Staying Fit with FAI Hip Impingement

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If you have FAI hip impingement, then figuring out how to stay active without pain can be challenging. Here’s my story about staying fit with FAI and my journey through hip pain

If you have FAI hip impingement, then figuring out how to stay active without pain can be challenging. Here's my story about staying fit with FAI and my journey through hip pain | thefitcookie.com #fai #health #fitness

So you might be reading the title and wondering what the heck is FAI? FAI is short for femoroacetabular impingement, a condition where there is abnormal impingement in the hip joint where the acetabulum meets the head/neck of the femur and causes non-arthritic joint pain.

There are people that have this and it never bothers them, but very active individuals tend to find out about it sooner than most since their active lifestyles can bring about hip pain. FAI isn’t caused by exercise, but exercise can exacerbate it and cause flare ups. FAI is actually a deformity in the hip joint itself that usually occurs during bone growth and development in childhood.

Read my other post about how to safely do yoga with FAI

There are a few different kinds of FAI: cam impingement, pincer impingement, and a combination of those 2. I have pincer impingement in both hips, with a bone spur in my left hip joint.

I was officially diagnosed with FAI last summer when I was having increasing pain, aches, and stiffness in my hips after doing lots of PiYo. I was doing PiYo nearly every day preparing for my upcoming class, and I was really working hard at increasing my flexibility. During my practice and classes I was really pushing into my hips. Bad idea.

I misinterpreted my limited hip mobility as a flexibility problem and didn’t realize that it was really a mechanical joint problem. Pushing through my hip stretches made my hip joints hurt and ache! My physical therapist was the one that figured out what was going on, and recommended I get hip x-rays.

Sure enough, I had FAI as she suspected and if I had continued to push myself I could tear the hip capsule cartilage (labrum) which requires surgery to fix.

Finding out I had a joint deformity was rough at first. I felt so limited in what I could do and mentally I was frustrated to find out I had a permanent hip disorder. I cried, and felt powerless and frustrated. I thought for sure I was going to have to give up PiYo and yoga completely.

I really enjoyed teaching my fitness classes and loved that I was getting better at PiYo, getting stronger and more flexible, but my hips posed a problem. My increased hip pain spread into everything else I did: squats and lunges hurt, rowing was painful, and bike riding grew uncomfortable even though those activities posed no problems before I regularly started PiYo. Sitting for lengths of time then getting up to walk was painful. I started limping around and people noticed.

I didn’t try to keep my health problems from my students: I had to modify my moves or quit, so I provided my class with modifications that I was doing and why I was not able to do certain things. Everyone was super understanding and very gracious! When I got sore or stiff, I told my students I wasn’t moving as well that day and I would be moving slower.

The doctor was going to give me cortisone shots in my hips but I decided against them. I decided to try and help my hips myself and get a second opinion if things would not improve. I modified my PiYo moves and I stopped doing so many squats and lunges until the inflammation had gone down considerably.

If you have FAI hip impingement, then figuring out how to stay active without pain can be challenging. Here's my story about staying fit with FAI and my journey through hip pain | thefitcookie.com #fai #health #fitness

I can keep doing PiYo and yoga as long as I watch the deep hip-hinge poses

I also started taking more anti-inflammatory supplements like turmeric, quercitin, and tart cherry extract to manage the inflammation in my hip joints. The doctor had said he didn’t see any arthritis in my hip joints, so the pain at this point was mostly mechanical so I could manage the inflammation in my joint.

Since being diagnosed with FAI last summer, I had to make a conscientious decision to really watch the hip-opening yoga poses and deep hip-hinging poses like low lunge, 3 point balance, single leg down dog, etc. I started using a yoga block in low lunge and that really seemed to help.

I also had to make sure that I was using my muscles in each position instead of simply sinking into my hip joints. I cut back on how many days a week I did PiYo and yoga so my hips had a chance to rest. I also started using a TENS unit so I could help my hips recover better.

So far, have been able to manage things pretty well! It has taken months to heal, but my pain and stiffness has finally subsided and I didn’t have to get cortisone shots. I may eventually have to get surgery on my hips if bone spurs continue to grow and impingement increases, but we are hoping to avoid surgery.

I have never had surgery before yet (knock on wood) and if I can make it through life without having surgery I’m all for it!

And I have had to come to grips with the realization that I simply cannot do things like everyone else: I can’t squat below parallel, I can’t do a great pistol squat, I will never touch my nose to my leg in 3 point balance… BUT I can do other things and I need to focus on what I CAN do instead of the things I CAN’T do!

Resources and info on FAI:

If you have FAI hip impingement, then figuring out how to stay active without pain can be challenging. Here's my story about staying fit with FAI and my journey through hip pain | thefitcookie.com #fai #health #fitness

31 thoughts on “Staying Fit with FAI Hip Impingement”

  1. How are you now? I ask as I have bought a concept 2 rowing machine this week as want cardio without load bearing but I have FAI. I’ve been in lockdown. I thought a rower would be better than a stationary bike.

    Reply
    • Hi Anita, I think a rower is fine if you don’t have a ton of inflammation and pain in your hips. I still have limited range of motion in my left hip even after my hip surgery, and my right hip still has FAI but I’ve not had as many problems with it. I just used the rowing machine the other day and did fine with it. You can give it a try and see how you do with it. If it causes pain in your hips, you might try a different machine.

      Reply
  2. Hi Sarah,

    Brilliant article!! You say you used EMS, did you do it directly on the hinge if your hip? I was going to do this but worried about the femeral artery.
    Many thanks, Louise.

    Reply
  3. Hiya Sarah.

    I really did enjoy your bio. I’ve just been told that I have suspected FAI by a physio, although we can’t be positive without an CT.

    I’m very active and this is quite a hit for me as I’m a keen runner and cyclist. I’ve had discomfort in my hip before when I run over 3 miles but just kind of put it down to running being hard on your body in general.

    Ive started getting dull aching and discomfort whilst sitting down and pulling/tightness when walking which worried me. These days I just want to lie down and not move! I’m 34 and out door need a endurance sport to do.

    I’m a nurse and I’ve seen hip surgery it’s brutal and that just getting to the area they will need to adjust. No thanks! I have a appointment with a rehab PTI tomorrow morning so hopefully I’ll get some answers.

    Anyway, was refreshing to read this and the comments. Nice to know that I’m not alone.

    Reply
    • I’m glad you found us Abby! I hope you can find some relief, it’s definitely frustrating when our bodies don’t work the way we want them to or expect them to. But seeing a physical therapist should help!

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  4. I misinterpreted my hip mobility problem as a flexibility issue too!!! I just couldnt understand why my lunges were hurting me soo bad. Now I understand. This is a great article and it really resonated with me. This has been an ongoing battle the last 2 years and I finally am pointing a name to my hip issue. FAI. Ive decided not to do lunges anymore. Instead I will be strengthening my muscles.

    Thanks for posting this. I hope you have a pain free and peaceful day.

    Reply
    • Hi Rob! If you have poor hip mobility and pain with lunges, it’s best to get x-rays and have FAI diagnosed by a orthopedist. There can be multiple reasons why your hips might be hurting, so it’s always best to get to a doctor and not self-diagnose using a blog post (we don’t want this post to be taken as medical advice). I hope you can get some help for your hips! 🙂

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  5. That was a really helpful article. I was diagnosed with FAI last spring and went through a very similar journey to what you describe here. The frustration with limitations, the desire to find creative solutions to work around it. Thanks for sharing

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  6. If you are living with FAI and have the means to do so, I would highly suggest hip arthroscopy to sculpt the joints.

    I am a former college athlete and have had FAI pain in both hip joints. I began treating my pain conservatively with physical therapy and other methods (Egoscue, Yoga) but just wasn’t able to keep an active lifestyle as the pain would always return. My activities include sports, running, weight lifting, and I am not ready to give those up at age 26.

    After having surgery, I was able to fully return to all activities after 4-5 months and am pain free. It also helps preserve the joint from further damage.

    Good luck everyone, I know FAI is a tough one to deal with.

    Sam

    Reply
    • Hi Sam, thanks for sharing your experience! I’ve considered having that surgery, my physical therapist has talked to me about it. It’s a tough one for sure, the pain in my hips comes back a lot more easily now, and it’s a struggle for sure. Not sure I’m ready to have surgery on my hips yet (I’ve had 3 surgeries this year so far for other things), but I’ve heard that hip arthroscopy can make a big difference for people.

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  7. HEllo,

    There is a program geared for people (especially athletes) who have FAI for them to gain mobility again. The program is called “The FAI Fix” and was created by several athletes who had the issue.
    P.S. They also have a Youtube channel as well

    Reply
  8. Hey there!

    I recently found out I have FAI in both hips. I’ve been a long distance runner for awhile and recently got into yoga. I’ve had to take over a month off and have been at a loss of what is the best step into working out again. Everyone, doctors included, seems plenty able to say what you can’t do but so little on what you can. I definitely want to look into PiYo after seeing this article. Would love if you could share more on staying fit with FAI. 🙂

    Reply
    • Hi Ellen! Sorry to hear about your hips, it’s frustrating when we find out about that kind of stuff 🙁 Were you doing good before you started yoga? I would be cautious about what poses you do in yoga, and I would also be careful about getting into PiYo. Since it moves faster and can be more aggressive than yoga, it isn’t always great if you have inflamed hips. Yoga and PiYo aggravated my hips until I began to modify things quite a bit. My hips are doing good now, but it took over a year for the inflammation to go away since I decided against cortisone shots and even now certain yoga poses are troublesome for me.

      If your hips are inflamed, focus on exercises that don’t aggravate them, like swimming, walking, the elliptical, maybe biking (if your hips feel okay with it). I’d avoid any deep hip motions like the rowing machine for a while, and be careful with squats and lunges. Some yoga poses like down dog and warrior 2 are okay if you’re watching how you’re hips are feeling, but be careful with really fast-paced yoga or fitness classes since you may need to take some time to make sure your postures and movements are comfortable.

      I’ve had several people message me and ask for some tips on how to do yoga with FAI, so I plan on creating some more content around FAI within the next month or so. I plan on doing some videos on which yoga poses to avoid with FAI, so stay tuned for that!

      Reply
  9. Hi,

    I also have FAI. Got surgery on both hips four years ago. I can’t do Yoga or Pilates at a normal GIM since I don’t know exactly which moves I should be doing and which positions are bad for me. Regular instructors don’t have this information either.

    It would be life-changing if you could upload a class of Yoga or PiYo especially for those with FAI! I would make that my daily routine.

    I hope you do it!

    Reply
  10. I also have FAI, Bilaterally, lucky me. I am a former runner and it kills me not to be able to run! I have become stiff from lack of movement and saw a piyo infomercial and googled if it would be good with FAI… hence how I came across your page.
    I have had two rounds of hip injections and they offered some temporary relief for a short time. I need to find something I can do to help me feel better. I know I feel worse not moving. I do not want to have surgery unless it’s my last alternative.
    I’d love to chat and keep up to see where you are in your progress. Sounds like I’m not alone.
    Any suggestions would be appreciated and welcomed!
    Katie

    Reply
    • Hi Katie! Sorry you’re not able to run 🙁 It took me about 6 months to get the pain in my hips to go away mostly through modifying what I was doing. But I have to preface that by saying that I hadn’t torn my labral cartilage. If I had, I don’t think there would have been much that would have relieved the pain. I’ve had friends who have had labral tears from FAI and surgery helped their chronic pain. If you do have labral tears, you’ll have to talk to your doctor about the best treatment. If you don’t have cartilage tears, you can help your hips feel better, it will take several months.

      Moving definitely helps with hip mobility, but I would be very careful about which activities you choose. You can try out PiYo, but I would definitely be cautious of the moves you are doing. It moves quickly, so sometimes it’s hard to get good form when moving so fast through poses. PiYo actually made my hips worse until I stopped pushing into poses and modified as needed. Once I modified everything, my hips started getting better. If anything hurts your hips, move out of that pose or modify. Really listen to your hip joints. Pushing through the pain with FAI is never a good thing and won’t help.

      If your hips are really inflamed, some of the poses that might bother you could include low lunge, child’s pose, right angle, 3 point balance, and single leg downdog. Those are the ones that I have to be careful of sometimes when I’m teaching yoga (I teach yoga now instead of PiYo these days). Also focus on anti-inflammatory foods in your diet 🙂

      Reply
      • Hi All,

        Here too because I have been diagnosed with FAI. Pincer I believe. I have been told by the bone specialist it is in both left and right hips, but the pain has presented itself in the left. Same story, I thought it was over stretching, an issue with my hip flexor. Had pain for 2 years and then suddenly felt like I passed the pain of no return. Got the x ray to find out the same.
        I am now seeing a sports therapist. It is a 4 month program. In the mean time I have been told basically no physical activity. It sounds like anyone with this problem are highly active and this is a huge life change to live up to. I was scheduled for yoga teacher training in November which I canceled due to the fact the pain still exists so strongly and I am seeing no progress (2 months in) I have been told it will get more painful before it gets better but the lack of physical activity is hard to cope with. I find daily motivation difficult.

        Thank you Sarah for writing this, I am going to read through FAI and Yoga because I stopped yoga all together and feel the empty space as a result of it. Great tip on the anti inflammatory foods.

        I a wondering if anyone has found any cardio activity (other than swimming with arms only) to fill the void. I am not sure if i have a tear or not. they have not advised of this. I can say I am in pain most of the day. I have a standing desk which helps.

        Any feedback on activity is so much appreciated!

        Reply
        • Hi Shannon! Sorry to hear about the terrible pain you’re having 🙁 For activity, maybe the elliptical, NuStep, light water walking, or non-vigorous water running would be okay? You’d definitely want to run those ideas by your doctor or therapists first, of course, and may have to wait a while before you can return to even light activity. It’s hard to wait sometimes, but in the end if it helps your body heal, then it’s worth it for sure. Especially if you’re not sure yet if you have cartilage tears, moving too much may make that even worse (unless the doctor clears you for it).

          I’d chat with your care providers about those options and if they’d want you to try those. But just a heads up, once your hips have gotten really painful, your hips probably won’t ever be the same again. It’s been 3 years since I wrote this post, and although my hips aren’t as painful, I still don’t have as good of mobility in them like I used to. And the pain sets in my hips much easier these days, too.

          Good luck with your treatment plan, keep me posted with how it goes for you!

          Reply
  11. Sarah do you have instagram? I would love to follow your progress. I’ve recently just been diagnossed with FAI with hopes of getting back into Rollerderby and AFL.

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  12. I had fai surgery about 18 months ago, and in the last few months just started feeling comfortable with doing piyo and yoga type moves.My movements are much more limited now and have less flexibility than before. I cannot sit criss cross as my leg stays at about 45 degrees or less. Do you have any suggestions of how to safely increase flexibility?

    Reply
    • Hi Emily! You could have shortened tendons and ligaments from surgery, and scar tissue build-up. I would definitely see a physical therapist and perhaps a massage therapist (often physical therapists will incorporate massage into their treatments). They can help restore mobility to joints after surgery. I highly recommend finding a good PT – it can make a world of difference! You can also do some massage yourself in those tight areas, and any stretching should be done gently. it might take a while to get full mobility, but be patient and gentle with your body. Good luck and keep me posted!

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  13. I am SO GLAD you wrote about this. I suspect I have FAI. I broke my femur 15 years ago. The head of it died and affected my hip joint. I have to stretch like crazy to keep it from stiffening up on me. I can’t sit too long and get up. I look like an old lady. I can’t squat farther than parallel either. People always think I’m weird for having this, but truth is I think a lot of people have it & don’t know it.

    Reply
    • I agree! I think there are a lot of people with it but don’t know it. I have had it for years, probably since childhood, but didn’t realize that I even had limited mobility in my hips until I saw my PT for hip pain and she figured out that’s what I had, then the doc confirmed with an x-ray. I have a bone spur on one hip, and I tend to get bone spurs easily, so I’m hoping I don’t get any new ones…

      Reply

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