Friday, July 18, 2014

It's all in the hips -- what your hip pain could be

Training for events like the Barber Beast can expose problems in the hip earlier than they would appear in someone who is less active. Hip pain in the athletically active person can indicate several different conditions, however one such condition known as Femoroacetabular Impingement (FAI), has received significant attention in recent times. It is characterized by abnormal contact between the top of the femur and the acetabulum (hip socket). A combination of certain factors may predispose some people to FAI, predominantly, a developmental hip abnormality together with environmental factors such as activities involving recurrent motion of the legs. It is regarded as a cause of premature hip osteoarthritis in young and middle aged adults, and is usually associated with a tear in the labrum (cartilage lining the socket).
Symptoms of FAI are usually felt in the groin, but can also present as back pain or buttock pain. Typically, limited range of motion during a physical examination will lead to further testing including x-rays, MRI, or CT scan.
Three types of FAI are recognized. They are: cam deformity, pincer deformity and a combination of both.

Cam Deformity: an excess of bone along the upper surface of the femoral head.

<---- normal hip

<----- cam deformity with excess bone

Pincer Deformity: an excess of growth of the upper lip of the acetabular cup (hip socket)

Combination: an excess of bone growth at the head of the femur and around the acetabulum.

Conservative treatment of FAI includes: reducing levels of physical activity, anti-inflammatory medication and physical therapy.  Physical therapy is used to improve the movement of the joint to reduce the abnormal stresses created by the impingement.  Joint mobilization can be used to improve the elasticity of the capsule, thus, improving the mechanics of the ball and socket joint and reducing stress caused by impingement.

<----- example of a joint mobilization technique 

- Jason Dudzic, PT, MSPT, OCS, Cert. MDT
Board Certified Orthopaedic Physical Therapist
Saint Vincent Rehab Solutions

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