Hip Impingement (FAI): Diagnosis and the Right Treatment

Femoroacetabular impingement (FAI) has become one of the most frequently diagnosed hip conditions in active adults over the past decade. It refers to abnormal contact between the femoral head and acetabulum during hip movement — typically caused by a bony prominence on the femoral head (cam lesion), the acetabular rim (pincer lesion), or both. The diagnosis is often made on imaging, but the imaging findings don't always correlate with symptoms — and this is where management often goes wrong.

Does an FAI diagnosis mean surgery?

Not necessarily — and for many people, not at all. Multiple studies have demonstrated that conservative management produces equivalent outcomes to surgery for the majority of FAI cases. The key is accurate assessment of what's actually generating the pain and dysfunction: is it the bony morphology, restricted hip mobility, neuromuscular control, or a combination? An MRI finding of cam or pincer morphology is common in asymptomatic hips and isn't automatically the cause of pain.

Osteopathic management of hip impingement symptoms

Treatment focuses on improving hip joint mobility in the planes that are restricted, building the hip abductor, rotator, and deep flexor strength needed to control joint position during load, and addressing any lumbar or pelvic mechanics that are contributing. For most patients across Berwick and South-East Melbourne, this approach produces significant functional improvement without requiring surgical intervention.

If you've been told you have FAI, the next step is a thorough clinical assessment — not just an imaging report. Book at RISE Sports & Spinal and we'll give you a clear picture of what's driving your hip symptoms and what conservative management can achieve.

What conservative management for FAI actually involves

Conservative management for femoroacetabular impingement works by reducing the mechanical provocations that compress the acetabular rim and labrum, rather than ignoring the structural variant. This involves improving hip joint mobility in restricted planes — particularly internal rotation and flexion — so the femoral head can move more freely within the acetabulum. Hip abductor, external rotator, and deep stabiliser strengthening then reduces the dynamic loading on the rim during single-leg activities. The structural variant remains, but the movement environment around it changes.

At RISE Sports & Spinal in Berwick, FAI assessment goes beyond reading the imaging report. Clinical examination maps where the actual restriction and provocation lie, and treatment is targeted accordingly. Many patients across the Casey and South-East Melbourne area who come in after being told to consider surgery have not yet completed a structured conservative trial. In the majority of cases, function can be restored to a level that allows return to full activity — with surgery remaining an option only if conservative management genuinely fails.

Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.