Femeroacetabular Impingement, or FAI, has received some notoriety in the sports and orthopaedic world over the past decade. Mostly due to confusion over diagnosis and the debate over best treatment.
FAI is recognised as a significant contributor to hip and groin pain in elite athletes and recreational exercisers alike. So what is FAI, and how should it be managed? Our hip pain specialist Physiotherapist, Travis Kluckhenn answers some of your frequently asked questions.
What is Femoroacetabular impingement (FAI)? – FAI, or hip impingement, occurs when the ball and socket-shaped hip joint pinches surrounding cartilage or labrum, a ring of fibrocartilage that surrounds the socket.
What are the symptoms of FAI? – Symptoms include pain felt in the hip or groin, aggravated by specific movements and positions. Pain may also be felt in the buttock or thigh. Other symptoms can include clicking, catching, locking or feelings of stiffness.
Why do people get FAI? – Research shows that up to 25% of the population have the hip shape that makes them prone to FAI, however only a few of those go on to experience symptoms. Some repetitious sporting, exercise and work movements, along with prolonged sitting and standing postures may aggravate symptoms.
Sports such as AFL football, soccer, hockey, gymnastics, callisthenics are all associated with higher rates of FAI due to the position that the hip is often placed in whilst playing these sports. Whilst workers that bend and lift, or sit all day may also be at risk.
How is FAI diagnosed? – A thorough assessment performed by your physiotherapist can diagnose FAI, and can be further correlated with X-Ray to show the shape of the hip joint. MRI scanning is not required to make a diagnosis of FAI, however, may be useful in some cases to identify which tissues inside the hip joint may be affected.
Can my hip pain be treated? – Yes, research has shown that an exercise program including hip & core strengthening exercises, along with good advice about which movements and activities to minimise, along with balance and cardiovascular exercise can be a good way to reduce the symptoms of FAI. Whilst massage to the tight muscles of the hip in combination with this exercise program can help relieve pain.
Depending on the sporting or work tasks, some people may fail physiotherapy treatment, in which case a consultation with an orthopaedic surgeon, who specialises in hip arthroscopic surgery, may be required.
So not all people suffering hip pain due to FAI require surgery? – No, a great deal of people with this problem can recover without surgery, particularly when recognised early and provided with the best evidence-based treatment. However, depending on the daily stresses placed on the hip and the extent of the impingement, some people may require hip surgery. Surgery for FAI is typically arthroscopic (key-hole) surgery, and rehabilitation following surgery to strengthen the hip takes about 4-6 months.
But I’ve got a labral tear, how does that tear fix without surgery? – Despite the thought of having a tear in the hip being quite concerning, many people will recover from pain and function fully without surgery. In a recent study, it was found that 60% of people with no pain, scanned using MRI, actually had a labral tear, but had no symptoms.
If you’re suffering from hip pain, you can book an appointment to see Travis at Pathways Physiotherapy.