FAI – Femeroacetabular Impingement

This condition is being diagnosed with increasing frequency, and can be the cause of chronic groin pain, hip pain or back pain. It is caused by excessive bony growth due to ongoing stress, and can be from the hip socket developing a spur, or from the neck of the femur thickening, or both. This results in bony impingement as the hip is flexed (knee raise).

While we used to hear commonly that players would be diagnosed with OP (osteitis pubis) it is far more common now that this primary hip pathology is the cause of the ongoing pelvic torsion and hip stiffness, resulting in instability in the centre of the pelvis (pubic symphysis) and protective muscular spasm causing goin tendinopathy, hip tendinopathy, or sacroliliac joint dysfunction (with back pain).

Unfortunately, strong evidence suggests that even surgical debridement of the offending bony material often results in poor outcomes, and also shows the presence of these same bony issues in asymptomatic (normal) people. Good management should always involve physiotherapy as the primary treatment, involving education about the hip pathology and its poor correlation with dysfunction, exercise to improve the ability of the hip to tolerate load, and advice about weight loss to reduce the load experienced by the painful inflamed tissues of the hip.

FAI diagram