Your hip is the joint where your thigh bone (femur) meets your pelvis. It is called a ball-and-socket joint, because the ball-like top of your thigh bone fits into a cup-like area within your pelvis.
Normally, the ball glides smoothly within the socket, but a problem with the ball or socket rim can interfere with smooth motion. This smooth motion is often disrupted by additional bone growth around the hip joint. Repetitive multidirectional exercise during adolescent years can lead to developing hip impingement or femoro acetabular impingement (FAI). It is believed to be a major cause of early osteoarthritis of the hip, particularly in those under age 40.
Hip Impingement Symptoms
You can have hip impingement for years and not know it, because it is often not painful in its early stages.
When hip impingement causes symptoms, it may be referred to as hip impingement syndrome. The main symptoms are "pain" in the groin, especially when walking or flexing the hip, and decreased range of motion in the hip.
At first, you may only feel pain when you move the hip near its limits. As the condition progresses, however, you may feel pain with more subtle activities, such as sitting for a long time or walking up a hill. Pain that occurs at night or when still for long periods of time suggests that there is inflammation in the area which is common with hip impingement. Over time the cartilage cushioning the ball and socket can begin to break down and wear away, a condition known as osteoarthritis.
There are 3 types of hip impingement:
1) Cam deformity = additional bone growth in the head/neck of the femur.
2) Pincer deformity = additional bone growth on the rim of the acetabulum.
3) Mixed = both of the above together (this is the most common).
Diagnosing Hip Impingement
If you have symptoms of hip impingement, your physiotherapist can diagnose the problem based on your description of your symptoms, a physical assessment, and the findings of imaging tests. These tests may include one or more of the following:
X-ray: Takes a picture of the hip joint and is effective at assessing if there are any bone abnormalities.
Magnetic resonance imaging (MRI): A procedure that uses large magnets, radio waves, and a computer to produce more detailed pictures of tissues inside the body. An MRI can show fraying or tears of the cartilage, including that which runs along rim of the socket (labrum).
CT scan: A technique that combines multiple X-rays to produce multiple images or pictures of the inside of the body. These images can help a doctor decide whether you need surgery.
Conservative Treatments For Hip Impingement
Treatment for hip impingement should begin with:
Resting the affected leg
Modifying your activities to avoid moving the joint in a way that causes pain
Taking anti-inflammatory pain medications
Exercising as recommended by a physiotherapist to strengthen the muscles that support the hip
Watch the video below to see what exercise we recommend for hip impingement:
Invasive Treatments For Hip Impingement
If these treatments do not relieve pain, it may be recommended to proceed with hip impingement surgery.
The type of surgery needed will depend on the problem causing hip impingement.
Often, surgery for hip impingement can be performed arthroscopically. This technique involves inserting a lighted scope and thin tools through small incisions over your hip instead of making a large incision.An arthroscopy is usually a day case outpatient surgery. This means you can go home the same day.
If your hip impingement has progressed and has lead to hip osteoarthritis then a total hip replacement may need to be considered.
Surgery for hip impingement is not very common and in most cases symptoms significantly improve with physiotherapy alone.
If you think you may have hip impingement and would like to have a physiotherapy assessment please contact us via:
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