Femoroaccetabular impingement (FAI) is a structural and mechanical problem of the hip joint. There are various different kinds of bony irregularities in the hip that are a characteristic of FAI. These abnormalities mainly affect the head or neck of the thigh bone, or the hip socket.
The hip is a ball and socket joint and because these atypical changes, it can impact on how the ball and socket articulate which may cause friction which may lead to irritation and ‘pinching’ of structures.
FAI can be put into 3 subgroups. It tends to affect young sporting males who are involved in high impact sport such as football or hockey. It is quite often found with active people because of the nature of some sports i.e. they involve twisting which is loaded or change of direction or loaded hip flexion (bringing the hip upwards). It can come with other problems, causing issues in the back and leg, making it more difficult to diagnose.
Sometimes it can lead to, or be caused my osteoarthritis (wear & tear) or previous fracture. You’re generally born with the irregularity in the hip, but problems tend to start between 20-40 years old if they do.
Like many problems, it can be shown on X-ray and be dormant and not cause any problems. About 20% of the population have hip impingement and never have any problems. Our team at Pure Physiotherapy are very familiar with this condition and can help to determine which structure or problem is generating the pain through history taking and a detailed physical examination. It accounts for around 12% of soccer injuries.
Our Physiotherapists can accurately and quickly diagnose a variety of musculoskeletal problems. They will create a tailor-made exercise program to address any weakness or tightness and help with the problem directly. By listening to how it started and what aggravates your problem among other things your Physiotherapist can start to get a better understanding. They will then perform a thorough physical examination to get to the bottom of the problem.
Sometimes an X-ray or an MRI/MRA scan is required to help inform ongoing management. This is something which your Physiotherapist at Pure can refer you for but in most cases, this doesn’t tend to be necessary.
Your Physiotherapist will educate you on your condition so that you can understand how to help yourself with recovery. They may recommended activity modification strategies to allow your symptoms to settle whilst increasing strength and stability around the affected hip. You Physio will work with you to establish a set of individualised goals to aim for. Regular re-assessment will track your progress and allow treatment modifications to be made.
This problem can be treated by exercise and activity modification. The correct exercise programme can help change your bodies’ pain generation/processing. The increased delivery of oxygen and nutrients to the area coupled with the body producing more chemicals such as endorphins and serotonin which can elevate your mood and assist healing. Some pain can be caused by overload; if you have muscular weakness/or tightness you’re more likely to exceed the capacity of that body part. Therefore, by increasing/restoring strength, you’re much more likely to be able to cope with everyday tasks your body performs.
Please find the patient resources section of our website where we have created a series of recommended exercise programmes to strengthen and stabilise the hip. To access these, please contact us to obtain the password. We advise consulting with your Physiotherapist prior to trying any of these exercises.
Manual therapy entails pain modulation techniques which increase movement to structures (ligaments, tendons, muscles or joints). Soft tissue/joint mobilisations and trigger point therapy can be helpful alongside exercise to help ease pain. At Pure, we provide a combination of all these treatment modalities in addition to offering correct advice to formulate a robust bespoke plan and direction over the course of your healing time, allowing you to get back to full health and function.
Corticosteroid injections and surgery are other options if the correct exercise and manual therapy have been fully exhausted. These are much more invasive and less preferable options due to some associated risks. Normally graded exercise with/without manual therapies are longer lasting treatments with better long-term outcomes.