Hip impingement syndrome, or femoroacetabular impingement (FAI), is a fairly common and painful condition that results from too much friction between bones in the hip joint. Hip impingement is often caused by repetitive movement of the hip, which is why it’s frequently seen in sports like soccer and football. But in other cases, a condition called congenital dysplasia can lead to changes in the hip that will go on to cause hip impingement later in life. Regardless of its cause, hip impingement leads to bothersome symptoms that can interfere with patients’ lives, but all cases can be effectively managed with a course of New York City physical therapy.
The hip is a ball-and-socket joint in which the “ball” is the thighbone (femur) and the “socket” is the pelvic bone (acetabulum). Both the femur and the acetabulum are covered with smooth articular cartilage that protects the bones and prevents them from rubbing against one another. In addition, another specialized piece of cartilage called the labrum provides a suction seal and helps to further stabilize the hip joint.
In a normal hip, the femur easily fits into a concave section of the acetabulum, and the joint glides smoothly with its additional reinforcements from the labrum and articular cartilage. Hip impingement arises when small bony projections (bone spurs) develop along either the femur or acetabulum, causing these bones to rub against each other directly, without protection. This rubbing leads to pain and decreases the range of motion of the hip. Other symptoms of hip impingement include stiffness in the thigh, hip, or groin, and pain in the groin area, particularly after the hip has been flexed.
Many cases of hip impingement occur from repetitive activity that involves recurrent movement of the legs beyond their normal range of motion. Athletes in sports like soccer, baseball, football, tennis, and hockey, are therefore all at an increased risk for developing it. A single traumatic injury that damages the hip joint may also be responsible for hip impingement.
Some people actually have hip impingement for their entire lives but aren’t affected by it, while others will eventually go on to notice symptoms. One possible reason for impingement is congenital dysplasia, a condition present at birth in about 1 of every 1,000 babies. In patients with dysplasia, the hip socket may be shallow, which lets the head of the femur slip in and out of the socket, sometimes completely. Although dysplasia is not a common cause of impingement, it can be very painful when it does occur. Patients usually describe the pain to be more like a pinching sensation in certain positions of sitting or hip movement, such as a high kick when dancing.
New York City physical therapy to the rescue
Whether the hip impingement is due to sports activity, congenital dysplasia, or some other cause, all cases can be effectively managed with a course of New York City physical therapy. Each treatment program will vary depending on the patient’s specific condition and involvement in sports, but most will typically consist of the following components:
- A full-scale evaluation in which the physical therapist will identify specific movements or activities that may aggravate pain and advise against them
- Recommendations for rest and limiting or temporarily stopping participation in whatever sport caused the injury (when applicable); icing the injured area is also helpful
- A muscle-strengthening program that focuses on the muscles of the hip, as well as the core and legs, which will also affect the functioning of the hip
- Manual therapy, in which the physical therapist will gently move muscles and joints to decrease pain and improve motion and strength
- Movement re-education, which will include self-stretching techniques to help restore normal motion of the hip, back and legs; we will also offer advice on stretches to avoid, like passive stretching, which can be damaging to the hip
So if you’re dealing with any symptoms that might suggest the presence of hip impingement, Dynamic Sports Physical Therapy would like to help. Pete Schultz, DPT and Bridget Dungan, DPT specialize in treating hip pain for active and athletic individuals, and both were recently selected as two of the few physical therapists to complete the Advanced Hip Clinician credential through the Hospital for Special Surgery. Contact us at 212-317-8303 to schedule an appointment today to get started with your personalized New York City physical therapy program, or click here for more information on hip impingement.