What is Femoroacetabular Impingement (FAI)?
FAI is a condition of the hip caused by abnormal movement within the hip joint, resulting in hip and or groin pain and often hip joint stiffness. To diagnose FAI syndrome symptoms, clinical signs and imaging findings must all be present and Keilor Road Physiotherapy is at the forefront of diagnosing this condition.
FAI syndrome occurs when an overgrowth of bone on the ball of the hip joint, the socket, or both parts of the hip joint (known as cam or pincer morphology) prevents normal movement of the joint. It is likely that FAI syndrome is the result of a combination of an individual’s genetics and environment. Some of the research and evidence based literature suggests that significant athletic activity before skeletal maturity may increase the risk of FAI, however this is not definitive at this stage. It is important to note that recent reviews have found FAI morphologic features on radiological imaging are common in people who have no symptoms, particularly athletes.
Assessment of the hip for FAI.
FAI often presents as hip and groin pain with restricted range of hip motion. The onset of symptoms can be acute, after an injury, or of gradual onset. Patients commonly report that their pain often comes on with prolonged sitting (particularly with legs crossed), walking, or during and after sport or exercise. Pain is primarily felt deep in the groin at the front of the hip. More rarely, it can be on the side or even behind the hip joint or the buttock. As symptoms, clinical findings and imaging findings must all be present to diagnose FAI, your treating physiotherapist at Keilor Roadd Physiotherapy will listen to your symptoms, perform a detailed assessment of your hip and may suggest specific hip imaging if appropriate.
THE ROLE OF PHYSIOTHERAPY IN FAI
The primary aim of expert Physiotherapy care in the management of FAI is to improve hip strength, range of motion, neuromuscular control, balance and functional patterns of movement. There are a variety of techniques that our physiotherapists may use to address and improve tight structures, including the joint capsule or muscles around the hip joint. Individualised and targeted physiotherapy treatment will improve dynamic hip stability that is directed towards improving your overall hip function and quality of life. Treatment also includes education about the condition and addresses any necessary activity and lifestyle modifications.
Hip range of motion testing in the presence of FAI.
Will I need surgery for FAI?
This is often a question asked and the physiotherapists at Keilor Rd Physiotherapy are in the lucky position to work closely with a number of the best GP’s, sports doctors and hip surgeons in Melbourne. If surgery is the best option for your hip then this can be discussed within the consultation and physiotherapy before hip surgery (Prehabilitation) and following surgical intervention (Rehabilitation) is definitely the treatment of choice. Sometimes an open or arthroscopic (minimally invasive) surgery can be performed to improve the hip structure, and repair or remove damaged tissues. There is no current evidence to suggest that this surgery will reduce the risk of later developing osteoarthritis, or 'cure' your hip problem. Physiotherapy post-surgery is important for assisting people in regaining range of movement, strength, mobility and returning to sport. Any decision regarding surgery should be made after consultation with your physiotherapist, doctor and then hip surgeon.
The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. This agreement states clearly that to reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery of which expert physiotherapy care and management plays a crucial role.
Keilor Road Physiotherapy are the experts at rehabilitation and management of FAI. Servicing Niddrie, Essendon, Airport West, Keilor & Melbourne’s Northern suburbs for over 40 years, you can book with one of our highly trained hip experts below or call 93794557 to speak to one of our admin superstars.
Related links
The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement
(Griffin DR, et al. Br J Sports Med 2016;50:1169–1176. )
Article by
Jenny Hynes | Clinical Director
Sports & Musculoskeletal Physiotherapist
Jenny has over 20 years of experience in the treatment of the musculoskeletal conditions, holding a Masters degree in musculoskeletal physiotherapy and post graduate training in Osteopathy. She is a lecturer at Latrobe University and has specialized expertise in the management of low back, pelvic girdle and hip pain.
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.