The hip is a notoriously troublesome joint, and we see a lot of patients with hip problems. They can cause low back discomfort or knee pain, and the hip joint plays an important role in our daily life, from walking to jogging to moving upstairs, as well as rotational sports. If you experience hip discomfort, you are most likely suffering from femoroacetabular impingement, or FAI. This is a long, intimidating word for an illness that, in most cases, can be treated conservatively. The parts below explain what the problem is, how we assess it, and what treatment choices are available. If you'd like to learn more about this from a third-party source, follow the link below.
Femoroacetabular impingement (FAI) results from an abnormal articulation between the femoral head and the pelvis or the acetabular rim. It is classified as bony or morphological changes in either the femoral head and/or the acetabular rim from either repetitive injury or degeneration of the soft tissue in the area such as the labrum and articular cartilage.
This bony growth we refer to as wolf’s law, which states bone grows in response to stress due to adaption and protection. This is an excellent protective measure the body uses to protect hard tissue but can cause biomechanical restriction we want to avoid. We typically see this with males age 20-50 with painful motions of the hip being flexion, adduction, and internal rotation. This can be withstanding, walking uphill, sitting, or jumping, but also, we see this at the end of the swinging motions or the deceleration phase of both golf and tennis players. Other activities that may provoke this include getting out of a car or swimming breast-stroke.
People who walk with a toe out or retroverted hips are predispositioned to this condition because they lack internal rotation of the femur and repetitively run into the joint motion barrier until pain occurs. The pain typically is dull and achy unless aggravated it could present as sharp, and these patients tend to have hip flexor tightness with reported catching or locking in the hip associated with a snapping sound with the hip in a neutral position (not extended in the case of a psoas tendon snapping noise) in internal or external rotation.