Hip Impingement Tests

What is Hip Impingement?

, also known as femoroacetabular impingement or FAI, is a hip disorder wherein extra bone grown on the femoral head, acetabular, or both prevents the smooth and painless movement between the two joints.

Depending on where the extra bone is located, a patient’s hip impingement can be one of three types:

• Cam impingement - The extra bone growth is located on the femur or femoral head, resulting in a non-rounded shape. This deformity prevents the femoral head from moving smoothly within the hip socket.
• Pincer impingement - The extra bone growth is located on the socket resulting in an "extra cover" that causes labrum and cartilage damage.
• Combined impingement - The extra bone growth is located on both the femoral head and the hip socket.

As for causes, a patient may be diagnosed with FAI if they fall under the following:

• They are born with a ball-and-joint that has an abnormal structure.
• They regularly participate in activities requiring repetitive movements outside one's normal range of motion, like baseball, soccer, football, tennis, etc.

Aside from the ones mentioned above, other injuries or diseases such as Perthes or SCFE may lead to a possible diagnosis of FAI.

It's important to note that, unlike other diseases or disorders, a practitioner cannot diagnose hip impingement with a single test. Aside from physical assessments, a patient must undergo different imaging tests such as X-rays, CT scans, and MRIs.

We’ll be providing you with a template that'll hopefully help streamline the process of diagnosing. In the template, you'll find four physical tests - FADIR, FAVER, IROP, and the Maximal Squat test - where you can place the results and additional notes you may have per test. Check the next section for a free copy of the template and a guide on using it.

How does this Hip Impingement Test work?

Interview your Patient

Before you begin, it’s best that you interview your patient to know more about their medical history. This may help with deciding which tests they must undergo before diagnosis.

Download the Template

Based on your interview, if you think your patient may have hip impingement, it’s best to conduct physical tests on them first. You can start with the ones we have on our template.

To access and download our template, you can do either of the following:

• Click the “Download Template” or “Use this Template” button above
• Go to Carepatron’s template library on our website or app and search for “Hip Impingement Tests”

Conduct the Tests

On our template, you’ll find instructions for four tests:

• FADIR or Anterior Labral Tear Test
• FABER or Patrick Test
• IROP Test or Internal Rotation Overpressure Test
• Maximal Squat Test

To conduct each, simply follow the steps provided. We’ve also provided diagrams for some of the tests to aid you.

Record the Results

Within each test, aside from a test result interpretation, there’s also a dedicated space where you can check the patient’s result and write down additional notes you may have.

Further Tests

If they’re positive in most, if not all, of the tests we have, you may proceed to do more physical tests involving the hip and imaging tests. All of these are needed for you to diagnose your patient with FAI.

Scoring

All of the tests you’ll find in the template aren’t quantitative. Therefore, scoring will be as simple as ticking the negative or positive result per test based on their reaction. 

When to use these Hip Impingement assessments?

You, as an expert, would know best when to use our template and the four assessments in it to help with your diagnosis of FAI. However, in case you need some assistance, you should conduct the tests when your patient has the following symptoms of hip impingement:

• Pain in the groin, hip, or lower back while at rest for extended periods or during/after activities such as running, riding a bike, etc. 
• Pain in the groin area when the patient flexes the hip or inability to flex the hip beyond a certain angle
• Stiffness in the hip, groin, or thigh

Who is this Hip Impingement Test PDF for?

Those who will benefit from having a PDF copy of our Hip Impingement Tests template are the following practitioners:

• General Physicians
• Physical Therapists
• Orthopedic Specialist/Surgeon
• Sports Therapist

Benefits of these free Hip Impingement Test Templates

Easy to Administer

With each test only having simple instructions, practitioners such as yourself can easily understand and conduct the test.

Time-Saving

Save time by downloading our template, which includes four physical tests complete with instructions and a space for recording your results instead of searching for a guide and templates for the tests separately.

Reliable

According to researchers, the four tests are among the most reliable physical tests one can use to help diagnose hip impingement in their patients. Therefore, we’ve decided to provide you with a template that includes these four tests as a starting point for your assessment and diagnosis.

Written Results for Future Reference

These tests usually don’t come with a template. For your ease and benefit, you can download our template so you have a document where you can write down results you and fellow practitioners can use as a reference as you do further physical and imaging tests.

Accessible

If fellow physical therapists want to access your notes and test results, they can easily do so since our template can be saved as a digital file. Suppose you want to make sharing the file effortless among involved parties. In that case, we suggest saving it on Carepatron and toggle viewing access only to physicians in charge of caring for the patient.

References

Ayeni O, Chu R, Hetaimish B, Nur L, Simunovic N, Farrokhyar F, Bedi A, Bhandari M. A painful squat test provides limited diagnostic utility in CAM-type femoroacetabular impingement. Knee Surgery, Sports Traumatology, Arthroscopy. 2014 Apr;22(4):806-11.

Pacheco-Carrillo A, Medina-Porqueres I. Physical examination tests for the diagnosis of femoroacetabular impingement. A systematic review. Phys Ther Sport. 2016;21:87-93. doi:10.1016/j.ptsp.2016.01.002

Wong SE, Cogan CJ, Zhang AL. Physical Examination of the Hip: Assessment of Femoroacetabular Impingement, Labral Pathology, and Microinstability. Curr Rev Musculoskelet Med. 2022 Apr;15(2):38-52. doi: 10.1007/s12178-022-09745-8. Epub 2022 Feb 16. PMID: 35171468; PMCID: PMC9076795.