I’ve been told I have hip impingement - what does that mean?

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Femoracetabular impingement (FAI) is a relatively new diagnosis (from 2003) which is used to explain pain in the hip and groin region. To simplify things we will use the term ‘hip impingement’ to explain the condition, and what that means for you as a sports person. 

To be 100% confident that you do have hip impingement, there are 3 things that need to be ticked (or crossed) off:

  1. Suffering from specific symptoms

  2. Positive physical findings (in-clinic assessment)

  3. Imaging findings (usually with an x-ray)

Let’s go into a bit more detail on each of the above:

SYMPTOMS

Hip impingement symptoms will tend to begin to show in the athletic/active younger adult population, and usually presents as a slow onset groin/hip pain with or without a traumatic incident. Pain can often feel like it starts in the hip, but refer to other areas, commonly the groin and buttock regions. Early on, the pain is usually on and off, and presents as an ache. Aggravating or exacerbating factors are commonly an increased exercise or general activity load. It is not uncommon for long periods of sitting-particularly in low chairs/seats, to increase pain levels. As well as pain, it is not uncommon to feel sensations such as locking, catching, or giving way. 

Physical Findings

You might be starting to ‘self-diagnose’ after reading through the above symptoms. However, your Physio plays a key role in the diagnosis side of things. The major things we look for is limited range of movement in the hip, particularly with the hips ability to rotate internally. At times, the flexion in the hip can also be limited/sore, with a combination of the two mentioned movements being quite painful. There a number of other tests used to determine how irritable the hip is, and also whether there may be bony abnormalities causing limitations.  

IMAGING FINDINGS

Usually an x-ray is all we need to confirm the diagnosis of hip impingement. Hip impingement itself comes about due to bony abnormalities of either the socket (acetabulum) or ball (head of femur) aspects of the hip joint. X-ray imaging will pick up whether someone has a bump on the ball (called a CAM lesion) or a hip socket which is too deep (which causes ‘Pincer’ impingement). In some cases- there can be a combination of both. In the images below; A: represents a ‘normal’ hip joint, B: shows a ‘CAM’ lesion, C: shows a ‘Pincer’ lesion, and D: the appearances of combination of both lesions. 

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In part 2 of the blog, we will discuss the treatment and management of hip impingement once the diagnosis has been made. 

IF YOU’RE STRUGGLING WITH HIP PAIN SIMPLY CONTACT THE CLINIC ON 5174 7250 or BOOK ONLINE with myself or one of our expert Physio's below. We can't wait to help get you back to your best!

AUTHOR: JARRYD CROXFORD - Physiotherapist

Ganz, R., Parvizi, J., Beck, M., Leunig, M., Nötzli, H., & Siebenrock, K. (2003). Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clinical Orthopaedics and Related Research, 417, 112-120.