaway? When in doubt have it checked. I recommend an X-ray and/or MRI with contrast. It’s not fun, but it’s the only way you can really know if FAI is your problem.

John Platero
Director of Education, National
Council for Certified Personal Trainers
Newbury Park, California

IDEA FitnessConnect: “Visible Success”

Great IDEA Trainer Success issue (January 2012). Also, my clients received their first IDEA FitnessConnect e-newsletter [from me], and the feedback has been great. I recently dropped a newsletter service and instead use IDEA FitnessConnect’s free newsletter service to connect with current and potential clients. One of my trainers has seen the visible success I have had with FitnessConnect; she has climbed aboard and is about to get an IDEA membership as well.

Kurt Gillon
Decatur, Georgia

Great Nutrition Starts With Great Flavor

Thank you for including my submission as one of the top five vision statements submitted at the 2011 IDEA World Fitness Convention™ (“Your Vision for the Future,” January 2012). As a whole, the fitness industry has historically and understandably put virtually all of its emphasis and focus on the various ways clients/members can engage in physical activity and exercise. This is great, but it’s only half of the wellness picture. The other half of wellness is nutrition training, which focuses on making improvements on what (and how much) our clients eat.

As a certified personal trainer, a certified group fitness instructor, a certified clinical nutritionist and a cooking instructor, my current vision statement for the future is to show/train greater numbers of people that their first step to better nutrition begins with improving their existing diet through tweaking and swapping out the fatty and unhealthy ingredients for those that boost nutrition value. Most people are genuinely surprised that healthy food really can taste great. When they realize that, they begin to acquire an enthusiasm for better nutrition.

It’s important also to note that when I succeed in training a nutrition client or teaching a room full of people how to improve their diet and change their recipes, I’m also having a direct impact on improving the diet of all the other members of his or her family.

You really want to impact the health and fitness of our world? Step 1: Nutritionally improve what and how much our clients eat; train them to understand they do not have to forgo flavor to enjoy healthy, nutritious foods.

Cappie Geis, CCN
Cooking Instructor, Great News Cooking School
San Diego, California

Sign Me Up for IDEA World Fitness Convention!

Minor heart attack of pure excitement [after receiving] the 2012 IDEA World Fitness Convention brochure. Dying at the offerings. I’m 100% making an effort to be there and suck each of those experiences dry. Stand-up paddle boarding?. . . Sign me up!

Serena Scanzillo
Arlington, Virginia

I have to tell you how thrilled I am about the line-up for the 2012 IDEA World Fitness Convention. I’m so happy to see Kari Anderson (a top-notch, incredible, creative woman—my favorite presenter!) as well as Rebecca Small and Kim Miller, to name a couple of other fantastic presenters [on the program]. I’m a stepper from way back when it first came out; I’m so happy to see that it’s back! I’m looking forward to the conference this year.

Jo-Anna Mitrano
San Diego, California

The Exercise-Church Connection

An item in Making News (July–August 2011) addressed research that showed younger people who regularly participated in religious activity may be at risk for becoming overweight. It also asked if readers offered any programming at their places of worship.

I lead a fellowship/fitness group called Body Matters at the Roswell Presbyterian Church in Roswell, Georgia. It is a yoga/Pilates/stretching class for participants of various ages and levels. The class is free, and the church even provides free childcare, which several moms take advantage of. Friends and nonchurch members are invited. I am an ACE-certified group fitness instructor and church member. I see people there who work so hard at taking care of others, yet neglect their own health.

We are a pretty small group, but people come and go as they are able. We provide a way for people to make connections in the church in a place that recognizes that our health is important and that we cannot best take care of others if we are not healthy. Each class ends with a prayer. I have been happy to lead this group and feel so fortunate that the church sees value in it and supports it.

By the way, my husband leads a running group [at the church] and another member leads a hiking/biking group as well.

Tricia Hovorka
Roswell, Georgia

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