FAI with CAM

Whether you’re enduring hip pain, groin pain, or both, it’s important to get a diagnosis. If the cause of your discomfort is something known as femoral acetabular impingement — FAI for short — it’s important to understand that there are two types, both of which can be treated with a variety of approaches.

The two types of FAI and their symptoms

When you suffer from either type of FAI, it means that the ball and socket movements of your hips are not in sync and are causing significant irritation. Extended irritation erodes the cushioning around your femoral head or your socket’s interior cartilage. 

When the cushioning is gone, FAI damage manifests in one of two ways. Pincer FAI is when your hip joint socket covers more of your femoral head than it should. This can seriously compromise your labrum. 

Cam FAI results from your femoral head becoming distorted. Since it’s no longer smooth and round, it wears away at the acetabulum’s cartilage. 

Patients with either type of FAI experience not only hip pain, but groin pain too. FAI pain is:

  • Progressive — goes from intermittent to constant

  • Audible — snapping may be heard during movement

  • Debilitating — limits walking and other movement, and makes sitting still for long periods difficult

What are the warning signs?

1- Deep squat- heels rotate in

2- Shift away during squatting (hip shift)

3-SI joint pain on one side

Reasons for This

1- Bone- CAM- head of the fetus is too thick or has bumps and can’t fit into the socket

PINCER-The rim of the socket has extra bone and causes the head of the femur to not fit well.

2- Muscle- flexibility, tissue quality, activation or lack thereof

What do most people feel during the day?

  1. stiffness in the hip and groin

  2. can’t flex the hip past 90*

  3. pain with flexion and internal rotation

  4. pinching in the front of the hip, groin or outer rim

  5. SI joint pain

TESTS

  1. active hip flexion- stand on one leg and raise leg. Try to get to 110-120* If there is no discomfort you pass

  2. passive hip flexion- repeat steps from above but use hands to pick up your leg.

  3. Hip Internal rotation- lie on back on the floor, hip should be in 90/90 position. Internally rotate legs. Should be able to get to 30-45*. If so you pass

  4. Hip External rotation- lie on back, cross hip over knee. If you can get to 45* you pass.

WHAT CAN BE DONE?

  1. massage- temporary fix

  2. stretching- hamstrings in supine, contract relax technique, sigh and relax technique

  3. activate- there are many drills you can do. I like single leg RDL’s, adductor lifts on the floor, standing hip abd, standing hip flexion without arching your back, hip extension from the Single leg RDL position. Each done 10 reps with a 10 sec hold at the end.

  4. work on posture and lifestyle- I like to include Single leg dead bugs, double leg dead bugs, hollow body lowers, hollow body rocks, heel taps single and double leg from dead bug position.

Please know there are alternatives to surgery. I have worked with many individuals and athletes with this issue as well as labral tears and have successfully avoided surgery.

Becky Coots-Kimbley