What is Femoral Acetabular Impingement Syndrome (FAIS)?

Femoral Acetabular Impingement (FAI) is a condition involving a mismatch between the femoral head (ball) and the acetabulum (socket) of the hip. This results in increased friction and rubbing between the ball and socket, causing:

  • Pain – deep in the groin and front of the hip
  • Restricted hip range of motion – typically hip flexion and internal rotation

Types of FAI:

  • CAM: There can commonly be a bump on the surface of the femoral head that hits the rim of the acetabulum. Many healthy people have bumps or slightly deep sockets and have the potential to develop an FAI
  • PINCER: There is greater coverage over the anterior femoral head by the acetabulum – less common
  • COMBINED: A combination of Cam and Pincer

Management: Arthroscopic Surgery or Conventional Physiotherapy??

There has been a notable increase in the diagnosis of FAI in recent years alongside the use of arthroscopic hip surgery as the treatment of choice. However, there is an absence of high-quality evidence to support its use over conventional Physiotherapy interventions.

A recent review was undertaken and presented by ‘Physio Network’ – we want to pass this golden knowledge on to you.

The study explored the 2-year outcomes between patients with FAI that underwent either arthroscopic surgery or a supervised physiotherapy program:

  • Improvements were seen in both groups
  • No significant difference was reported for all outcomes
  • General satisfaction rating between the groups was also the same
  • Costs in the Physiotherapy group were lower

“Surgery may not be necessary for the management of FAIS as outcomes are similar with a well-constructed exercise and manual therapy program”

Exercise Program

  • Manual therapy by a Physiotherapist to mobilise (move) hip joint
    • These mobilisations can be performed with movement using a Mulligan’s belt to gap the space in the hip joint
    • It is very important to stretch the tight structures such as muscle and capsule ligaments
  • Comprehensive Mobility Home Exercise program
    • Initially intensive of 1 – 3 times per day
    • Range of motion exercises
  • Progression with motor control and proprioception exercises
    • 3 times per week

Our take home message is that a well-constructed Physiotherapy program is necessary for the management of FAI as it reports similar outcomes and improvements in comparison to surgery.