What’s the True Link Between FAI Bone Shapes, Hip Pain, and Hip Arthritis?
Conventional FAI Orthopedic Theory Comes Up Short on How Bone Shapes Affect Hip Pain, Arthritis, and Movement. Diagnostic Scans and Studies Tell a More Accurate Story.
FAI and Arthritis: Scrutinizing Orthopedic Theory
The current theory of FAI and pain is that malformed bones lead to degenerative changes in the hip joint, resulting in pain and discomfort. That means even if young people with these bone shapes have no symptoms, they likely will as they get older because those shapes lead to osteoarthritis (OA) later in life, as joints wear down with age and use.
There’s a major hole in this theory: FAI has NOT been shown to lead to arthritis.
FAI Is Not a Precursor to Arthritis
If FAI bone shapes eventually lead to arthritis and joint damage, it would certainly make sense to try to fix the bone shapes as soon as we spot them. But studies show they don’t.
In 2011, researchers published a study where they looked at the long-term outcomes of patients with no hip problems but who had FAI bone shapes. They looked for any relationship between those bone shapes and the development of hip osteoarthritis.
They found no link. And their summary states it plainly: “We conclude that a substantial proportion of hips with femoroacetabular impingement may not develop osteoarthritis in the long-term. Accordingly, in the absence of symptoms, prophylactic surgical treatment is not warranted.”
Then in a 2015 study, researchers looked at 547 athletes with an average age of 67. None of the athletes had hip problems. Researchers evaluated them for signs of FAI, osteoarthritis, and hip dysplasia (another story altogether). They found a stunning 83 percent of the athletes had signs of FAI in their x-rays.
Their conclusion: “Radiographic findings consistent with FAI in these senior athletes were common and were not associated with the presence of OA. These data suggest that the need to screen for asymptomatic young athletes for radiographic evidence of FAI … may not be necessary.”
In other words, having the alleged bad bone shapes doesn’t lead to hip problems even when you’re a senior-aged athlete.
Think about this: The FAI bone shapes are present in young people in high numbers with no apparent ill effects. And a 67-year-old can have the FAI bone shapes his or her whole life and still suffer no ill effects.
That means the bone shapes are not related to hip pain when you’re a teenager or in your 20s. And the bone shapes don’t lead to hip degeneration or hip pain when you’re older. So now what reason would we have to fear the bone shapes?
The answer is that we don’t have a reason to fear the bone shapes. They are clearly not the cause of hip degeneration for the young or old. This completely undermines hip surgeons’ theories about hip pain and bad bone shapes.
A Self-empowering Strategy that Works: the FAI Fix
If FAI bone shapes, arthritis, and pain aren't related, it makes sense to put our attention on something other than bones.
What else is there? Muscles and movement.
Hip impingement is a problem that shows itself generally with movement, and movement requires muscles. You want to move your muscles properly in order to move your bones safely and without pain. Even something as simple as sitting requires healthy muscle activity for you to feel comfortable, capable, and confident.
The FAI Fix is designed to help you focus on strategies that help you retrain muscles for better hip-joint function — regardless of what studies or diagnostic scans show.
What about success rates for surgery for hip impingement? Read: Can Surgery Guarantee Improvement for FAI?