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Hip Pain: FAI Syndrome

 

Spring is here and the gardening season is upon us as I can tell from the recent phone calls with patients suffering with stiff achey backs after the weekend. Its usually the time of year that I dust of the Golf clubs being the fair weather player I am.

This month we are going to look at the epicentre of the body and delve into the hips. Its an area that I assess on nearly all my patients, as not only do we get pain in this area but it is usually a common cause of why clients get low back pain.

The hip joints primary function is to support the weight of our head, arms and trunk in tasks such a running, walking and yes playing sports such as tennis and golf. Its greatly influenced when we are weight bearing as the forces going through them, go up exponentially with activities such as running.

When patients present with hip pain they usually describe an array of symptoms ranging from pain deep in the groin, on the outside of the hip, into the lower back and even down the front of the thigh

 

Hip Pain: Femoroacetabular Impingement (FAI) Syndrome

This is one particular condition that patients have presented to me with more commonly over the last 12 months due to the symptoms they present with, the tests that we performed on them and the results after and MRI or CT Scan. Now the most important thing to take away from getting imaging done with these patients, is that the findings are only really relevant if the patient has symptoms as well, otherwise they are normal morphological findings. If you take a look below, Pincer and Cam morphologies are common and there is a good chance that one of your favourite golfers has one, so don’t freak out!

 

The BJSM in 2016 published a paper for this condition and presented the following symptomatic findings:

“The primary symptom of FAI syndrome is motion-related or position-related pain in the hip or groin. Pain may also be felt in the back, buttock or thigh. In addition to pain, patients may also describe clicking, catching, locking, stiffness, restricted range of motion or giving way.” 

So now we have a problem that we need to sort out.

Now before we rush off for surgery, there are some strategies that we can implement to help with FAI that can help that patient back to their functional activity that they want to accomplish. Depending on how long the patient has had the symptoms may determine their potential recovery but if I can get them in and educate them on their rehab and treatment approach we can have some really nice positive outcomes.

Here are some keys points that I like to focus on!

• The hip is irritated so lets tweak your movements so you can offload the stresses on it, so we give it a fighting chance of calming down and becoming less sensitised.
• As this is a bone hence structural problem at the hip where else in the kinetic chain can we buy some more range of movement to help that hip.
• Lets look at the 6 fundamental movements that the hip can perform and work on the ones that highlight some imbalances, so that we can improve your load tolerance.
• Lets gradually expose and integrate you back into your chosen sport as we improve your functional and loading capabilities.

So my take home point this month is that we can get fixated with structural findings on scans but that is exactly what they are….structural findings. These findings can’t predict how someone is functioning.

If I can get a client with a Cam or Pincer hip back to doing what they love best with greater movement variability and performance while being pain free then that is surely the outcome finding we should try and measure.

Have a great month and I’ll see you next month when we start to explore the lower back.

Motion is Lotion

 

Mario

 

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