The hip joint is designed to move smoothly and without pain, but sometimes structural problems can get in the way. Femoroacetabular impingement (FAI) occurs when the bones in the hip don’t fit together properly, leading to friction, pain, and limited movement. If left untreated, FAI can cause damage to the cartilage and increase the risk of developing osteoarthritis. Whether you’re an athlete, someone who stays active, or simply dealing with hip pain, understanding FAI is important. It can help you manage symptoms and protect your joint health for the future.
Types of FAI
FAI happens when the hip bones don’t develop correctly. This causes a bad fit between the femoral head and the acetabulum. Athletes and people who do repetitive hip movements are more likely to get FAI. This includes dancers, soccer players, and weightlifters. The exact cause isn’t always clear. However, this condition likely comes from a mix of genetic factors and repeated stress on the hip joint during adolescence. The three main types of FAI include:
- Cam Impingement: The femoral head is not perfectly round, causing it to rub against the socket.
- Pincer Impingement: The socket covers too much of the femoral head, leading to the pinching of soft tissue.
- Combined Impingement: A mix of cam and pincer impingements leads to a greater risk of joint damage over time.
Symptoms of FAI
FAI can cause a range of symptoms that affect mobility and comfort in the hip joint. Common signs include:
- Hip Pain: Pain is typically felt in the groin area, but can also radiate to the thigh or buttocks, particularly with physical activity or prolonged sitting.
- Reduced Range of Motion: A person with FAI may experience stiffness and difficulty moving the hip, especially during activities requiring bending or rotation.
- Clicking or Catching Sensation: Individuals may feel a sensation of clicking or catching in the hip, often when moving the joint in specific directions.
- Pain During Exercise or Activity: Physical activities such as running, squatting, or cycling can trigger pain in the affected hip, making it harder to perform everyday tasks.
- Discomfort After Long Periods of Sitting: Sitting for extended periods, especially in positions that flex the hip, may exacerbate symptoms and increase discomfort.
Diagnosing FAI
To diagnose femoroacetabular impingement (FAI), doctors usually start with a physical exam, a review of the patient’s medical history, and imaging tests. During the physical exam, the doctor will assess how well the hip moves and check for pain during specific movements. One test they may use is the Flexion, Adduction, and Internal Rotation (FADIR) test, which helps detect signs of impingement. The doctor will also ask about the patient’s activity level and any previous hip injuries to better understand potential causes.
Imaging tests, like X-rays, MRIs, and CT scans, are essential for identifying problems in the hip joint. These tests can reveal issues such as bone spurs or irregular shapes in the femoral head or acetabulum. The images confirm the diagnosis and help doctors understand how much damage has occurred, which is important for creating an effective treatment plan.
Risk Factors
Several factors can increase the chances of developing femoroacetabular impingement (FAI). One major factor is participating in high-impact or repetitive activities, such as running, soccer, or weightlifting, which put stress on the hip joint. Athletes in these sports often make movements that involve a lot of hip flexion, which can lead to abnormal bone growth or joint misalignment.
Some people are more likely to develop FAI due to congenital or developmental issues, such as a misshapen femoral head or an overhanging acetabulum. Previous hip injuries, like fractures or labral tears, can also raise the risk of FAI because they change the joint’s structure, leading to further problems. Genetics may also play a role, as individuals with a family history of hip issues are more likely to develop FAI.
Treatment Options for FAI
The treatment for femoroacetabular impingement (FAI) varies depending on the severity of the condition and how much it affects daily life. Options range from conservative methods to surgery. The goal is to reduce pain, improve hip function, and prevent further joint damage.
- Physical Therapy: A customized physical therapy program boosts strength and flexibility in the hip joint. It also reduces pain and increases range of motion. Targeted exercises can stabilize the hip and improve overall function so individuals can return to daily activities without discomfort.
- Medications: NSAIDs can ease pain and inflammation linked to FAI. In severe cases, doctors may use corticosteroid injections. These can help relieve symptoms temporarily, especially if pain affects movement or daily tasks.
- Activity Modification: Changing some activities can lessen stress on the hip joint and help manage symptoms. Avoid high-impact exercises or sports that need a lot of hip rotation or bending. Low-impact activities, such as swimming or cycling, may be recommended to maintain fitness while reducing strain on the hip.
- Surgical Intervention: If conservative treatments don’t help or if joint damage worsens, surgery may be an option. Arthroscopic surgery is a small incision procedure. It helps remove bone spurs or repair the labrum. This restores the hip joint’s alignment. In more advanced cases, open surgery or hip replacement may be necessary to address extensive damage.
- Lifestyle Changes: Keeping a healthy weight and following a balanced exercise plan can help reduce stress on the hip joint. Good nutrition, with enough calcium and vitamin D, can support bone health and joint function. This may lower the risk of arthritis later on.
Managing FAI and Preventing Further Damage
Once femoroacetabular impingement (FAI) is diagnosed, it’s important to manage the condition to protect your hip joint and prevent further damage.
- Exercise and Stretching: Low-impact exercises like swimming, cycling, and stretching can help strengthen the hip muscles and improve mobility.
- Weight Management: Maintaining a healthy weight reduces stress on the hips, helping to protect the joint.
- Monitor Symptoms: Keep track of pain or stiffness and report any changes to Dr. Peter Howard to adjust your treatment plan if needed.
- Education: Learning about FAI helps you make better choices for your hip health. Dr. Howard’s team is here to guide you.
Contact Us
If you’re experiencing hip pain or suspect you may have femoroacetabular impingement (FAI), Dr. Peter Howard, M.D. is here to help. With years of experience in diagnosing and treating hip conditions, Dr. Howard is dedicated to providing personalized care to each patient. Our team is ready to answer any questions you may have and assist you on your path to better hip health.