• It is premature contact between the acetabulum and head of femur.( flexion,internal rotation, adduction of the hip)
• This results in particular symptoms - clinical signs and imaging findings.
• In the long it may develop degenerative change s and osteoarthritis.
Causes
• Structure of the bone
• Intrinsic factors
• Repeated stress injuries
• Childhood diseases
• After fracture of head and neck of femur bone
• Post surgical
Types of Hip Impingement
1. Cam impingement- occurs because the ball-shaped end of the femur (femoral head) is not perfectly round. This interferes with the femoral head's ability to move smoothly within the hip socket.
2. Pincer impingement- involves excessive coverage of the femoral head by the acetabulum. With hip flexion motion, the neck of the femur bone “bumps” or impinges on the rim of the deep socket. This results in cartilage and labral damage.
3. Combined impingement- cam and pincer impingement,can exist at the same time.
● Symptoms :-Stiffness, restricted ROM, clicking, catching, locking or giving way.
Pain in the hip and/or groin, may also be their in thigh or buttock.
Pain increases with acceleration sports, squatting, climbing stairs and prolonged sitting.
Management
• Conservative:
Physiotherapy Management :-
•Posture & Ergonomic advice. (Avoid common activities like squats, stairs up&down)- Manual Therapy (Hip mobilisation).
•Strengthening Exercise of deep hip muscles (external rotators, abductors,and flexors) .This helps in reducing the loading of labrum and thus reducing of inflammation. lower limb strengthening.- Pelvic control exercises.
•Mobility Exercises.
•Electrotherapy.
•Taping:- To assist with postural modification.
•Hydrotherapy.
•Orthotics: For biomechanical abnormalities. It helps in changing the kinematics of the joint. (Bracing is practically not used).
• Intra-articular injection steroid).
• Surgery:-
Arthroplasty: Post operative physiotherapy plays an important role in recovery. All patients treated conservatively get better.