Femoroacetabular Impingement

[slime]

Hi Rip

I'm wondering if you've heard of this condition?

Here's a description from the site http://www.hipfai.com/

"Femoroacetabular impingement or FAI is a condition of too much friction in the hip joint. Basically, the ball (femoral head) and socket (acetabulum) rub abnormally creating damage to the hip joint. The damage can occur to the articular cartilage (smooth white surface of the ball or socket) or the labral cartilage (soft tissue bumper of the socket)"

In the past 2 years, I've injured my right hip twice from back squats. Recovery has taken a few months. This last time I had some xrays done and the sports physician reckons its Femoroacetabular Impingement. The first injury didn't happen until I was squating 60kg, the second time 35kg. The recommendation is that I either don't do squats or only do half squats.

Another poster mentioned tendonitis from not contracting hamstrings at the bottom of the squat. My xrays do show denser bone on the sides of the head of the femur, where they may have been coming into contact with the hip.

I'm hoping there is a solution where I can do squats, I've just lost 8kg in the past 6 weeks due to the birth of my daughter and a bout of gastro. So I need to get some weight back on.

Could box squats maybe help?

Cheers
Simon

[Mark Rippetoe]

I'm wondering if you're squatting correctly. Knees out, hips back, all that rot. "Until I was squatting 60kg" does not make me feel comfortable with your grasp of either the program or correct squat technique.

[slime]

I was doing 5x5, starting of very slowly. Firstly, no bar for a couple of weeks just doing body weight squats, dynamic stretching etc and then starting with a 20kg bar and then upping the weight 2.5kg each session, so basically it was around 6 weeks in when I did the first injury at only 60kg. I'm 6'1" and was 85kg at the time. Sure, I understand about correct form, have done heaps of reading and watching vids, getting my wife to check my technique (with lots of instruction). I'm also very active with surfing and yoga, so I wasn't in a sorry state to begin with.

Have you come across this condition before? I was crossing my fingers that you had and maybe had some advice. The fact that I've been diagnosed by a sports physician with x-rays that shows the condition in my hip\femor bone structure, leaves me to believe that I don't have much in the way of options.

[Mark Rippetoe]

As I suspected, you were not doing the program, and since that is the case it is quite probable that you are not squatting correctly either. I say this because a blatant misreading of the program such as would have resulted in your interpretation of the way to implement the squat would lead me to believe that you don't read very well and have done the squat wrong too. I have never heard of this condition, and it is quite likely that there enough normal ideopathic differences in acetabular morphology to account for the misdiagnosis of this condition. About 1/2 of the population will x-ray/MRI positive for asymptomatic conditions such as lumbar disc herniation, so this is not entirely surprising.

I think you need to get some coaching other than from your wife whom you have taught, read more carefully, and disabuse yourself of the notion that yoga has prepared you for anything other than more yoga.

[slime]

Jee wizz Rip, no need to have a go.

After seeking professional medical help, I find myself in a situation and don't know where to go next. You're an expert in strength training and have trained a great many people, so I was taking the chance to see if you've heard of the condition. That's a no.

Thanks anyway.

[Mark Rippetoe]

You're missing my point. Seems to be a pattern.

[Steve Hill]

On the medical side of things, Rip, you will recall that I had a similar issue (labral tear from an osteophyte). A couple of toughts:

1) Knees out helped bunches.
2) A video posted here and your comments helped with my confidence in my form.
3) The gold standard medical test for both Slime's and my injury is an injection of radioactive dye into the hip joint, along with lidocaine. This allows for a proper CT-Scan or MRI and provides diagnoses (through the lidocain numbing the hip joint) that the pain is not from some other source (there are several injuries that radiate pain INTO the hip).
4) An Orthopedist who is a serious weightlifter may not be worth his weight in gold, but he is worthy of my money.
5) This test does not leave room for "maybe" or "reckoning."


Oh, and slime? Don't get your feelings all hurt. Go watch Gran Torino. This is how men talk to each other.

[tmatt]

Hey there Simon, I noticed on the FAI page you linked to that Yoga is listed as one of the causes. Maybe you should drop that? Do you really think a 60kg squat qualifies as "Deep squatting activities such as power lifting"? I think you have some work ahead of you.

Also, since Rip is an "expert in strength training and have trained a great many people", maybe you should buy his book and follow his program. While I think it's great that Strong Lifts is out there and is making people stronger, there is no better instruction on the squat than what you will find in Starting Strength. Get the book and follow the program. I don't know why Rip wastes his time with us though I'm thankful as hell that he does, but at the very least you could humor him and first follow his instruction before coming here with your issues.