Hipimpingement or Femoroacetabular impingement (FAI) syndrome is an extremelycommon condition, particularly in young adolescents.
Hip impingement syndrome or Femoroacetabular impingement syndrome is a repetitiveuse injury of the hip. It is typically associated with hyperflexion of the hip(commonly during belly dancing or pitching in baseball). And caused due toabnormal morphology of the femur and/or acetabulum.
Hip impingement syndrome is also associated with the presence of soft-tissue(labrum & cartilage) damage & increased risk of degenerative arthrosislater on in life.
groin pain,pain outside the hip joint, discomfort in walking, etc are some symptoms of hipimpingement syndrome.
Typicalmanagement of hip impingement syndrome includes- activity restriction,anti-inflammatory medication, or intraarticular injection of corticosteroid.
In somecases, if conservative treatment somehow failed then you have to undergosurgical management.
Physiotherapy is the treatment option that can save you from surgery and enhance the resultof conservative treatment.
Physiotherapytreatment of Hip impingement syndrome includes:
Treatment ofhip impingement syndrome starts with pain management. And this can be achievedmanually as well as mechanically by some manual techniques such as manual jointmobilization, Taping, Heat-therapy, etc.
Therapeuticmodalities- Extracorporeal shockwave treatment, High-intensity Class 4 LaserTreatment, Super Inductive System (SIS), and TENS, etc. They can alleviate painand improve the healing process.
Manual therapy includes- Hip extension in standing mobilization with movement (MVM),Hip distraction during internal rotation, & lateral glide in externalrotation, etc.
Trigger pointrelease- Releasing of rectus femoris muscle, TFL, gluteus medius, and gluteusminimus, etc. do it for 30-60 seconds per trigger point.
Lumbar spinemobilization- it will improve mobility and pain-free movement.
Deep hiprotator muscle strengthening- progress the difficulty through prone,four-point-kneel, and dynamic standing position, with or without resistance.
Strengthening exercises such as- Squats, lunges, leg press, leg extension, hamstring curls.
Hip muscle stretching- it will help in regaining full hip extension range of motion.Stretching of quadriceps, IT-band, & Piriformis, etc.
Gentle pendular swing of the affected leg in Four-point kneel position.
Posterior capsular stretching- lying on the unaffected side with affected hip as close to90-degree flexion as comfortable and affected leg over the bedside.
Stationary cycling- it will improve hip ROM as well as strength.
Hydro-therapy-this can be done in the pool such as walking in the pool.
Swimming- itwill maintain and regain Cardio-vascular fitness.
Cross-training-2 times per week.
Functional training such as Jogging on running track or grass, with the affected leg tothe outside of the track, that is, anticlockwise for the right hip.
Motor ControlExercise- such as- reverse lunge with front ball tap, isolateral Romaniandeadlift. & Side plank, etc.
Agilitytraining.
Sports-specificdrills.
Customorthotics- for the treatment of biomechanical abnormalities.