Are you someone that loves to exercise and train and push yourself in your strength training journey?
Hip impingement may not stop you from exercising at first. It will however impede how much you want to push into it. The movements or exercises begin to feel pinchy or uncomfortable. You may even notice a slow decline in strength.
What is hip impingement you might wonder? It is an un-uniform architecture of the hip on the pelvis where they meet and work together. There are two different types. The issue is that of a structural matter. It is also a matter of understanding what can increase your symptoms within your training.
Hip impingement is the common name for Femoral Acetabular Impingement. In the hip we have a socket-like structure that houses the head of the femur, a round ball-like shape. From the head of the femur there is the neck portion. With hip impingement this is commonly the problem spot. Either there is a growth of the neck portion that comes in contact to the acetabular rim of the pelvis, or there is a growth of that acetabular rim that contacts the neck of the femur.
Each type has their own name. CAM lesions are the growth on the neck of the femur, causing a growth of the bone that more resembles an egg shape instead of an hourglass shape. . And Pincer lesions are growth around the acetabular rim and account for 18% of the FAI cases. It is more common in FAI that these two sub-categories are seen at the same time in a person. Combined impingement is more common at approx 72-80% of cases.
A recent 2021 study in Clinical Rehabilitation found that the outcome of surgery for FAI and conservative treatment found no difference in disability after 6 and 12 months.
What does that mean for you? Depending on what your circumstances are, surgery may not be a better choice for you.
In recent cases here at ChiroMovement we have seen patients with FAI. One such case has had the surgery to clean up or shave the bones of the hip. Post surgery by 2 years and the symptoms of Hip FAI are still present. We have seen an improvement by applying targeted exercises to strengthen the hip flexor and improve the function of the hip.
Exercises that we have utilized are as follows, but not limited to this:
- Hip flexion isometrics
- Core stability training
- Hip 90/90’s with mobility patterns included.
- Joint centration exercises.
What we have seen from this is that certain musculoskeletal conditions improve when strengthened in a guided manner with a clinician or educated strength training.
If you are experiencing hip pinch like pain, before getting expensive imaging please get examined thoroughly. Conservative care may be the right thing for you.
- Zhang C, Li L, Forster BB, Kopec JA, Ratzlaff C, Halai L, Cibere J, Esdaile JM. Femoroacetabular impingement and osteoarthritis of the hip. Can Fam Physician. 2015 Dec;61(12):1055-60. PMID: 26668284; PMCID: PMC4677941.
- Griffin DR, Dickenson EJ, Wall PDH, Achana F, Donovan JL, Griffin J, Hobson R, Hutchinson CE, Jepson M, Parsons NR, Petrou S, Realpe A, Smith J, Foster NE; FASHIoN Study Group. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018 Jun 2;391(10136):2225-2235. doi: 10.1016/S0140-6736(18)31202-9. Epub 2018 Jun 1. PMID: 29893223; PMCID: PMC5988794.
- Bastos RM, de Carvalho Júnior JG, da Silva SAM, Campos SF, Rosa MV, de Moraes Prianti B. Surgery is no more effective than conservative treatment for Femoroacetabular impingement syndrome: Systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2021 Mar;35(3):332-341. doi: 10.1177/0269215520966694. Epub 2020 Nov 4. PMID: 33143438.
- Griffin DR, Dickenson EJ, O’Donnell J, Agricola R, Awan T, Beck M, Clohisy JC, Dijkstra HP, Falvey E, Gimpel M, Hinman RS, Hölmich P, Kassarjian A, Martin HD, Martin R, Mather RC, Philippon MJ, Reiman MP, Takla A, Thorborg K, Walker S, Weir A, Bennell KL. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016 Oct;50(19):1169-76. doi: 10.1136/bjsports-2016-096743. PMID: 27629403.