Hip impingement: causes and treatment

Next in our series of blogs looking at groin pain, this time it’s hip impingement.

Unlike the problems covered in our last two blogs (here and here), hip impingement is to do with the bones rather than muscle strains or tears.

What is a hip impingement problem?

Hip impingement (or femoroacetabular impingement/FAI) is related to the bones in the hip joint, a ball socket joint connecting the the femur (thigh bone) and the acetabulum (pelvis). The head and neck of the femur joins the hip-bone at the acetabulum,and this is where problems can occur.

There are two types of hip impingement; CAM and Pincer.

This video shows a CAM impingement.

This one shows a pincer impingement.

How does it happen?

Hip impingements can be the result of biomechanics (the way you move and how your muscles control that movement) or it can be congenital.

When muscles don’t take the strain they should, more weight gets put through the joint and your body may then lay down new bone to spread the load. This can lead to the pincer or CAM deformity which will exacerbate the problem.

It can also lead to a tear in the labrum, which is essentially like an octopus sucker around the joint that connects the bones together to improve stability.

If left untreated this can increase the chance of developing osteoarthritis in future.

What’s the treatment for hip impingement?

Stretching is a good first step to help manage tightness that can build over time. Known as a Japana, this stretch also gives you the range of movement necessary to perform some of the strengthening exercises that you will progress onto.

Hip impingement stretch

Alongside this, manual treatment is often used to help offload the hip-joint and loosen muscles around the hip and pelvis.

Strengthening exercises are key – if the underlying issue is a muscle control one then you need to both strengthen these muscles and also to train them to work at the right time.

This weight-shifting squat continues to improve flexibility whilst also improving muscle control in what is called the frontal or coronal plane.

Other exercises such as a single leg squat can be added later to further improve stability, along with work to improve control of the movement of the legs in running and walking.

As with all issues, the sooner you get this looked at the better. The good news is that, even if the issue is congenital, it’s possible to see a full recovery from symptoms and return to sports.

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