Is Hip Pain Slowing You Down? It Could Be Femoroacetabular Impingement (FAI) Syndrome

Does your hip ache when you sit too long? Do certain movements cause a sharp, uncomfortable pinch? If this sounds familiar, you might be dealing with femoroacetabular impingement (FAI). The good news? You are not alone, and with the right physiotherapy, you can get back to doing the things you love.

What is FAI, and why does it happen?  

FAI is a condition where the bones in your hip joint don’t glide smoothly like they should. Instead, they rub against each other, causing pain and limiting how your hip moves. Think of it like a door hinge that doesn’t quite fit — it works, but not without some resistance.

There are three types of FAI:

• Cam-type: A bony bump on the ball of your hip joint that creates friction. This type is more common in young males and athletes, especially those who participate in high-intensity sports that require frequent hip loading with running, jumping, and kicking. (Eg. rugby, soccer, rowing, and dancing).
• Pincer-type: Extra coverage of the hip socket that pinches the joint; common in females.
• Mixed-type: A combination of both, and the most prevalent.

Although FAI is often seen in active individuals and athletes, it can affect anyone. Left untreated, it may lead to joint damage, but with early intervention, you can avoid complications.

How do you know if it is FAI?  

FAI doesn’t hide its symptoms. Here is what to look for:

• Persistent pain in the hip or groin that worsens with activity or sitting.
• A clicking, locking, or catching sensation in the hip.
• Feeling stiff or unable to move your hip like you used to.

If you are nodding along, it is time to take action.

Why physiotherapy is your best first step  

Physiotherapy is a powerful tool to manage FAI. It is non-invasive, tailored to you, and can make a world of difference in how your hip feels and moves. Here is how it works:

1. Learn about your hip  

Knowledge is power! Your physiotherapist will explain what is causing your pain and show you ways to avoid triggering activities, like deep squats or sitting cross-legged.

2. Strengthen and stabilise 

Strengthening your hip muscles (like the glutes) gives your joint the support it needs to move better and hurt less.

3. Fix your movement patterns  

Everyday activities, like walking or getting up from a chair, can become second nature — even if you are moving in ways that strain your hip. Your physiotherapist will teach you how to move smarter, not harder.

4. Hands-on help  

Manual therapy, like stretches and gentle joint movements, can help loosen up stiffness and make it easier for your hip to move naturally again.

5. Dry needling for pain relief  

Dry needling is another effective tool your physiotherapist may use to relieve muscle tension and reduce pain. By targeting trigger points around the hip, dry needling can help improve mobility and support your recovery.

6. Low-impact exercises  

Until your hip feels stronger, activities like swimming or walking are great ways to stay active without adding extra strain.

How soon will you feel better?  

The timeline varies for everyone, but many people notice improvement within a few months of starting physiotherapy. Sticking to a tailored programme can significantly reduce pain and improve movement — and for many, it can help avoid surgery altogether. Research shows that non-surgical treatments for a minimum of three months can reduce pain and relieve symptoms for up to five years.
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What is the success rate of non-surgical treatment?  

Here is the great news: non-surgical treatment works for many people with FAI.

• A recent study by Pasculli et al. (2023) shows that non-surgical management is successful in 39–82% of cases.
• For adolescents, 70% respond well to physiotherapy within two years, and another 12% find relief with corticosteroid injections.

Don’t let FAI hold you back  

Your hips are at the centre of everything you do — from walking to dancing, and even just sitting comfortably. If FAI is slowing you down, physiotherapy could be the solution you need.

Not to be clicky ... but our Cape Town physiotherapists are some of the best in business. Click here to make an appointment at Hein Viljoen Physiotherapy.