GTP TV Episode 40: FAI Surgery & Hip Impingement

Welcome to Goalie Training Pro TV, episode 40. Every time we get to something divisible by five I get a little excited, and one day we actually will have a party, but it’s not today. Today we’re gonna talk about, I know I’m gonna say it, what to expect if you have to have surgery for FAI, if you have to have impingement surgery.

I know, don’t shoot the messenger.


Don’t miss this video and the other Goalie Training Pro TV episodes on YouTube here >>


First of all, what brought me to this is, I’m writing a new article and it’s actually gonna be the most comprehensive article I’ve probably have ever written for So probably in nine years, this is the most comprehensive article. I’m having flashbacks to when I did my masters of science degree, that’s how in depth it is.

So I am pulling out all the articles, ones I’ve read years ago, the newest ones, and I’m gonna do a really comprehensive resource on hip impingement for goalies. But what I wanted to do right now is just hop on and quickly go over what to expect if you do have surgery.

So hip impingement is basically when the ball of the joint, so the hip’s a ball and socket joint. The ball is attached to my femur, it’s attached to my thigh bone. The socket is attached to my pelvis. Well, sometimes just the way we’re put together, we’re not a perfect fit.

Sometimes the head of the femur is a little misshapen, sometimes the socket is a little misshapen or it’s a little tilted this way or tilted that way. So sometimes it’s just the way we are.

Sometimes combined maybe with a little bit the way we are, we put ourselves in positions where we’re butting the neck of the femur into the socket, and that kind of responds by creating a callous, much like if you’re out there digging in the yard or like everyone was trying to do here, just rake up their leaves before more snow came. You get callouses on your hands.

Well on your hand, those callouses are skin. On your joint, those callouses are bone, and so then that creates more impingement and more trouble.

The other point is that you don’t feel it until you feel it. And again, I’ll cover this in the article, but they do x-rays of athletes who are asymptomatic, have no hip pain whatsoever (and I’m really terrible at remembering numbers so don’t quote me) but like 20% of them have FAI but they don’t feel any symptoms.

But what movements put your hip in more of an impinged position? This is gonna be pretty interesting.

So it’s flexion, so that bringing your thigh up towards your body.

It’s adductions, so bringing your leg across your body.

And it’s internal rotation.

So let’s think about this in terms of goaltending. What do we do that would be an internal rotation, adduction and then even, too, add to that like we’re playing more play down on the puck, flexion.

So you can see how a lot of the positions, even just being in the butterfly if you’re trying to get forward, will put your hip in that stress position. It’s not to say that every goalie will get FAI, but it just isn’t a natural position for the hip to be in.

And it’s not just butterfly either. When they look at if you’re pushing from your post T push to the top of your crease let’s say, and then you come around and when you kind of stop and swing your pelvis on your femur, that actually creates the greatest magnitude of internal rotation at the hip.

It sounds alarming, like, “Oh my God.” But if you think of a pitcher, pitchers shoulders aren’t designed to do that. And pitchers have a lot of wear and tear issues in their shoulder. And we’re the same with our hips, so we need to try to take steps to help reduce and minimize that wear and tear.

But let’s say some of you, no matter what you do, even baseball pitchers, they’re gonna have to have shoulder surgery.

So let’s say you have to have FAI surgery. Here’s what to expect.

Expect the unexpected because it’s going to be different for everybody. I’ve helped rehab and return to sport about 12, a dozen or so, and it’s always, for me anyway, it’s always been different. Which is really weird because when I worked at the Sport Medicine Clinic, if it was an ACL tear or ACL reconstruction, you know like boom, boom, boom. These are the milestones, this is where you should be. You’re either ahead of schedule or behind schedule. Same with shoulder surgeries.

But FAIs were always so different. So you’re gonna have days when you feel like, “Oh my God, I’m over the hump. I’m good to go. It’s gonna be steady sailing from here.” And then the very next day, you’re gonna be like, “I had hip pain. I don’t know. Maybe they didn’t fix it. Maybe it’s still there.” And that might last for four or five days, and we’re both like these are the worst because no one can sleep. We’re both like, “Oh my God, what if they need another surgery.” And then, “Oh, no, now it feels really, really good.”

So it’s gonna be a rollercoaster like that.

You have to be patient, and it’s hard because goalies, a lot of you got really good by working very hard. So your answer, and I was the same way as an athlete, my answer is to throw more work at it. In this case, you can’t do that because your hip is gonna have, when they do that surgery and reshape either your socket or the ball or a combination of both, you’re actually gonna have more range than what you had before. Your body doesn’t know how to use or control that at all, so you need to learn that, you need to give it time to heal, so you have to be really, really patient with it.

The first year is the hardest. Even if you return to play, I don’t know that I’ve … I can’t think of any athlete who once they got back to play, you know, say eight months after their surgery was like, “Oh yeah, I’m perfect, like I’m good.” I’m sure it’s happened, but even they still feel, “Ah, it just doesn’t feel quite right, or it’s still a bit achy.”

But often the second year it’s like, “Yeah, I’m good.”

It’s not like an ACL whereas, and this used to happen in the clinic pretty regularly, someone’s knee would feel so good that they’d think, “Wow, I’m just gonna go out and do some running, or I’m just gonna do some agility drills because it feels really good.” And then they’ll tear their graft and they’ve ruined it, and so now they have to have another surgery.

With FAI, and I’m not saying be blasé about it and bust through pain, but once you get through that healing phase and that rehab phase and that return to sport phase, it’s not really so much unless they’ve done some other kind of surgery along with it. It’s not so much you’re gonna ruin it, because really they just are reshaping those surfaces, so it’s not like you’re gonna tear a graft and then automatically go back for surgery.

If your symptoms persist, even though you’re doing all the right rehabilitation with the physiotherapist and then you’ve done a good return to sport program working with your strength coach and your physiotherapist, to get back on the ice, you start with just skating. And then a bit of skating with pads on, and then a few easy standing goalie movements with pads, you know, over months. If you’re doing all that, you’re not gonna just ruin it. They’ve reshaped it, and if you’re still having pain, and you’ve done everything right and it’s persisting, persisting, persisting, then it’s time to look at, hey, maybe we missed a spot, maybe there’s a spot that’s still rubbing or impinging, or there’s a labral tear that we missed or something like that, and they might have to go back in and reshape it, which is like, “Oh my God, are you kidding me?”

It does happen.

But then usually you can come back, so return to sport, return to play is actually really good with the surgery, and even playing at the professional level. So it’s not like a baseball pitcher, a lot of time they’ll lose their velocity when they’ve had shoulder surgery and so it makes it a little harder coming back. They have to adapt more.

Return to elite level, pro level, is really, really good after this surgery, but it just takes time. It’s frustrating, it’s upsetting, but eventually, you’ll get there.

So that’s just a little snippet on it. That article is probably gonna take me at least, I’m thinking at least three weeks to put together, but stay tuned, I’ll let you know when it’s all set up. It’s gonna be more than you ever wanted to know about hip impingement.

So my inner geek is gonna be shining brightly there, but that’s it for episode number 40 of Goalie Training Pro TV.

If you wanna try to reduce some wear and tear on your hips so that you can use the mobility that you have a little bit better, do check out the butterfly challenge. It’s free, it’s a 14-day hip mobility program for goalies. And you can just get it at the link below this post.

That will help reduce some of the wear and tear and then, too, especially if you’re a young kid, just because you can, doesn’t mean you should. So you shouldn’t be like just boom, boom, boom, boom, boom, in the butterfly and smashing into your RVH because that’s cumulative wear and tear that it feels fine now when you’re 12 years old, but then when you’re 19, 20, 21, when you’re really hitting your stride and maybe getting some really serious opportunities to play college or junior or pro, now you’ve got this hip pain and it has to be fixed at that stage. So there you go, I’ll catch you later, bye bye.