Hip Impingement Treatment Pune

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Overview

Hip impingement, also called femoroacetabular impingement (FAI), is a condition where the bones in your hip joint don’t fit together properly. The ball at the top of your thigh bone (femoral head) and the hip socket (acetabulum) have an abnormal shape, causing them to rub against each other during movement.

This abnormal contact creates friction that damages the soft tissues around the joint, including the labrum (a ring of cartilage) and the smooth cartilage that covers the bones. Instead of moving smoothly, the bones “pinch” or “impinge” on these tissues.

While some people may have the bone shapes associated with FAI without any symptoms, others experience pain and difficulty moving their hip. When symptoms occur, doctors call it Femoroacetabular Impingement Syndrome. If left untreated, hip impingement can lead to early osteoarthritis, especially in younger adults.

Symptoms

Hip impingement symptoms can vary from person to person and may develop gradually. In the early stages, you might not experience any pain at all. However, when symptoms do appear, they typically include:

Groin pain: This is the most common symptom, often felt as a dull or sharp ache in the groin area. The pain may also occur in the buttock, lower back, outside of the hip, or radiate down the thigh to the knee.
Hip stiffness: You may feel like your hip is “tight” or difficult to move, especially during certain activities.
Limited range of motion: Difficulty bending your hip, rotating it inward, or moving your leg toward your body.
Pain with activity: Discomfort that gets worse during physical activities like walking, running, squatting, or sitting for long periods. Simple tasks like riding a bike or tying your shoes may also cause pain.
Clicking or catching sensations: Many people report hearing or feeling their hip “catch” or “click” during movement, which may indicate a labral tear.
Changes in walking: Your walking pattern may change due to pain or stiffness in the hip.

It’s important to note that hip impingement primarily affects the hip, but the way you move to avoid pain can sometimes cause secondary problems in your lower back or other areas.

Causes

Hip impingement happens when the bones in your hip joint have an abnormal shape. These shape differences can be present from birth or develop over time. There are three main types of bone problems that cause FAI:

Cam Impingement : This occurs when there’s an extra bump of bone around the head of your thigh bone. This bump makes the bone less round, causing it to jam into the hip socket when you bend your hip. Cam impingement is more common in men.

Pincer Impingement : This happens when the hip socket covers too much of the ball of the thigh bone. The rim of the socket sticks out too far, causing the neck of the thigh bone to bump into it during normal movement. Pincer impingement is more common in women.

Mixed Impingement : This is the most common type in people with symptoms, where both cam and pincer problems are present.

Other factors that can contribute to hip impingement include:

Childhood hip conditions: Problems like slipped capital femoral epiphysis or Legg-Calve-Perthes disease can cause bone deformities that lead to impingement later in life.
Repetitive movements: High-impact sports involving twisting, squatting, or repetitive leg movements can worsen the condition.
Developmental issues: The hip joint may not develop normally during childhood.

Risk Factors

Several factors can increase your risk of developing hip impingement:

Age and activity level: The condition is most common in young, athletic individuals. About 55% of athletes experience symptomatic FAI compared to only 10-15% of the general adult population.
Type of sport: High-impact sports that involve repetitive hip movements, deep bending, or forceful kicking increase risk. Examples include football, hockey, basketball, dance, and gymnastics.
Sex: Cam impingement is more common in men, while pincer impingement is more common in women, likely due to differences in pelvic anatomy.
Genetics: While not directly inherited, genetic factors can influence the shape of your hip bones, making you more likely to develop FAI.
History of childhood hip disorders: Previous hip problems during childhood increase the likelihood of developing FAI deformities.

Remember, many people have the bone shapes associated with FAI but never experience symptoms.

Diagnosis

Diagnosing hip impingement involves several steps to get a complete picture of your condition:

Medical History: Your doctor will ask about when your hip pain started, what activities make it worse (like squatting or sitting for long periods), and whether you experience clicking or catching sensations. They’ll also want to know about any previous injuries or childhood hip problems.

Physical Examination: The doctor will watch how you walk and test your hip’s range of motion and strength. They’ll perform special tests, including the anterior impingement sign (pain when your hip is bent, moved inward, and rotated) and the FABER test to check for labral problems.

Imaging Tests

X-rays: These are usually the first imaging tests performed. They help identify cam and pincer problems and show the overall shape of your hip bones.
MRI scan: Often done with contrast dye injected into the joint, an MRI provides detailed images of soft tissues like the labrum and cartilage. It can show tears or damage caused by impingement.
CT scan: This creates detailed 3D images of your bones, which is especially helpful for surgical planning.

Types

Hip impingement is classified into three main types based on where the bone abnormality is located:

Cam Impingement: The problem is on the ball of the thigh bone (femoral head), which has an abnormal bump that prevents smooth rotation in the socket. This type is more common in men, especially those who play high-impact sports.

Pincer Impingement: The problem is with the hip socket (acetabulum), which covers too much of the ball. During movement, the neck of the thigh bone hits this overhanging rim. This type is more common in women.

Mixed Impingement: This combines both cam and pincer problems and is the most common type seen in patients with symptoms.

Regardless of the type, the main issue is that abnormal bone shapes cause the hip bones to rub against each other, leading to damage of the cartilage and labrum.

Treatment

Treatment for hip impingement typically starts with non-surgical options and may progress to surgery if symptoms don’t improve.

Non-Surgical Treatment

The first approach focuses on reducing pain and improving function without surgery:

Rest and Activity Changes: Avoiding activities that worsen your symptoms, such as deep squatting or prolonged sitting, can help reduce strain on your hip. Simple changes like using higher chairs or placing a pillow between your knees while sleeping can be helpful.

Medications: Over-the-counter anti-inflammatory drugs like ibuprofen can help reduce pain and swelling.

Physical Therapy A customized physical therapy program is often the most important part of non-surgical treatment. It focuses on:

Strengthening hip and core muscles
Improving hip flexibility
Correcting movement patterns
Teaching proper body mechanics

Surgical Treatment

If non-surgical treatments don’t provide relief and pain significantly affects your quality of life, surgery might be recommended:

Hip Arthroscopy: This minimally invasive procedure uses small incisions and a tiny camera to view and treat the hip joint. Surgeons can reshape excess bone and repair damaged labrum tissue. This approach typically involves less pain and faster recovery than open surgery.

Open Surgery: For more severe cases, open surgery may be needed. This involves a larger incision and provides better access to extensively reshape bones and repair damage.

Hip Replacement: If significant osteoarthritis is already present, hip replacement might be the best option to eliminate pain and restore function.

The success rate for hip impingement surgery is generally high, with good outcomes reported in most patients.

Rehabilitation

Rehabilitation is crucial for both non-surgical and post-surgical treatment of hip impingement.

Non-Surgical Rehabilitation

Physical therapy for non-surgical treatment focuses on:

Strengthening muscles around the hip and core
Improving flexibility and stretching tight muscles
Teaching proper movement patterns
Gradually increasing activity levels
Learning self-management techniques

This process typically takes 3 to 6 months to see significant improvement.

Post-Surgical Rehabilitation

Recovery after hip impingement surgery happens in stages:

Early Phase (0-4 weeks)

Use of crutches and protective weight-bearing
Immediate start of physical therapy
Focus on gentle range of motion exercises

Intermediate Phase (4-8 weeks)

Gradual increase in weight-bearing
Active movement exercises begin
Strengthening and walking training

Advanced Phase (8-12+ weeks)

Focus on restoring full strength and balance
For athletes, gradual return to sport-specific activities
Full return to high-level sports usually takes 6 to 9 months

Complications

While hip impingement surgery is generally safe and effective, potential complications can occur:

Major Complications (rare but serious):

Fracture of the thigh bone neck
Severe fluid complications
Loss of blood supply to the bone
Joint dislocation
Deep infection

Minor Complications (more common but less serious):

Blood clots
Nerve damage causing numbness
Superficial infection
Abnormal bone formation
Need for additional surgery

Prevention

While you can’t prevent the bone shapes that cause hip impingement, you can reduce your risk of developing symptoms:

Modify high-risk activities: Adjust techniques or intensity in sports that stress the hip joint
Maintain hip strength and flexibility: Regular exercise focusing on hip and core muscles
Listen to your body: Pay attention to early warning signs like stiffness or mild pain
Pace your activities: Gradually increase activity levels and take breaks from repetitive motions
Maintain healthy weight: Reduce pressure on your hip joint
Improve posture: Address poor posture that can contribute to hip problems

These strategies can significantly reduce your likelihood of developing painful symptoms or slow progression toward osteoarthritis.

Living With Hip Impingement

Managing hip impingement involves ongoing lifestyle adjustments and self-care strategies:

Daily Life Modifications

Choose higher chairs and avoid sitting cross-legged
Take regular breaks from prolonged sitting
Be mindful of movements that trigger pain
Change positions frequently throughout the day

Exercise and Movement

Continue prescribed physical therapy exercises
Stay active with low-impact activities like swimming or cycling
Focus on maintaining hip strength and flexibility

Pain Management

Work with your healthcare provider to manage pain effectively
Use anti-inflammatory medications as directed
Consider corticosteroid injections when appropriate

Key Takeaways

Hip impingement occurs when abnormally shaped hip bones cause friction, leading to groin pain, stiffness, and limited movement
Early treatment with physical therapy and activity modifications can effectively manage symptoms in many cases
Hip arthroscopy offers a minimally invasive surgical option when conservative treatment fails
Rehabilitation is essential for optimal outcomes, whether you choose surgical or non-surgical treatment
Prevention strategies focus on maintaining hip strength, flexibility, and proper movement patterns

At Sancheti Hospital, we understand that hip impingement can significantly impact your daily life and athletic performance. Our team of experienced orthopedic specialists and physical therapists provides comprehensive care for patients with FAI, from initial diagnosis through complete recovery.

We offer advanced diagnostic imaging, minimally invasive hip arthroscopy techniques, and personalized rehabilitation programs tailored to each patient’s specific needs and goals.

Our multidisciplinary approach ensures that you receive the most appropriate treatment, whether that’s conservative management or surgical intervention, with the ultimate goal of helping you return to the activities you love pain-free.

Meet Our Hip Specialists

Patient Stories & Experiences

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Parvati

I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.

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The knee pain I've carried for years finally went away with the help of Sancheti Hospital.

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Other Conditions

Snapping Hip Syndrome

Avascular Necrosis

Labral Tear

Trochanteric Bursitis

Hip Dysplasia

Hip Arthritis

Hip Fracture

Frequently Asked Questions

At what age does hip impingement typically start causing problems?

Most people develop symptoms between ages 20-40, especially active individuals and athletes. However, the bone shape abnormalities are usually present from birth or develop during teenage growth spurts.

Can I still exercise and play sports with hip impingement?

Yes, but you’ll need to modify activities that worsen symptoms. Low-impact exercises like swimming and cycling are usually safe. High-impact sports may require technique adjustments or temporary breaks during flare-ups.

How do I know if my hip pain is serious enough to see a doctor?

See a doctor if your hip pain persists for more than a few weeks, interferes with daily activities, causes limping, or if you experience clicking sounds with movement. Don’t ignore pain that gets worse over time.

Will hip impingement get worse if I don't treat it?

Yes, untreated hip impingement typically worsens over time. The ongoing friction can cause more damage to cartilage and labrum, potentially leading to early arthritis. Early treatment usually leads to better outcomes.

Hip Impingement