A randomized controlled trial published in May 2026 in the British Journal of Sports Medicine examined two different physiotherapy approaches for people with femoroacetabular impingement syndrome.
The results are interesting because the primary and secondary outcomes tell somewhat different stories.
And interpreting that distinction is important for clinical practice.
The study
The PhysioFIRST trial included 154 participants aged 18–50 with femoroacetabular impingement syndrome.
Participants were randomly assigned to one of two six-month physiotherapy programs.
Group 1: STRENGTH
A physiotherapist-led program emphasizing targeted strengthening.
Group 2: STRETCH
A physiotherapist-led program emphasizing standardized stretching.
The trial used assessor blinding and limited disclosure of treatment hypotheses.
The primary outcomes included hip-related quality of life, measured with the International Hip Outcome Tool-33, or iHOT-33, and patient-perceived global change.
The primary findings
Both groups improved substantially.
OutcomeStrengtheningStretchingParticipants7975Mean iHOT-33 improvement19.2 points20.8 points
The adjusted between-group difference in hip-related quality of life was approximately 0.2 points.
The 95% confidence interval ranged from −5.9 to +6.3.
There was no statistically significant superiority for strengthening on the primary quality-of-life outcome.
Both groups experienced improvements that the researchers considered clinically meaningful. British Journal of Sports Medicine
But the secondary outcomes are interesting
When researchers categorized participants according to whether they reported improvement in pain, the results favored strengthening.
Approximately:
72% of the strengthening group reported improvement.
52% of the stretching group reported improvement.
That's an absolute difference of approximately 20 percentage points.
The reported odds ratio was 2.36, with a 95% confidence interval of 1.15–4.84.
The strengthening group also demonstrated greater improvements in hip muscle strength.