Last week, we discussed the differences between shoulder and hip anatomy. As you now know, the hip has more of a “ball and socket” nature. Of course, as with all anatomy, not everything is textbook. So although the intention of the hip joint is to have a perfectly round femur head fit exactly into the acetabulum of the ilium, there is a percentage of hip joints that have mismatched structures, leading to hip injuries.
Picture used from www.chiroup.com a great resource for chiropractors!
This condition is known as femoroacetabular impingement (FAI), which results from hip abnormalities. The presentation is sharp, deep hip pain with squatting, running, starting and stopping, or quick change in directions. The pain is felt in the anterior hip and can limit range of motion in flexion and internal rotation of the leg. The hip range of motion is already limited compared to the shoulder due to the location of the ball and socket joint. Add in anatomical changes, and motion is limited even more.
The types of FAI are as follows –
Pincer – the acetabular rim cartilage pinches a normal femur head. The acetabulum growth creates a “claw-like” formation around the femur head.
CAM – the femur head presents with imperfections, creating friction against a normal acetabulum. This is also known as “pistol grip deformity.”
Combined/Mixed – a combination of both Pincer and CAM. As reported by chiroup.com, combined/mixed is responsible for 72-80% of FAI cases.
FAI can be diagnosed with x-ray and/or MRI, which will show abnormalities of the hip joint. Currently, there are no conservative management motions for FAI and arthroscopic treatment – a minimally-invasive procedure that helps debris and “clean” the joint – has demonstrated good short-term results.
But no fear! With imaging, it is possible to rule out FAI. This means that if you present with similar symptoms and with no anatomical changes, conservative care (e.g., myofasical treatment, chiropractic manipulation to the hip, pelvis and lumbar structures) in addition to active chiropractic care (e.g., controlled articular rotation exercises) can help improve hip pain and get you back to your active lifestyle!
If you suffer from hip pain and have more questions about conservative treatment, contact Stumpff Chiropractic at 954-368-4054 or visit us at www.stumpffchiro.com. As always, consult with a healthcare professional if any symptoms present.
Souza, T. Differential Diagnosis and Management for the Chiropractor: Protocols and
Algorithms. 4th ed. Sudbury:Jones & Bartlett Publishers.2009; 356
www.chiroup.com