When young people feel a sharp twinge deep in their hip during a sprint or a squat, femoroacetabular impingement syndrome is often to blame — and now, researchers at La Trobe University have found a surprisingly straightforward answer: targeted strength exercises work 2.3 times better than stretching alone.
The finding matters because hip pain in young adults is far more common than many realize. FAI syndrome affects up to 40% of young people struggling with hip discomfort, and the condition carries a sobering long-term consequence: it can increase someone's risk of developing osteoarthritis later in life by 47 times. For athletes and active young people, that prospect can feel like a potential career-ending diagnosis — which is exactly why many rush toward surgery as a first resort.
The PhysioFIRST study, published in the British Journal of Sports Medicine, tracked 154 participants over six months to directly compare two physiotherapist-led approaches. One group completed a targeted strengthening program while the other followed a standardized stretching regimen. Both groups received the same professional support structure: six face-to-face physiotherapy sessions over the first three months, paired with 12 supervised exercise sessions. After that initial phase, participants got a three-month gym membership to continue working out independently, plus three more consultations with their physiotherapist.
The results were decisive. Participants in the strength group were 2.3 times more likely to report meaningful improvements in pain and showed significantly larger gains in hip muscle strength compared to the stretching group. Interestingly, both programs improved overall quality of life equally well — but strength training pulled ahead on the metric that matters most to people in pain: actual pain reduction.
Lead researcher Professor Joanne Kemp, an NHMRC Emerging Leader Fellow from La Trobe's Sport and Exercise Medicine Research Center, emphasized what this means in practice. "Strengthening didn't outperform stretching on overall quality of life, but it did lead to better pain outcomes and stronger hips, which could matter for long-term recovery," she explained. That distinction is crucial: stronger hips may protect against the cascade of problems that leads to arthritis down the road.
Perhaps most importantly, the study delivers reassuring news to the countless young people convinced that surgery is their only option. "Many young people with hip pain are concerned they may need surgery," Professor Kemp said. "Our findings show that physiotherapist-led care is a safe and effective first-line option, and for many younger people it may help them avoid or delay more invasive treatment."
This is one of the first randomized controlled trials worldwide to directly pit two physiotherapist-led treatments against each other for FAI syndrome, making it a landmark study for how clinicians approach hip pain in young adults. The message is clear: before considering the operating room, a program of expert-guided strength work offers a proven pathway to real relief — and potentially stronger hips for whatever comes next.