Therapeutic Exercise Approaches to Nonoperative and Postoperative Management of Femoroacetabular Impingement Syndrome

Abstract

Femoroacetabular impingement syndrome (FAIS) is characterized by premature contact of the femur and acetabulum during hip motion. Morphologic variations of FAIS present as either aspherical femoral deformity (cam femoroacetabular impingement) or overcoverage (pincer femoroacetabular impingement) or both. Patients with FAIS often describe discomfort with hip flexion, adduction, and internal rotation. The use of hip arthroscopy to treat FAIS has risen substantially over the last 15 years. Given that one practice domain of the athletic training profession involves injury prevention and wellness protection, optimal FAIS treatment and management strategies warrant discussion. Sports medicine professionals often help patients with FAIS explore nonoperative exercise strategies and direct rehabilitation exercises for those who pursue surgery. Both approaches demonstrate key pillars of exercise program design, which include postural control, core stabilization, hip strength and motor control, and mobility. The purpose of this article is 2-fold: to present an overview of FAIS, including common diagnostic strategies, and commonalities in therapeutic approaches between nonoperative and postoperative rehabilitation for the treatment and management of patients with FAIS.

Hip Pain in an Athlete

“…Activity modification, oral analgesics, and physical therapy should be started early in symptomatic individuals. Evidence-based rehabilitation protocols are lacking, but consensus suggests individualized and progressive programs that focus on posture, core stabilization, hip strength and motor control, and flexibility and mobility (26,27). An image-guided IA injection with an anesthetic agent (with or without CSI) can give important diagnostic information.…”

Benefits of a Specific and Supervised Rehabilitation Program in Femoroacetabular Impingement Patients Undergoing Hip Arthroscopy: A Randomized Control Trial

“…This protocol consists of an education program, including advice on movements that should be avoided, use of devices, posture, lifting and carrying, washing and bathing, nonspecific strengthening and stretching of lower limbs. The participants in the experimental group performed the same education program, early mobilization and walks, and in addition they followed a different program of exercises focused on stabilization, proprioception, flexibility and strengthening specifically designed to FAIS, following the guidance of the American College of Sports Medicine [ 23 , 24 ]. The program of exercises in the experimental group was applied in a physiotherapy session of 45 min each, once every two weeks for a total of 7 sessions (weeks 2, 4, 6, 8, 10, 12 and 14 post-surgery) following an adaptation of the Takla O’Donnell protocol [ 10 ], with the aim of restoring ROM and strength and reducing pain.…”

Fisioterapia Na Síndrome Do Impacto Femoro-Acetabular

“…A fisioterapia conservadora é indicada em um período de até 6 meses no máximo com o intuito de tratamento na reabilitação de força, mobilidade e estabilidade pélvica. A literatura cientifica através de estudos indica eu exceder este período eleva as chances de agravamento das lesões (GRIFFIN et al, 2018;TERRELL et al, 2020;BENNELL et al, 2017;KEMP et al, 2018).…”