Physiotherapy for Femoroacetabular Impingement (FAI)

What is femoroacetabular impingement (FAI)?

Femoroacetabular impingement (FAI) syndrome is a motion-related hip disorder where morphological variations in the femoral head-neck junction (cam) or acetabulum (pincer) cause repetitive mechanical abutment and groin pinching, often stressing the acetabular labrum. In athletes, gym enthusiasts, and individuals frequently performing deep floor squats across India, symptoms present as anterior groin pain during sitting, driving, or athletic cutting. Following the international Warwick Agreement, evidence-based physiotherapy combines progressive hip muscle strengthening (gluteus medius, deep hip external rotators, and core), hip joint mobility within comfortable range, and activity modification to manage symptoms and avoid unnecessary surgery.

How physiotherapy helps

• Gluteus medius and deep hip rotator loading
• Hip flexor release and mobility exercises
• Pelvic lumbar control and core stabilization
• Squat depth and athletic cutting re-education
• Pacing advice avoiding painful hip impingement

Common signs

• Deep anterior groin or hip pain, often described with the C-sign grasping the outer and inner hip
• Sharp groin pinch during deep squats, getting into a low car, or tying shoelaces
• Stiffness and reduced hip internal rotation when the hip is bent to 90 degrees
• Clicking, catching, or giving-way sensations inside the hip joint from labral involvement
• A dull ache in the groin, lateral hip, or buttock after prolonged sitting or sports activities

Clinical rehabilitation framework

Evidence-informed clinical progression and starter exercise targets for femoroacetabular impingement (FAI).

Frequently asked questions

Related conditions & care

Knee and Hip ArthritisOsteoarthritis of the knee or hip is common with age and causes pain, stiffness, and reduced movement. Physiotherapy is a recommended first-line treatment: strengthening the muscles around the joint, easing pain with hands-on care, and advising on activity helps many people stay active and may delay or reduce the need for surgery in some people.

Knee OsteoarthritisKnee osteoarthritis affects the whole knee joint, including the cartilage, bone, and joint lining, causing pain, stiffness, and reduced movement. It is common with age and more likely with previous injury or extra load on the joint, though symptoms do not always match what a scan shows. Physiotherapy is a first-line treatment: it strengthens the muscles that support the knee, eases pain, and helps you stay active and independent.

Sacroiliac Joint DysfunctionThe sacroiliac (SI) joints connect the sacrum at the base of the spine to the iliac bones of the pelvis, transferring loads between the upper body and lower limbs. Sacroiliac joint dysfunction occurs when micro-instability, ligamentous sprain, or hypomobility generates localized pain over the posterior superior iliac spine (PSIS). In India, common triggers include falls directly onto one buttock, pregnancy-related pelvic ligament laxity, asymmetric heavy carrying, and repetitive vibration from autorickshaw or tractor driving over uneven roads. Physiotherapy utilizes the Laslett 4-test provocation cluster (distraction, thigh thrust, compression, sacral thrust) for accurate clinical identification, followed by pelvic realignment, deep core and gluteal stabilization, and supportive sacroiliac belt fitting during the acute phase.

Avascular Necrosis of the HipAvascular necrosis (AVN) of the femoral head (also known as osteonecrosis of the hip) occurs when temporary or permanent loss of blood supply leads to bone cell death, subchondral micro-fractures, and potential collapse of the femoral head articular surface. In India, a major surge in hip AVN has been documented following corticosteroid treatment (such as during COVID-19 therapy), chronic alcohol use, or trauma. While orthopaedic surgery (such as core decompression in early stages or total hip replacement in advanced collapse) addresses the vascular and structural pathology, physiotherapy plays a critical role in preserving hip capsular range of motion, strengthening supporting gluteal and core muscles without compressive overload, teaching assistive cane or crutch gait to protect the healing bone, and accelerating post-surgical recovery.

Clinical guides & articles for femoroacetabular impingement (FAI)

Evidence-informed articles, recovery timelines, and home care advice from our clinical library.