Can exercise improve hip pain even with femoroacetabular impingement and a labral tear?

Veronica was told she had femoroacetabular impingement (FAI) and a labral tear. She was told that she would have to get surgery if she was going to ever feel good again. Walking around was painful. Squatting was painful. Jiu jitsu felt dangerous. She shares her experience coming to Upright Health to retrain her hips for 4 sessions.

While the current conventional medical approach to FAI suggests that movement makes things worse, experience without own clients seems to strongly suggest that working with muscles carefully and gradually can be a successful, safe, and rewarding alternative to surgery.

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1) FAI bone shapes are common as anatomic variants and are not indicative of a disease.
•Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study. Link: http://europepmc.org/abstract/MED/25736918
•The prevalence of cam-type deformity of the hip joint: a survey of 4151 subjects of the Copenhagen Osteoarthritis study. Link: www.ncbi.nlm.nih.gov/pubmed/18415788

2) Cam and pincer impingement do not lead to arthritis.
•Predictors of progression of osteoarthritis in femoroacetabular impingement: a radiological study with a minimum of ten years follow-up. Link: http://www.ncbi.nlm.nih.gov/pubmed/19190047
•Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study. Link: http://www.ncbi.nlm.nih.gov/pubmed/23850552

3) Labral tears and other joint pathologies exist in high numbers in individuals without any pain or hip symptoms.
•Identification of acetabularlabral pathological changes in asymptomatic volunteers using optimized, noncontrast 1.5-T magnetic resonance imaging. Link: http://www.ncbi.nlm.nih.gov/pubmed/22422932
•The prevalence of acetabularlabral tears and associated pathology in a young asymptomatic population. Link: http://www.bjj.boneandjoint.org.uk/content/97-B/5/623.long

4) Surgery for FAI often fails to meet patient expectations.
Fulfilment of patient-rated expectations predicts the outcome of surgery for femoroacetabular impingement. Link: http://www.oarsijournal.com/article/S1063-4584(12)00988-0/abstract

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More FAI videos: https://www.youtube.com/playlist?list=PLfKNSz5BBcBH4lL9pn4XUX9ef0OyZPFtj

For more relevant hip impingement articles:
Problems with FAI hip impingement - https://www.uprighthealth.com/blog/femoroacetabular-impingement-overview
Special test for femoral acetabular impingement - https://www.uprighthealth.com/blog/FAI-special-tests

5) Prevalence of FAI in CT scans of young asymptomatic population: http://www.ajronline.org/doi/full/10.2214/AJR.12.8546
6) Is a Positive Femoroacetabular Impingement Test a Common Finding in Healthy Young Adults?: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676610/
7) Does FAI cause arthritis? This 2010 study gives a resounding NO: http://www.bjj.boneandjoint.org.uk/content/93-B/5/580.short
8) Does pincer impingement lead to arthritis? This study also says NO: http://www.ncbi.nlm.nih.gov/pubmed/23850552

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Movement Improvement Consulting, Orthopedic Massage and Posture, Alignment, and Coordination Training in Redwood City (San Francisco Bay Area)
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