Hip Impingement (FAI)

What is Hip Impingement?

Femoroacetabular impingement (FAI) occurs when abnormal contact between the ball of the hip and the socket damages the labrum or cartilage. This sometimes results in a bony overgrowth causing the impingement. It often presents as deep hip or groin pain with flexion or rotation.

Common Symptoms

• Sharp groin or hip pain with sitting, squatting, or pivoting

• Limited hip mobility, especially internal rotation

• Clicking or catching sensations

• Pain after prolonged activity

Physical Therapist Diagnosis

A PT evaluates hip mobility and mechanics. The FADIR test (flexion, adduction, internal rotation) often reproduces symptoms. Movement analysis identifies compensations and muscle imbalances.

Why it Happens

Structural differences in the hip joint (cam or pincer deformities) cause abnormal contact during movement. Repetitive loading in sports like hockey, soccer, and dance can accelerate symptoms.

Why it Doesn’t Always Heal on Its Own

Bony changes don’t go away without surgery, but physical therapy can significantly reduce symptoms by addressing strength, mobility, and movement mechanics.

Ideal Physical Therapy Treatment

The goal is to optimize hip mechanics and reduce stress on the joint. Dry needling can relieve tightness in hip flexors, adductors, or glutes, which often contribute to pain.

Key strategies include:

• Manual therapy, joint mobilizations, and stretching to restore hip mobility

• Dry needling for muscle tightness contributing to impingement

• Strengthening of glutes, core, and hip stabilizers

• Movement retraining for squatting, running, and sport-specific patterns

• Activity modification to reduce painful positions

Expected Outcomes

Many athletes manage FAI successfully with rehab. In cases requiring surgery, PT is critical for both pre-hab and post-op recovery.

Key Takeaway

FAI doesn’t always require surgery. With the right therapy, athletes can improve mobility, reduce pain, and return to performance.