Hip Impingement (Femoroacetabular Impingement)

Hip impingement, or femoroacetabular impingement, involves a change in the shape of the surface of the hip joint. It can lead to stiffness, pain, and damage of the tissue and/or bone. It most often occurs in young, active people. Conditions that cause hip impingement can be present at birth or develop over time. It affects men and women. Physical therapists help people with hip impingement regain movement, flexibility, and strength, and return to their regular activities and sport.

What Is Hip Impingement?

The two types of hip impingement, “pincer” and “cam,” may occur alone or together. Hip impingement usually affects people who are younger than 50. It may precede hip osteoarthritis.

Pincer-Type Impingement

Pincer-type impingements affect men and women. This type may result when:

– The hip socket, which is typically angled forward, angles toward the back.

– Protruding bone develops on the pelvis. This makes the hip socket deeper so that it covers more of the ball or head of the femur bone.

Cam-Type Impingement

Cam-type impingements affect men more often than women and may result when:

The shape of the bone around the head of the femur (the ball at the top of the thigh bone) is misshaped. This deformity can be due to:

– Variation of the “normal” shape of the head of the femur. This may be present at birth or can develop over time.

– Bone that is overgrown at the top and front of the femur head. The nickname “pistol grip” deformity often describes this bony overgrowth on X-rays.

The overgrown or misshapen bone contacts the cartilage that lines the hip socket, possibly causing it to peel away from the bone in the socket. The labrum can become worn, frayed, or torn as well.

How Can a Physical Therapist Help?

Without Surgery

Physical therapy may be beneficial for people with low-level hip pain and/or disability. Conservative care aims to:

– Ease pain and discomfort.

– Address individual limitations.

– Improve overall function.

Your treatment may include:

– Modify your daily, job-related, and sports activities.

– Improving lower-extremity muscle flexibility and joint movement.

– Improving the strength of your lower extremities and trunk.

– Strengthening the hips and trunk can reduce abnormal forces on the already injured joint.

– Improving lower-extremity balance and coordination.

– Designing a home exercise program.

– Functional training.

Following Surgery

Surgery for hip impingement is performed using arthroscopy. Arthroscopy is minimally invasive and only requires small incisions in the skin. The surgeon will insert pencil-sized instruments into the joint to repair the damage. The surgeon may perform one or more techniques during surgery as needed. After surgery, physical therapy will depend on the type of procedure performed

During later visits, your physical therapist may provide the following treatments:

– Education

– Gait raining

– Range-of-Motion exercises

– Flexibility exercises

– Strengthening exercises

– Balance and Coordination exercises

– Job or activity-specific training

Further Reading

The American Physical Therapy Association (APTA) believes that consumers should have access to information that could help them make health care decisions, and also prepare them for their visit with their health care provider.

 

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