Rx: Hip Impingement
Hip impingement is the sensation of pinching in the front side of the hip when you bring your knee up to your chest or out to the side. It is usually felt deep within the joint and may be accompanied with muscle soreness in the surrounding area. The formal term for this is femoral acetabular impingement or FAI, which occurs when there is excess bone growth either on the socket of the acetabulum (on the pelvis), or along the outer part of the ball of the femur (leg bone). This can be congenital (genetic) or because of past injury and trauma to the joint.
[Mechanism of Injury + Affected Tissues]
Most people with hip impingements complain of pain in the inner groin after prolonged periods of standing, walking or exercise. The pain tends to be associated with deep flexion (deep squats; “ASS TO GRASS”) and hip rotation during the movement.
If the impingement is caused by bony abnormalities, it’s usually more apparent in athletes who are performing fast, repetitive rotational movements, like with sprinting, soccer, basketball and football. Those with bony abnormality on the femur, known as a CAM lesion, tend to have the most difficulty flexing, adducting and internally rotating the hip (see Figure 1). If growth is present on the acetabulum of the pelvis, it’s referred to as a pincer lesion and motion limitations are really determined by the shape of the acetabulum. Over time, excessive pressure in these areas can also lead to excessive wear on the labrum and acetabulum in the hip, leading to further pain and dysfunction.
Muscular tissue adaptations are common with pain and limitations in range of motion. While it’s difficult to predict the painful areas, it’s common to feel pain in the hip flexors and adductors as your body tries to move and make adaptations in light of pain.
Treatment for hip impingement pain has been focused on using different physical therapy modalities to improve blood flow to the area to stimulate the healing process, increasing mobility and stability of the muscles surrounding around the hip.
Physical Therapy should focus on:
*improving blood flow to the area to stimulate the healing process
*Improving hip range of motion and mobility
*Decreasing compression in the hip joint due to muscular adaptations
*Improving hip and core strength
*Improving hip control
*Retraining faulty movement patterns to utilize improvements in motion and muscle function
If successful (this all depends on how compliant the patient is!), people usually feel improvement in pain over 4-6 weeks with a return to previous activities in 8-10 weeks.
It may take about 3-6 months to perform until the patient experiences no pain after physical activity and about 6 months to return to sport in most cases.
Incidence of FAI is generally poorly understood amongst the general public, but tends to be more dominant among active individuals involved in rotation sports.
Check out our Instagram post for a short Hip Impingement rehab guide – @BespokeTreatments Rx:Hip Impingement
*This does not constitute medical advice. If you have pain or injury please consult a medical profession in person