Femoracetabular impingement – also known as hip impingement – has become the go-to diagnosis for anyone who has hip pain and range of motion restriction. It is a diagnosis that was not even around until 2003 (when a group of surgeons proposed it as an explanation for pain, range of motion problems, and even arthritis), but its prevalence has exploded in the last 15 years.
People who receive the diagnosis often look for alternative treatments besides surgery. Often surgery is presented as the only legitimate answer to hip impingement because the conventional understanding of FAI is that it is a problem caused purely by misshapen bones. Since you cannot change bone shapes with any method other than surgery, surgery is your only option of recovery.
This line of thinking is based on numerous assumptions that pin the existence of labral tears, cartilage damage, and pain on the bone shapes. When this whole perspective was introduced, it was introduced by surgeons looking for a plausible explanation to tie all these things together. FAI gave them a plausible explanation, and surgery to correct the problem was the obvious choice.
However, there are numerous problems with theory and the diagnostic process. Check out this video for a full explanation of the many problems with the diagnostic process as it exists today.
As you can see from the flow chart in this video, the case for FAI being a problem of bone shapes is a weak one at best. Old data and old beliefs are still being used to justify surgery. Recent data and recent studies simply do not provide any evidence that the old theories are true and/or healthy! Virtually every step in the diagnostic process is fraught with erroneous assumptions – all of which lead to an eventual recommendation of surgery.
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