What is femoroacetabular impingement / hip impingement syndrome?
Your hip joint where the round head of your femur (thigh bone) joins the cup-like depression of your pelvis (the acetabulum) is a ball-and-socket joint. A slippery cartilage covers the surfaces of the ball and the socket, which creates smooth surfaces that help the bones glide easily across each other. This form of joint allows for the dynamic rotary motion of our hips. If the femoral head rubs along the cartilage damage can occur to the articular cartilage, or to the labral cartilage leading to possibly pain and/of loss of hip function. This medical condition is called femoroacetabular impingement also known as hip impingement syndrome.
Symptoms of femoroacetabular impingement
In its early stages, femoroacetabular impingement could be painless, therefore, undetected. The symptom can be stiffness in the groin, the lower back, around the hip and front of your thigh. There may be also an imperfect range of hip motion. Gradually, you begin to feel pain in your thigh movements, which intensifies in the following stages of the condition. In acute cases such as traumatic incidents, the symptoms appear right after the incident. There may be a sharp stabbing pain with twisting and turning of the hip/leg, but sometimes there is just a dull pain. You may experience pain and discomfort during or after walking, prolonged sitting, and exercises.
Causes of femoroacetabular impingement
The round head of your femur could be deformed and interfere with the smooth motion of the femur in the socket when the hip is bent. This may happen in activities like tying your shoes or riding a bicycle. This mostly painful condition is called cam impingement that typically affect young male athletes. Cam impingement is characterized by excess bone along the top surface of the femoral head. Sometimes, the deformity is within the socket, which is called pincer impingement. In these deformities that are more common in females, the neck of the thigh bone bump into the protruded rim of the acetabulum (the socket) during flexion movement of your hip. However, about 70% of the cases have deformities in both, the femoral head and the acetabulum. In some medical conditions such as Legg-Calve-Perthes disease, coxa vara (a deformity of the hip where the angle between the head and the haft of the femur are less than 120 degrees), and slipped capital femoral epiphysis (a fracture through the growth plate aka physis), we may see these type hip joint disorders.
First steps for the treatment of femoral acetabular impingement
The treatment plan of this relatively self-limiting medical condition mainly consists of:
- Resting the joint
- Avoiding pain-provoking activities
- Supervised exercises
- Pain-killers and anti-inflammatory drugs
- Physiotherapy assessment with special clinical tests for the hip
- Additional diagnostic tests such as an x-ray or MRI
Physiotherapy has a major role in treating your femoral acetabular impingement by using following techniques:
- Joint mobilization to improve joint range of movement and function
- Improving soft tissue flexibility and length
- Laser therapy can be helpful to reduce inflammation and decrease pain
- Shockwave Therapy uses acoustic waves to break up scar tissue on muscles, tendons, and ligaments
- Strengthening of different layers of hip muscles
- Improving hip range of movement through stretching
- Improving functional control of the hip
- Acupuncture of the hip joint and surrounding musculature