Overview
The hip is a major joint enabling you to perform common but overlooked actions such as standing, walking, and sitting. Your hips are important in balancing your body weight and helping you maintain your balance and posture.
These heavy duties increase the chances of injury to the hip. One notable problem impacting the hips is called hip impingement.
Anatomy
The hips serve as a bridge to the upper and lower bones of the body. One of the bones joined at the hip is the thigh bone (femur). Atop the femur is a structure called the femoral head. This component is the circular-shaped bone serving as the ball of the hip. The femoral head connects to the pelvic bone in a socket-like position (acetabulum).
Description
In healthy and well-functioning hips, the ball-and-socket moves easily and fits together well. Various underlying causes can disrupt this connection. When the joint is disturbed, a condition known as hip impingement occurs.
Causes
Hip impingement typically results from two primary causes:
- Socket Irregularities – Sometimes, the front of the hip’s socket juts out farther than it should. In such instances, the thigh bone and socket routinely come into contact during normal movement. Over time, this friction can result in injury. In medical terms, this is called pincer impingement.
- Ball Deformities – If the femur head or ball part of the hip joint does not develop properly or experiences deforming damage, it can rush into the socket too quickly when the hips are bent. This is called a cam impingement.
Less frequently, hip impingement may result from medical conditions that cause decreased blood flow to the hip bones and surrounding structures.
Risk Factors
No one is immune to the condition, but your risk might be higher if you:
- Play contact sports like football.
- Engage in activities placing significant weight on your hips, like weightlifting or cycling.
- Were born with some type of hip structural abnormality.
- Have an underlying illness like arthritis.
Chances of developing hip impingement also increase if you’ve sustained a traumatic hip injury.
Symptoms
Often, symptoms are not felt in the condition’s beginning stages. When problems arise, a significant degree of discomfort is felt in the groin area. This pain typically worsens when walking or bending.
As the injury progresses, you can experience considerable discomfort with greater frequency. Pain might even occur when sitting for extended intervals, at night, or when performing the most basic and simple movements.
Moderate to severe cases also produce symptoms such as:
- Stiffness.
- Mobility limitations.
- Difficulty performing typical exercises like climbing stairs.
- Noticeable limping.
Balance issues also indicate the presence of a more advanced case.
Complications
If left unchecked, hip impingement can bring forth problems to neighboring body parts.
A common complication associated with the condition is the tearing of the surrounding labral tissue. The labrum is a covering made up of a strong protective material known as cartilage. A damaged labrum leaves other structures like bones and soft tissues more vulnerable to injury. A weakened labrum often worsens hip impingement resulting in more intense pain and disability.
Untreated hip impingement increases the risk of developing a painful and debilitating condition called osteoarthritis. This condition, which is characterized by inflammation in the hip joint, gradually destroys the structure and may eventually bring about the need for hip replacement surgery.
Diagnosis
Your doctor will first evaluate your symptoms and may ask questions such as:
- When did the discomfort start?
- Do any activities worsen the pain?
- What is your profession?
- What sports or leisure activities do you participate in?
- Have you experienced any significant hip injuries during your lifetime?
- Were you born with any known hip deformities?
After gathering this initial history, your doctor will visually examine your hip, looking for apparent problems.
You will need to undergo X-rays, which enable your doctor to capture internal images of your hip bones. Such photos will help identify any bone irregularities. Doctors might also perform an MRI (Magnetic Resonance Imaging). This internal imaging allows doctors to assess the health of soft tissues surrounding your hip.
Treatment Overview
Treatment will hinge on factors such as age, general health, fitness levels, goals, the stage of impingement, and how life-limiting the symptoms are.
Initial treatment for early-stage impingement often includes conservative home-care methods. Moderate to severe cases may need surgical correction.
Non-Surgical Options
Early-stage or uncomplicated cases may respond favorably to home-care treatments like rest. Limiting movements, stopping all strenuous exercises or activities, and using pain-relieving and inflammation-lessening medications can all help.
You may also benefit from a physical therapy program. This treatment method, often abbreviated as PT, is a guided exercise program designed to help your hip joint and neighboring physical features regain the strength and motion gradually lost as the injury progressed.
Surgical Procedures
Severe or debilitating cases often need surgery that will address two main problems:
- Joint Damage – Joint damage may be significant enough to where injured tissues must be fixed or removed.
- Bone Deformities – Many issues arise due to the surrounding hip bone deformities. Surgical procedures focus on correcting these existing abnormalities.
Doctors have different surgical procedures to choose from.
Less severe, uncomplicated cases use arthroscopic surgery. Hip bone reforming is often completed using this less-invasive procedure performed with a surgical tool called an arthroscope.
A thin, camera-equipped device uses smaller incisions than typical operating tools, and the patient typically recovers faster. More severe cases may need open surgery, with larger incision sites and a longer recovery time.
Doctors will consider several factors before recommending a specific type of surgery, such as your age, overall health, professional requirements, fitness goals, weight, and whether you have experienced any previous hip injuries.
Recovery
Recovery is usually the quickest in cases treated during the condition’s earliest stages. Conservative treatments may produce symptom relief in a matter of weeks. If you have undergone surgery, recovery times will be longer. It is difficult to give specific recovery time frames in such cases. Individuals heal at their own rate, but it will likely be at least several months before you can fully return to previous activities.
Prevention
You might reduce your risk of experiencing full-blown hip impingement through measures such as:
- Exercising – Engage in exercises designed to strengthen the hip joint and surrounding structures. This can often increase injury resistance and heightens your ability to heal if problems arise.
- Adjusting Your Lifestyle – You may prevent or lessen the severity of hip impingement by consuming a healthy diet, staying adequately hydrated, getting enough rest, and limiting stress whenever possible.
- Seeking Medical Attention When Appropriate – It’s best to seek medical treatment at the first sign of hip impingement. You are less likely to experience potentially debilitating complications when found and treated early.
Next Steps
Hip impingement does not have to result in chronic pain or life limitations. If you experience the symptoms of this physical disorder, please contact Dr. Peter Howard.