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Femoroacetabular impingement (FAI) syndrome is an important condition that can be managed by physiotherapists, together with other health professionals. ‘Failed conservative care’ for FAI syndrome is a reason for surgery being introduced into the shared decision-making process with the patient. Two recent landmark randomised controlled trials (RCTs) have brought new data to that patient-centred discussion—‘Would you consider surgery for this condition? What is the likelihood that your impairments will be appreciably improved with arthroscopic hip surgery followed by rehabilitation?’1 2 As clinicians delivering exercise therapy, we need to reflect on the question ‘are we providing high-quality, outcome driven, exercise therapy programs to these patients?’
Contemporary exercise therapy should be informed by patient needs and preferences, and address patient-specific impairments. Specific hip-related impairments in FAI syndrome include hip muscle weakness, particularly hip adductors3; lower trunk strength bilaterally3; poor dynamic single-leg balance3; and lower functional task performance3 in non-operative, preoperative and postoperative groups. None of these impairments can be corrected by surgery alone. These impairments could be best addressed with graded exercises.3
In this editorial, we question whether the non-surgical treatment programmes evaluated in the recent RCTs included the type, dose and progression of exercises needed to generate a meaningful change in strength and function. In both studies, the physiotherapist-led groups did …
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