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What Is Hip Impingement?

Femoroacetabular impingement (FAI), also known as a hip impingement, is a mechanical or structural disorder of the hip where the bones of the hip are abnormally shaped. In femoroacetabular impingement, bone spurs develop around the femoral head and/or along the acetabulum. The bone overgrowth causes the hip bones to friction against each other, rather than to move smoothly. In the healthy hip, there is a smooth gliding between the femoral head (rounded top of thigh bone) and the acetabulum (hip socket).  In hip impingement, due to the abnormalities of the bone, the femoral head and the hip socket rub against each other and cause damage to the joint.

Types Of Hip Impingement

 There are three types of Femoroacetabular Impingement:


  • Cam impingement: occurs when the femoral head is not perfectly round and interferes with the head’s ability to rotate smoothly inside the acetabulum. A bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum. Over time, the labrum can become worn, frayed or torn.
  •  Pincer impingement: occurs because extra bone extends out over the normal rim of the acetabulum (hip socket) excessively covering the femoral head. With hip flexion motion, the neck of the femur impinges the labrum. The labrum can be crushed under the prominent rim of the acetabulum. If this condition persists, eventually the cartilage the lines the hip joint can become worn or torn.
  •  Combined impingement: occurs when both the cam and pincer types are present.

Hip impingement can occur with or without the presence of osteoarthritis. However, in many patients, untreated hip impingement is thought to lead to hip osteoarthritis.


What Causes Hip Impingement?

People with hip impingement may have been born with a structurally abnormal hip bones. A misshapen femoral head, deformed femoral neck and/or excessive growth of the acetabular rim could cause hip impingement. In other cases, the hip joint may have become structurally abnormal during development. Over time, repetitive activity involving recurrent movement of the hip joint increase friction or impingement of the femur on the rim of the acetabulum that leads to hip impingement.

Athletically active people who may work the hip joint more vigorously, they may begin to experience pain earlier than those who are less active. However, exercise does not cause femoroacetabular impingement.


Signs And Symptoms Of Hip Impingementhipimpingement3

  •  Pain primarily in the groin area and sometimes towards the outside of the hip
  •  Pain is often provoked with prolonged sitting, walking, crossing the legs as well as after sports and exercise
  • “C-sign” pain described in a specific location marked with the thumb and the hand from the front to the side of the hip
  • Sharp stabbing pain especially getting up from sitting position, squatting, climbing stairs, twisting and pivoting
  • Stiffness in the hip, thigh, or groin area
  • Restriction in hip range of motion, especially flexion, internal rotation


Physiotherapy Treatment For Hip Impingement


Step 1 – Thorough History & Assessment

 The key to an effective treatment plan is to have the correct diagnosis. We start every management plan with a thorough history of your condition followed by a physical exam to ensure the correct diagnosis is made and to rule out any medical condition for which further evaluation may be required. We then discuss our findings and treatment options and together come up with a treatment plan. Once this is agreed upon, treatment typically starts on the first visit. On occasion, a referral to your doctor will be necessary for further testing (ex. blood work or x-rays) prior to treatment.


Step 2 – Pain Management

 Managing hip pain is frequently the main concern for people with hip impingement. Your physiotherapist will choose from a variety of modalities the most appropriate for your particular case. These modalities may include electrotherapy (interferential current, TENS), acupuncture, heat/cold therapy, and manual techniques to help improve your pain.


Step 3 – Restoring Range Of Motion And Strength

 Hip impingement usually presents with restrictions of range of motion and restoring normal range of motion is essential to improve function. Your physiotherapist could use several manual therapy techniques (long and short hip traction, traction + mobilization, muscle energy technique, and facilitation techniques) to improve hip range of motion. Additionally an exercise routine, including stretching, range of motion exercises and strengthening exercises will help you to restore hip flexibility, balance and function.


Step 4 – Restoring Function And Providing Walking Aids

Most patients with hip impingement experience difficulty with certain activities, such as getting in-and-out the car, sitting-to-standing, squatting, climbing stairs and even walking. Restoring function is the ultimate goal of the physiotherapy treatment. As part of your rehabilitation process, a functional exercise program is designed to help you improve your function and facilitate your daily activities. Sometimes, using assistive devices like a cane could improve your mobility and independence.


Step 5 – Education and Self-Management

Understanding your condition is the first step in your recovery. Educating you about your condition, what to expect and giving you the tools to self-manage is a fundamental part of the rehabilitation process. Good communication with your physiotherapist is key to have positive outcomes.


Why Choose 1 t0 1 Physiotherapy At Kinetesis Spine & Joint Clinic?

There are many places around HRM to get Physiotherapy services. At Kinetesis Spine & Joint Clinic, we offer a 1-to-1 Physiotherapy service. What this means is that every session is a 1-to-1 session with our Physiotherapist in a private treatment room, not just the initial session. By offering a 1 to 1 service, you can rest assured that you are getting your therapists full attention and great quality care, every visit. Other advantages to choosing us are:

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To schedule an appointment by phone, please call our office at 902-407-7207, anytime. When you call, we will be happy to answer any questions regarding the conditions we treat, clinic fees and billing practices, or any other questions you may have.