Hip Impingement Symptoms, Causes and Treatments

The hip joint is a crucial joint responsible for bearing the majority of the body’s weight. It allows us to move, walk, jump, and run, and is one of the most flexible joints in the body. When the hip is unable to perform these normal, everyday functions, it may be due to a condition known as femoral acetabular impingement (commonly referred to as hip impingement).

Femoral acetabular impingement (FAI) is a deformity of the hip joint that limits the hip’s normal range of motion.

This condition can be caused by trauma to the hip or repetitive movements, but is most often caused due to bone growth in the femoral head or in the hip joint’s socket. FAI is considered a major cause of early osteoarthritis of the hip, especially in those under 40.

What Causes FAI?
The hip joint is where the thigh bone (femur) meets the pelvic bone. This joint is known as a “ball and socket joint” because the head of the thigh bone is round and fits into the cup-shaped area of the pelvis (acetabulum).

“In a person with no health impairments, the thigh bone rotates smoothly in the socket. Problems arise when the head of the thigh bone doesn’t have a full range of motion within the socket or ability to move smoothly. This would be when FAI occurs,” says Dr. Jerome DaSilva.

Two common causes of FAI:

• A Deformity at the Femoral Head
  If the top (the ball) of the femur is abnormally shaped, then it can be jammed into the socket when you bend your hip. This kind of damage can be done while performing activities such as bike riding, but it can even occur when doing something as simple as bending over to tie your shoes.

• A Deformity of the Socket (Acetabulum)
  If the front rim of the socket sticks out too far, the neck of the femur may bump into this rim during normal hip movement.

Who is at Risk of Developing FAI?
Many people develop FAI because their hip bone/s did not form normally during childhood. Those with osteoarthritis can develop FAI as well. There are certain factors that may increase your chances for developing FAI without osteoarthritis. Those with a higher risk include:

• Those who have abnormally shaped femur bones
• Athletes who participate in high-level sports or activities
• Younger athletes
• Those with a history of traumatic or sports-related injuries to the hip

What are the Symptoms of FAI?
Many people can live with FAI and not know, because it is often not painful in the early stages. Over time, symptoms may develop. Those with more advanced FAI typically experience the following symptoms:

• A clicking or locking sound or sensation within the hip joint
• Difficulty performing routine tasks such as putting on shoes
• Difficulty walking uphill
• Lower back pain or pain in the pelvis area
• Sharp pain when squatting, turning, twisting
• Dull pain

The pain that is experienced from FAI is often confused with general pain, or other sources of pain.

Non-surgical Treatments
The first course of action is typically conservative treatment. This usually involves taking anti-inflammatory medication and modifying your activity level. Physical therapy may also be recommended, and some patients may opt for cortisone injections in the hip.

Surgical Treatment
Those with established damage are usually past the point of conservative treatments and may require surgery. Common surgeries include arthroscopy and hip replacements. The right option for you will depend on the severity of the damage.

• Arthroscopy
  “Arthroscopy involves repairing damaged tissue, removing bone growths, and addressing damaged cartilage. This surgery is designed to restore the normal range of motion to the hip joint,” says Dr. DaSilva.

• Hip Replacement
  Those who have significant cartilage loss in the joint may require a more extensive operation that includes a hip replacement.

If you or a loved one is experiencing joint pain, contact us to schedule a visit with one of our hip specialists. A delay in treatment can result in further damage to the cartilage of the hip, and it’s important to seek treatment as soon as possible.