Femoral Acetabular Impingement (FAI) occurs when bony aspects of the femur and acetabulum of the hip pinch together during certain movements of the leg. The acetabulum is the socket of the hip joint that the head (ball) of the femur sits inside. FAI can be divided into either cam impingement or pincer impingement subtypes. Cam impingement occurs with a thickening of the femoral neck. Pincer impingement occurs with osteophyte growth on the acetabular rim.
FAI often causes hip pain during sitting and activities that involve hip flexion and internal rotation. It can limit range in these motions and people often notice these limitations before they ever have pain. FAI generally occurs in middle-aged adults with cam impingement much more likely in males (14:1), and pincer impingement more likely in females (3:1). This condition can result in damage to articular cartilage and the labrum over time. Physical therapy has been show to have similar results to surgical intervention in people with FAI. Unfortunately, many people still report pain after surgical intervention.
Physical therapy program for FAI often includes a combination of much of the following:
- Manual Therapy: Hip Extension in Standing MWM, Hip Distraction during Internal Rotation MWM, Loaded Lateral Hip Distraction MWM, Loaded Internal Rotation, Lateral Glide in External Rotation, Long Axis Hip Distraction
- Motor Control Exercises: Reverse Lunge with Front Ball Tap, Isolateral Romanian Deadlift with Dowel, Lateral Step-Down with Heel Hover, Side Plank, Seated Isometric Hip Flexion, Supine Hip Flexion with Theraband.
- Mobility Exercises: Kneeling Internal Rotation Self-Mobilization with Lateral Distraction, Half-Kneel FABER Self-Mobilization, Quadruped Rock Self-Mobilization with Lateral Distraction, Prone Figure-4 Self-Mobilization, ITB Soft Tissue Self-Mobilization on Foam Roll, Quadriceps Soft Tissue Self-Mobilization on Foam Roll, Piriformis/Glut Min Self Myofascial Release on Ball, Standing Figure-4 Stretch, Kneeling Tri-Planar Mobilizations
If you think you have Femoracetabular Impingement Syndrome and could benefit from treatment for this condition, visit http://www.rockandarmor.com/contact.html or call 208-917-2660 to schedule an appointment.
Mansell et al (2018)