Hip impingement syndrome

Hip impingement syndrome is also known as Femoroacetabular Impingement (FAI) is the condition of the hip that causes pain often in front of the hip or groin, or sometimes pain radiate to the back of the hip, pain on doing flexion, adduction & internal rotation, often time there may have symptoms of catching, locking or clicking, etc.

The hip joint is made up of the femur, the pelvis, and soft tissues called the articular cartilage and the labrum. The labrum is a rubbery ring of cartilage that seals the joint. Labrum also acts as a shock absorber.

The cartilage and labrum allow the hip bone to move smoothly. If these bones are in abnormal shape, they can damage the soft tissues. Also, cause pain, and limit the range of motion of the hip. Hip impingement syndrome is what it is.

There are three types of hip impingement. A CAM lesion is the first type. Which is when the neck of the femur is thicker than it should be. The lesion can pinch the labrum and damage the cartilage.

The second is PINCER Lesion, which is when there’s an extra bone at the edge of the socket. It can also pinch the labrum.

The third type is the SUB-SPINE Lesion. Which is when an area of bone just above the socket called the anterior inferior iliac spine is too large. Between the femur and extra bone, the labrum and soft tissues can become pinched.

Common causes of hip impingement syndrome can be repetitive hip flexion, abnormal morphology of the femur and/or acetabulum, and the presence of soft tissue (labrum) damage.

Physiotherapy of hip impingement syndrome includes

Stretching of hamstring (SLR), IT band, Quadriceps muscle, gluteal, piriformis, and groin muscles, etc.

Strengthening exercises such as active straight leg raise, hip adductor muscle strengthening, prone hip extension exercise, hip abductors muscle exercise, Clamshell for gluteal muscle strengthening, and core muscle exercises, etc.

Motor control exercises such as Reverse lunges, iso-lateral Romanian deadlift, lateral step down with heel hover, side plank, and seated isometric hip flexion, etc.

Mobility exercises such as kneeling internal rotation self-mobilization with lateral distraction, ITB soft tissue self-mobilization on foam roller, and piriformis/glut self-Myofascial release on the ball.

Hip joint mobilization (lateral hip distraction) such as lateral glide in external rotation, loaded internal rotation and loaded lateral hip distraction movement with mobilization.

Custom Orthotics are an alternative to the treatment of biomechanical abnormalities.

Kinesio taping to assist with postural modification like taping the thigh into external rotation and abduction.

Therapeutic modalities such as Extracorporeal shockwave therapy, Class 4 Laser therapy, Super Inductive System (SIS), TENS, etc