FAI Hip Impingement (Femoro-acetabular Impingement)

FAI Hip Impingement Awareness facts - It is estimated that approximately 15% of the young, adult population have hip impingement, so who do you know that might have it?
Hip impingement causes painful labral tears within the hip socket.
Hip FAI symptoms are misleading to the average medical professional, as FAI hip impingement pain frequently presents as low back pain and interesting only 10% of back pain is ever clinically diagnosed and cured... Which begs the question what percentage is actually caused by hip FAI or hip impingement, as its otherwise known.
The more active you are, the more likely you are to trigger hip impingement symptoms, so busy mums and gym bunnies beware... but at least you're in good company as many premiere league football players have also suffered FAI hip pain.
Hip impingement is diagnosed through x-ray and labral tears are diagnosed through MRI arthograms - but both need to be read by hip consultants specifically trained in FAI hip impingement.
There are 60,000 hip replacements every year in the UK and it now appears that FAI hip impingement, over the years, could be the leading cause of hip osteoarthritis. A silent epidemic.
Hip arthroscopy can reduce the hip impingement and reattach the torn labrum to the hip socket. This surgery can eliminate the pain and disability caused by FAI hip impingement and divert the need for hip replacement in later life.

Also please feel welcome to join in our help and advice forum for support. We have 3 advising FAI expert hip surgeons, 3 PT/physios and a sports medicine doctor as well as the largest international FAI hip impingement forum on the net:

Wednesday, 22 June 2016

Hip arthroscopy for hip impingement - prehabilitation

If ever you wondered what your physio/PT should be doing when preparing you for a hip arthroscopy for hip impingement, then read on and find out.
Louise Grant, hip specialist physio/PT, has just had an article published in Fitpro magazine, Spring 2016, titled Exercise as medicine: prehabilitation for hip surgery patients and its a fascinating read. Access the full magazine on iPhone via the FitPro app at fitpro.com/app or download from FAI hip experts Physiocure here: http://www.physiocure.org.uk/news.php


Sunday, 7 June 2015

ISHA in the UK this year - by guest writer Louise Davies-Grant, physiotherapist, UK.

Introduction to this years ISHA meeting, by guest writer 

Louise Davies-Grant - UK Physiotherapist, specialising in hip impingement.

Physiotherapists, sports medical doctors and medics with interest, please come along for the most up to date information by some of the very best hip experts in the industry. See below:

Welcome from the President

It is a pleasure to welcome you in advance of the 2015 ISHA Annual Meeting. An especially remarkable program awaits us in Cambridge, the home of our inaugural ISHA President, Mr.Richard Villar. Please peruse the website and see some of the exciting components that have been composed under the guidance of our Program Chair, Professor Richard Field and Host Chair, Mr. Tony Andrade. I am especially excited that my mentor, Dr. James Andrews, internationally renowned sports medicine physician and arthroscopy pioneer, will join us as the Invited Presidential Guest Lecturer.

The program is expertly organized to accommodate the needs of everyone with an interest in hip preservation. Each day highlights different components of the overall strategy necessary in the treatment of simple and complex hip disorders. Interspersed throughout the program will be debates, highlight lectures, symposia, and instructional courses focusing on the most current and controversial topics in hip preservation. A delightful social program awaits us with a Wednesday evening welcome reception and gala dinner on Friday. This will provide each of you an opportunity to interact on a personal level with the thought leaders from around the world. Mark your calendars now, register early, and don't miss this program. It will keep you up to date with all of the latest in this rapidly evolving field. The entire ISHA family and I look forward to meeting and greeting each of you in Cambridge.

J. W. Thomas Byrd, MD

Welcome from the Host Chairman

Dear friends, colleagues, and fellow enthusiasts in Hip Preservation Surgery,

It is my very great pleasure to invite all of you with an interest in Hip Preservation Surgery, and in particular the ever growing ISHA membership to come and join us at the 7th ISHA Annual Scientific Meeting, being held in Cambridge, England from the 23rd - 26th September 2015.

Cambridge is one of the world`s oldest universities and leading academic centres, and has once previously welcomed the international hip arthroscopy community. In June 2004 the 1st International Hip Arthroscopy Meeting was held at Homerton College, Cambridge, convened by ISHA`s inaugural president Mr Richard Villar. It is therefore only fitting that we should be returning to Cambridge.

This year`s Annual Scientific Meeting will be held at the Corn Exchange and the Guildhall, in the centre of Cambridge. These two venues are opposite each other and within walking distance of all the accommodation we have secured for those attending the meeting. We have even secured some accommodation within Cambridge Colleges to offer a truly authentic experience of student life in Cambridge, just before the students themselves return from their summer break.

We have a distinctly eco-friendly theme for this year`s meeting, using recycled materials and locally sourced organic foods. Furthermore, in order to reduce our carbon footprint, we have deliberately sought to avoid the need for transportation to or between our venues; once already in Cambridge. Professor Richard Field has organized an exciting academic program that will bring together surgeons, physiotherapists and other clinicians for a meeting encompassing all aspects of hip preservation surgery and pre- and post-operative rehabilitation.

We have also planned a social program that encompasses culturally rich venues, and for the first time ever a Gala Dinner on the Friday night at Queen`s College, which promises to be a memorable evening for all. In addition to the Cambridge Colleges, there are a variety of museums and galleries to delight visitors to Cambridge. There are many other "things to do" in Cambridge, and in particular the punting tours should not be missed.

September will be an exciting time for sports fans to be in the UK. Not only will Premiership football be in full flow, but the UK will also be hosting the Rugby World Cup. There may well be opportunities for those of you who are interested to secure tickets for some of these matches on the weekends before and after the meeting, so do book early to avoid disappointment!

I look forward to welcoming you all to Cambridge, in September, and with you learning all the latest developments in the rapidly evolving field of Hip Preservation Surgery. I am confident that you will have a truly memorable and enjoyable experience.

Tony Andrade, MB BS, MSc, FRCS (Tr & Orth)

Host Chair for ISHA Cambridge 2015
and ISHA membership Secretary

Welcome from the Scientific Programme Chairman

I hope that everyone who attends the 2015 ISHA meeting, in Cambridge, finds plenty to inform, educate and entertain themselves. I am most grateful to the ISHA members who kindly responded to our on-line questionnaire. Your suggestions were enormously helpful and full of good ideas. Where possible, your recommendations will be incorporated into the programme.

In keeping with ISHA tradition, the key meeting events will be held in the main auditorium with no concurrent activities. In Cambridge, these events will be in the Corn Exchange lecture theatre and will include Dr James Andrews` Presidential guest lecture, the awarding of prizes, Thomas Byrd`s Presidential lecture and the transfer of the ISHA Presidency to Marc Safran.

The conference will include Instructional Course Lectures on Friday and Saturday morning. During the daytime sessions, we will follow the tried and tested strategy of General and Concurrent sessions. We are looking to make the General sessions a little more interactive with the introduction of Clinical Case Reports and Debates on potentially contentious topics. The Concurrent sessions will be structured to reflect the themes represented in your abstract submissions and the suggestions that you provided through the on-line questionnaire.

As in Rio, we are encouraging allied professions to attend the ISHA meeting. This year, our Physiotherapy colleagues will be organising a parallel meeting on Thursday. Throughout Friday, they will join us for combined sessions. On Saturday morning, we intend to provide an exciting new session that will be organised around video presentations of cutting edge procedures.

Finally, I am most grateful for all your kind offers to contribute. Please submit your abstracts and keep sending in your suggestions. ISHA is your meeting and my role is to ensure that ISHA 2015 truly reflects your interests.

Richard E Field, PhD FRCS(Orth)
Scientific Programme Chair for ISHA Cambridge 2015
& ISHA Vice President

Welcome from ISHA Physiotherapy Group Chair

I am delighted to invite my physiotherapy and sports medicine colleagues to the 2015 ISHA Annual Scientific Meeting.

This year, there will be a parallel meeting held on the first day of the conference, dedicated to topics of specific interest to physiotherapists, osteopaths, sports physicians and other allied health delegates.

We have an exciting line up of internationally renowned speakers focusing on key aspects of hip disease and its management. There will be the opportunity to join with international colleagues, share knowledge and learn about the latest research in the field of conservative management, rehabilitation and cutting edge hip preservation surgery.

Finally, I am greatly encouraged by the ever-increasing membership of therapists within ISHA and the growing number of research publications led by therapists from around the world.

I look forward to welcoming colleagues to this exciting conference in the beautiful city of Cambridge, UK.

All the very best,

Amir Takla
Chair of the Physiotherapy Group


Friday, 15 May 2015

Understand the hip pain scale 1 - 10

The 1 - 10 pain scale needs deciphering for many of us. They, hip consultants, GP's, PT's, routinely ask "How bad is your hip pain on a scale of 1 to 10?"
This question often baffled me, any number felt presumptuous and what if I was accidentally over-estimating, or under-estimating... what did 6, 7 or 8 mean... Surely '1' must mean something much more than say a mild headache, why else would you be there, in their consulting room?!  But no, actually it doesn't and it turns out I have been under estimating for years and I bet you have too.
Finally there is a system, an explanation which is wonderful, but needs to catch on, internationally.

Hope this is of use to you. It might even be worth printing a copy for your own reference and taking with you to your appointments, so you and your health professional are on the same page. I hope this definition catches on, it would help both the patients and the professionals.


0 – Pain free.

Mild Pain – Nagging, annoying, but doesn't really interfere with daily living activities.

1 – Pain is very mild, barely noticeable. Most of the time you don't think about it.

2 – Minor pain. Annoying and may have occasional stronger twinges.

3 – Pain is noticeable and distracting, however, you can get used to it and adapt.

Moderate Pain – Interferes significantly with daily living activities.

4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.

5 – Moderately strong pain. It can't be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.

6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.

Severe Pain – Disabling; unable to perform daily living activities.

7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.

8 – Intense pain. Physical activity is severely limited. Conversing requires great effort.

9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.

10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain.

Avoiding the Pitfalls

When rating their pain, the most common mistake people make is overstating their pain level. That generally happens one of two ways:
  • Saying your pain is a 12 on a scale of 0 to 10.
    While you may simply be trying to convey the severity of your pain, what your doctor hears is that you are given to exaggeration and he will not take you seriously.
  • Smiling and conversing with your doctor, then saying that your pain level is a 10.
    If you are able to carry on a normal conversation, your pain is not a 10—nor is it even a 9. Consider the fact that natural childbirth (no epidural or medication) is generally thought to be an 8 on the pain scale. Just as with the first example, your doctor will think you are exaggerating your pain and it is probably not nearly as bad as you say.
If you want your pain to be taken seriously,
it's important that you take the pain scale seriously.

Because pain is subjective, it is difficult to explain what you're feeling to another person—even your own doctor. The pain scale may not be ideal, but it's the best tool we have right now. Researchers are working on developing tests that one day may be able to objectively measure the degree of pain we're experiencing. But until those tests are perfected and become widely available and affordable, we'll have to make the best use of what we have.

Comparative Pain Scale.” Lane Medical Library, Stanford Medicine. December 2008.
Medical Pain Scale.” The Spine Center. Retrieved 4/7/15.