Hip Arthroscopy (FAI Decompression) Recovery
Hip Arthroscopy with FAI Decompression
What the operation does
Through two or three small punctures, and with the hip gently pulled apart to make room, the surgeon reshapes bone at the edge of the joint. Most often that means trimming a bump on the neck of the thigh bone — a cam lesion — and sometimes also trimming an over-covering rim on the socket. The aim is a hip that no longer jams against itself at the end of its range.
What impingement actually is
The ball and socket normally clear each other through the whole arc of movement. Where extra bone sits at the edge, the two collide when the hip is bent up or turned in — the position of a deep squat, a low chair, or a football tackle. That repeated collision is what causes the deep groin pain, and over years it is what shears the labrum and the cartilage inside the joint.
Why the bone is reshaped rather than the pain treated
Because the bone is the cause. Injections, rest and physiotherapy can quieten a hip that is impinging, but the collision continues every time the hip goes to that position, and the damage inside accumulates. Reshaping removes the mechanical problem. It is the reason a labral repair alone is rarely done — stitching the labrum while leaving the bump in place means it tears again.
Bone healing sets the early limits
Worth understanding, because the punctures look trivial and the restrictions do not match them. Reshaping bone leaves a raw surface that has to heal over, and loading it hard too early risks both pain and, uncommonly, a fracture through the reshaped neck. That is why weight is usually limited at first even though nothing was stitched.
Weight-bearing and crutches
Most people use crutches with partial or flat-foot weight for around two weeks, then build up. Practice varies with how much bone was removed. Crutches here are protecting bone, not managing pain, which is why they stay for a set period rather than until you feel able.
Adhesions, and why motion starts immediately
The single biggest early concern. The hip has been distracted, instrumented and had its capsule opened, and the raw surfaces inside can scar to one another — an adhesion — leaving a stiff, painful hip that is difficult to put right. The answer is early, frequent, passive movement, which is why gentle circling of the hip appears in the programme from the first days and is done several times a day rather than once.
Why the bike is not filler
Stationary cycling with little or no resistance appears from the first week and is doing real work: it moves the joint through a controlled arc repeatedly without loading it, which is exactly what discourages adhesions. It is one of the few things you can actively do for the hip early rather than simply avoid.
Hip flexor irritation
Extremely common and often the most annoying symptom of the first months. The tendon at the front of the hip is disturbed by the surgery and by the instruments, and it becomes irritable — a sharp catch lifting the leg into a car, or pain when raising the straight leg. It usually settles over two to four months, and pushing hip flexor strengthening early tends to inflame it. It is not a sign the operation failed.
Numbness after traction
The hip has to be pulled apart to get instruments into it, and that traction can stretch nerves. Temporary numbness in the groin, genital area, or the foot is recognised and usually settles within days to weeks. It is unsettling if you were not warned and is very rarely permanent.
Extra bone forming
Occasionally new bone forms in the soft tissues around the hip afterwards — heterotopic ossification. Many surgeons prescribe a short course of anti-inflammatory medication for a few weeks specifically to reduce that risk, and it is worth taking as directed rather than only when sore.
Whether it works
For a hip with genuine impingement, good cartilage, and a surgeon confident in the diagnosis, results are generally good and most people return to their sport. Where arthritis has already set in, results are much less predictable, and a hip arthroscopy in a substantially arthritic hip can leave someone no better. Your surgeon weighed that on your scans beforehand.
Returning to sport
Straight-line running commonly returns around three to four months, and cutting or pivoting sport somewhere between six and nine. Progress is judged on strength and on whether deep flexion still pinches, rather than on a date. Rehabilitation after this operation is long and matters more than people expect.
Driving and work
For a right hip, driving generally waits until you are off crutches and could brake hard without hesitating — commonly around two to four weeks. Desk-based work is often possible within one to two weeks, though sitting in a low chair may be uncomfortable. Work on your feet commonly six to twelve weeks.
How the first year usually unfolds
Two weeks on crutches with passive circling several times daily and gentle cycling. Two to six weeks brings walking normally and the start of hip strengthening. Six to twelve weeks builds strength in earnest. Three to six months brings running and most activity back. Six to twelve months is sport-specific, and deep-flexion comfort often continues improving through it.
Staying in touch with your care team
How much bone was reshaped, and what the cartilage inside looked like, shape this recovery more than anything else. Your surgeon saw both. If something about your recovery is worrying you or does not match what is described here — particularly a hip becoming stiffer rather than looser — contact your care team rather than waiting.
Exercises for Hip Arthroscopy (FAI Decompression)
An illustrated, phase-by-phase exercise program for this procedure. View the Hip Arthroscopy (FAI Decompression) exercise program.
Recovery education · Condition guides · Exercise programs
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This guide is general education and doesn't replace evaluation by a licensed provider. Recovery and treatment vary by person — follow the guidance of your own surgeon or care team.