Dr. Vaishali Suri (P.T.)
Femoroacetabular Impingement: An Increasingly Common Diagnosis
Femoroacetabular impingement (FAI) is abnormal contact between the femoral head and acetabular rim during hip movement, typically at end-range flexion and rotation. It is increasingly recognised as a source of groin pain in young adults and athletes, and is associated with labral tears and early-onset hip osteoarthritis. With improved MRI arthrography, FAI is now diagnosed much more frequently.
Types of FAI
Cam impingement: excess bone on the femoral head (non-spherical head) creates impingement during flexion and internal rotation. Most common in young male athletes. Pincer impingement: over-coverage by the acetabular rim creates impingement at end-range flexion. Often seen in hypermobile females. Combined (mixed): most common in clinical practice.
Conservative vs. Surgical Treatment
A landmark 2018 trial (UK FASHIoN trial) compared hip arthroscopy to physiotherapy for FAI and found both produced similar improvements at 12 months, with some evidence of faster pain improvement with surgery. However, given the risks and cost of surgery, current guidelines recommend a minimum 3-month trial of physiotherapy before considering hip arthroscopy.
Physiotherapy Treatment for FAI
Activity Modification
Identifying and temporarily avoiding the specific positions and activities that cause impingement: deep squats, sitting with knees higher than hips, sports involving hip flexion and internal rotation.
Hip Strengthening
Progressive hip abductor and external rotator strengthening reduces dynamic impingement by controlling femoral head position during movement. This is the most important treatment component.
Lumbopelvic Control
Anterior pelvic tilt worsens FAI. Core stabilisation and posterior pelvic tilt training reduce impingement in functional positions.
FAI Treatment in Faridabad
At Realign Rehab Clinic, NIT-5, Faridabad, we provide evidence-based FAI conservative management. Book your hip assessment today.