Hip Impingement, OR Femoroacetabular Impingement (FAI)
The hip is a deep ball and socket joint that connects the femur (thigh) with the ilium (the pelvis). The head of the femur sits within a socket called the acetabulum at the pelvis.
The deep socket structure of the joint allows for great stability. It also allows for movement in all directions, making it a very mobile and clever joint!
A must for a happy and healthy hip is ideal activation of the muscles surrounding the joint, throughout all movement. This ensures that the ‘ball’ remains positioned centrally in the ‘socket’ with movement to decreas stress and strain on the structures at the joint.
Muscles that are important to movement at the hip are – the hip flexors (ilopsoas, rectus femorus), the hip extensors (glutes, hamstrings), the rotators (glutes, and deep rotators at the hip) and the adductors and abductors (TFL and adductor group).
What is hip impingement and what causes it?
Hip impingement is what happens when the ideal activation of the muscles surround the hip joint is lost… and as a result the ‘ball’ isn’t centralised (kept at the centre) of the hip socket! As a result, stress and strain builds up at the structures surrounding the joint where ‘impingement’ or contact between the femur and pelvis occurs.
Congenital (born with) anatomical variances in the shape of the hip joint may also contribute to hip impingement. For example, if the ball has an unideal shape, or the socket is too deep, movement at the hip will be limited and impingement more prevalent.
Here are some photos:
What are the symptoms of hip impingement?
Some impingement is normal, but excessive impingement may be associated with pain and injury.
The symptoms of excessive hip impingement are…. Pain at the hip, usually localised, usually sharp and quite severe.
How does Physiotherapy treat hip impingement?
Your Physio will perform a full assessment of your condition. We are looking carefully at the way your hip moves as well as how you move and perform day to day movements such as walking, squats and kneeling etc. We will also test the strength in your hip muscles and other muscles which help control the hip.
We will then treat tight muscles to improve the movement in your hip, teach you how to move to better protect your hip and look to strengthen your hip to take pressure off the sore area.
In a small percentage of cases, a significant contributing factor to the hip impingement are structural abnormalities at the femur and pelvis. Where this is present, we treat it exactly the same way, but acknowledge that referral for review by an orthopaedic surgeon may be required if the limitation is significant and if pain is severe.
What will we ask you to do to manage hip impingement?
We may ask you to avoid aggravating activities and postures short term. We will ask you to perform exercises at home to strengthen your hip and practice new ways of moving to reinforce the improvements.
We want you to understand your condition so ask you to be involved in your treatment every setup along the way.