Hip impingement is
increasingly recognized as a common cause of hip pain in athletes, adolescents,
and young (less than age 50) adults. The hip is a ball and socket joint with a
wide range of motion, stabilized by a capsule, surrounding muscles and cartilage
(the labrum). Hip impingement happens when the ball hits the edge of the socket
due to structural mismatch. This causes injury to the cartilage and can lead to
hip arthritis if untreated. While activity increases symptoms, this is not due
to overuse.
Activities
that are troublesome include prolonged sitting, leaning forward, getting in or
out of a car or pivoting in sports. People are predisposed to impingement by
congenital or development abnormalities. The onset of pain is usually gradual
and progressive. Since the normal activities of daily living cause pain, it’s
not helpful to recommend rest. Anti-inflammatory medications can sometimes be
helpful and it’s wise to try physical therapy to improve hip muscle flexibility
and strength, as well as posture. Success with these measures may be due to the
young age of the patients. If these measures do not give adequate relief,
consultation with an orthopedist is needed as well as imaging studies.
Arthroscopy
can give good results. The goals are to alleviate impingement, to repair or
remove injured tissue and to prevent or delay osteoarthritis.
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