What is Femoroacetabular Impingement Syndrome (FAIS)
Femoroacetabular Impingement Syndrome (FAIS) is a condition that occurs when structural abnormalities in the hip joint lead to excessive friction during movement. This can cause pain, reduced mobility, and potential joint damage over time. FAIS is commonly seen in athletes and physically active individuals due to repetitive stress on the hip.
FAIS develops due to irregularities in the hip’s bone structure. These abnormalities may be genetic or result from high-impact activities that place excessive strain on the hip joint. The condition is often classified into three types:
Cam Impingement: A bony growth on the femoral head (ball) creates friction with the acetabulum (socket), leading to pain and restricted motion. This type is more common in young athletic males.
Pincer Impingement: Excessive coverage of the acetabulum over the femoral head causes increased joint pressure, often affecting middle-aged women.
Mixed Type: A combination of both cam and pincer impingements, resulting in greater joint stress.
FAIS can also develop secondary to previous hip injuries, conditions such as Perthes disease or Slipped Capital Femoral Epiphysis (SCFE), or even subtle anatomical variations.
Causes and Risk Factors
FAIS often presents as pain in the hip or groin, sometimes extending to the buttock or side of the hip. Symptoms may develop gradually over time or suddenly after an injury. Common indicators include:
Deep groin pain, especially during or after physical activity
Discomfort while sitting for extended periods
Pain when crossing legs or performing twisting movements
Limited range of motion, particularly with hip flexion and internal rotation
Weakness in hip muscles
Daily activities such as walking, running, and squatting can exacerbate symptoms, making early intervention essential.
Signs and Symptoms
Diagnosis: Clinical Assessment and Imaging
A thorough diagnosis involves a combination of:
Physical Examination:
Reproduction of symptoms during the FAIR (Flexion, Adduction, Internal Rotation) test
Pain elicited during the FABER (Flexion, Abduction, External Rotation) test
Reduced hip mobility and muscle weakness
Imaging Tests:
X-rays to assess bone structure and joint abnormalities
MRI scans to detect cartilage damage and inflammation
CT scans in complex cases to provide detailed 3D images of the hip
For most individuals, FAIS can be effectively managed with a structured physiotherapy program lasting at least three months. Treatment focuses on:
Joint Mobilisation: Techniques to relieve stiffness and improve movement
Muscle Strengthening: Targeting deep and superficial hip muscles for better joint stability
Flexibility Exercises: Stretching exercises to improve soft tissue mobility
Proprioception and Functional Training: Enhancing hip control and movement patterns to reduce strain
Pain Management: Temporary relief with anti-inflammatory medications, under medical supervision. Ice can also be a useful modality to manage the pain.
Engaging in a tailored rehabilitation program can significantly reduce symptoms and improve function.
When is Surgery Necessary?
If conservative treatments fail to alleviate symptoms, referral to an orthopaedic surgeon may be recommended. Surgical options include:
Hip Arthroscopy: A minimally invasive procedure to reshape bone and repair damaged cartilage, with a recovery period of 3–4 months
Open Hip Surgery: Used in severe cases, requiring a more extended rehabilitation process of up to 12 months
Post-Surgical Rehabilitation
Successful recovery after surgery depends on a structured rehabilitation plan with a physiotherapist. This includes:
Gradual reintroduction of movement and weight-bearing activities
Strength and stability exercises to prevent re-injury
Sport-specific training for athletes aiming to return to competition
Non-Surgical Treatment Options
If you are experiencing hip or groin pain, seeking early physiotherapy intervention can help prevent long-term damage and improve your quality of life. Contact Melbourne Physio Clinic for a comprehensive assessment and personalised treatment plan.