Femoral Anterior Glide Syndrome

Femoral Anterior Glide Syndrome and Femoral Anterior Glide with Medial Rotation Syndrome

Definition:

Your hip pain is located in the front of your hip or in the groin and is associated with excessive anterior glide of the femoral head (ball) in the acetabulum (socket) during flexion activities, usually with an increase in medial rotation of the femur.  These symptoms are usually most evident during sitting or deep squatting (hip flexion).

This is a common problem for people who participate in activities that encourage excessive hip extension like running dancing or stand with their hips in hyperextension.

Tests:
Sahrmann Tests:
Standing Alignment:

  • posterior tilt
  • hip extension
  • knee hyper extension
  • decreased gluteal definition

Supine Hip and Knee Flexion:

  • active: pain after 90 deg flexion
  • passive: posteroinferior glide decreases is stiff, but decreases pain and improves ROM

Supine Straight Leg Raise: Active: deviation of PICR; posteroinferior glide stiff, but decreases pain and improves ROM
Prone Hip and Knee Extension: anterior displacement of the greater trochanter with late glute max engagement (second 1/2 of motion)
Quadruped: pelvis on involved side is higher, affected hip does not flex as easily with early posterior pelvic tilt during rocking

MMT: weak iliopsoas and glute max
Muscle Length: iliopsoas long, short hamstring, short TFL – ITB
Gait: knee hyperextended
Sitting: legs crossed

Kinetic Control:

Supine: active (vs. passive) straight leg raise test
Prone: active (vs. passive) prone leg lift test
Supine: active (vs. passive) ‘figure 4’ turnout test (Bent Knee Fall Out)

Treatment:

  • Improve active posterior glide of the femoral head.
  • Improve muscle balance between the gluteus maximus and the hamstrings during hip extension.
  • Improve muscle balance between the iliopsoas and the tensor fascia lata.
  • Improve muscle balance between the posterior gluteus medius and the tensor fascia lata.
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2 thoughts on “Femoral Anterior Glide Syndrome

  1. Ivan

    Thank you for the great information.
    Can you please explain the role/difference of the anterior pelvic tilt in relation to femoral anterior glide syndrome? To my understanding the femoral anterior glide will be caused by overactive glutes due to hyper extension. Is this correct? If so then would the treatment of femoral anterior glide syndrome essentially be the opposite to the anterior pelvic tilt? I know with FAGS you cannot stretch the hip flexors but does this also mean you should not be stretching the quads?
    I used to be a triple jumper and sprinter so lots of movement was extension based. Does the sway back attenuate femoral anterior glide? Would treatment of sway back be more parallel to treatment of FAGS?
    Cheers!
    I appreciate your help.

    1. Femoral Anterior Glide could theoretically be caused by overactive glutes, but I think it is more a result of standing with the hips hyperextended or hyperadducted (hanging out on one hip). I don’t see a problem with stretching the quads, but I would avoid stretching the hip flexors, you are just reinforcing femoral anterior glide. Sway back probably doesn’t accentuate anterior glide, posterior tilting of the pelvis does more than sway back. Although some people can stand in both sway back and hip hyperextension. Treatment of sway back with focus more on using the glutes to affect spine vs. hip position. For instance, if your hips and knees are flexed and don’t change position, glute max engagement should decrease anterior pelvic tilt, but not affect the hips. So in a way this would be a treatment that could help both. Femoral Anterior Glide Syndrome and Sway back would both benefit from supine lower abdominal progressions, due to the use of hip flexion as a prime mover. Keeping the knees flexed and relaxed is essential as this should target iliacus and psoas rather than rectus femoris. See Sahrmann’s article on the biomechanics of rectus femoris and the hamstrings role in affecting femoral anterior glide syndrome.

      I hope this helps.

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