Hip Impingement
May 16, 2019
Have you ever felt a sharp, “pinching” type pain in front of your hip when sitting for a long period of time or while stretching your glutes (figure 1)? Or even the odd click or catch while walking or running? If so, you may have femoral acetabular impingement syndrome or FAIS. Femoral acetabular impingement is defined as “is a motion-related clinical disorder of the hip involving premature contact between the acetabulum and the proximal femur”1 (figure 2). It is most commonly diagnosed in active young male athletes who participate in high-impact sports like basketball, hockey and soccer2.
This condition requires 3 characteristics to be clinically diagnosed1:
1) Symptoms of hip pain (Figure 3), clicking, catching, stiffness or giving way.
2) Clinical signs consistent with FAIS (e.g. restricted range of motion, or positive impingement test)
3) Diagnostic imaging (e.g. X-ray) consistent with FAIS
This condition is most commonly managed with physiotherapy or surgery. Surgery can be affective but carries a higher risk for post-operative complications3, has a much greater wait time, and is significantly more costly on the healthcare system. Comparatively, physiotherapy can be just as effective, and has the potential to be more effective than surgery4 for treating FAIS.
Physiotherapy can use a variety of treatments to manage FAIS including, but not limited to manual therapy, motor control, strength, and mobility exercises, dry needling, and therapeutic modalities. Visit your nearest Active Physio Works location for an assessment and treatment from a qualified Physical Therapist with locations in Edmonton, St. Albert and Fort Saskatchewan or call at 780-458-8505 today!
References
1) Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016; 50(19):1169-76
2) Kuhns, B. D., Weber, A. E., Levy, D. M., & Wuerz, T. H. (2015). The natural history of femoroacetabular impingement. Frontiers in surgery, 2, 58.
3) Nakano N, Lisenda L, Jones T, Loveday D, Khanduja V. Complications following arthroscopic surgery of the hip: a systematic review of 36761 cases. Bone Joint J 2017; 99: 1577–83.28 Walters SJ, dos Anjos Henriques-Cadby IB, Bortolami
4) Griffin, D. R., Dickenson, E. J., Wall, P. D., Achana, F., Donovan, J. L., Griffin, J., ... & Petrou, S. (2018). Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. The Lancet, 391(10136), 2225-2235.
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