{"id":11547,"date":"2025-03-31T06:00:24","date_gmt":"2025-03-31T05:00:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11547"},"modified":"2025-03-30T22:21:46","modified_gmt":"2025-03-30T21:21:46","slug":"femoral-acetabular-impingement-syndrome-and-its-impact-on-mental-health-a-physiotherapists-perspective","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2025\/03\/31\/femoral-acetabular-impingement-syndrome-and-its-impact-on-mental-health-a-physiotherapists-perspective\/","title":{"rendered":"Femoral Acetabular Impingement Syndrome and Its Impact on Mental Health: A Physiotherapist\u2019s Perspective"},"content":{"rendered":"

Keywords:\u00a0<\/strong>Femoroacetabular Impingement Syndrome (FAIS), Mental Health, Hip Arthroscopy<\/p>\n

Femoral acetabular impingement syndrome (FAIS) was a condition I knew little about. I was completely unprepared for the challenges it would bring.\u00a0\u00a0\u00a0<\/span><\/p>\n

I boarded a 26-hour flight as a fit and active football enthusiast, but by the time I landed, I was faced with unexpected hip pain which marked the beginning of a difficult and painful journey. In this reflection, I explore the personal and professional challenges I went through while focusing on mental health and its connection to FAIS, as well as the gaps I found in healthcare support.<\/span><\/p>\n

The Physical Challenge<\/b><\/p>\n

I was diagnosed with hip exostosis (described as a large CAM lesion) with a labral tear. The next six months were a blur of constant discomfort, leading to a significant shift in my lifestyle. I couldn\u2019t sit at a right angle without feeling considerable pain, and my hip refused to heal. My identity as a sports physiotherapist is tied to staying fit and active. This setback affected both my daily life and professional practice, forcing me to find new ways to manage pain and maintain my function. Patients with FAIS often report pain and quality of life scores comparable to older adults with advanced osteoarthritis [1]; this is something I can relate to.\u00a0<\/span><\/p>\n

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Figure 1. 3D CT scan of my left hip exostosis\u00a0<\/i><\/b><\/p>\n

The Impact on Mental Health<\/b><\/p>\n

The change from being active and sporty to dealing with chronic pain was emotionally devastating. My social circles quickly shrank as I withdrew from football and other physical activities. I felt that I had lost my identity overnight. I became anxious and depressed about the uncertainties that lay ahead, and I became fear avoidant as I catastrophised after reading my MRI and CT scan results.<\/span><\/p>\n

Fast forward two years, and I\u2019m well on my way to recovering from hip arthroscopy, but unfortunately, I\u2019ve hit another hurdle: I developed FAIS in my non-operated hip. My mental health journey continues. My optimism and mental health fluctuate, leading to inconsistency with my rehabilitation efforts. Only 57% of hip arthroscopy patients return to their pre-injury level of sport, and just 17% achieve optimal performance [2].<\/span> I\u2019ve lost hope that I will ever come close to my previous sporting capabilities.\u00a0<\/span><\/p>\n

Despite showing visible signs of anxiety and depression, I received no mental health screening from the various healthcare professionals (physiotherapists, sports <\/span>doctorsdoctor<\/span> and surgeons) I visited.\u00a0<\/span><\/p>\n

Expert consensus suggests that comorbidities like chronic pain, insomnia, and anxiety can affect both prognosis and treatment effectiveness in FAIS [3].<\/span> FAIS patients with mental health disorders typically report lower outcomes before and after hip arthroscopy, with less pronounced improvements compared to those without such disorders [4]. Similarly, patients with minimal to mild depression symptoms have better outcomes and are more likely to benefit from surgery than those with moderate to severe depression [5].<\/span><\/p>\n

Lately, my mental health and FAIS symptoms have both improved, but it isn\u2019t easy to differentiate the relationship between the two. I believe that addressing my mental health disorders, catastrophising, and fear avoidance earlier would have been significantly beneficial to my progress.\u00a0\u00a0<\/span><\/p>\n

Reflection\u00a0<\/b><\/p>\n