Femoroacetabular Impingement (FAI) can feel like an unsolvable puzzle—especially when every step or deep squat triggers sharp pain. But what if the key isn’t in masking the pain with medication or rushing into surgery, but in fixing the root cause?
In this guide, we’ll dive deep into what FAI is, why it happens, and how you can take action to restore mobility and comfort through proper alignment and targeted exercises. Plus, we’ll guide you toward the support you need with our Hip Impingement Program.
What is Femoroacetabular Impingement (FAI)?
FAI occurs when the ball-and-socket joint of the hip doesn’t move smoothly due to abnormal bone growth or misalignment. This condition can limit hip mobility and lead to pain, especially during activities that involve hip flexion or rotation. If left unaddressed, FAI can contribute to labral tears, cartilage damage, and osteoarthritis.
What Causes Hip Impingement (FAI)?
FAI doesn’t develop overnight. Hip impingement is often the result of poor movement patterns, postural misalignments, and reduced joint mobility. Here’s how these factors contribute:
- Postural Imbalances: Anterior pelvic tilt or slouched posture alters hip joint alignment, increasing the risk of impingement.
- Muscle Imbalances: Tight hip flexors and weak glutes disrupt the mechanics of the hip joint, leading to excessive strain and restricted movement.
- Repetitive Movements: Sports or activities that involve repetitive hip flexion (like soccer or cycling) can exacerbate impingement over time.
- Reduced Mobility: Stiffness in surrounding joints, like the lower back or pelvis, forces the hip joint to compensate, causing abnormal movement patterns.
How to Test for FAI
Testing for FAI typically involves a combination of physical exams and imaging studies. If you go to a physical therapist’s office, they’ll likely perform the following tests:
1. The FADIR Test (Flexion, Adduction, and Internal Rotation):
- A therapist will have you lie on your back and flex your hip to 90 degrees, then move it inward across your body (adduction) while rotating it internally.
- Pain or discomfort during this test often indicates FAI. You can watch a helpful video to show exactly how it’s done here.
2. Range of Motion (ROM) Assessment:
- Physical therapists will evaluate your hip’s range of motion during flexion, extension, and rotation.
- Limited ROM, especially in flexion and internal rotation, is a hallmark of FAI.
3. Gait Analysis:
- Your walking pattern is observed for compensations like limping, uneven hips, or excessive external rotation.
4. Imaging Tests (if needed):
- X-rays or MRIs are used to confirm the presence of bony abnormalities or labral damage.
Before you head that direction, take a look at these 5 Simple Hip Mobility Self-Tests You Can Do at Home.
How to Fix FAI: A Path to Pain-Free Movement
Correcting FAI involves a combination of improving joint alignment, strengthening weak areas, and increasing hip mobility. The following exercises are foundational for addressing FAI:
1. Pelvic Tilt with Deep Core Engagement
- Lie on your back with knees bent.
- Flatten your lower back against the floor by engaging your core and tilting your pelvis slightly upward.
- Hold for 5 seconds, then release. Repeat 10–15 times.
2. Glute Bridge with External Rotation
Too many people do these with poor form! Check out how to do a Glute Bridge the right way!
- Lie on your back with feet hip-width apart.
- Push through your heels to lift your hips while squeezing your glutes.
- At the top, press your knees outward slightly to activate the glute max. A resistance band placed just above your knees will provide greater challenge. Lower and repeat for 3 sets of 10.
3. Hip Flexor Stretch
- Kneel on one leg with the other foot forward in a lunge position.
- Tuck your pelvis under and shift your weight slightly forward until you feel a stretch in the hip flexor. If your left leg is the back leg, reach your left arm overhead and tilt your torso slightly away from the back leg to increase the stretch. Same for the right side. Remember to breathe.
- Hold for 20–30 seconds per side. Repeat 2–3 times.
4. 90/90 Hip Switches
- Sit on the floor with knees bent at 90 degrees, one leg in front and one behind. The back leg will be internally rotated and the front will be externally rotated.
- Rotate on your hips and swivel the knees over to switch sides, keeping your spine tall and chest lifted.
- Perform 10–12 slow, controlled repetitions.
5. Clamshells with Resistance Band
- Lie on your side with heels aligned with your hips and head with your knees bent and a resistance band around your thighs.
- Keep your heels together as you raise your top knee like you’re opening a book, engaging the glute medius.
- Lower with control and repeat for 3 sets of 12–15 reps per side.
Why Surgery Isn’t Always the Answer
While surgery might seem like a quick fix, it doesn’t address the root causes of FAI—misalignments, poor posture, and muscular imbalances. Studies suggest that many patients report persistent symptoms even after invasive procedures. Exploring non-invasive methods first is often more effective and far less risky since evidence from these studies is mostly low level, reported results are short term, and at least 1 study suggests a noticeably lower level of sport activity at 3 years postsurgery.
MoveU Membership: Your Path to Fixing FAI Hip Impingement
The key to fixing FAI lies in developing better body awareness, improving core stability, and gradually increasing hip strength and alignment.
The MoveU Membership offers:
- Expert-led programs like Back & Core and Hips & Glutes to address FAI’s root causes as well as the MoveU Hip Impingement Program.
- Personalized coaching to guide you step-by-step.
- A supportive community that keeps you motivated.
Ready to Fix Your Sh*t? Don’t wait. Join MoveU today and let’s get MUving toward a healthier you!