Massage therapy · Kitchener–WaterlooFemoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint, giving them an irregular shape. Because the bones do not fit together perfectly, they rub against each other during movement. Over time this friction can damage the joint, causing pain and limiting activity (American Academy of Orthopaedic Surgeons, n.d.).

Femoroacetabular Impingement (FAI) Anatomy

The hip is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, the upper end of the femur (thighbone). A slippery tissue called articular cartilage covers the surface of the ball and the socket, creating a smooth surface that helps the bones glide easily across each other. The acetabulum is ringed by strong fibrocartilage called the labrum. The labrum forms a gasket around the socket, creating a tight seal and helping to provide stability to the joint (American Academy of Orthopaedic Surgeons, n.d.).

What Causes FAI?

Signs & Symptoms

Pain often occurs in the groin, although it may be felt towards the outside of the hip. Turning, twisting and squatting may cause a sharp, stabbing pain, and sometimes the pain is just a dull ache (American Academy of Orthopaedic Surgeons, n.d.).

How to Treat Femoroacetabular Impingement

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Surgery can successfully reduce symptoms, and correcting the impingement can prevent future damage to the hip. However, not all of the damage can be fixed by surgery, especially if treatment has been put off and the damage is severe, and further problems may develop in the future (American Academy of Orthopaedic Surgeons, n.d.).
• The American Academy of Orthopaedic Surgeons describes surgery as currently the best way to treat painful FAI, but a large UK trial found that both hip arthroscopy and physiotherapy-led care improved symptoms, with surgery only modestly better after 12 months (American Academy of Orthopaedic Surgeons, n.d.; Griffin et al., 2018).
• FAI starts with how the hip bones form during childhood, so there is little that can be done to prevent it (American Academy of Orthopaedic Surgeons, n.d.).
• It is the cam bump, the pincer bump, or both, that leads to pain and joint damage (American Academy of Orthopaedic Surgeons, n.d.).
• See a physio first to find out whether treatment may help before considering surgery.
• If your symptoms persist, see a doctor; the longer painful symptoms go untreated, the more damage FAI can cause (American Academy of Orthopaedic Surgeons, n.d.).
• If you do have surgery, follow your surgical team's rehabilitation programme fully.

FAI comes from the shape of the hip bones, so I can't change the joint itself. What I can do is ease the pain and the tight, guarded muscles around the hip, and help you build strength and control so your hip copes better with what you want to do.

I start by assessing how your hip moves, which positions bring on the pain, and the strength of your hip, thigh and trunk muscles. I'll also look at how you walk, squat and move in your sport or work. If your symptoms don't fit the usual picture, or they keep getting worse, I'll suggest seeing your family doctor or nurse practitioner.

Settling It Down

• Working out which movements pinch the hip, often deep bending, twisting and squatting, and changing them for a while rather than stopping everything
• Hands-on work for the hip flexors at the front, the hamstrings, the outer thigh, the muscles that rotate the hip, and the low back
• Gentle joint mobilisation and a slow, sustained pull along the leg to help the hip feel less compressed, with no quick or forceful movements
• Warm applications in the clinic to ease tight muscles

Building Strength and Control

1. American Academy of Orthopaedic Surgeons (n.d.) Femoroacetabular impingement. OrthoInfo. Available at: https://www.orthoinfo.org/diseases--conditions/femoroacetabular-impingement/ (Accessed: 7 October 2026).
2. Griffin, D.R., Dickenson, E.J., Wall, P.D.H. et al. (2018) 'Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial', The Lancet, 391(10136), pp. 2225–2235. doi: 10.1016/S0140-6736(18)31202-9