Femoroacetabular Impingement (FAI) | Hip & Groin Pain (Rehab | Education | Exercises)

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Do you have hip pain from squatting, sitting, or playing sports? Check out this video to learn everything you need to know about Femoroacetabular Impingement (FAI) including exercise progressions with exact sets and reps.
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Intro (0:00)
Femoroacetabular Impingement (0:14)
Should You Get Surgery? (3:06)
Load Management & Activity Modifications (5:25)
Resistance Exercises (7:28)
Exercise #1: Split Squat (8:16)
Exercise #2: Hamstrings (9:43)
Exercise #3: Adductors (10:28)
Exercise #4: Extensors (11:08)
Exercise #5: Abductors (11:41)
Exercise #6: Flexors (12:18)
Guidelines, Not Rules (13:12)
Plyometric and Sport-Specific Exercises (13:52)
Banded Mobilizations and Stretching (14:23)
Summary (14:58)
4 Stage Plyometric Progression: • Plyometric Training fo...
4 Stage Running Progression: • Adductor Strain Rehab ...
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Disclaimer: The information presented is not intended as medical advice or to be a substitute for medical counseling but intended for entertainment purposes only. If you are experiencing pain, please seek the appropriate healthcare professional.

[@E3Rehab]

Thanks for watching! Here's the blog with references: e3rehab.com/blog/fai/

[@anthonylong311]

I'm a PT (practicing over 20 years in outpatient setting) and I have to commend you on your channel and videos. Fantastic information, progressions, research citations, and presentation. Easily digestible for patients, very informative and streamlined for practitioners. Keep up the great work and thanks again for the information.

[@E3Rehab]

Thank you, Anthony. We really appreciate that.

[@sherirx]

I was diagnosed with FAI 2 months ago and I’m in learning/research mode. This is the best video I’ve seen about this diagnosis thus far. Very thorough and as a healthcare worker, I appreciated the evidence-based medicine you included as well as all the detailed explanations of each exercise. Very well done! Thank you!

[@E3Rehab]

Thank you!

[@kenabelson8423]

I delayed for years and it got much worse. Wish I had started rehab sooner. Sooner the better.

[@spindleblood]

agreed, I love the citations!

[@johnglonga1627]

yup this video killed it! do u do all ur own video editing?

[@jonahgarrett7138]

Sheri, how are you feeling now… I think I have FAI but don’t want surgery

[@wallyjames7825]

Probably the best video on FAI I’ve seen. It’s so easy to feel hopeless and alone with this disorder. I can’t count how many doctors/physios I’ve seen now who couldn’t explain it to save their life. I’m so tired man. I want my twenties back.

[@Lars42042]

I got operated last year September. Much better since. Had an amazing doctor after I went through a load of docs who didnt find it at first.

[@seanhallett7156]

I had FAI surgery for CAM lesions on both hips as a 33-year-old male, and I do not regret the surgeries. I went the PT route for months before electing for surgeries during COVID. PT did help abate some of my symptoms, but there was always lingering pain and daily maintenance required to lessen the pain. After the surgeries, I don't have the same mobility as before the hip pain initially started in my late 20s, but it's allowed me to get back to probably 90% hip functionality and much less pain. I also think the months of PT before and after surgery helped greatly.

[@tomskelton317]

I'm currently on the NHS waiting list in the UK to have my right-hip surgery (Cam lesion), most likely to be the end of 2024 so having to deal with and manage my pain day-to-day. I also play golf and it's really starting to hurt / affect the way I am now able to play until I get my surgery done. Out of interest, how long did you wait between having your right & left hip surgery?

[@seanhallett7156]

@tomskelton317 about 4 months. The doctor said he doesn't do back to back procedures with less than a 3 month interval. Both of mine were painful but the right which I had done first was much worse.

[@tomskelton317]

Can’t wait to get mine done, but going to be a long year waiting! Did you experience any SI joint or lower back pain when you had FAI?

[@seanhallett7156]

@tomskelton317 No, my pain was limited to my hip and flared up by external and sometimes internal rotation of hip joint. Tying my shoes was painful, I couldn't sit with my legs crossed on the ground or cross one leg over the other in a chair. If you can get into physical therapy or do strengthening exercises before the surgery, I think that helped me speed up my recovery. I already had strong balanced hip flexors and glutes, and it made my progression much easier back to walking, running, etc.

[@matty946]

Thanks for sharing your experience. I'm a healthy 54 year old male, and I thought my groin/hip pain was hip flexor muscles. XRays showed it's CAM FAI and arthritis is moderate to severe in my right hip. I'm floored, and now I'm waiting to see an orthopedic surgeon for a consult.

[@chillyhouse]

thank you! Excellent summary and thanks for the exercises and progressions. I especially liked your discussion of the science of surgery vs therapy. It will be helpful to review the literature. I also especially liked how you gave good reasons to be patient and not expect a quick fix.

[@TheLittlegoaty]

Best FAI video on KZbin. Honest and informative. The others just tell you how you can "clear out" your FAI and fill you with a false sense of hope. If you've got FAI, accept it, manage it through low load exercise and don't force your hip into painful positions (as told by the gentleman in the video)

[@FitNerdz]

Man... so happy I found your channel! Awesome work!

[@SuperstituM]

Underrated video. Ty!

[@PratherCompetes]

You guys are the most underrated PT video source. Appreciate the quality content.

[@robwilkins304]

Fantastic video. You guys have some of the best content on KZbin. Very clear and precise. Thanks for posting.

[@borjavanstokkumsanz]

Incredible work!! Congrats

[@CheburashkaGenovna]

The most comprehensive summary of the FAI on the Internet! 👏

[@modemarcoj8026]

Phenomenal job across the board on this breakdown and guidance

[@AGMeleven11]

Love this channel. Thank you for all these evidence based videos.

[@mahonypa]

Thank you. This is exactly what I’ve been dealing with for 2 years. I even had a surgeon tell me he was certain I had a hernia, I needed surgery, and there was no need for further testing.

[@yavor_zlatanov]

One of the best instructions I've watched so far anywhere. Especially valuable to me were the statistics and citations from recent medical studies which were included in this. Excellent job, sir!

[@papee29]

Just what I needed in my life! Thanks.

[@torpacio]

Thank you for these well detail, explained, and progressed exercises for rehabilitation. This is very generous of you. Thank you again.

[@lowelllomberio]

This is phenomenal. Thank you!

[@gotrainfitness4345]

Very impressive video - thanks for sharing your knowledge!

[@ThePavlincho]

absolutely fantastic video , ty for the work

[@jmvgj99]

Thank you so much for making this with such a high level of detail and research!!

[@SmithsFitness]

This is a great video mate. Thanks a bunch!

[@kimberlywood7783]

Thank heavens for this. I have the symptoms etc and I'm very appreciative of the exercises. Bless you. My right hip is like this.

[@bonquequecodm6885]

incredible video really informative and helpful probably the best ive ever seen

[@hayleywilliams5076]

What a brilliantly informative clip. I have FAI caused by MS and think this clip will benefit me massively!

[@rayspicer4412]

This channel deserves so much more attention. This video is a life saver. Thank you so much for putting this level of time and effort into your videos!

[@E3Rehab]

Thank you, Ray!

[@Zephromonia]

Brilliant video, thank you so much.

[@MrRohirrin]

Thank you !! Years ago I had surgery (bone sanding) for a CAM injury and my rehabilitation was not good, so I have been in pain ever since. I start testing it today !!!

[@xavierharo9909]

Just amazing as allways guys. So clear and simple and with the background of science. Congrats ans thanks.

[@ash785lo]

Like others have posted, this is the most comprehensive and most informative video regarding FAI. I love running. I'm always getting injuries in the pelvic hip region. I can see how they will help strengthen muscles surrounding the hip joints. Thank you for sharing your valuable knowledge!

[@dn1084]

Thank you for doing this video very informative.

[@xxPhilAdelpihaxx]

Amazing info. Thank you

[@DammIhateThisName]

simply the best i have seen.

[@andresmontalvo427]

This video is a gem. I found your channel when I had a contusion injury on my left knee meniscus 3 months ago, and a week ago I could squat 315 once again pain free. Im a personal trainer and Kinesiologist, so I have todo be in constant movement and ranges of motion, which makes getting injured so hard mentally. I went to my physician yesterday and well, he found a bilateral femoral cam deformity. Which causes limited hip flexion and impingement. I have been scared for my life for surgery. All my life ive been focused on squatting as deep as possible below parallel and doing all the range of motion I can. My hips hurt, pop and click from time to time a lot. And im glad Ive found your channel and this video. I always feel splits squats comfortable, box squats and heel elevated squats. I saw you mention those variations and im relief my mind was on the right track. Cause I dont like the idea of surgery worsening my ability to move. Im 24 and have had hip shifts and issues for years. Thank you for the work you do. My physician only told me to squat to parallel but, I think strengthening every muscle around the hip is the way to go.

[@IntelligentProbe]

While there are TONS of YT channels that offer help and fantastic rehab exercises etc... I haven't seen any that give you a detailed path of progression like this channel. And this is the most common question I had and see in the comments often... how do I progress? how often do I train? etc... Top tier channel for sure.

[@beckhameto]

Excellent video! 👍

Your videos are all só great. Thanks

[@juanmartinpayne8332]

"Load management and activity modifications...", these are very good tips. I find this video excellent because it gives vey helpful and comprehensive guide-lines to achieve progressive exercises. Congratulations!

[@ft2078]

Really like your videos, super informative.

[@reganvanas4851]

thanks for the useful and sound info!

[@javierbrokenleg]

Thank you very much for this video!

[@jorgeparente6424]

Best video on the web on this topic

[@Nick-kf3io]

BY FAR the best science based physio channel on KZbin. You guys are brilliant!

[@jlanthony76]

Excellent, thank you!

[@samrehab7316]

Awesome work 👍

[@timcowley3032]

This is absolutely brilliant. Thanks guys 🙏👍

[@E3Rehab]

Thanks, Tim!

[@tataruovidiu9305]

so helpful!

[@jeremy.lichtman]

I keep saying this, but you guys are doing amazing work. Love how the information is presented. Thank You!

[@E3Rehab]

Thank you, Jeremy!

[@NewbeYAHtheVFG]

Happy to have found this. New subbie 🥳

[@josherz7]

Super helpful! Thank you

[@oliverlopez7600]

Great advices... Thanks!!!... 🙏💯🙏

[@lebaronmxfit5948]

Thank you for sharing. I found this info / exercises very valuable. Greetings from Mexico 🇲🇽

[@davebond7380]

Just done the beginners workout top draw I'll stick at this thanks very much buddy

[@kenabelson8423]

I love the clear structure. Just bought your hip course. Will print everything out and do my best. This hip thing has ruined my life. I chatted with you in IG. Thanks for your guidance. I know your story, and looking at your legs and chatting with you, you are an inspiration.

[@debanjansengupta6606]

Maybe if more people got to know about the inspirational story they would be more motivated.

[@Nik-cq1fm]

Awesome video🙌

[@davebond7380]

Thanks ill give this a go cheers

[@mikevaughn2074]

Awesome informative video. I was diagnosed with FAI and had it scoped in 2018. Through PT & Dr my leg w discovered to be 7 mm shorter. We added a 5 mm lift. Although my back issues have gotten much butter but now it’s dealing w the changes in my gait etc from the lift. Any ideas or tips are MORE than welcome!!!!!!!

[@DropkickMangan]

Excellent video. Had a brodstrom repair on opposite ankle, only to discover a cam lesion. This is totally on point. I’m still in discomfort 2-3 months after diagnosis but slowly getting better. Really wanted a video with everything in one spot. Cheers. Also, what shows are you wearing??

[@chukupuku3978]

The best video on the net on FAI. I have been following the topic since my pelvic pain started about two and a half years ago, I have read dozens of physiotherapy books, thousands of videos on KZbin but the content you have brought was the most comprehensive, thorough and clear. I'm happily subscribe to your channel. I would be happy if you upload more videos and exercises on FAI, thank you very much in advance.

[@E3Rehab]

Thank you!

[@chukupuku3978]

@@E3Rehab Thank you, Dr!!!

[@sujitprathameeshravichandr127]

Hey man is there a way to contact you?

[@javierstrickler920]

Solid review and exercises

[@E3Rehab]

Thank you!

[@rb3883]

What an amazing video, thank you. Would you combine the core exercises you described with plyometrics in a single sessions and if so, any order preference. And would you recommend foam rolling before the session and stretching after? Thx again

[@soranhernandez6425]

First video I've seen of this guy and he reminds me of a rehab orientated Jeff Nippard! Awesome content and absolutely helped me!

[@Bunin888]

great job

[@dulcemejia8305]

Excellent

[@ziad4996]

Thank you for the complete instructions, excellent information My question is should some of the exercises be done on one side or both. Like the side plank for example?

[@imassageandstretchcomMiami]

This was amazing! I've been diagnosed with FAI trying to avoid surgery. Goingbto give this routine a try. Thanks again, blessings

[@Jkanderson1]

I had the surgery a few months ago and glad I did. Hope physical therapy or workout routines work for you.

[@trentriver]

Incredibly well done video. Question. Do you work the "good side" as well as the "bad side", assuming only 1 side is troublesome.?

[@spindleblood]

Hey, this is a great video! The most comprehensive one I've seen so far. Recently, saw my doc for left groin pain. Was told I have FAI. Had the hip/leg rotation/adduction test plus x-ray and MRI. I'm a bodybuilder. I squat and deadlift often. Why did my doctor recommend sumo squats? Don't those also cause the femur to grind into the labrum tissue/acetabulum if you have an impingement? I will say that I've been doing them sumo style with lower loads and it doesn't hurt like narrow stance squats... maybe because I'm abducting out instead of adducting? I noticed when I used to squat narrow, sometimes my knees would get pushed inward which I didn't think was safe/ok. Maybe that caused my FAI to aggravate my labrum? I wish I had started out with sumo squat only. :( hindsight 20/20 though. I have yet to try sumo deadlift....

[@eh3535]

Two complete hip replacements(. 6 years apart) I used most of these exercises post surgery ( not right after surgery ) to get my legs/hip back in shape, great video

[@ludwigstenberg1050]

Are your hips healthy now?

[@stevenlaupert3089]

Congratulations on a comprehensive well explained video. I am a newbie and ignorant to health. When I was in my twenties I was a healthy fit person but I’m two months from 58 and I can’t walk use two canes to get from point a to point b. So I am all in and hope to utilize your information to get healthy. Oh yeah almost forgot the reason for this comment is first to say thank you and how about knee pain? I have hip knee back and groin pain. My back pain is almost gone but now I have knee pain with my groin hip and glut pain. So what about knee pain? It’s definitely tied into the groin hip and glut pain because I can press certain areas and relax the pain or stop it all together. Ok and by the way your in unbelievable condition your leg muscles are unreal Tom plats I tell you.😀 much thanks

[@chimauwah8133]

Thanks!

[@ZackTheDude]

Loved this video! I just recently found out my hip pain is due to FAI. I was wondering if you have any input in regards to FAI leading to arthritis? That’s the one thing my healthcare provider keeps emphasizing to me, but I’m just unsure as it is feels like I’m being given more of a heavy sales pitch to get surgery.

[@nick2aim431]

After suffering with FAI for 1 year I have finally found the video with all the information I need, concisely, all in one video.Do you have a time frame in which you expect recovery, if so, what is it?

[@kutaibakassar141]

Thanks for the great video but which part of it is for internal rotation because I have had pain for 5 years

[@jackliang567]

Great Video and content! Got a question, why the pain threshold for this condition is no more than 2, while for other conditions such as tendinopathy is no more than 4? Thanks!

Thanks

[@jethronilescynricdeleon9629]

thank you for this info i've been using the banded mobilization, yes its effective but i keep on noticing that the pain keeps coming back

[@khrisnoboa2906]

Thanks youu Im a gym heavy lifter and I got pretty sad because this pain is annoying but u gave me exercises that I love so I’ll try to get better 🫶🏻 my question I usually stretch before training, but hip abduction It bothers me. I do these exercises to have a better range of movement and activate the muscles but most of the common ones are difficult for me. Do you have any exercises in mind?

[@tymeomanzimunyamashara7017]

Fantastic

[@madelinepepin]

Thank you!! I've been looking for some strength related training videos for FAI. This was more informative than a $130 PT appointment. Thanks :)

[@yevhenhrodzitskyi2376]

Did you feel a pain in the lower back area? My PT said that that location can't be associated with FAI

[@madelinepepin]

@@yevhenhrodzitskyi2376 No back pain.

[@KatJ3st]

I notice a lot of THR patients complain of this issue post op. I was lucky I got a kinesiologist to work on my glute strength and form with exercises.

[@pepitogrillo8228]

Hi, When you said 3X60 seconds ¿Do you mean 60 second isometric contraction or various repetitions during 60 seconds, for example 6 10second contraction x 6 repetitions? Regards from Spain.

[@Knud451]

Thanks a lot! What if the pain/symptoms occurs only with activities and very little in the clinical tests? Is that an indication of something else?

[@Jkanderson1]

I'm in my 20's and just had FAI surgery 1 week ago and I already feel relatively mobile and flexible. Also keep in mind FAI and Hip Replacement are different things. Hip Impingment ususally results in surgery by resurfacing the hip in order for the ball and cup of the joint to fit. It's also a less invasive surgery, since the surgeons use 3 small rods to reach your hip(minimal scaring). I was hesitant as well to get surgery, but I was already a person who is in shape, bodybuilds, and did physical therapy for 6 months prior to surgery. There also may be more problems going on in/around the hip such as calcium deposits, tears in ligaments/other tissues, etc., that require surgery regardless of wanting to due FAI surgery (which happened to be my case). Make sure to get a MRI and X-ray done to ensure your FAI hasn't affected more then just your hip, otherwise physical therapy in order to strengthen muscles around your joint won't help or fix your FAI anyways. This is also information I received by my own research on scientific articles as well as speaking to several doctors. Simply put - Would you rather have your joints misalligned with muscular support from physical therapy, or have alligning joints with muscular support from phscial therapy? At least one might fix your problem.

[@SanBr1]

how is your recovery going? i had hip arthroscopy around the same time as you

[@Jkanderson1]

@@SanBr1 Fantastic. I stuck to doing my physical therapy every day and going to a Physical Therapist twice a week. I wasn't walking for a couple days at first, but have made it to now running and playing any sport better than before without thinking about my hip. I can walk at my job for 12 hours a day(25-30k steps). I would say I'm weaker in certain areas when working out and felt some discomfort during certain exercises, but its progressively getting a lot better. My flexibility isn't to where I want it to be, but it takes awhile to stretch out scared tissues and muscles. Overall I'm very glad I did the surgery and expect to be 100% very soon. How's it going for you.

[@jarman65]

How is your recovery going after 9 months? I have a similar background as you but I'm 32 and still considering surgery after being diagnosed by my ortho. Were you able to continue doing upper body weighlifting and at what point were you able to start running again?

[@debanjansengupta6606]

Aren't leg lifts/raises a good way to train the hip flexors? Like lying leg raise, then hanging knee raise, etc....?

[@overshare7]

I am pretty sure I have fai but never diagnosed, the only thing near a diagnose was a us that showed tendinitis to the r femoralis tendon. I have both tests positive some parestisia on this leg lately and it was a trauma after a stretching yoga pose (cobra pose)

[@RoryDavidWatts]

This is an excellent overview, thank you. I've had FAI for 3 years with cam morphology + cranial femoroacetabular retroversion + labral tears on both sides. I've avoided surgery so far, but the times where I've had the worst experience is when I reached for the "quick fixes", which you rightly shrug off. Slow progression, taking note of how irritation is caused, and gradual exposure to positive load have helped me the most. Your video does a great job of outlining routes to progress, cheers.

[@borjavanstokkumsanz]

3 years too for me

[@yevhenhrodzitskyi2376]

Did you feel a pain in the lower back area? My PT told that those location can't be associated with FAI

[@RoryDavidWatts]

​@@yevhenhrodzitskyi2376not me, at least nothing that feels causative (the occasional stiffness). Lower back pain could certainly present lower

[@devonbriggs4513]

​​@@RoryDavidWattsWhere did you have pain? Was it more in the groin area?

[@RoryDavidWatts]

@@devonbriggs4513 It varied over time. Originally groin yes. After managing movements, strengthening adductors, avoiding excessive flexion (e.g. deep squats), and now there is mainly irritation on the lateral aspect which feels more like a glute tendinopathy than anything else. E.g. I can run for about 45 minutes now, but the last 20 minutes feel like I've bruised my glute, and it's sore with every step. This is the residual issue now.

[@TheTkndnv]

Good video, thanks. But wouldn't these exercises potentially cause a labral tear (if you don't have one already) since FAI predisposes people to one?

[@timmaloshtan557]

Great instruction! But it seems like it only deals with 'weakness' part of the equation. What about tightness? Are there any guidelines on which muscles to stretch for FAI and how to stretch them?

[@thearrsfan]

Very good question that also i want to ask and learn. At the streching part of this, i have right hip pain with hip extension + external rotation + little abduction position. Plus crack sound wit hip rotations. I find etiology of this M. Pectinous (function of Pectinous muscle adduction + flexion + internal rotation of hip.) And other hip Adductors (adductorlongus/brevis/magnus and m.gracilis). However iliopsoas bursitis or tendinitis can make same symptoms. How can i go differencial diagnosis?

[@nicholassaal1776]

This is a very good video. Thank you. I was waiting for the "buy my plan for so much a month to find out how" etc but no, there is a lot of very informative information here. Sounds like I need to dedicate myself to the rehab in this area. I have suffered for too long. One glute is weak as hell and I am recovering from a bilateral herniation of l4/L5 9 months. I swear the two are linked somehow. Don't let the surgeons in unless there is no other option I say. Many thanks again. Nick age 46.

[@banukerk]

I have no symptoms when doing the Fadir test but do have pain in the Faber test. What could this mean?

[@user-hr6uj3px6x]

as a a recently graduated PT my self i have had a patient present to me and was a bit unsure on whether i had the correct diagnosis and was wondering if you had any input, the Pt was a 22yr old female dancer presenting with pain in the adductors and hip the patient had pain with resisted hip adduction in 90 degrees flexion, pain with resisted hip flexion, pain with faddir, very limited hip internal rotation in 90 degrees flexion and pain provocative, hip ir in prone was normal and not symptomatic pt had top over the adductors faber normal i diagnosed her with fais , treated her with hip mobilisations which signicantly improved ir by almost 3-4x improved flexion range and sent her away with hip rom exercises, strength work- isometric copenhagens for the groin and left it at that as she was quite symptmatic and sore on presentation. i was just wondering if you think the groin hypertonicity and pain was as a result of somatic reffered pain from the hip or was there an element of activity related hip and groin pain

[@pritime21]

Is it possible to have FAI after a hip replacement?

[@altodude890]

I recently got official diagnosis cam type impingement and doctor basically told me to deal with it . I’ve had it for years and it’s gotten worse and my hip now crunches every step I take . I really hate it and it’s not excruciating pain it’s just a gross broken feeling and the more active I am the worse it is . Doc still gave me an order for an mri if I wanted to Pursue it but I’m worried that insurance is not going to cover it .

[@Jakobguldager70]

Hi! Great stuff! How come you're focusing on isometrics on many of the exercise progressions? As opposed to isotonic at say 3x10RM?

[@E3Rehab]

It's just an option to get comfortable with challenging positions. Isotonics work as well.

[@mrmagorium12]

Is this safe to do for someone who has a labrum tear? I have FAI cam lesion which resulted in a torn labrum confirmed by MRI. Can I still do these exercises and not make it worse? Really want to avoid surgery

[@Knud451]

Thanks a lot for the info! Do you also use the Vivo for squatting when you're training (not just in this video)?

[@E3Rehab]

I don't normally barbell back squat, but yes, I use them for training.

[@Knud451]

@@E3Rehab thanks a lot!

[@dennisrond3286]

Such a great video! So, it would be good to start with Bulgarian Split squats? I was in the assumption to avoid the movement of the upper leg and the hip going into a 90 degres angle. Or is this not correct?

[@yevhenhrodzitskyi2376]

Did you feel a pain in the lower back area? My PT said that that location can't be associated with FAI