Hip impingement.

What is it? Hip impingement or femoral acetabular impingement (FAI) occurs when there is a change in the shape of your hip joint, which also causes pain, inflexibility and difficulty doing everyday chores. Your hip joint is a ball and socket joint, and changes can occur on either the ball (called a CAM morphology) or on the socket side (called a pincer morphology).

These are shown in the image below. This does make your hip more inflexible as there is less space to move for the ball and socket, and may cause a pinch and pain when crossing your legs, pivoting on one hip, and deep squatting.

It is common for young athletes to develop an extra growth (CAM morphology) on the ball end of the joint, where the ball is no longer as circular and tends to be more oblong. This is though to occur due to high levels of impact during sporting activities that involve running, changing of direction and kicking like soccer, hockey, rugby. It is though  that these high level of stresses stimulates the growing adolescent bone to lay down more protection around the neck  of the femur (near the hip joint). The majority (as many as 65%) of the athletic population will develop this CAM morphology without developing symptoms.

However when it does cause symptoms it is though to be a precursor to osteoarthritic, labral (the cushioning of the joint) and cartilage changes within the hip.

Many people with hip impingement find their quality of life is reduced as it stops them from doing many things and also causes daily pain. Even lying in bed, sitting, standing for too long, and engaging in walking and running can be difficult.

The first port of call, if you have hip impingement is conservative management with physiotherapy.

               Physiotherapy is aimed at relieving pain and also increasing the strength and stability and movement patterns of the muscle around the hip to prevent further deterioration of the joint. One of the most effective ways to relieve FAI is by strengthening the adductors using the Copenhagen exercise as shown below.

Arthroscopic Surgery to remove the CAM morphology and clear out any labral injuries – is the last option. From studies in 2019, we know that surgery can produce some beneficial results in the short term but outcomes have been shown to be similar to conservative management with physiotherapy at the 2 year mark.

Do you think you have FAI pain? Does crossing your legs, deep squat, pivoting and running hurt your hip. Book in with us today for a through assessment and treatment.

Written by Jonathan Khoo

Movement Mill Physiotherapist