Femoroacetabular Impingement (FAI)
FAI or femoroacetabular impingement is a mismatch between the femur and the acetabulum (hip socket) creating contact and eventually damage to the articular cartilage or labrum. (1) FAI is further sub classified as cam, pincer or combined. A cam FAI is caused by a loss in the normal femoral head-neck shape. A pincer is formed by an abnormal hip socket causing it to be too deep or have too large of a rim. Combined FAI is when an individual has a combination of both a cam and pincer lesion. These lesions cause a firm end range to hip motion that is often painful.
Individuals with FAI typically have a slow onset of hip or groin pain. It is initially described as dull and achy but can progress to be sharp with movements. Pain is often worse after long periods of sitting, stair climbing or stressful activity that requires a high degree of hip flexion and rotation. Initially pain is only worse with specific activities, but progress to interfere with all activities.
Treatment consists of patient education, activity restriction, balance training, manual therapy and stability/strengthening. (2,3) It is important to maintain physical conditioning while avoiding activities that aggravate their symptoms. Manipulation of the lumbar spine and sacroiliac joints as well as hip mobilizations can help decrease symptoms and increase pain free range of motion. Any underlying functional limitations should be addressed as well.
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Ganz R, Bamert P, Hausner P, Isler B, Vrevc F. Cervico-acetabular impingement aft femoral neck fracture. Der Unfallchirurg. 1991 Arp;94(4):172-5
Samora JB, Ng VY, Ellis TJ. Femoroacetabular impingement: a common cause of hip pain in young adults. Clinical Journal of Sport Medicine. 2011 Jan 1;21(1):51-6.
Emary P. Femoroacetabular impingement syndrome; a narrative review for the chiropractor. The Journal of the Canadian Chiropractic Association 2010 Sep;54)3:164