Managing Hip Impingement with Chiropractic
What you need to know
FAQ about Hip impingement
Common Questions and Answers with Hip Impingement
01
How do you diagnose Hip Impingement
Performing hip flexion, adduction, and internal rotation (FADIR) in the supine patient is another common clinical procedure used to diagnose FAIS
Loss of internal rotation ROM unilaterally suggests FAIS.
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What are the signs of Hip Impingement
Patients with FAI routinely demonstrate decreased ROM in flexion, abduction, and internal rotation. Interestingly, when the hip is flexed to 90°, the loss of internal rotation becomes profound
02
What are the two types of Hip Impingement
Cam lesions are the result of the non-spherical shape of the femoral head, often referred to as a “pistol-grip” deformity, which causes abrasions to the acetabular cartilage and subsequent avulsion from the labrum and subchondral bone
Pincer lesions, on the other hand, are the result of excessive coverage of the femoral head-neck junction by the acetabular rim and can lead to labral tearing
04
What are the Treatments of Hip Impingement
Chiropractic Therapy
Massage Therapy
Rest
Ice
Activity Modifications
FAQ about Hip impingement
Common Questions and Answers with Hip Impingement
5
Associated Conditions
Athletic Pubalgia- Groin Pain (pain in your adductors potentially from the rectus abdominis muscle or internal oblique muscle
Iliopsoas Impingement
Internal snapping hip syndrome, this leading to a decrease in range of motion in external rotation and abduction.
7
Will I need surgery for hip impingement
Hip arthroscopy appears to be an efficacious treatment for hip and/or groin pain, caused by pathologies such as FAI or labral tears, in elite athletes in the shorter term
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How Common is Hip Inpingement
In athletes with hip pain, nearly 90% had radiographic signs of hip impingement
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What are some tests the Chiropractor will do to diagnose hip impingement
1.Flexion, adduction, internal- rotation test
2.Supine log-roll test
3.Drehmann sign
4.C-palpation sign
5.Dynamic internal-rotatory impingement test
6. Hip Scouring
What is Hip Impingement
Femoral Acetabular Impingement
Known as Femoroacetabular impingement , it is a gradual onset problem withouth a specific injury. It is more common in those who require to do hyperflexion and a wide range of motion at the hip joint . Common Symptoms are clicking, catching, locking, restricting and stiffening of the hip with movement
Who Gets Hip Impingement ?
Lets discuss
Femoroacetabular impingement (FAI) is the most common cause of hip pain in both professional and recre- ational athletes Athletes typically become symp- tomatic after reaching skeletal maturity and common- ly describe deep groin pain that worsens with activities such as squatting, cutting, or pivoting motions For this reason, sports such as hockey, football, and soccer can be particularly irritating to an athlete with FAI. The development of symptoms in FAI results from abnormal contact between the proximal femur (head, neck and head-neck junction) and the acetabular rim, which causes labrum and cartilage tears. It is classified as either the cam or pincer type on the basis of the underlying anatomic deformity. Patients complain of groin pain that occurs during athletic activities or prolonged sitting. Episodes of locking may occur, mainly related to unstable labral tears.
How to Prevent Hip Impingment
Things to Avoid
Activities such as deep flexion, positions that provoke symptoms, squats and heavyweight strength training should be avoided.
Return To Play Advice with hip Impingement
When will you play sport again ?
9/10 Players return to sport
8/10 Players will be able to play at full capacity
The time from diagnosis to return to sports ranges from 3 to 6 months depending on Surgery VS non-surgery.
Rehab Hip Impingement
A quick guide to what to expect with Hip Impingement rehab
Phase 1
Weeks 1-4
Stationary Bike
Ankle Pumps
Passive ROM- Internal Rotation, circumduction and prone lying
Piriformis Stretch
Heel Slides
Hip Joint Mobilisations
Uninvolved Knee to Chest
Phase 2
Weeks 5-7
Wall Sits with Abductor band
Stationary biking with resistance
kneeling hip flexor stretch
involved knee to chest
adductor stretch
seated resisted internal and external rotation
leg press
single leg bridge
Stairclimber machine
Phase 3
Weeks 8 -12
Standing resisted Hip External Rotation
lunge
Lunge with Trunk Rotation
core ball stabilisation
Progression with running
Phase 4
12 Plus weeks
Starting sport-specific drills
Resume activity if there is full ROM and pain free joints