Hip Impingement
Hip Impingement
Hip impingement, also known as Femoroacetabular Impingement (FAI), is a condition where there is an abnormal contact between the ball (femoral head) and the socket (acetabulum) of the hip joint. This abnormal contact or “impingement” can occur during certain movements or positions of the hip.
There are generally two types of FAI:
- Cam Impingement: This occurs when the femoral head is not perfectly round, causing it to jam in the socket during certain movements.
- Pincer Impingement: This is when there is extra bone on the socket side, leading to the socket pinching the femoral head during certain movements.
FAI can cause restricted hip movement and pain, and over time, it may lead to damage to the cartilage inside the hip joint, possibly contributing to early arthritis.
What conditions are associated with hip impingement?
Hip impingement, or Femoroacetabular Impingement (FAI), can be associated with several conditions and factors, including:
- Labral Tears: The labrum is a ring of cartilage around the hip socket. The abnormal contact in FAI can cause tears in this cartilage.
- Osteoarthritis: Chronic FAI may lead to the breakdown of joint cartilage, contributing to early osteoarthritis in the hip.
- Hip Dysplasia: Although it’s a different condition, hip dysplasia may coexist with or be confused with FAI. Dysplasia involves a shallow hip socket.
- Sports and Activities: Certain sports and activities that require repetitive hip flexion and rotation can predispose individuals to FAI.
- Inflammatory Arthritis: Conditions like rheumatoid arthritis can be associated with FAI due to changes in joint structures.
- Previous Hip Injuries or Surgeries: Past trauma or surgical interventions on the hip can alter the joint’s anatomy, leading to impingement.
- Bone Spurs: Overgrowth of bone in the hip joint can contribute to impingement.
What are the symptoms of hip impingement?
Symptoms of hip impingement, or Femoroacetabular Impingement (FAI), include groin pain that may radiate to the hip or buttocks, stiffness with limited range of motion, a clicking or catching sensation in the hip, pain during or after specific activities involving hip flexion, and limping in more severe cases.
What causes hip impingement?
Hip impingement, or femoroacetabular impingement (FAI), is caused by abnormal contact between the ball and socket of the hip joint. Factors contributing to FAI include:
- Bone abnormalities:Â
- Cam impingement: A misshapen femoral head.
- Pincer impingement: Over-coverage of the socket.
- Developmental condition: Like hip dysplasia.
- Trauma or injury: Prior injuries or surgeries affecting hip mechanics.
- Repetitive movements: Such as deep hip flexion in certain sports.
- Age: Natural wear over time.
- Genetic predisposition.
What is the best treatment for hip impingement?
Treatment often begins with conservative measures like physical therapy and pain management and may include surgery if these measures are unsuccessful. The surgical approach would aim to correct the abnormal bone shapes that are causing the impingement.
Who should I see to fix hip impingement?
To address hip impingement, you should initially consult a physiotherapist who can perform an initial assessment. This will then result in the creation of a treatment plan, providing exercises and therapy to improve mobility and alleviate symptoms. If needed, they may refer you to an orthopaedic specialist, specifically one with expertise in hip disorders.Â
Is exercise good for hip impingement?
Exercise can be beneficial for hip impingement when tailored to the individual’s needs and guided by a physiotherapist, focusing on flexibility and strength without exacerbating the condition.
Will I need surgery for hip impingement?
Surgery for hip impingement, or Femoroacetabular Impingement (FAI), is not always necessary and is typically considered when conservative treatments like physiotherapy, lifestyle modifications, and medications have not provided sufficient relief.Â
The goal of surgery would be to correct the anatomical abnormalities causing the impingement, such as shaving down a bone overgrowth. An orthopaedic specialist would evaluate the specific situation, consider the severity of symptoms, the impact on daily life, and the underlying cause to determine whether surgery is the most appropriate treatment option.Â