What is Hip impingement syndrome & how does it causes hip pain?

Hip impingement, also known as Femoroacetabular impingement (FAI) syndrome, is a very prevalent condition, especially in young adolescents.  It is a hip injury caused by repeated usage that produces hip pain. It is usually accompanied by hip hyperflexion (commonly during belly dancing or pitching in baseball and during bowling in cricket). And is caused by aberrant femoral and/or acetabular morphology.

Hip impingement syndrome is also linked to soft-tissue (labrum and cartilage) injury and an increased risk of degenerative arthrosis later in life.

Symptoms of Hip impingement:

• Groin pain, pain outside the hip joint, discomfort in walking, etc are some symptoms of hip impingement syndrome.

Typical management of hip impingement syndrome includes- Activity restriction, anti-inflammatory medicine, or intraarticular corticosteroid injection are common treatments for hip impingement syndrome. If conservative therapy fails, you may be required to undergo surgical management. Physiotherapy is a therapeutic option that can spare you from surgery while also improving the outcome of conservative treatment.

Physiotherapy treatment of Hip pain due to Hip impingement syndrome includes:

Pain control is the first step in treatment. This may be accomplished manually as well as mechanically through the use of various manual treatments such as manual joint mobilization, taping, heat therapy, and so on.

Therapeutic modalities-

• Extracorporeal shockwave treatment, High-intensity Class 4 Laser Treatment, Super Inductive System (SIS), TENS, etc. They can alleviate pain and improve the healing process.

Manual therapy includes-

• Hip extension in standing mobilization with movement (MVM), Hip distraction during internal rotation, & lateral glide in external rotation, etc.

Trigger point release-

• Releasing of rectus femoris muscle, TFL, gluteus medius, gluteus minimus, etc. do it for 30-60 seconds per trigger point.

Lumbar spine mobilization-

• it will improve mobility and pain-free movement.

Deep hip rotator muscle strengthening-

• progress the difficulty through prone, four-point-kneel, and dynamic standing positions, with or without resistance.

Strengthening exercises such as-

• Squats, lunges, leg press, leg extension, hamstring curls.

Hip muscle stretching-

• it will help in regaining full hip extension range of motion. Stretching of quadriceps, IT-band, & Piriformis, etc.

Gentle pendular swing of the affected leg in a Four-point kneel position.

Posterior capsular stretching-

• lying on the unaffected side with the affected hip as close to 90-degree flexion as comfortable and the affected leg over the bedside.

Stationary cycling-

• it will improve hip ROM as well as strength.

Hydro-therapy- this can be performed in the pool such as walking in the pool.

Swimming- it will maintain and regain Cardiovascular fitness.

In addition, Cross-training- 2 times per week.

Functional training such as Jogging on a running track or grass, with the affected leg to the outside of the track, that is, anticlockwise for the right hip.

Motor Control Exercise- such as reverse lunge with front ball tap, isolateral Romanian deadlift. & Side plank, etc.

Agility training.

Sports-specific drills.

Also, Custom orthotics- for the treatment of biomechanical abnormalities.