Anterior hip pain is commonly caused by a condition called Femoroacetabular Impingement (FAI). The impingement that occurs in this condition is caused by the presence extra bony growth in the ball and socket joint of the hip, the femoral head (ball) or the acetabulum (socket).
*The red sections on the diagram indicate the presence of extra bony growth*
The extra bony growth prevents the femoral head’s ability to move smoothly within the acetabular (hip socket). Over time, repetitive movements, particularly flexion of the hip, can cause impingement or catching of the cartilage in the hip (the labrum).
This condition is most common in athletes, particularly gymnasts and football players who regularly participate in activities involving repetitive movement of the legs beyond the normal range of motion.
Symptoms vary depending on the stage of the condition. In the early stages of the condition symptoms may be mild or even absent.
Typical symptoms include:
- Pain over the anterior hip (groin), particularly with hip flexion
- Stiffness in anterior hip (groin), hip or thigh.
- Clicking or catching of the hip
- Inability to flex the hip beyond 90 degrees.
- Pain in hip, groin, or low back pain at rest.
- Pain with prolonged sitting.
- Pain with running.
How do we diagnose FAI?
Osteopaths can provide a suspected diagnosis of FAI with special orthopaedic testing, physical examination and taking a clinical history.
The gold standard for confirming diagnosing FAI is an X-ray, to confirm the presence of extra bony growth and which type.
An MRI scan is sometimes recommended to further assess the hip to see if there is any damage to the cartilage of the hip (labrum) and other surrounding soft tissues.
Imaging is important, as it provides us with the necessary information about whether we can treat the condition or need to refer you on to a specialist.
How do we treat FAI?
Conservative treatment of FAI is focused on improving lower limb strength, core stability and hip range of motion. Hands on treatment can include but is not limited to, soft tissue massage, articulation, muscle energy technique and dry needling. A tailored exercise rehabilitation program will also be provided for the patient to complete at home.
Non-steroidal anti-inflammatory medications like Nurofen or Voltaren can be used to help reduce the inflammation causing pain, although are not recommended for prolonged use and should be used under guidance of your GP.
If conservative treatment fails and pain is not reducing or is increasing, referral to an orthopaedic surgeon is recommended, for possible arthroscopic surgery. A conservative management plan of rehab and hands on treatment will always be considered and tried before surgery is recommended.
FAI can lead to chronic and severe pain if left untreated and can put you at risk of developing hip arthritis. Early intervention to find the most effective management can improve the chances of conservative treatment being successful and can prevent prolonged financial burden.