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Hip Impingement

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Hip impingement is a condition where the hip bones become shaped slightly abnormally. Since the bones don’t align perfectly, the bones end up rubbing against one another and cause inflammation and eventually joint damage.

Sometimes known as femoro-acetabular impingement (FAI), pain is experienced mostly in the groin, but often radiates to the lateral hip, buttock, and sometimes down the front of the thigh.

There are differing opinions on the cause. Some experts believe the condition normally occurs because the bones don’t properly form through the formative growing years in childhood. However, the condition can also be caused from over-training in sport and especially from high impact exercise. This is often when people dramatically increase the exercise load on the body too quickly.

Bone spurs can form: It’s the deformity of a pincer bone spur, cam bone spur, or both together, which end up leading to pain and damage to the joint. When the bones are abnormally shaped, little can be done to prevent the impingement from occurring. Sometimes inflammation in the joint line can lead to cysts forming.

Hip Impingement Anatomy

The hip is a ball and socket joint connecting the thigh bone (femur) to the pelvis socket. It allows the leg to move. The hip joint is composed of multiple parts, including that of the lesser and greater trochanters. The greater trochanter is the place where countless muscles from the buttocks allow and meet to promote hip abduction and movement from one side to the other. When it comes to the lesser trochanter, this is the point where the iliopsoas muscle is attached to the hip joint to provide for forward movement within the leg, which is otherwise referred to as hip flexion.

Hip Impingement anatomy image

As the thigh bone (femur) moves into flexion, the ball can pinch against the socket. This can cause some bony growth that literally impinges the hip. Sufferers will get pain when the flex their hip (as if they were taking their knee towards the chest). Pincer is when there is too much bone on the socket of the joint, so the ball of the socket butts against it. Cam is when there is too much bone just below the ball of the joint and this hits the socket too. Sometimes other issues can also present with hip impingement including labral tears (similar to cartilage), and as mentioned previously, cyst formation on the joint line.

How To Treat Hip Impingement

1. Activity Change

The first thing that is often recommended is to make changes in your daily routine and avoid participating in those activities that bring on symptoms. Stop all high impact training.

2. Anti-Inflammatory Medication

Ibuprofen is often prescribed in a prescription-strength to help reduce inflammation and pain. Use it for short term relief. Don’t get reliant on anti-inflammatories, seek other help if the problem persists.

3. Physical Therapy

Performing specific exercises will help to improve movement in the hip and strengthen the surrounding muscles responsible for supporting the joint. This helps relieve stress on the cartilage and joint. Acupuncture has also been shown to be clinically effective.

4. Surgery

If tests indicate that the damage to the joint from the impingement cannot be relieved through other methods, surgery might be the only option. Many impingement problems can often be treated with arthroscopic surgery. The procedure is performed by making a small incision and using tiny instruments. Using a small camera, the inside of the hip can be viewed. During the procedure, damage to the cartilage and labrum can be cleaned out or repaired. The bony rim of the acetabulum is trimmed, while the femoral head bump is shaved down. Severe cases require an open operation using a larger incision to accomplish the task.

Tips

  • When symptoms first begin, you need to try and identify what activity was performed that caused the pain. Refrain from activities and sports that are causing pain and allow the area to rest to help promote healing.
  • The longer the symptoms remain untreated, the more damage the impingement is going to cause in the hip.
  • Pain often starts in the groin area, but it can begin toward the outside part of the hip.
  • Pain that occurs when twisting, turning and squatting needs to be addressed by medical professionals. Hip impingement is diagnosed by clinical examination but backed up by MRI scan, so if your hip pain remains an MRI scan be very diagnostic.