Femoracetabular Impingement (“FAI”) is a near and dear topic for us at Upright Health. We have had countless clients at Upright Health who wanted conservative treatment for FAI (meaning NO surgery). 

Unfortunately, many people diagnosed with FAI get pushed toward unnecessary hip surgery every day. There is plenty of controversy around surgery for FAI. Recently, researchers started to publish studies comparing the effectiveness of surgery with conservative treatment for FAI.  

The usual conclusion is that surgery is more effective than the non-surgical option. These comparative studies usually use the best available surgical interventions. But the conservative treatments are not what we consider...

This is part II of a three-part series.  If you haven’t read part I yet, check it out as I explain my two biggest reasons for not getting surgery after being diagnosed with Femoroacetabular Impingement. 

In this article, I’ll dive into the main strategies I utilized that helped me get out of hip pain. The strategies below are not specific exercises but more general principles that led to important breakthroughs during my training. 

(1)  Looking “Beyond” the Hip Pain

When I first began troubleshooting my FAI diagnosis and hip pain, I kept trying to find that one exercise that “fixed” everything. That one movement pattern I can optimize that held me back from a healthy...

Thinking about surgery for hip impingement? Years ago, I met online with a young attorney named Maks in New York City who was afraid he needed to get hip surgery. He had lost the ability to play basketball. His doctors were sure he needed surgery to fix his hips. He was told he had femoroacetabular impingement, and the only solution for it was surgery. 

It is now 4 years on, and this is Part 1 of Maks' story...

Getting ready for hip surgery

It was the fall of 2014 and I had just stepped out of yet another appointment with my highly-respected Manhattan orthopedic surgeon. Unlike prior appointments, though, I pulled the trigger and scheduled  surgery to finally cure my hip pain once and for all.

I’d already gotten...

We’ve talked about hip impingement, the success rates for FAI surgery, and even if surgery is worth it. But what if we compare the results of treating hip impingement with surgery versus physical therapy?

A study published in the American Journal of Sports Medicine in 2018 compared the outcomes of patients with a femoroacetabular impingement (FAI) diagnosis who underwent different treatments: hip surgery or PT. Researchers measured the outcomes six months, one year, and two years after the treatment.

This study is very interesting as it is the first we’ve seen that actually does a side-by-side comparison.

Why compare FAI surgery to physical therapy? 

First, there’s relief from hip pain. 

Nobody likes...

When people are considering surgery for femoroacetabular impingement, they often hear some extraordinary predictions of success. One client with hip pain said his surgeon gave him 99% certainty that hip surgery would cure his hip pain. I’ve had people email me from around the world say their hip surgeons are 90% certain that the hip surgery will solve their FAI hip pain.

And yet you hear a never-ending chorus of hip surgery patients say that their hips are no better after surgery. 

So, what is the real FAI surgery success rate?

Is the FAI surgery success rate at 90%?

I’ve posted on this topic before, and if you haven’t read that article, it’d be a good idea to do so now....

If you have hip pain, are PRP (platelet-rich plasma) injections worth it? Will PRP injections help with knee or shoulder pain? What about your elbow or foot? Let’s see what the science says so you can make an informed decision.

Why talk about PRP injections? 

We work with a lot of clients who have had chronic hip, knee, back, and shoulder pain. Our clients have usually spent all kinds of money and time trying to fix their aches and pains with massage, chiropractic, physical therapy, dry-needling, acupuncture, etc. etc. 

When those approaches fail to help, people often get desperate. And that’s when PRP injections pop up on the radar.

The premise of PRP injections is that all you need to do is pull some...

You’ve been told you’ve got hip impingement. You don’t want surgery. You’ve started learning how to exercise your hips and to do massage work on yourself. Now you’ve discovered TRIGGER POINTS!

Someone posed this question on a Facebook support group for people who are suffering with femoroacetabular impingement (FAI):

I do have a question about muscles that need strengthening (as glutes) but that are painful because full of trigger points…same for muscles that need stretching but are full of trigger points. What do you suggest in such cases? I know that muscles with painful trigger points shouldn’t be stretched or strengthened, you should first get rid of the trigger points otherwise they...

When you do research on FAI surgery, you often come across numbers that sound spectacular. You find claims that hip surgery for FAI is about 80% effective in curing your hip pain.

If this number were correct, surgery for FAI would make a lot of sense. Why suffer with hip pain, clicking, and snapping when you can just do a surgery and be 100% back to normal? Everyone wants to be able to move well, play sports, and enjoy their daily lives, right?

What’s the real success rate for surgery for femoroacetabular impingement?

The real success rate of surgery for femoral acetabular impingement is unfortunately nowhere near 80%.

A study published in January of 2013 investigated the relationship between patient expectations and hip...

If you've been told you have a labral tear and that it's the cause of your shoulder pain and movement issues, there's something you need to know: Labral tears are not as important as your doctor thinks.

Labral tears don't have anything to do with pain - as near as we can tell.

For many years, the conventional medical wisdom has been this: if we can see something "torn" in your shoulder, that must be the reason you have pain. Based on MRIs and this belief, surgery has long been proposed as a way to solve shoulder pain that appears to be "caused" by labral tears.

If, in fact, the labral tears are causing people shoulder issues, we should be able to take someone off the street and, if we find a labral...

New Study Compares Arthroscopic Surgery for FAI to Conservative Treatment

In a recent study, researchers compared the effectiveness of arthroscopic surgery for FAI versus conservative treatment (non-surgical methods and physical therapy).[1]  The researchers concluded that surgery for FAI was more effective than non-surgical treatment.

Other studies have shown that physical therapy and surgery for FAI are equally disappointing. So like any study, sometimes you have to lift the hood and look at the fine print to see what's really going on. 

An analysis of the data actually shows us that neither FAI treatment was that good.  Arthroscopic surgery for FAI showed weak results. The nonsurgical treatment for FAI showed weak...