Hip impingement is also known as a femoroacetabular impingement (FAI), occurring when the femoral head presses against the acetabulum. In this occurrence, the labrum is damaged, causing pain, limited mobility, and even arthritis. When the two do not properly fit together, friction and wear and tear can occur on the joint.
There are two types of hip impingements. One is caused when the femoral head is more of an oval shape than a rounded shape. Because of this deformity, friction is created when the femoral head hits the edge of the acetabulum. The other is caused when the acetabulum is shaped in a way that covers too much of the femur structure. Friction is created when the acetabulum rubs against the head of the femur. It is also important to note that both types of hip impingements can occur at the same time.
The hip is a ball-and-socket joint. On each side of the hip bone, or the pelvis, is the acetabulum, which is known as the socket. The ball, or femoral head, rests against the acetabulum, completing the ball-and-socket joint. Surrounding the acetabulum is the labrum, or ring of cartilage that helps eliminate friction and adds support to the joint. Synovial fluid also exists in the hip joint, serving as a lubricating fluid to assist in hip mobility.
Hip impingement signs and symptoms include many feelings of discomfort. They include but are not limited to: pain in the groin area during and after activity, pain in the area after sitting still for an extended period of time, stiffness in the hip area, trouble extending the hip joint further than a 90 degree angle, reliance on the act of limping, and loss of balance when on your feet.
Hip impingement causes are typically unknown. The most acknowledged cause of the injury is a deformity in the hip joint, where either the femoral head or the acetabulum does not fit into the other properly. Because of this, the ball-and-socket joint cannot move properly, creating complications in mobility and pain during activities.
Because hip impingement often results from bone structure deformity within the hip joint, specifically the femoral head or acetabulum, it is important to acknowledge how this can occur. Hip impingement risk factors include the participation in athletics and sports that involve constant twisting of the hip and squatting motions. Deformities in the hip structures can often be seen more commonly in young athletes, for their bodies are still developing and heavily impacted by physical activity.
Another risk factor includes the pre-existing condition, slipped capital femoral epiphysis. This condition can cause abnormalities and deformities in the shape of the femoral head and acetabulum in young adolescents. In this condition, the growth plate is damaged, causing the femoral head to glide and impact the femur. Because of this shift, bone structure shapes can become deformed.
Hip impingement can also result from Legg-Calve-Perthes disease, which is a disease where the acetabulum structure of the hip joint does not receive enough blood, thus killing the ball bone.
Coxa vara can also be a risk factor of hip impingement, for it occurs when the thigh bone and the ball bone do not grow and develop at the same speed as the child. Because of this, bone deformity can occur, thus causing the ball-and-socket joints to not work and function properly together.
When experiencing symptoms of hip impingement, it is important to know when to see a doctor. If you are experiencing new pain in the hip area, worsening pain, stiffness, or limited mobility, it is a good idea to seek medical care. Seeing a doctor who can treat your symptoms is crucial, for you want to avoid injuring your hip any further.
If you are experiencing symptoms of hip impingement, your doctor will administer a physical examination, where they will assess where the pain is coming from, take a look at the physical appearance of the area, and assist you in performing exercises to help determine the issue with the joint. In the process of using image testing to diagnose the problem, your doctor may administer x-rays, MRIs, and/or CT scans. An x-ray is a test that shows the shape of the ball-and-socket bones specifically as well as the other bones in the hip area. An MRI, or a magnetic resonance imaging, is used to see detailed images of tissues in the body, such as cartilage in the socket. CT scans use x-ray technology and computers to see images of the inside of the body that can be seen on a monitor or can be printed. This scan can help determine if surgery is a necessary approach for your healing.
Non-Surgical
Resting the area is crucial to ensure that the injury does not worsen. Anti-inflammatory and pain medications can also help alleviate pain. You may also be advised to alter your daily activities so that you avoid performing any movements that can harm the joint.
Physical therapy is one of the most used and successful treatment options. Many physical activities such as stretches and strengthening exercises can ensure that the joint is growing stronger, more flexible, more mobile, and more comfortable for you.
Surgical
First, a hip arthroscopy can be performed. In this procedure, the doctor inserts an arthroscope, or a small camera, through small incisions and into the hip joint. During this, the doctor can see the hip joint and structures and can assess the issue. The bone may be shaved or buffed to ensure that the issue is cured.
The next surgical procedure is a surgical hip location. In the event of this procedure, the doctor will treat the abundance of extra bone or joint deformity. At the conclusion of the procedure, the doctor will secure the femur back into place with screws.
Anteverting periacetabular osteotomy is an open procedure that is used alongside a surgical hip location to correct hip dysplasia. When the hip socket or acetabulum is facing the wrong way, doctors will use this procedure technique to correct the issue.
A femoral osteochondroplasty can be used during a hip arthroscopy to remodel and alter bone shape of the socket to ensure that they fit into one another like a puzzle piece.
Pincer osteochondroplasty is the process of removing extra cartilage from the ball-and-socket joint to ensure that the femoral head fits more securely and precisely in the joint.
Subspine decompression is a procedure that allows for removal of extra bone in the cup-like area of the hip. This procedure can be administered both openly or arthroscopically.
Hip impingement prevention is important to acknowledge in the years of adolescence. It is important to avoid any activity that can cause impingement at a young age. Harmful activity can be monitored in terms of intensity and frequency. To further prevent hip impingement, a doctor can be consulted to identify areas of weakness in your hip joint, so that you can be mindful and aware of the weakness while partaking in physical activity.
For more information about hip impingement treatment in Long Island, contact Hicksville Physical Therapy today.
