FAI Syndrome
What is FAI Syndrome?
Introduction
Femoroacetabular Impingement syndrome also known as FAI Syndrome or hip impingement is a common condition of abnormal movement within the hip joint causing symptoms including pain and limited mobility in the hip joint. In this blog post, we'll explore the intricacies of hip impingement, shedding light on its causes, symptoms, and how physiotherapy can help manage this condition effectively.
Understanding Hip Impingement
Hip impingement occurs when there is abnormal contact between the bones of the hip joint, leading to friction, pain, and potential damage to the surrounding soft tissues. The ball (femoral head) and socket (acetabulum) rub abnormally, leading to symptoms, clinical signs and changes in morphology (the particular form, shape, or structure). This condition typically involves structural abnormalities in the hip joint, such as excess bone growth on the femoral head (cam impingement), the acetabulum (pincer impingement), or both.
To formerly diagnose FAI syndrome symptoms, clinical findings and and imaging findings must all be present. Antero-posterior X-rays can be undertaken to confirm the diagnosis.
Mechanism of Injury
FAI syndrome is associated with three variations in the morphology of the hip joint:
o Cam: flattening or convexity of the ball (femoral head)
o Pincer: ‘over-coverage’ of the ball (femoral head) by the socket (acetabulum) where by the sockets rim is extended beyond the typical amount.
o Combination of Cam and Pincer
These morphologies are thought to be fairly common with around 30% of the general population.
Causes of FAI Hip Impingement
Several factors can contribute to the development of hip impingement, including:
Anatomical variations: Structural abnormalities in the hip joint, such as a misshapen femoral head or acetabulum, can predispose individuals to develop impingement.
Overuse or repetitive stress: Activities that involve repetitive movements of the hip joint, such as running, cycling, or squatting, can lead to wear and tear on the joint surfaces, increasing the risk of impingement.
Muscle imbalances: Weakness or tightness in the muscles surrounding the hip joint can alter biomechanics and contribute to impingement.
Trauma or injury: Previous hip injuries, fractures, or dislocations can disrupt the normal anatomy of the hip joint, leading to impingement.
Symptoms of FAI Hip Impingement Syndrome
The symptoms of hip impingement can vary depending on the severity of the condition but commonly include:
Groin pain or discomfort primarily felt deep in the groin at the front of the hip, particularly with activities that involve hip flexion, such as squatting, sitting, or climbing stairs. Pain can also be on the side of the hip or the buttock.
Pain or stiffness in the hip joint, especially after periods of rest or prolonged sitting.
Restricted or limited range of motion in the hip joint, particularly with movements that involve internal rotation or adduction
Clicking, popping, catching, locking or giving way sensations in the hip joint
Pain that worsens with weight-bearing activities or high-impact exercises
Onset of symptoms: can be acute, after an injury or slow onset.
Decreased ability to perform activities of daily living and sports.
Aggravating activities include: prolonged sitting, walking, crossing the legs, squatting, climbing stairs or during or after sport or exercise.
Management of FAI Syndrome
Physiotherapy Strategies for Managing Hip Impingement
Physiotherapy treatment aims to improve hip strength, neuromuscular control, range of motion, muscle tightness, balance and patterns of movement.
Physiotherapy techniques utilised:
Comprehensive assessment: A thorough evaluation by a qualified physiotherapist is essential for accurately diagnosing hip impingement and developing an individualised treatment plan.
Pain management: Physiotherapists may employ various modalities such as ice therapy, heat therapy, and transcutaneous electrical nerve stimulation (TENS) to alleviate pain and inflammation in the affected area.
Exercise therapy: A tailored exercise program focusing on strengthening the muscles around the hip joint, improving flexibility, and correcting biomechanical imbalances is crucial for managing hip impingement. Specific exercises may target the hip abductors, external rotators, and core stabilisers to support proper alignment and reduce stress on the hip joint.
Manual therapy: Hands-on techniques such as joint mobilisation, soft tissue massage, and myofascial release of the hip and thigh muscles can help improve joint mobility, reduce muscle tightness, and alleviate pain associated with hip impingement.
Biomechanical correction: Addressing underlying biomechanical issues, such as poor posture, faulty movement patterns, or gait abnormalities, can help reduce strain on the hip joint and prevent recurrence of symptoms.
Activity modification: Modifying activities that exacerbate hip impingement, such as avoiding excessive hip flexion or rotation, can help minimise pain and promote healing.
Conclusion
FAI Syndrome / Hip impingement can significantly impact daily activities and quality of life, but with the right approach, individuals can find relief and regain function in the hip joint. Physiotherapy plays a crucial role in the management of hip impingement by addressing pain, improving mobility, and correcting underlying biomechanical issues. If you're experiencing hip pain or suspect you may have impingement, don't hesitate to seek guidance from a qualified physiotherapist who can provide personalised care and support tailored to your needs. With the proper treatment and rehabilitation, you can overcome hip impingement and return to an active, pain-free lifestyle.
Read more about how the Warwick Agreement assists in the assessment and treatment of FAI Syndrome.