My FAI Story: Beating FAI Hip Pain Without Surgery

fai hip impingement hip labral tear Jan 28, 2022
Beating FAI Without Surgery

FAI. Hip Impingement. Hip Labral Tear. Getting a diagnosis like this can throw a wrench in the next few years. Doctor visits, MRIs, chiropractor visits, PT appointments, surgery and on and on. The diagnosis and the pain take a hold of your life.

Figuring out what is best for your FAI and hip pain becomes a full-time job. But what do you do? Do you get surgery? Do you try another physical therapist even though the last one didn’t work? You’ll do whatever it takes to get out of pain but nobody is showing you HOW.

Figuring out how to get out of hip pain from FAI changed the course of my life. It changed how I looked at just about everything. How my hips move but also how the rest of my body functions.

I examined what I do every single day. For work. For fun. I investigated my relationship with pain. My relationship with other people. I looked at my psychological and emotional well-being. Everything.

And this article summarizes my FAI journey during the last decade. From when I first started getting hip pain and received an FAI diagnosis to now, out of chronic hip pain and helping others do the same.

In this article, I share things that helped me get out of chronic hip pain from FAI and mistakes I’ve made on the way. I hope the reader can learn from my experience and possibly make their journey a little more comfortable.

How my Chronic Hip Pain and FAI Started 

I’ve always identified as an athlete and more specifically, a basketball player. In high school, I was captain of a winning team and this is still how people remember me in my hometown. Although I didn’t play for my college team, I played recreationally and stood out.

It was just for fun but it mattered. I made relationships on the court. It helped me stay in shape. Although no one but me cared, my performance on the court affected my entire life. If you grew up as an athlete, you’ll know what I’m talking about.

In 2010, I enrolled in Law School. A few months into my first year, I discovered that the law school had a basketball team. The team played in a competitive New York City law school league and went to an annual tournament in Massachusetts.

Hell yeah! I was pumped. I made the team. Made new friends. Some of which I still have great relationships with today. The first season went pretty well. We didn’t win anything but with me coming back, there was a lot of hope for the 2012 season.

But 2012 was the year my hip pain decided to make its introduction. I remember starting to feel the pain when I would drive to law school. This annoying ache in the outside of my hip that radiated to my low back. It was frustrating but I just blamed it on the car and sitting a lot.

Then during an exhibition basketball game I went for a rebound. I didn’t know at that time but going up for that rebound would change the entire course of my life. When I landed, the sensation in my hip was no longer a dull ache. Nope. It was a sharp and intense pain that I’ve never experienced before.

I tried to keep playing but I couldn’t move. Every step I took the pain would travel through my entire body. I went to the sidelines and just laid down. “I’m done,” I told the team. And this continued the entire season. I still have memories of me laying on the sidelines with an icepack on my hip.

And it wasn’t just with basketball. Laying on the couch for longer than an hour was unbearable. Walking sucked. Working out was impossible. What was happening to me? I was in my early 20s but I felt broken.

Getting the FAI Hip Impingement Diagnosis

So I did what anyone would do. I went to my doctor who recommended I see a specialist. The specialist for joint pain is an orthopedic surgeon. So that’s who I saw. The surgeon recommended I get an MRI. So that’s what I did.

The surgeon looked at my MRI results and told me I had hip impingement aka FAI and a torn hip labrum. He explained that the only way to truly fix FAI is through arthroscopic hip surgery.

He explained that there would be certain activities I couldn’t do without the surgery. But there were some other options. I could start with some cortisone injections and try physical therapy (“PT”).

Below are my actual MRIs showing FAI and a labral tear from 2013. 

The pain might go away with those interventions, the doctor said. But if it doesn’t, I would have to modify my activities until I get surgery.

“Modify my activities? What did that mean?!” I remember thinking that I just needed to get this surgery so I can continue doing the stuff I want to do. But I decided to give the cortisone injections and PT a try first.

I was amazed at how ineffective the cortisone injections were. The doctor doing the injections said it can last anywhere from 3 months to forever. Well it wasn’t forever because my pain came back the next day.

So on to PT it was. And boy, did I give PT a fair shot. Three PT clinics in fact. Knowing what I know now about the human body, I can’t believe the things they had me do. I remember walking into a clinic and the therapist telling me to go to the leg press machine. I sat in that machine for 25 minutes by myself. Then I went on the massage bed, got stretched out for 15 minutes and that was my PT session. What!?

In another clinic, the therapist recommended I do cobras every hour. And me being desperate to get rid of this pain I did just that. I remember interning at a law office and going to the conference room to do my hourly cobras. I don’t mind coworkers thinking I’m a weirdo but only if it helps me get out of pain. The hourly cobras did not help.

In another clinic, the therapists would put those electrical stimulation pads on me for an hour. And when I came back and said the pain was not getting any better, they would just shrug their shoulders. I’ll never forget one younger therapist saying “Oh you have FAI, you just gotta get surgery for that man. That’s the only way to get rid of it.”

Maybe he was right. But I wasn’t ready to get surgery yet. And because PT wasn’t helping, I thought it was time to enter the world of Alternative Medicine.

Looking for Alternative Treatments for FAI and Hip Pain 

I didn’t want surgery. PT didn’t work. So I dove into the world of alternative medicine. It started with a “non-traditional PT” that friends of family recommended. Apparently this guy did miracles for people in joint pain so I was hopeful.

In my first session with this PT, he put my feet together and he explained how easily and smoothly my feet came together. He put my feet down and then put a small glass jar of gluten on my stomach. He then tried putting my feet together again. This time the feet would not come together. No matter how hard he tried, there was a dead stop.

I was 25 years old and impressionable. So I was sold. “This is it!” I thought. I’m going to stop eating gluten and my hip pain will be gone forever. And to be honest, my back and hip did start feeling a little bit better. But in hindsight and knowing what I know now, it was probably because I finally started eating healthier.

And I think this happens to a lot of people. They cut out gluten or dairy or sugar or whatever. And they see some improvement. Mix that in with some placebo and you’ve got some die hard supporters of fad diets.

When I cut gluten out, I also cut out pizza, bagels, cookies and the like. So yes I stopped eating gluten but I also stopped eating like a college kid for the first time in my life. So maybe this (along with some placebo) provided some minor relief at the time.

But it wasn’t long until I realized this gluten thing wasn’t going to do the trick. I kept gluten free for another 5 years or so but that’s a story for another time. So I continued my search in the world of alternative medicine. And then, another family friend recommended a chiropractor. Damn family friends, am I right!?

I went to this chiropractor not knowing what to expect. I explained that I had hip pain, FAI, impingement etc. The chiropractor said he was familiar with these issues and asked me to lay on a massage bed.

After telling me to relax, I just heard “CLICK, CLACK, CRAACCKKK.” I received my first adjustment. The adjustment was on my spine though. So i asked the chiropractor, “How is this supposed to help with my FAI and hip pain?” Give it time, he said. It takes a few weeks of adjustments to start seeing results.

So I went back for a few weeks. He finally asked me to show him my X-rays. He took a look at the X-rays and said, “Oh you have arthritis. I’m not sure I can help with that. But I have a massage therapist who works in-house that can help.”

I walked into the massage therapist’s room and she started rubbing my shoulder. My shoulder! She said that there are nerve connections in the body. And the shoulder has a pressure point that affects the hip. What!? I RAN out of there. Even knowing the little that I did back then about pain, I recognized that I was in an office full of quacks. I think that office is still trying to collect their last payment from me.

After that, there were yoga classes, personal training sessions and a few other non-traditional PTs. There were probably many more things I tried but 10 years later, I honestly can’t remember.

I was losing patience and hope. Nothing was helping. And playing basketball, working out and being otherwise active was still incredibly painful. I decided to find a really good orthopedic surgeon and get a second opinion on surgery.

Scheduling Hip Surgery for FAI Hip Impingement 

I worked and lived in NYC so I knew there were some really good orthopedic surgeons in the area. I met with a reputable doctor and she asked me all about my FAI hip symptoms. She then performed all of the FAI hip tests:

  1. FADIR and FABER.
  2. Injection at the labral site to ensure pain is coming from the tear.
  3. MRI and X-Ray.

After going through my results, the doctor said I was a good candidate for arthroscopic hip surgery. All of the tests indicate FAI hip impingement and a hip labral tear. She also said my left hip was showing FAI and labral damage but if there was no pain, she did not recommend surgery.

I told her I’d think about it. I left the medical office depressed and confused. How much longer was I going to push this off? I just have to rip the band-aid off. After speaking with some close friends and family, I was convinced. I had to get surgery. This was the only way out of pain. It was the only way to get my life back. 

I called the office to get my affairs in order. I was nervous about the cost of the operation so I wanted to make sure I gave myself time to save up for the procedure. I called the office and the receptionist said she can get me in for surgery next week. “Next week!?”

“But I need time to save up”, I told the receptionist. That’s when she told me something absolutely shocking. “You have $0 out-of-pocket costs for this surgery.” Wow. $0. This surgery was upwards of $20,000 to $40,000 and insurance was paying for all of it. What a steal! I scheduled my surgery for 2 weeks later.

Second Thoughts about Hip Surgery for FAI 

The next two weeks were rough. Something was eating at me. Surgery at 25 years old because of wear and tear!? And my left hip had the same thing on an X-ray but there was no pain there!? I kept going back and forth. I was driving my wife (girlfriend at the time) absolutely crazy.

This went on for days. Until 2 days before the surgery, I discovered a video on YouTube. It was Matt Hsu from Upright Health. And the video was titled “I Don’t Buy FAI.” I watched the video. I watched it again. And again. And again. Finally! I found someone who understood what I felt. Who discussed the uncertainties of this FAI diagnosis and the treatments for it.

I called the doctor’s office and cancelled the surgery. I actually spoke to the doctor herself and she asked me what I was going to do instead. I said “I found a video on YouTube. I'm going to try to use exercise to heal my hips.” “OK, good luck with that,” she said sarcastically.

But it didn’t matter. I didn’t know exactly why but I trusted Matt and his message. I didn’t know what lay ahead but I was confident that I’d figure it out. Movement was going to bring me into the promised land. I just knew it.

Starting to See Progress in my FAI Pain

And so the journey began. I purchased online programs. Scheduled sessions with experts. And started bringing function back into my hips. After doing 3 months of targeted stretching, activation drills and soft tissue work, I noticed a huge improvement in my pain levels.

I was able to play basketball and other sports. I could work out the way I wanted to. My body was finally starting to work with me instead of against me. Although I still had moderate pain and stiffness, I saw the light. Movement would heal my hips. To that point in my young life, there were few things I felt more certain about.

For a few years, I was satisfied with how my hips felt. I was a practicing attorney in NYC which meant A LOT of sitting down at a desk. I figured that stiff hips were part of the gig. I was no longer in excruciating pain so I thought I could live with this.

But the stiffness only got worse. It wasn’t just my hips but the rest of my body. It wasn’t just my body but also my soul. Day after day sitting behind a desk was crushing me. “Is this it?” I’d ask myself. Sitting at a desk for the rest of my life while my hips and body just got stiffer and weaker?

I can write a completely different blog (probably just as long) about my current transition from an attorney to a personal trainer but I’ll save that for another day. It all started when someone emailed me about my FAI journey. They read my story on Upright Health’s website and wanted to ask me some questions.

That email exchange sparked something inside of me that none of the legal case files on my desk did. I felt alive. I wanted to help this guy with his hips! I knew what he was going through and I knew surgery wasn’t the path for him. And I wanted to help other people too.

I decided to study for a personal training exam. I also decided to dive deeper into training my hips. I knew that if I wanted to help people, I needed to know more. Much more. I also needed to get 100% out of pain and get rid of this lingering stiffness I’ve had for years.

But what I didn't know was what would come next. That by putting so much more attention on my hips, my pain and stiffness levels would only get worse before they got better.

Finding balance in training out FAI hip pain

I decided I would become a personal trainer that helped people get out of FAI hip pain. This was my calling. So I dove deep into the world of training. I learned all of the great corrective exercises out there. Learned how muscles and bones work. And trained every single day.

And then something unexpected happened. My hip pain came back. It wasn’t quite as bad as it was a few years back but it was uncomfortable. “Well this is good,” I thought. “If I figure out how to cure this pain, I can help others do the same.”

I looked for the perfect exercises to get my hip to feel better. The perfect combination of exercises in the perfect order to ensure my hip would not hurt. I stretched my inner thighs out for hours. “Activated” my glutes for days. And laid on a softball for weeks. And all of these things helped, temporarily.

But the pain and stiffness would come back. So I would stretch, foam roll and activate again. And over and over this cycle repeated itself. It took a very long time for me to understand that the things that helped me before weren’t going to help me now. In fact, it might’ve been doing more harm than good.

Then one day, my wife and I went on vacation for a couple of weeks. Long drive. No time to do my exercises. “Man, this was going to kill my hips!” I thought. I was surprised to learn the opposite happened. After a few days on vacation, the pain and stiffness went away.

This was an epiphany for me. Maybe less is better? Years later I’d read a quote by the ancient Roman Emperor Marcus Aurelluis that would be a quote I live by: “Do less, better.”

During this same time, I was on an emotional and psychological journey as well. I’ve always struggled with anxiety and obsessiveness. I was obsessed with living a healthy lifestyle. With work.  And many other things. So while I was learning more about the body, I was learning more about the mind as well.

I learned about fear. And all of the things humans do to avoid feeling fear. Or sadness. Or vulnerability. Essentially, I learned to feel emotions. And this was liberating. I still experience fear but it doesn't control my life. It is a part of me and I no longer do things to avoid feeling it. In fact, I go right into it and embrace it. 

I noticed the exact same thing with pain. All of the exercises, stretches and soft tissue work I was doing were ways to avoid feeling pain. It’s not that exercise didn’t help. It did. But eventually, I started getting diminishing returns. I was doing exercises to get rid of the pain instead of improving function. And this was a recipe for disaster.

And I noticed this with many of the clients I started working with. It wasn’t just a physical problem but a psychological and emotional one as well. They were so sick of dealing with this hip pain, they would do anything. And this desperate energy fueled the pain pattern even more.

If every time we get a pain signal from the nervous system, we run for the foam roller. Or start doing clamshells. Or whatever else. We’ll never intimately understand our pain pattern. We’re like Pavlov’s dogs responding to stimuli.

Once I paused and listened to the pain. And took a step away from the pain. I was able to see the pain more objectively. I was able to look at my hip movements objectively. How was my hip extension? How was my hip flexion? How did I stand? Bend? Etc.

I started reflecting on questions that mattered for my long-term hip health. I was no longer being pulled by my lizard brain. And this mental shift is what made the biggest difference for me.

How I feel about FAI Today 

The only times I think about FAI these days is when I’m writing an article about it or convincing a client that it doesn’t matter. I probably still have FAI and hip impingement. And a hip labral tear. But I experience no pain. I am able to do any activity I want. So it just does not matter.

And this is the message I try to put out in my content and in my work with clients. Our goal is not to “fix” or get rid of FAI or hip impingement. It’s to improve movement function. It’s to move with more ease and balance. And this starts from taking a step away from the pain like I did.

There can certainly be something going on in the area where the pain is. But there can equally be something going on in the opposite hip. Or on the other side of the hip. Or in the feet. Etc. The more we can shift our focus away from the pain and toward our movement, the better.

The more we can sit with the pain without immediate action, the better. To prove to our brain and nervous system that this discomfort does not require us to do something NOW. That we can be patient and listen. And that we will use the pain signal as a source of information but not treat it as the whole story.

Conclusion - My Words of Wisdom to those in FAI

My journey out of FAI and hip pain was not a smooth one. It was bumpy and strange. I had to learn about movement but I also had to learn about my relationship with pain. I had to be consistent with my exercises but I also had to be consistent in how I responded to pain signals form the brain.

If I can leave you with any sage wisdom, it would be the following three points of advice:

  1. No one will “fix” your pain and there is no magic pill. But good coaches and mentors are irreplaceable.
  2. Our relationship to chronic pain is just as important to recovery as an effective movement practice.
  3. Learn from others but your path will be unique.  Every body and every hip is different. Don't get stuck trying to imitate someone else's path. 

There is a path out of chronic hip pain from FAI. It just might not be the one you expected.