Femoral Acetabular Impingement

Femoral acetabular impingement (FAI) is a global term that describes normal variations in the bony structure of the hip joint. There are three main types anatomical differences, cam lesions, pincer lesions and a combination of the first two. The pincer type involves a bony prominence that forms and protrudes from the front of the acetabulum (the socket side of the hip joint) and the cam type involves a similar bony protrusion but rather on the front of the femoral head (ball side of hip joint).

These variations develop during early childhood and adolescence (9-15yrs) in response to increased load in the area, particularly large amounts of cutting, twisting and kicking activities such as soccer, football and rugby. However as many as 60% of the normal population are thought to have evidence of these morphological differences on imaging but not all of them will develop hip pain during their life. It is not the cam or pincer lesion that becomes painful itself but rather the tissues around such as the labrum, synovium, cartilage or bone. It is usually the presence of a cam or pincer lesion combined with other structural variations, poor biomechanics and/or poor load management that result in injury to these tissues and thus a symptomatic hip. 

A multi-modal approach is the best way to manage a hip with symptomatic FAI. While physiotherapy is unable to change the physical structure of your hip, it can help address the other contributing factors such as biomechanics, motor control, strength, muscle length, hip joint range of movement, and load management. Doctors may also be able to prescribe anti-inflammatories and pain medication to help settle the hip joint down and allow for rehabilitation to commence. As with many other knee and shoulder conditions, a hip arthroscopy is the last line of treatment and usually only considered if the patient has ongoing pain and dysfunction after a comprehensive rehabilitation program has been completed. 

For the long term health of your hip it is important to find out what is causing your pain and have it managed correctly. Touch base with us at Ascend Physiotherapy to get back to doing what you love!