FAI TREATMENT OPTIONS (Surgical vs. Non-Surgical)

Femoral Acetabular Impingement (Surgical vs. Non Surgical Options)

If you have FAI hip impingement you might be researching a few options:

Rest / NSAIDS / Injections
Physical Therapy
FAI Fix / FAI Fix for Athletes
Surgery
Combination approach.

REST / INJECTIONS:
In general, non-surgical treatment should always be considered first when treating impingement. Rest and injections may or may not “calm the fire” / inflammation in your hip but they probably won’t ultimately resolve the issue.

NON SURGICAL APPROACHES:
Non surgical, non invasive options are usually something that every single person (whether they ultimately get surgery or not) should be doing.

Non surgical methods include modifying activity behavior and employing tissue work, stretching, re-activation, and motor control training.

The combination of working on the body using this systematic approach can be successful in reducing pain and swelling in the joint, thus reducing symptoms which is why everyone should be including it whether they already had surgery, or might get surgery in the future.

PHYSICAL THERAPY:
Physical therapy can be very helpful but it can also be hit or miss. You may get a good therapist or a mediocre therapist and they may or may not have specifically lived through the issue themselves. If they have not personally resolved the issue without surgery then their rehabilitation protocols may be based more on theory than experience.The advantage is that the physiotherapist can be hands on which can be invaluable if the therapist is highly skilled. They may use mobilizations and manual therapy to compliment whatever exercise program you are doing on your own (such as the FAI Fix.)

THE FAI FIX / FAI FIX FOR ATHLETES:
The FAI Fix is a conservative method developed by people who actually have FAI hip morphology and were able to fix it without surgery. It is very comprehensive compared to your average physical therapy protocol and features tools and exercises that are not found in typical PT protocols.

The tissue work in the program is particularly novel and we consider it maybe the most important component of fixing FAI non surgically. It is a “do-it-yourself” program which means less hands on guidance, but it can be a very helpful method of restoring range of motion, strength and function and thus avoiding surgical intervention.

SURGERY:
Surgery is the most invasive option that should be considered as a last resort. There are a variety of Doctors (with different skill levels) and techniques for performing surgery with mixed results.

MIXED APPROACH:
No matter what you do to fix your FAI we think it should at least include:

Tissue work (very targeted tissue work..not just foam rolling and generic massage.)
Stretching (that doesn’t make things worse)
Re-activation / Re-education (of certain muscle groups and movement patterns.)

If you can combine this “do it yourself” work with a skilled physical therapist / physiotherapist / manual therapist / bodyworker we think this is ideal.

SUMMARY:
As you can see from the video it is not “either or” or “black and white”. The important thing is that you are addressing all of the systems of your body (muscles, bones, fascia, motor control, etc) and not just 1 system (the bones.)