Hip FAI: Looking at Hip Pain through a Global Lens


Syndrome of impinged hip also called FAI is a medical condition implying a great deal of pain, discomfort and debilitation. Femoroacetabular Impingement hits adults in middle age. It heavily limits the way a person moved before the condition manifested itself. Hip joint lays at heart of the problem. Femoral head excessive rubbing causes inflammation and pain. The symptoms include:

  • range of motion limitations
  • groin related painful sensations
  • lower back aches
  • CT scan and MRI usually show signs of osteoarthritis

Anatomy of hip Joint

Acetabulofemoral joint is the joint in the pelvic area that supports the body weight in static and dynamic positions. The way a hip joint is built the way so the head of the greater femur rotates. This way the range of motion of the hip is almost unlimited. If an inflammation occurs, the range of motion becomes largely limited. The parts of this joint fit tight together when the joint is in healthy condition. It normally allows for unobstructed motion.

The smooth slippery glossy cartilaginous layer almost fourth of an inch thick covers the head of the femur. Thanks to this layer a joint moves freely.

Femoroacetabular impingement

In the case of Femoroacetabular impingement boney needley structures start to form on top of the femur and start rubbing the socket of this joint, prompting trauma and inflammation. The needles are called bone spurs, they are the cause of irregular excessive friction within the joint, inhibiting normal movement. Glenoidal labrum of the hip joint gets tears over time, causing osteoarthritis (swelling and inflammation within the joint) as well as slow cartilage breakdown.

The symptoms of this condition include:

  • groin pain
  • indirect hip pain
  • aching sensation in lower back area
  • rigidity and constraint when attempt to move is made
  • peripheral pains in buttocks and hamstrings.

Increased stiffness after exercise

Femoroacetabular impingement is usually treated using NSAIDs to manage pain, activity modification,PT complex. Rare cases are that surgery becomes an option to remove bone spurs.

Attempting to alleviate the pain and the obvious epicentre of it, the major picture may go out of focus. Human movement as we know it is not isolated to one joint or body part. Other factors may as well impact the situation. Faulty movement mechanics, poor postural habits, neglected injuries, muscle tightness, weakness could all contribute to all the wrong things going on in hip joint function. When addressing FAI, clinicians should pay attention and assess holistically.

How to treat Femoroacetabular impingement in NYC?

Sports medicine team at NYDNRehab in NYC understands this common integrated nature of human motion. We use the latest therapeutic methods and cutting edge technologies to figure out correct deficiencies in functional movement, eliminating pain at its source.

Contact NYDN Rehab today. Let our highly-trained hip pain specialists diagnose your condition properly. Your hip pain is about to be treated. Leave hip related aches behind.

ACL Injury.Return to Great Performances

Professional sports players whose lives revolve around their sport, having an injury that takes them off the playing field can be torture. In eagerness to get back in the game, athletes often play down their symptoms and exaggerate their degree of recovery.



A clinical exam and diagnostic ultrasound imaging can help your therapist pinpoint the exact location and cause of your hip and groin pain.

Ultrasound enables you and your therapist to view the hip and groin region in real time, while in motion. In addition to ultrasound, video gait analysis can help us identify faulty movement mechanics that contribute to hip and groin pain. Once the exact cause is determined, an effective treatment plan can be initiated.


Explore more advanced diagnostic tools available only at NYDNRehab:


Hip dysfunction and pain can be a complex issue due to interactions of the trunk, pelvis, low back, groin and hip joint. Physical therapy and rehabilitation that is based only on subjective clinical analysis often addresses the symptoms without resolving the underlying cause.


At NYDNRehab, our groundbreaking motion analysis technology and high resolution diagnostic ultrasonography have enabled us to develop a battery of tests that perfectly reveal the dynamic functional pathology of the hip joint and pelvis. Our tests are evidence-based protocols that are considered to be the gold standard in the world of research.

Our testing protocol includes:


Combined lumbopelvic hip stability test using DLEST methodology with C.A.R.E.N., our computer assisted rehab environment


Hip joint stability test using DLEST methodology with C.A.R.E.N.


3D star excursion banner test (SEBT) for assessing the involvement of the hip joint and muscles in postural stability


3D gait or running analysis


3D kinematic joint angle analysis during a squat, lunge, drop jump and pelvis on hip rotation


Rehabilitative ultrasonography for viewing intrinsic hip stabilizing muscle activation patterns


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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