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Hip Impingement

What is Hip Impingement?

Hip Impingement or Femoral Acetabular Impingement (FAI) is a condition of the hip where additional bone is present on joint surfaces. This additional bone is known as a CAM or pincer lesion and can cause joint impingement with certain movements, such as deep squatting. Around 20% of the population have FAI but only 23% of these people complain of hip pain.

Hip Anatomy

Hip Anatomy

hip-impingement-anatomy
Source: http://www.arthroscopichipsurgeon.com/hip-arthroscopy.html

Pincer and Cam Lesions

pincer and cam lesion hip impingement
Source: http://orthoinfo.aaos.org/topic.cfm?topic=A00571

Risk Factors

Current or past high level athletes, especially athletes or play high intensity sports that require repeated hip flexion and twisting movements e.g. AFL, netball, and cycling, are at greater risk of hip impingement. Other factors that may increase your risk include;

  • An active lifestyle especially throughout childhood and adolescence
  • Muscle imbalances
  • Poor biomechanics
  • Instability
  • History of knee surgery
  • Obesity
  • Genetics
  • Gender – males are more at risk than females

Signs & Symptoms

  • Dull ache over front of the hip and/or groin – this pain may also be sharp at times
  • Pain with deep squats, sitting cross-legged, running, twisting, walking upstairs, prolonged sitting (especially in a low chair)
  • Hip stiffness
  • Muscle deconditioning for moderate to severe cases
  • Altered walking and running biomechanis for moderate to severe cases

It is possible to still have FAI if you do not have all of the symptoms listed.

Prevention

The risk of developing FAI can be reduced and/or prevented by;

  • Monitoring exercise intensity and frequency (especially during childhood and adolescence)
  • Cross training
  • Assessment and treatment from a physiotherapist to address areas of weakness, tightness and instability
  • Correct rehabilitation of previous injuries
  • Pre-season screening

Immediate Management

Rest, ice, avoid high intensity exercise and movements requiring repeated hip flexion, twisting and deep squatting to relieve symptoms of hip impingement. Seek professional opinion from a physiotherapist for a correct diagnosis and an individually tailored rehabilitation program.

Rehabilitation

This will vary depending on the severity of your symptoms and the duration of your condition. Physiotherapy will assist with symptom relief and will provide strategies to address any factors that may be limiting your recovery.

It is important to remember that this condition is an anatomical matter but symptoms can usually be managed well through conservative treatment. However, if you do not is not respond well to this approach after 4-6 weeks, you may require a corticosteroid injection or surgery.

For more information on femoral acetabular impingement (FAI) head to the website of Dr Matt Lyons, orthopeadic surgeon specialising in hip and knee surgery. Follow the link below for a video which explains the condition in more detail and provides information about the surgical intervention of FAI:
http://www.drmattlyons.com.au/patient-info/conditions-procedures/hip/

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