What do you know about FAI?

I found myself talking about this with patients and other providers a lot lately…. thought someone else may be interested.

Sometimes you must admit when you’re not the expert… this is it for me.  Still working at mastering this.  So here’s what a few others have to say.FAI Hip

As several of my patients had hockey related hip pain I asked a Canadian… here’s what Jeff Cubos, DC sent me: http://www.jeffcubos.com/2011/08/02/so-your-athlete-has-fai-now-what/

From Kevin Neeld: http://www.kevinneeld.com/2011/training-around-femoroacetabular-impingement

From Eric Cressey: http://www.ericcressey.com/newsletter150html

From Craig Liebenson, DC: http://www.craigliebenson.com/?p=1741

And below, 52 seconds to remind you that conservative measures should be attempted prior to performing surgery due to imaging findings of impingement.  (Please seek care and advise from a qualified health care professional to be sure you’re a candidate for conservative care and something more pressing is not going on.)  For appropriate conservative care, see above links.

Do I need orthotics or special running shoes???

An age old question from so many runners, walkers, athletes, and those who work on their feet.  In hopes of catching the blog up, this along with others, will be old posts that I often find myself discussing with patients and colleagues.

Read NY Times Blog Post below:

http://well.blogs.nytimes.com/2010/07/21/phys-ed-do-certain-types-of-sneakers-prevent-injuries/

While not a definitive study, it appears to have debunked the idea that so many people need ‘motion control’ shoes due to foot problems.  The original idea was that a ‘motion control shoe’ reduces pronation and would subsequently reduce injury in those pronators who wear them.  I suspect that more often pronation is the end-result of another issue  and should not be our main focus.  While in a small number of cases pronation may be solely a foot issue, it is likely that it is the result of a problem farther up the chain (most likely the hip; with delayed onset or weakness of the gluteus medius or lateral rotators).  My estimation is that as we fix pronation with a ‘motion control’ shoe, the compensation for the hip issue is eliminated.  This prevents energy leakage from the system and as energy remains during each step it overloads a different tissue/structure/joint leading to the increased rates of injury noted in the article.  Further study is needed, but we need to be aware of these sacred cows and exercise myths.  Look for future posts on strengthening the foot (foot drills & short foot exercises) as well as hip stability exercises.