Femoroacetabular Impingement (FAI) is a common cause of hip pain. Impingement occurs because of an abnormal shape of the ball or socket of the hip joint. There are two types of FAI. The first type is called cam impingement. In cam impingement, the femur (thigh bone) has a bump on it. This bump rubs against the hip joint whenever the leg moves. This is more common in young, athletic males. The second type is called pincer impingement. This occurs when the socket of the hip, the acetabulum, covers too much of the top of the femur. Pincer impingement is more common in middle-aged women. Commonly patients have a combination of both a pincer and cam impingement. Patients with FAI are at risk for tearing the labrum. The labrum is a type of cartilage that forms a ring around the socket of the hip joint. A major injury like a hip dislocation or even just overuse can cause a labral tear.
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nt Resource Courtesy of SportsMedToday.com.
Patients with FAI usually have groin pain whenever the leg moves forward or backward or when it twists. The pain may occur with sports like hockey, soccer, or football, or it may occur with walking, running, or prolonged sitting. Patients may also feel clicking or catching in the groin if there is a labral tear present
On physical exam, patients may have decreased movement of the hip. X-rays are often very helpful in making the diagnosis of FAI. Advanced imaging may be done to confirm a labral tear. The most common test ordered is called MR arthrogram. It is like an MRI, but dye is injected into the hip so that the labrum is more easily seen.
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Treatment for FAI and labral tears usually includes Activity modification, pain medications, and rehabilitation. Core strengthening is an important part of treating FAI. If the pain continues, surgery may be needed to correct the abnormality in the hip. Patients with FAI may be at increased risk of osteoarthritis as they get older.
There is no specific way to prevent FAI but patients with hip or groin pain should limit activities that cause symptoms. An athlete that continues activities despite pain may damage the labrum of the hip. That is why it is important to see a doctor if there is painful snapping or locking in the hip or groin.
Once a patient has been diagnosed with FAI or a tear of the labrum, a patient will perform exercises to decrease stress on the hip. Athletes are progressed back to sports once they have good movement, strength, and are functionally ready to play their sport.