This the most common question one asks after a hip injury, and here we lay down some basic facts.
What Is Hip Impingement?
Hip impingement, also known as femoroacetabular impingement (FAI), is a condition in which there is abnormal and wearing contact between the ball and socket of the hip joint. The result is increased friction during hip movements that may damage the joint.
Patients often complain of pain in the groin after prolonged sitting or walking. Many athletes often describe pain in the groin with deep flexion or rotation of the hip during activity. Occasionally, a popping or clicking in the front of the hip is described. Pain may also radiate along the side of the thigh and in the buttocks. It is important to rule out other causes of pain in this area which may originate in the low back or abdomen.
Hip impingement is a relatively new diagnosis, discovered about ten years ago. But is this surgery really necessary, or are there less extreme ways to deal with this condition?
How Is Hip Impingement Caused?
The actual cause of hip impingement is not known. It may be genetic, or the result of poor bone formation as a child. Strenuous exercise often puts stress on the hips and can lead to spurs forming earlier, but exercise alone does not cause impingement.
Is Surgery Necessary?
Some physicians recommend surgery for hip impingement to remove the bone spurs. However, there is increasing evidence that removing the spurs is simply treating the symptoms, not the underlying problem. A 2013 paper by a team of physicians in Norway showed that pincer impingement did not lead to arthritis — in fact, the bone spurs formed to protect the joint from stresses that might have damaged the hip. If this is true, then removing the spurs is a bad idea and may lead to more severe hip injuries over time.
Research has shown that it’s actually possible to lessen the severity of hip impingement through activity modification, physical therapy, and exercise. Another study of 50 patients with hip impingement proved that posture made a difference. Standing or sitting with the pelvis tilted forward makes the impingement more severe, while tilting the pelvis backward means less impingement and less pain.
How can we help you
This research into pelvic tilt suggests the true cause of hip impingement may be poor posture, a result of age, obesity, and/or back pain. These conditions can cause the forward tilt of the pelvis that stresses the hips and may lead to the formation of bone spurs. If this is true, then surgery may be unnecessary to treat impingement. In fact, surgery may even make the problem worse by removing the body’s attempt to provide extra support to the overstressed hips.
Simply changing your activities, and avoid movements that stress your hips, allowing them to rest and heal, can be enough to treat mild cases. If this is not enough, impingement can be dealt with through exercises that strengthen your hips, upper legs, groin, and abdomen. This will enable improved posture, so the pelvis can return to its natural tilt and the pain of impingement can be relieved.
Even if you have limited mobility due to age or other conditions, a physical therapist or orthopedic specialist will be able to work with you to design a regimen of stretches and exercises to strengthen the muscles of your core and legs.