Femoral Acetabular Impingement
Femoral Acetabular Impingement (FAI), known as hip impingement, is a common source of hip and dysfunction in young active individuals. It occurs when there is a structural abnormality of the hip causing undue stress resulting in pain and damage of the hip joint. Repetitive forces at extremes ranges of the hip can also lead to chondral damage. Which is no surprise why FAI is one of the most common factors associated with acetabular labral injuries. While FAI may seem like a scary injury, many individuals return back to their prior level of sport.
Common complaints one may have:
– Pain may be described as achy and sharp
– Experience stiffness, especially at extremes of hip flexion and internal rotation
– Slow and gradual onset of symptoms that may be precipitated by an initiating traumatic event (often minor)
– Pain location: groin very common, may experience symptoms along thigh, side of hip, buttock or low back
– Complaints of popping, locking, snapping or giving way during weight bearing activities
– Activities that may increase pain: sitting, climbing stairs , running, pivoting and walking
– Some may get relief with frequent position changes
How is it diagnosed?
– Your doctor will get a detailed history and complete a clinical examination
– 2 common imaging used to confirm
X-ray: provides detail of bony structure
Magnetic resonance arthrogram (MRA): detects cartilage changes and labral injuries
Why is it important to recognize FAI symptoms early on?
While FAI seems to be an under recognized cause of one’s hip pain due to the gradual build up of symptoms and mild structural abnormalities, it can be difficult to get a diagnosis immediately. Which is no surprise, you may be convinced you’re imaging your symptoms. It is noted some individuals may experience symptoms up to 3 years. Therefore, being able to recognize the clinical presentation early on will allow you to take the proper steps in order to preserve your joint.
Conservative Management
Speak with your doctor, as the conservative route is not for everyone. Non-surgical measures typically consist of education and participation of unloaded activities for the hip.
Surgical Management
- Surgery is commonly done arthroscopically because it is less invasive, less cutting up of muscles and usually a faster rehabilitation
- Goals: relieve pain, improve hip function, preserve the natural hip over time, return back to sporting activities
- Phases after surgery:
- Initially partial weight bearing with a focus on recovery of your passive range of motion. Some individuals may be provided a continuous passive machine (CPM) to prevent tissue adhesions and promote early recovery.
- Improvement of neuromuscular function of trunk, pelvis and lower limb
- Training of sport- specific tasks until return to sport
Time frame to return back to your sport: may vary from 6 months – 1.5 years (depending on extent of injury)
Now, if you’ve experienced hip impingement, I want to hear about your journey. What was your recovery like?