Femoroacetabular Impingement (FAI) or hip impingement is a common condition among athletes. The condition results in abnormal bony contact between the pelvis and thigh bones at the hip joint. Patients demonstrates increased bone growth on the pelvis socket and/or ball of the thigh. Authors continue to question if these changes are pathological and need to be corrected because of the high rates of bony growth found on asymptomatic athletes.
In addition to a decrease in joint space due to bony growth, symptomatic individuals frequently demonstrate significant weakness in their hip or gluteal muscles which are crucial to athletic performance and stabilization of the ball and socket hip joint. Impaired hip strength likely perpetuates the condition and its’ symptoms. In my practice, those who are able to compete and perform at a high level with FAI changes have worked to restore their hip strength and therefore compensate for the lack of joint space. Prior research has shown equivalent outcomes between surgery and Physical Therapy for patients with FAI. For those who opt for surgery pre operative hip strength may be a key predictor of post operative success.
Beck and colleagues in the journal Sports Health studied the importance of pre operative measures on post operative recovery in patients undergoing surgery for FAI (2020). Authors included 92 pre operative patients and a complete data set on 80% of these individuals at 6 months. They reported pre operative isometric strength of the hip muscles into abduction (to the side) and extension (to the back) were predictive of subjective functional hip outcome measures. They reported hip extension strength was the only pre operative measure that was predictive of a clinically meaningful post operative outcome.
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