Hip impingement Femoroacetabular impingement / FAI

Introduction

An impingement means "constriction". In a hip impingement, a ring of connective tissue or the hip cartilage becomes trapped between the femoral head and the hip socket. This causes pain in the hip.

Hip impingement is also called femoroacetabular impingement, often abbreviated as FAI.

hip femoroacetabular impingement FAI normal

Description of condition

The hip joint consists of a femur head and a hip socket. The head and the socket are covered by a thin, smooth layer of cartilage that ensures that both parts of the joint can glide over each other. Along the edge of the hip socket is a ring of connective tissue called the labrum. The labrum keeps the femoral head better positioned in the hip socket.

Normally, the hip joint consists of a rounded femoral head and a deep hip socket. The curve of the femoral head fits perfectly into the curve of the hip socket. With a hip impingement, the shape of the femoral head or the hip socket is unusual. This means that the head and the socket no longer fit together properly. As a result, the cartilage and the labrum can become trapped. We feel this as pain in the hip or groin.

There are three types of hip impingement. The different types describe the joint shape of the femoral head and the hip socket.

Cam impingement

In this case, the curve of the femoral head is too wide, so that it does not fit into the hip socket.

Pincer impingement

In this case, the hip socket has a defect. The edge of the hip socket sticks out too far, making the socket too deep. This may cause the femoral head to collide with the edge of the hip socket during movement.

Combined (mixed) impingement

This is a combination of a cam impingement and a pincer impingement. Both anomalies are present.

The misalignment of the hip joint in itself does not cause any symptoms. However, if the misalignment causes damage to the cartilage or the labrum, symptoms may arise.

Damage to the cartilage or the labrum is caused by the femoral head and hip socket colliding frequently and subject to strong forces due to the misalignment. Because the hip joint is protected by the cartilage and the labrum, these get damaged first.

Cause and history

An abnormal shape of the joint is usually congenital. A change to the hip joint can also occur after a broken hip (exercises for hip impingement.

More info

You can check your symptoms using the online physiotherapy check or make an appointment with a physiotherapy practice in your locality.

References

Magee, D.J., Zachazewski, J.E., Quillen, W.S., Manske, R.C. (2016) Pathology and intervention in musculoskeletal rehabilitation Elsevier, 2nd edition.
Magee, D.J. (2014) Orthopedic physical assessment Elsevier saunders: St. Louis.
Philippon, M.J., Brian Maxwell, R., Johnston, T.L., Schenker, M. & Briggs, K.K. (2007) Clinical presentation of femoroacetabular impingement Knee Surg Sports Traumatol Arthrosc. 2007-15:1041–1047.

hip femoroacetabular impingement FAI normal
hip femoroacetabular impingement FAI cam head
hip femoroacetabular impingement FAI pincer
hip femoroacetabular impingement FAI mixed combined
hip femoroacetabular impingement FAI types

Related conditions

Practices per province/territory

Exercises Find a physio Do the self-check