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Hip impingement is common, the underlying condition itself is not new but how it is treated has changed significantly over the last 15 years. The full name of the condition is femoroacetabular impingement (FAI). It is a mechanical problem that damages important soft tissues inside the hip joint, affecting the hip joint and causing pain and limitation in movement. Hip impingement is usually caused by asymmetry of the ball part of the ball and socket joint, known as a cam deformity. In medical terms, the damaged soft tissue is called the labrum, and damage to the labrum is what generates the pain you feel.

How do I know if I have hip impingement?

It is felt in the form of sharp and severe pain in the front of the hip/groin. Usually deep-seated, discomfort does not move from the front of the hip and can be brought on by specific reproducible movements, for example, deep squats or lunges at the gym. Simple day-to-day activities can also aggravate symptoms, such as getting in and out of the car or climbing stairs two steps at a time. (So, beware!).

“It is felt in the form of intense pain in the front of the hip/groin”

What else causes pain here?

There are many reasons for an intensity around the hip and groin. Similar pain can arise from the muscles and tendons in front of the hip joint, in particular the rectus muscles. Men commonly develop groin hernias which can cause comparable pain brought on by similar activity. Sometimes early wear and tear inside the hip joint (osteoarthritis) can cause problems in this area too.

What can be done?

Most cases of hip impingement can be diagnosed on clinical examination and X-ray. This is usually performed by an orthopedic surgeon with a special interest in hip surgery. To further assess the joint and surrounding tissues, an MRI scan will help quantify the degree of damage to the labrum. The scan also monitors the muscles and tendons around the hip and to a degree the cartilage inside the hip joint.

How can I manage it?

Fortunately, hip impingement is primarily managed with physiotherapy and activity modification. Excellent results can be achieved if the condition is mild or moderate – you do not need surgery just because the scan says you have a labral tear.  It is of paramount importance to make sure the labral tear is actually what’s causing the pain, as while labral tears on MRI scans are common, most are not symptomatic. If the condition is more severe the initial management remains the same, however, sometimes the pain does not resolve and keyhole surgery has positive outcomes in these cases.

Dr Gavin O’Neill is an Orthopaedic Surgeon specialising in hip and knee conditions. He trained in the UK and Australia. If you’re having issues with hip or knee pain contact us at Altius Clinic, Sports and Orthopaedic Surgeons for an appointment. altiusclinic.sg


Altius Clinic Sports and Orthopaedic Surgeons

 290 Orchard Road, #09-11/12 Paragon, 238859
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