FAI A Common Cause Of Groin Pain

FAI A Common Cause Of Groin Pain

FAI A Cause Of Hip Pain In Young Active Adults

Femoroacetabular Impingement (FAI) can effect young and middle-aged adults, contributing to hip and groin pain in active adults in this age demographic. It is unknown how many people have femoroacetabular impingement but it is estimated that a Cam deformity one of the few types of hip impingement may affect up to 25% of the general population, however not all of these individuals are symptomatic, as a Cam deformity like the other causes of hip impingement are not always painful.
When individuals are symptomatic be it the result of a Cam, or Pincer style impingement, these deformities can cause damage to the articular cartilage and fibrocartilage lining around the rim of the joint, known as the labrum. Symptoms such as pain, stiffness, and limping can indicate that there may be damage to the joint surface, or labrum, a process that may well progress and become more symptomatic over time if measures aren’t taken to manage it.

FAI Is Set In Motion In Your Developmental Years

FAI occurs because the hip bones do not form normally during developmental years. It is the deformity and development of a Cam or Pincer bone spur (or both), that leads to joint damage and pain with hip impingement.  When the hip joint bones are shaped abnormally, then ultimately there is little that can be done to prevent FAI and potentially associated symptoms. Active individuals in theory work the hip joint more vigorously than the sedentary population (depending obviously on the type of activity/s chosen) and therefore this is why sports people with Cam deformities may begin to experience pain earlier in life than individuals who are less actively inclined.

Symptoms Of Femoroacetabular Impingement

Individuals presenting with hip impingement in most circumstances tend to have an active lifestyle and there pain is most commonly triggered either during, or following their chosen activity. However, FAI related pain may also occur during normal activities such as the act of sitting down, or rising from sitting to standing. Many will complain that simply getting in and out of a car or truck causes significant discomfort.
People with FAI usually experience pain in their groin region, although sometimes the pain may be felt more towards the outside of the hip area, or even extending into the lower back. The pain may be felt as a dull ache, or a sharp stabbing pain with previously mentioned movements as well as occurring with turning, twisting, and squatting motions. The longer painful symptoms go untreated, potentially the more damage FAI can cause, so if symptoms persist then it is advisable you investigate to determine the exact cause of your pain, so you can consider any available treatment options.

Diagnosis Of FAI

X-rays, CT and MRI scans can all be of use for investigating pain thought to be caused by femoroacetabular impingement, providing an accurate image of the anatomy of the hip. Positive investigations indicating either a Pincer or Cam deformity (or both) coupled with appropriate history of symptoms and positive hip impingement signs on physical examination combined make for a fairly accurate diagnostic approach.
A special test used by physiotherapists that is very sensitive in picking up FAI is a FAIR test where the patient is positioned on their back and their knee is brought up towards their chest, then taken across their body towards the other leg and the hip is rotated inwards by taking the foot out and away from the body, if this reproduces “their” hip pain, the test result is considered as a positive hip impingement sign. This test however is not 100% specific for causing pain in only FAI, however used as part of a through assessment can be a useful tool in the diagnosis of hip impingement.

Treatment Of Femoroacetabular Impingement

Non-surgical treatment for FAI may include activity modification in an attempt to avoid activities causing symptoms, combined with anti-inflammatory medications to help reduce pain and inflammation this can be an effective first aid approach to managing the pain associated with hip impingement. First aid treatment like this coupled with physiotherapy treatment where the focus is working to optimise alignment and mobility of the joint, working at identifying and correcting any specific movement patterns that may be causing injury thereby decreasing excessive forces on irritable tissues can add another layer of effectiveness to the conservative management of hip pain.
Surgical treatment is considered when conservative treatment such as physiotherapy has not satisfactorily managed to improved patient function, or pain levels. Surgery can help successfully reduce symptoms of femoroacetabular impingement, correcting any impingement surgically can also prevent future damage to the hip joint. However, if treatment has been delayed and the damage to the joint is severe, surgery will obviously not solve all and patients may well still experience pain, as well as some range of movement (ROM) and functional limitations. Generally it is considered best practice to couple surgery with post operative physiotherapy, using physiotherapy following surgery can help restore ROM and restore biomechanical control of movements. Doing this enables the to lower limb to function optimally and help prevent possible problems that may develop in the future.

FAI is regarded as a cause of premature hip osteoarthritis and is characterized by abnormal contact between the ball and hip socket. A combination of certain factors may predispose individuals to some form of FAI, predominantly, bone development marginal to the hip joint surfaces, together with excessive athletic activities involving repeated loaded motion of the legs beyond those considered normal range. Ultimately the result here is then increased friction between the socket and femoral head which can result in pain as well as reduced hip motion and functional capacity.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding FAI A Common Cause Of Groin Pain should consult his or her podiatrist, sports medicine specialist or physiotherapist.