Femoroacetabular Impingement Treatment – Symptoms, Causes & Solutions
Hip pain can cause a major disruption to your life — especially when it stems from an injury like femoroacetabular impingement (FAI). This uncommon hip condition is called hip femoroacetabular impingement or femoroacetabular impingement syndrome, and it occurs when bone overgrowth in the hip joint causes cartilage to rub against bone. If untreated, FAI can cause long-term damage to the joint. Thankfully, early detection and treatment can avoid many complications.
What is Femoroacetabular Impingement?
Femoroacetabular impingement happens when the bones that make up the hip joint — the femoral head and the acetabulum — don’t fit together perfectly, causing the bones to abnormally rub against each other when a person moves. This repetitive contact can damage the joint’s cartilage and labrum, causing pain and stiffness.
Two types of FAI are most common:
- Cam impingement: This occurs when the femoral head (the ball of the hip joint) is not perfectly round and it grinds against the acetabulum during movement.
- Pincer impingement: This relatively unusual condition occurs when there is too much coverage of the femoral head by the socket (acetabulum), which causes compression in the joint.
Others have combination impingement, comprising both cam and pincer forms.
What Causes Femoroacetabular Impingement?
FAI typically occurs as a result of both genetic and environmental contributors. Some are born with a hip shape that makes them more likely to develop it (congenital factors). For others, it may build up due to repeated hip movements made in sports such as football, hockey, or ballet that stress the joint during adolescence when bones are still growing.
Read More: During growth (applies also in the teenage years), developmental abnormalities can lead to an unusual shape of the bone which causes impingement in later life. If not treated, FAI may lead to premature osteoarthritis.
Femoroacetabular Impingement Symptoms
Symptoms of femoroacetabular impingement are as follows:
- Pain in the hip, particularly deep in the groin, outer hip, or buttocks. It may feel like a dull, random ache, or a sharp, shooting pain that gets worse when sitting or moving around.
- Tightness in the hip, especially after sitting for a while or after vigorous activity.
- A reduction in the range of motion, with limited ability to rotate or bend the hip normally.
- A clicking, catching, or locking in the joint – which often feels as it sounds, uncomfortable and terrifying.
They can worsen slowly over time if untreated, with symptoms usually exacerbated by physical activity.
Femoroacetabular Impingement Treatment Options
The best treatment for FAI will depend on how severe your symptoms are and the amount of damage to your joint. Non-surgical and surgical options are usually considered.
A. Non-Surgical Treatments
- Rest and activity modification: Staying off the affected side as much as possible and avoiding running or deep squatting.
- Pain and inflammation control: Use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) and corticosteroid injections.
- Physiotherapy: Important to strengthen the muscles around the hip, improve hip mechanics, and regain flexibility.
B. Surgical Treatments
Surgery can be indicated when conservative measures are not successful. The most frequent surgeries are:
- Arthroscopic surgery: A procedure that, using minimal cuts, allows the surgeon to release bone deformities and reattach damaged tissue.
- Osteoplasty: The femoral head or the acetabulum is reshaped to correct joint dysfunction.
- Labral repair: If the cartilage (labrum) of the hip joint is torn or damaged, it can be repaired or reattached.
Femoroacetabular Impingement Exercises for Relief
If you experience chronic hip pain, femoroacetabular impingement could be the source.
Exercise Intermediate Phase: Although the majority of studies can be placed with a low or very low level of evidence, in this intermediate phase, no information is available on therapeutic exercise in FAI. However, considering the positive effect of therapeutic exercise on hip endurance in the short-term, this could be considered for this category of patients.
Some Suggested Exercises Are:
- Hip flexor stretches: To decrease tightness in the muscles that can increase stress inside the joints.
- Glute bridges: This exercise targets the gluteal muscles (buttocks) that support the hip.
- Clamshells: Focus on the hip stabilisers, particularly the smaller gluteal muscles.
- Hip rotations while seated: Will help maintain flexibility and increase range of motion.
Avoid deep squats, jumping, and high-impact sports that could aggravate the condition without professional guidance.
Recovery and Long-Term Management
Rehabilitation after FAI surgery can be expected to last around six to 12 weeks, and most patients will be able to return to regular activities within several months. After surgery, the patient will receive physical therapy to reintroduce strength and movement to the limb.
Long-term care includes:
- Continued physical therapy.
- Keeping weight under control.
- Selecting low-impact activities, such as swimming, walking, or biking, that are easy on the joint.
Lifestyle modifications can help prevent recurrence and protect your hips in the long run.
Conclusion
Femoroacetabular impingement is a very common, but definitely treatable, condition that can affect your ability to move and your overall quality of life. Long-term joint damage can usually be averted with early diagnosis, individualised therapy, and rehabilitation.
Schedule a consultation with our experts today to find out which is the best course of treatment for your hip pain.
Chase Lodge Hospital
