If you have hip pain, you know how difficult it can be to perform your everyday tasks. One type of hip condition, known as femoroacetabular impingement, is especially painful and challenging. Fortunately, this problem can be treated by physical therapy. Here’s what you need to know about hip pain and femoroacetabular impingement, along with the importance of getting physical therapy.
What Is Femoracetabular Impingement?
Also known as hip impingement, femoroacetabular impingement or FAI is the result of the ball of the hip (femoral head) pinching against the cup of the hip (acetabulum). This leads to the labrum (cartilage surrounding the acetabulum) becoming damaged, which causes hip pain and stiffness.
In other words, this problem causes hip pain that’s the result of structural changes of your femur and/or acetabulum that result in the breakdown of intra-articular structures which form the hip joint.
The Two Types of Femoroacetabular Impingement
There are two kinds of femoroacetabular impingement: Cam and Pincer.
Cam Impingement
This type of impingement is a condition occurring when a femoral head isn’t perfectly round and unable to smoothly rotate inside the acetabulum. In many cases, it occurs as a result of a bump that forms because of too much bone growth at the end of the femur. When the person moves, the bump grinds against cartilage on the interior of the acetabulum. Most people with cam impingement are young adults.
Pincer impingement
Unlike cam impingement, pincer impingement is an excessively deep acetabulum or there’s too much coverage of the femoral head, which can lead to excessive bone growth extending over a normal rim. This overhang can cause impingement of the femur neck.
Basic Hip Anatomy
It helps to understand some basic hip anatomy. Including the bones, muscles, and structures that affect the hip of someone who suffers from hip impingement. When one of these components begins to break down or is compromised, hip issues can occur.
Hip joint
The hip bones include the femur and pelvic bones. Hip articular cartilage is designed to reduce friction between these bones so that the bones glide smoothly.
Hip muscles
These muscles support the hip joint as well as enable movement.
Hip tendons and ligaments
These fibrous tissues are extremely tough and used for binding bones, besides binding muscles to bones.
Labrum
This soft cartilage surrounds the hip socket (acetabulum). It protects the surface of the joint and helps to stabilize the hip, making the socket deeper. An injury can cause a tear in the labrum.
Hip flexors
These muscles are situated on the front portion of the thigh in your pelvic region. It’s your hip flexors that allow you to bend your knees up to your hips in addition to letting you move your hips. You’re using the flexor muscles in your hip each time you take a step.
Hamstrings
Your hamstrings are the three muscles running from the thigh to the knee on the back of the leg. They help with knee bending and hip extension.
Gluteal musculature
Commonly known as glutes, these are three muscles making up the buttocks or gluteal region.
Common Symptoms
Initial symptoms are usually mild but intensify over time with pain usually being worse during physical activity, such as turning, running, or jumping.
- Groin pain radiating to the medial thigh
- Pain occurring throughout the deep inferior lateral part of the hip
- Pain with full hip flexion, such as when trying to complete a deep squat
- Leg pain
- Intermittent sharp, clicking, catching and locking pain
- An increase in pain symptoms when twisting or pivoting
- Limited hip internal rotation
- Hip, groin, or thigh stiffness
- Gait abnormality
Tests Used for Diagnosing Femoroacetabular Impingement
- The Faber test—This test involves a patient lying on their back and a doctor raising an affected leg, putting the hip and knee at a right angle. The doctor then pushes the leg across the patient’s body to check for pain.
- The Fadir test—This is similar to the Faber test. The hip is flexed to a 90-degree angle and is moved over the patient’s midline. This test is also called the roll test because the examiner gently rolls the patient’s leg.
- The scour test—In this test, a doctor has the patient in a supine position. The doctor rotates the hip externally to check for pain or unusual movement.
- Resisted SLR test—The SLR (straight leg resistance) test entails a patient’s hip joint is flexed to a 30-degree angle with the patient’s knee extended. The doctor then applies pressure on the leg above the knee, moving in the direction of the exam table. Groin pain can indicate a positive result.
How Physical Therapy Helps in Improving Pain and Functional Status
One of the best ways to address this condition is physical therapy. Physical therapy consists of:
- Soft tissue mobilization
- Core/lumbopelvic strengthening—Stretching tight muscles reduces the forces causing pain when doing movements.
- Joint mobilization—This can help in relieving pain from your hip
- Ice/heat treatment
- Ultrasound
- TENS unit
- Avoiding squats
Contact Cawley Physical Therapy & Rehabilitation Today:
- A highly trained and experienced physical therapist knows how to develop a specific plan to improve strength, range of motion, posture, and decreased pain so that you can return to your prior level of function.
- Physical therapists can identify other possible impairments that can prevent you from having further occurrences and injuries.
Don’t continue to suffer from hip pain. Consider that untreated symptoms can result in osteoarthritis.
Call 570-208-2787 to set up an appointment at Cawley Physical Therapy & Rehabilitation.
