Hip Impingement (FAI)Expert Treatment
Expert treatment for femoroacetabular impingement and hip pain. Learn about effective management strategies.
Femoroacetabular Impingement (FAI) is a condition where abnormal contact occurs between the femoral head and acetabulum during hip movement. This abnormal contact can damage the labrum and cartilage, potentially leading to early arthritis if left untreated.
Common Symptoms
- • Deep groin pain with activity
- • Hip stiffness and reduced range of motion
- • Clicking or catching sensation
- • Pain with prolonged sitting
- • Difficulty with squatting or pivoting
- • Pain that worsens with hip flexion
Diagnostic Tests
- • FADIR test: Flexion, adduction, internal rotation
- • FABER test: Flexion, abduction, external rotation
- • X-rays: Show bony abnormalities
- • MRI: Assess labrum and cartilage
Types of Hip Impingement
Abnormal bone growth on the femoral head
Anatomy
Aspherical femoral head creates bump
Symptoms
- • Deep groin pain
- • Pain with hip flexion
- • Stiffness after sitting
- • Reduced internal rotation
Demographics
More common in young athletic males
Mechanism: Bone-on-bone contact during hip flexion
Excessive coverage of the femoral head by acetabulum
Anatomy
Deep or angled hip socket
Symptoms
- • Groin and lateral hip pain
- • Pain with external rotation
- • Clicking or catching
- • Pain with prolonged sitting
Demographics
More common in middle-aged women
Mechanism: Labrum gets pinched between bones
Combination of cam and pincer morphology
Anatomy
Both femoral and acetabular abnormalities
Symptoms
- • Combined symptoms of both types
- • More severe pain patterns
- • Greater functional limitation
- • Faster progression to arthritis
Demographics
Most common type (85% of cases)
Mechanism: Multiple contact points during movement
Treatment Approaches
Duration: 3-6 months
Goals: Reduce symptoms and improve function
Success Rate: 60-70% improvement in symptoms
Key Interventions
- • Activity modification and hip precautions
- • Physical therapy focusing on hip mobility
- • Core and hip strengthening
- • Manual therapy and joint mobilization
- • Anti-inflammatory medications
- • Intra-articular corticosteroid injections
Duration: 6-12 months recovery
Goals: Correct bony abnormalities and repair soft tissue
Success Rate: 85-95% good to excellent outcomes
Key Interventions
- • Hip arthroscopy (preferred method)
- • Femoral osteoplasty (cam resection)
- • Acetabular rim trimming (pincer correction)
- • Labral repair or reconstruction
- • Capsular repair
- • Post-operative rehabilitation
Therapeutic Exercise Program
Frequency: Daily, 2-3 times
Hip Flexor Stretch
Lunge position, push hips forward
3 sets, 30-60 seconds each leg
Piriformis Stretch
Figure-4 stretch lying on back
3 sets, 30-60 seconds each leg
Hip Internal Rotation
Seated, gently rotate thigh inward
3 sets, 10-15 repetitions
Frequency: 3-4 times per week
Glute Bridges
Lying on back, lift hips up
3 sets of 15-20 repetitions
Clamshells
Side-lying hip abduction
3 sets of 15-20 each side
Core Strengthening
Planks and dead bugs
3 sets, 30-60 seconds
Frequency: As tolerated
Single-leg Balance
Stand on one leg with eyes closed
3 sets, 30 seconds each leg
Step-ups
Step up onto platform with good control
3 sets of 10-15 each leg
Squats (pain-free range)
Partial squats within comfortable range
3 sets of 10-15 repetitions
Risk Factors
- • Abnormal hip bone shape
- • Deep hip socket
- • Femoral neck abnormalities
- • Acetabular retroversion
- • High-level athletics
- • Repetitive hip flexion
- • Dancing or gymnastics
- • Hockey or soccer
- • Young active adults
- • Male athletes (cam type)
- • Female athletes (pincer type)
- • Family history
Activity Modifications
- • Avoid deep hip flexion positions
- • Modify squatting and pivoting activities
- • Use proper warm-up before sports
- • Gradually increase activity intensity
- • Consider alternative exercises
Long-term Management
- • Regular hip mobility exercises
- • Core and hip strengthening
- • Monitor for symptom progression
- • Early intervention for pain
- • Regular follow-up with healthcare provider
Conservative Treatment
- • Persistent groin pain
- • Hip stiffness affecting activities
- • Clicking or catching sensations
- • Pain with sitting or squatting
Surgical Consultation
- • Failed conservative treatment
- • Significant functional limitation
- • Young active individual
- • Progressive symptoms
Mobility & Stretching
- • Hip flexor stretching straps
- • Foam rollers
- • Mobility balls
- • Stretching blocks
Strengthening
- • Resistance bands
- • Hip strengthening devices
- • Core training equipment
- • Balance pads
Support & Recovery
- • Hip support braces
- • Ice therapy packs
- • Heat therapy pads
- • Compression garments
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