Hip Impingement Syndrome

The hip joint is a ball and socket synovial joint, which is formed by an articulation between the pelvic acetabulum and the head of the femur. The reason we call it a ball and socket joint is because the ball-like top of the femur bone fits into the cup like area within the pelvis joint. It connects the lower limb to the pelvic girdle, and with this it is designed to provide stability and weight bearing. It is not designed to do range of movements.

In a healthy individual, the ball glides smoothly within the socket. The problem with the joint is that either the ball or the socket rim can interfere with this smooth motion. When someone performs repetitive hip flexion it leads to damage of the cartilage of the socket which further leads to  hip impingement syndrome. It is believed that hip impingement syndrome is the major cause of early onset osteoarthritis of the hip.

Someone may be living with hip impingement syndrome for years and not be aware of it as it is often not painful in the early stages. So what are the signs that you are experiencing hip impingement syndrome?

– Stiffness in the high, hip or groin

– Inability to flex the hip beyond a right angle

– Pain in the groin area, especially when the hip has been flexed (such as running, jumping or even extended periods of sitting)

– Pain in the hip, groin or lower back during rest or after activity

There are two main causes of hip impingement syndrome:

Cam Impingement

This is where there is deformity of the ball at the top of the femur. The abnormal part of the head can jam in the socket when the hip is bent.

Pincer Impingement

Deformity of the socket. This is where the front room of the socket sticks out too far and the neck of the femur bumps into the rim of the socket during normal hip flexion movement.

Other problems that can cause hip impingement include conditions such as:

  • Legg-Calve-Perthes Disease, a disease in which the ball part of the hip joint doesn’t get enough blood flow which causes the bone to die.
  • Slipped capital femoral epiphysis, a separation of the ball from the thigh bone at the growth plate of the bone in adolescents. It is more common to occur in children who are obese.
  • Coxa vara, which is an unusual condition in which the thigh bone and ball do not grow at the same pace in children. This growing discrepancy leads to deformity of the hip joint.

How does one tell how that they have hip impingement syndrome?

If you are experiencing symptoms of hip impingement syndrome you should see your doctor who will be able to diagnose the problem. Your doctor will perform a physical exam and from there your Dr will need to confirm his diagnosis with one of the following  imaging tests. There are three types of imaging tests that your doctor can do to confirm his diagnosis.

1. X-ray. this will produce images of the internal structures of the hip joint. X-rays can show irregularities in the shape of the ball or top of the thigh bone or excess bone around the rim of the socket.

2. MRI scan. this gives a comprehensive insight to the tissues inside the body. An MRI can show fraying or tears of the cartilage, including that which runs along rim of the socket (labrum).

3. CT Scan. A CT or MRI scan can help a doctor decide whether or not they need to operate.

What is the treatment process for hip impingement:

First and foremost the most effective treatment process is to take the conservative route with resting the affected hip, cutting out activities to avoid moving the joint in a way that causes pain. Taking anti-inflammatory and pain medication to assist with pain relief.

Exercise is a highly effective form of treatment which is recommended by your Dr. This is where your biokineticist will come in and be able to prescribe you with safe  exercises that will help strengthen the muscles to support and help offload the hip joint.

If these treatments do not relieve pain, your doctor may recommend hip impingement surgery.

The type of surgery needed will depend on the problem causing hip impingement and how much cartilage damage has occurred. Ion majority of cases, arthroscopic surgery can be provided. This technique is not too invasive and it involves inserting a lighted scope and thin tools through small incisions over your hip instead of making a large incision. The patient should be able to go home the same day after undergoing this surgery.

The earlier someone has surgery, the higher there is a chances that there is a complete recovery. Even if there have been cartilage damage, surgery can still help to reduce pain and improve range of motion. However in severe cases if cartilage damage is too severely, the only option may need to be a complete hip replacement.

Related Posts