Pop and Lock it: Why are my hips pinching!?

What is FAI?

Femoroacetabular Impingement (FAI) is a common pathology that affects approximately 15% of the population. Common symptoms include mobility limitations in the hip and groin pain. There are two types of structural abnormalities that lead to FAI: PINCER and CAM. The type of FAI you are experiencing is based on the location of the abnormality.

In the image above, you can see how there are structural changes in the bone leading to this impingement. CAM impingements show structural changes on the femur while the PINCER is structural changes involved with the acetabulum.

FAI Syndrome

To be diagnosed with FAI syndrome you must have all three conditions

• Symptoms
• Clinical Signs
• Imaging Findings

Some people may have CAM or PINCER morphologies but never have any symptoms. 

What causes the pain and damage?

Common causes include sports and other recreational activities. This includes repetitive contact during intense activities such as skating, cutting, repeated hip flexion and internal rotation.

In addition, weaknesses and microinstabilities in the hip can lead to excessive movements of the femur in the acetabulum. Often the deep hip muscles are weak. 

Diving more into the hip musculature

With FAI syndrome, there is decreased activation noted in the gluteus maximus as well as the hamstring musculature. In addition, due to the proximity to the inflamed or damaged structure in the hip, the deep glut musculature is often most affected. These changes are often noted during dynamic balance exercises such as the single leg squat.

When hip weaknesses start to occur, you can often see other structures of the body start to feel the effects. Some of these symptoms include IT band syndrome, iliopsoas tendinosis, and/or snapping hip syndrome. The hip flexors will also start to be overactivated, making the femur move anteriorly. This will then lead to more irritation and tightness in the front of the hip. In addition, there will be more hip extension limitations.

Who is at Risk?

• Runners: When jogging, the hip/groin region sustains 8x a persons body weight. This is even more intense during vigorous athletic activities.
• Athletes in sports with impact loading of the hip sports (soccer, basketball, ice hockey).
• Athletes during periods of skeletal growth.
• Youth ice hockey players are 15x more likely to have a CAM deformity than their counterparts.

How can you prevent this?

• Diversify the sports activities, especially during the ages of 12-13
• Incorporate strength and conditioning programs
• Seek out physical therapy if you are experiencing any of these symptoms or concerns

Let us know if you have any questions or concerns for your kids on how to prevent FAI Syndrome and how to manage it if currently experiencing the symptoms. We are located in Falls Church and serve Arlington and the surrounding areas. 

Author

Alana Hamilton Alana Hamilton is a physical therapist at Advantage Physical Therapy in Falls Church, Virginia. She is a proud Hokie from Virginia Tech with a major in Biology and a minor in psychology and sociology. Following graduation, she immediately got her doctorate in Physical Therapy from Radford University. She is an avid fan of Pilates, running, and hiking. On the weekends, she can be found hanging out with her family and baby as well as doing Spartan races with her old physical therapy classmates and friends. She is a big believer that during rehabilitation, "Motion is the Lotion" and that staying active is key to remaining healthy.