Femoroacetabular impingement (FAI) occurs when there is abnormal bony contact caused by two types of mechanisms:
1. CAM impingement occurs when there is a structural abnormality of the femur (excess bone at the femur head-neck junction)
2. Pincer impingement occurs when there is an abnormality of the acetabulum and excess bone
Both cause damage to occur to the labrum (it is a common cause of labral tears) and cartilage of the hip joint.
FAI is a chronic process that causes gradual and progressive decay and degeneration and is a common cause of osteoarthritis of the hip.
It is very important to seek proper assessment and treatment so that the onset of hip osteoarthritis may be delayed or prevented.
The most common impingement movement occurs when the hip joint is moved into flexion and internal rotation (legs bent up and turned in across the midline)
1. What Are The First Signs Of Hip Problems?
The primary symptom that people with FAI complain of is gradual onset progressive one sided groin pain, which may be aching, sharp or often both.
Pain location is not restricted to the groin however, it may present in other areas around the hip, such as the front or side of the hip.
In some cases there may have been a history of minor trauma, but often there is not.
The pain is usually intermittent and is worsened by physical activity (often running or pivoting) or prolonged sitting. Pain may be eased by rest and frequent changes of position.
X-rays, MRIs or CT scans may be needed to confirm a diagnosis of FAI.
2. Is Walking Good For Hip Pain?
This depends on the severity of the pain, but in general, modified walking is okay to engage in with people suffering from mild to moderate levels of hip pain. Variations to one’s walking pattern such as altering speed and stride length alleviate stress across the hip joint. Decreasing the duration and increasing the frequency of walks while choosing to walk on flat surfaces instead of up and down hills all place less stress on structures such as muscles, ligaments and joints that comprise the hip joint. A physical assessment by a physiotherapist can help to reveal weakness in specific muscles and any compensatory movements that may contribute to hip pain. And last but not least, appropriate and supportive footwear that decreases the load on our lower limbs is important to minimise stress across our hips when weightbearing.
3. How Can I Get Rid Of Hip Pain?
Seeing your local Physiotherapist can greatly help to understand the underlying causes that contribute to hip pain. This is essential in determining the treatment approach. Your doctor may prescribe certain medication to alleviate inflammation and conduct certain radiological tests to help determine the cause of hip pain.
Physiotherapists are experts in managing hip pain and treatment may comprise a combination of the following –
- Manual therapy applied to loosen tight muscles
- Stretching of shortened muscles
- Education on appropriate walking/running patterns
- Advice on modified load and activities to help reduce stress on hip joint
- Exercise program to enhance strength/endurance of specific muscles
- Application of heat & cold therapy to alleviate muscle spasm & inflammation
4. When Should I Go To The Doctor For Hip Pain?
If your hip pain is not responding to rest and avoidance of any weightbearing activity that flares up your hip pain, and if your symptoms are not improving, or worsening, it is important to see your doctor as soon as possible for further investigation.
You may be referred to a specialist for an opinion on management to discuss your options.
We also recommend considering your first line options of education, exercise and managing your lifestyle factors!