Extreme FAI with Hip Surgery and Return to Surfing

What is your story about?
I'm a 32 year old male surfer with an active lifestyle who was diagnosed with FAI and a hip labral tear. I underwent surgery and physical therapy, and ultimately made a psychological breakthrough that led to positive outcomes.
How did your symptoms begin?
They began in early 2017. At the time, I was experiencing a hip flexor type strain, as well as lower back pain on the right side. It was quite strange, actually. I've been a surfer for a long time, but surfing would trigger the pain. In fact, anything athletic would trigger it. Even sitting was really triggering it as well. After the symptoms started, I kept on going along. I usually just deal with injuries, but this was getting worse and I stopped athletic activity for two weeks.
How did your symptoms progress over time?
Almost immediately after returning to activity, the right side between my lower back and up to where my rib cage was felt like it collapsed. So, I went to a physical therapist who diagnosed me with a strained psoas. This seemed to make sense at the time, since that's where the pain would have been. At that point, I took off for a month from athletics and then when I went back it came back really fast. I'd never experienced something like this.
What was the diagnosis process like?
I went to an orthopedist at UCSF and had an MRI done on my hip. The MRI results came back and they told me that I definitely have hip flexor tendinitis and psoas tendinitis. They also mentioned I might have something along the lines of impingement. They suggested I continue PT.
Did physical therapy work for you?
Only temporarily. A couple months into doing physical therapy, I was still experiencing symptoms. My PT regimen consisted of a lot of lower abdominal stuff, like dead bugs and leg raises. Plus some some stretching and squats. In total I did about 6-7 months of PT. I was very dedicated to following the protocol. I'm a very active individual so it's easy to get me to do PT, but it wasn't working.
What was the next level of treatment above physical therapy?
My orthopedist recommended a cortisone shot. The pain overall went away and I was surfing again. I was having a ton of fun, but 6-8 weeks after the cortisone shot, the pain starts creeping back. So I decided I was going to email the orthopedist and PT yet again. I also decided to take 2 months off before a surf trip to Ireland.
How did the Ireland trip go?
My hip felt fairly good and on the way back on the flight back, it started feeling like hell. At this point it was about 6-7 months into the whole saga. So I spoke to the PT and orthopedist and this time I was diagnosed with a labrum tear. In their words, "I think you want to speak with an orthopedic surgeon. It appears you might have FAI and you might have torn your labrum." So I get another MRI to check it out again, and the surgeon notes that my labrum is completely torn. I was told that if I don't have the surgery, I'll probably need a hip replacement at a young age. At this point I could ...(more)
What type of FAI bone deformity were you diagnosed with?
Cam-type impingement.
What did they do in the surgery?
They shaved down the femur to reform the femoral head. They anchored the labrum back to the hip socket and I had 3 anchors.
How was the recovery from the surgery?
Before the surgery, I was not feeling worried because I didn't know what I was getting into. My doctor told me I could go back to work in 3 weeks. That was bad advice. For the majority of people this isn't possible. Two and a half weeks into the surgery, I can't sit down and still feeling a lot. Psychologically, I was really feeling it at this time. I started to lose more and more faith in medical professionals. I felt like I was getting inconsistent advice all the time. I was afraid I wasn't going to get back to sports. And I really felt the anxiety from this. I was starting to feel like so ...(more)
During this time, what was your work environment like?
I was a psychologist and I had to sit down for a living. Sitting absolutely made it worse, and was one of the reasons why I would have to shut down my practice after returning for only a few weeks. In addition, in the work place I was really intimately connected to the trauma brought in by my clients. I didn't realize until later that this was having a big effect on my ability to recover.
What happened when you managed the psychological component of your recovery?
I just convinced myself that my hip was okay. Any time I would be doing something and would feel pain, I would just tell myself that my hip was ok. I would repeat the activity over and over again until it just didn't hurt. I just figured out nothing was wrong and built confidence in my body and my own sensation. I got back into the gym and started surfing again. Today, I'm deadlifting more than I used to be.
Is there anything you feel you still can't do today?
The only thing I can't do that I used to be able to do was run.
What was the key insight for you that enabled your recovery?
The key insight was letting myself go in the process and not fighting my body. It was about not having preconceptions of what I thought would happen. Not trying to force anything made a huge difference for me.
Overall, are you happy with your decision to have the surgery?
I definitely needed the surgery. There's no way to get to where I am today without the surgery. After all of this, I'm just happy to be able to surf again.