Hip Impingement (FAI) Physiotherapy in Sydney CBD

That sharp pinch deep in the groin when you squat, sit for too long, or load your hip at end range. It’s not a hip flexor stretch that will fix it. It needs a proper diagnosis and a structured plan.

City Physio & Pilates assesses and treats femoro-acetabular impingement (FAI) at our Sydney CBD clinic. Whether you’ve already had a diagnosis or you’re still trying to work out what’s going on, we’ll give you a clear answer and a clear path forward.

What Is FAI (Femoro-Acetabular Impingement)?

Femoro-acetabular impingement is a condition where the ball (femoral head) and socket (acetabulum) of the hip joint make abnormal contact at the end of certain movements — particularly hip flexion, internal rotation, and adduction. This abnormal contact causes pinching of the soft tissue structures between the bones, producing pain and, over time, potential damage to the hip labrum and cartilage.

There are two structural types:

Cam impingement — extra bone on the femoral head creates an irregular shape that jams into the socket during hip flexion. More common in men and in people who were very active during adolescence.

Pincer impingement — the acetabulum (socket) over-covers the femoral head, causing the labrum to be pinched during hip movement. More common in women.

Mixed impingement — a combination of both, which is actually the most common presentation.

It’s worth noting that many people have the structural features of FAI on imaging without any pain. What matters clinically is the combination of structural findings, movement patterns, and loading history — which is why a thorough assessment by an experienced physiotherapist is essential.

Symptoms of FAI

Deep groin or anterior hip pain — often described as a catching or pinching sensation
Pain with squatting, deep hip flexion, or getting in and out of low chairs or cars
Discomfort sitting for prolonged periods
Pain during or after sport — particularly running, cycling, martial arts, football, or dance
A feeling of stiffness or restriction in end-range hip movement
Clicking or catching with certain movements

FAI is common in active people aged 20–50, though it is seen across a wide age range.

How Physiotherapy Treats FAI

Surgery for FAI (hip arthroscopy) is sometimes appropriate — but the evidence is clear that well-delivered conservative physiotherapy produces equivalent outcomes to surgery for most presentations, and surgery outcomes are significantly improved when preceded by thorough physiotherapy rehabilitation.

Physiotherapy for FAI at City Physio & Pilates includes:

Movement pattern retraining — identifying and correcting the movement habits that increase impingement force. This includes squat mechanics, hip hinge patterns, gait, and sport-specific movements.

Hip and lumbopelvic strengthening — weakness in the deep hip rotators, gluteals, and core musculature is consistently associated with FAI symptoms. A structured strength training programme is central to long-term management.

Load management — identifying which activities provoke impingement and modifying them appropriately while maintaining fitness and function.

Manual therapy — hip joint mobilisation and soft tissue work to optimise joint mechanics and reduce pain during the early treatment phase.

Clinical Pilates — for hip control, lumbopelvic stability, and movement retraining in a supervised, progressive environment.

Surgical liaison — where conservative management has been thorough and symptoms persist, or where imaging shows significant labral or cartilage damage, we work with your orthopaedic surgeon to optimise pre- and post-operative rehabilitation.

FAI and Hip Labral Tears

FAI is one of the most common causes of hip labral tears. The repeated abnormal contact between the femoral head and acetabulum progressively damages the labral tissue, leading to tearing. If you have been diagnosed with both FAI and a labral tear, the physiotherapy approach addresses both — read more about hip labral tears here.

Frequently Asked Questions

Do I need surgery for FAI? Not necessarily. Many people with FAI manage very well with conservative physiotherapy, particularly when the structural changes are mild to moderate and symptoms are driven by movement patterns and loading rather than significant labral or cartilage damage. Your physiotherapist will give you an honest assessment of where surgery fits in your picture.

Will FAI get worse if I don’t treat it? Untreated FAI with ongoing provocative loading can contribute to progressive labral and cartilage damage over time. This doesn’t mean catastrophising every squat — but it does mean addressing the contributing factors rather than pushing through pain.

How long does FAI rehabilitation take? Most people see meaningful improvement within 8–12 weeks of structured physiotherapy. Full return to unrestricted sport or activity can take longer depending on severity and what you’re returning to.

I’ve had a cortisone injection and it didn’t help much. Can physio still help? Yes. Injections can reduce inflammation and pain in the short term, but they don’t address the movement and loading drivers of FAI. Physiotherapy targeting those factors typically produces better sustained outcomes.

Book a Hip Impingement Assessment

City Physio & Pilates | 25 Martin Place, Sydney CBD | Steps from Martin Place Metro and Wynyard

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