Hip impingement – what is it and how do we treat it?

Hip impingement, or femoroacetabular impingement to use its full name, is a term given to pain originating from the hip joint although it is a little different from arthritis.

First, some anatomy

The hip is a ball and socket joint, the ball being the head of the femur (the thigh bone) and the socket being on the acetabulum (pelvis). As can be seen from the picture, the ball is attached to the thinner femoral neck and it is usually this part rubbing on the rim of the socket which can bring on pain over time.

So how does it happen?

In simple terms, it happens if the muscles aren’t doing their job properly at the hip. This may be related to a pure strength issue or even a “movement skill” problem i.e. muscles not working at the right time. This means more weight tends to go through the joint rather than the muscles taking the load and your body then has to adapt accordingly.

So what adaptations take place?

Bone spurs. These are often misunderstood and are in fact a response by your body to try and spread the load that is going through the joint surface. This tends to happen in one of two ways – CAM and pincer. A CAM deformity is basically a bone growth on the neck of the femur and a pincer is excess bone grown around the edge of socket – kind of like a quarter pipe being built on towards a half pipe. Over time these can start to rub and cause inflammation and pain.

In addition to this, tears can happen to the labrum, which is kind of like a calamari around the joint and connecting the ball to the socket and it has a stabilising role.

So what can be done about it?

There are surgical options to treat this should they arise, but often this is not required. Firstly it is important to loosen off any tight muscles that may be restricting movement at the joint. This will often be accompanied by massage and other soft tissue techniques alongside joint mobilisations to ensure there is no joint tightness. Stretching is often an important part of this stage.

After that it will be important to address why the problem has come on in the first place. By addressing these issues not only will a full recovery be reached, but also it is possible to avoid a recurrence of the problem in future. This stage tends to involve some functional strengthening, such as this single leg squat to ensure good control from the lumbo-pelvic region (or “core”) down to the foot.

To discuss any issues you might be having just get in touch.