Known as FAI or hip impingement, this condition relates to a mechanical pinching or compression at the rim of the hip socket (acetabulum) and ball (femoral head). The presence of extra boney growth at the rim of the hip socket or ball makes the pinching more prevalent in people playing sports involving running, twisting, bending and changes of direction.
Pain is usually felt at the front of the hip and groin, and sometimes at the outer hip or buttock. Compensatory pain is common is the lower back and sacroiliac joint.
1) pain associated with the above mentioned activities,
2) positive impingement testing on examination, and
3) radiological evidence of the extra boney growth.
A variety of individual and environmental factors are involved in the development of FAI, and expect consensus currently supports extensive conservative rehabilitation and treatment before considering surgery. In particular modifying aggravating activities and retraining unhelpful biomechanics around the hip and pelvis are essential in persistent cases.
Sometimes known as Hip Hypermobility, Hip Instability or Developmental Dysplasia of the Hip (DDH), this condition relates to an increased amount of movement or “play” of the hip ball in the socket. This can be from a range of reasons relating to increased laxity of connective tissues or a lack of bone coverage of the hip socket over the hip ball. The instability means an increased sheering force on the surfaces of the hip and surrounding structures, and forces are focused on smaller amounts of contacting surface area.
The pain described can be similar to FAI (ache or sharp pain around the groin, buttock and thigh) and this is a common misdiagnosis. Other symptoms can be mechanical locking, popping, clicking or catching, as well as a feeling of instability of the hip. Quite often manual therapies have minimal impact and what is needed it to address the specific factors involved and retraining the deep stability muscles of the hip and the stabilisers of hip and pelvis.
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