Hip Impingement: Causes, Symptoms, and Treatment
Overview
Hip impingement, also known as femoroacetabular impingement (FAI), is a condition that occurs when there is an abnormal shape or structure in the hip joint. This condition will lead to pain, limited mobility, and eventually arthritis if left untreated. In this guide, you will learn about the causes, symptoms, and treatment options for hip impingement, as well as provide tips for managing this condition effectively.
What Is Hip Impingement?
Hip impingement refers to a situation where the bones of the hip joint do not fit together perfectly. It results in abnormal contact during movement, leading to joint damage over time. There are three types of FAI:
Cam Impingement
Occurs when the femoral head (ball) is not perfectly round and causes friction within the hip joint, particularly during activities involving flexion or rotation.
Pincer Impingement
This happens when the acetabulum (hip socket) covers too much of the femoral head, creating pinching sensations during movement.
Combined Impingement
Involves features of both cam and pincer impingement, making it the most complex type to diagnose and treat.
How Common Is It?
FAI is increasingly recognized as a leading cause of hip pain among young adults and athletes. Studies indicate that up to 15% of the general population may exhibit structural abnormalities associated with FAI, though not all individuals will develop symptoms.
Early diagnosis will make a significant difference in outcomes by reducing the risk of long-term complications such as arthritis.
Causes
Developmental Abnormalities
Irregular Bone Growth: During adolescence, growth spurts or conditions affecting bone formation may result in the irregular development of either the femoral head or acetabulum, creating structural mismatches that increase the risk of impingement of joint surfaces.
Growth Plate Injuries: Traumas to growth plates during critical periods of skeletal development will alter the joint morphology, increasing susceptibility to FAI in adulthood.
Repetitive Stress
High-Impact Sports: Athletes in sports requiring repetitive hip motion—such as football, hockey, and dance—experience significant wear and tear on their hip joints, leading to cartilage degradation and impingement.
Workplace Strain: Jobs involving heavy lifting, prolonged standing, or repetitive squatting will accelerate joint wear, contributing to the development of FAI over time.
Genetic Factors
Family History: Individuals who inherit an increased susceptibility to hip disorders are more likely to develop impingement. Genetic markers associated with cartilage and bone structure could play a part in susceptibility.
Congenital Abnormalities: Children born with hip dysplasia have an increased chance of impingement later on in life.
Symptoms
Groin and Hip Pain: Pain is often felt deep in the groin and may extend to the outer thigh. It typically intensifies during activities such as running, squatting, or prolonged sitting.
Reduced Range of Motion: Activities involving hip flexion, that is bending to tie shoes or sitting cross-legged, will become challenging.
Mechanical Symptoms: Clicking, catching, or locking sensations in the hip joint are telltale signs of labral damage or cartilage wear and tear.
Pain during Rest or Sleep: In advanced cases, individuals may even experience discomfort during periods of inactivity.
Diagnosis
Clinical Evaluation
Patient History: Physicians assess symptom patterns, onset, and aggravating activities.
Physical Tests: The FADIR test will assist with diagnosing impingement by reproducing symptoms during guided hip movements.
Imaging Techniques
X-rays: They provide clear views of bony abnormalities and joint spacing, making it easy to detect cam or pincer deformities.
MRI Scans: Offer detailed images of soft tissues associated with FAI, such as cartilage damage or labral tears that require repair.
CT Scans: CT scans provide high-resolution 3D images of the hip joint in complex cases and for surgical planning purposes.
Treatment
Conservative (Non-Surgical) Treatment
Physical Therapy: Techniques such as manual therapy and muscle activation to address movement imbalances.
Pain Management: Medicine such as NSAIDs like ibuprofen or naproxen to alleviate inflammation and discomfort. Topical creams and patches for localized relief.
Activity Modifications: Reducing activities that involve repetitive hip flexion, such as running or squatting. And incorporating low-impact alternative activities like swimming and cycling.
Injection Therapies: Corticosteroid injections to reduce inflammation and pain.
Platelet-rich plasma (PRP): Injections to promote healing in damaged tissues with the help of PRP therapy. Contact us to get a free consultation on PRP.
Surgical Treatment
Arthroscopic Surgery: A minimally invasive procedure to reshape the femoral head or acetabulum, repair labral tears, and remove loose fragments. Typically performed on an outpatient basis with shorter recovery times compared to open surgery.
Open Surgery: Required in complex cases where extensive reconstruction of the joint is necessary. Involves longer recovery periods but may provide significant long-term benefits.
Hip Replacement: Replacement is reserved for severe cases with advanced joint damage or arthritis.
Ergonomic Adjustments
Workplace Modifications: Adjustable chairs with lumbar and hip support to maintain proper posture. Standing desks to reduce prolonged sitting.
Home Adaptations: Cushions and supports for seating areas to alleviate pressure on the hips. Sleeping with a pillow between the knees to maintain alignment.
When to Seek Medical Attention
In case of persistent pain for more than a few weeks despite rest and over-the-counter pain relievers, the mobility becomes increasingly restricted, or symptoms worsen. If you are seeing new symptoms like swelling, redness, or visible deformities appear, immediately consult a medical professional.
Takeaways
Hip impingement can be easily treated with proper checkups and an active lifestyle. By doing targeted exercises and physical therapy, you can strengthen the hip joint and surrounding muscles. You can regain control over your physical health and enjoy a more active life.
FAQs About Hip Impingement
Can hip impingement cause arthritis?
Yes, if left untreated, FAI leads to cartilage damage and arthritis over time.
What sports increase the risk of hip impingement?
Activities like football, hockey, and dance involve repetitive hip movements, increasing the likelihood of impingement.
How long is recovery after hip surgery for impingement?
Recovery varies but generally ranges from 3 to 6 months, depending on the procedure and patient compliance with rehabilitation.