Femoroacetabular Impingement (FAI)
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If your hip pinches with certain movements
Femoroacetabular impingement (FAI) is a condition in which abnormal bone shape of the femoral head or the acetabulum causes the bones to collide during specific hip motions, leading to pain and labral injury. It is common in young, active adults and, if neglected, can progress to early-onset hip osteoarthritis.
The two types of FAI
- Cam type: An abnormally convex femoral head-neck junction collides with the acetabular rim during flexion. More common in young men.
- Pincer type: An acetabulum that over-covers the femoral head causes the rim to strike the femoral neck during joint motion. More common in middle-aged women.
- Mixed type: Coexistence of cam and pincer features is the most common pattern.
Symptoms and diagnosis
The classic symptom is sharp, deep groin pain with hip flexion and internal rotation. It worsens when standing up after prolonged sitting, climbing stairs, or squatting.
- FADIR test: Groin pain reproduced with flexion, adduction, and internal rotation indicates a positive result.
- Labral injury: Repeated impingement may tear the labrum, adding catching sensations.
- Imaging: X-ray reveals bony abnormalities; MR arthrography (MRA) evaluates labral condition.
Combining exercise therapy with Korean medicine
The core of non-surgical FAI treatment is to avoid impinging movements while strengthening the muscles around the hip.
- Exercise therapy: Strengthening the deep stabilizers and gluteal muscles secures joint stability.
- Acupuncture: Relieves pain around the hip and releases muscle tension.
- Chuna manipulation: Maintains functional hip mobility and prevents lumbar/pelvic issues from compensatory patterns.
- Movement modification: Avoid deep squats and excessive hip flexion.
If conservative care fails to respond or labral damage is severe, arthroscopic surgery may be considered, and pre- and post-operative Korean medicine treatment can support recovery.