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Managing Hip Impingement  with Chiropractic 

What you need to know

Back Pain Treatment

FAQ about Hip impingement 

Common Questions and Answers with Hip Impingement 

01

How do you diagnose Hip Impingement

Performing hip flexion, adduction, and internal rotation (FADIR) in the supine patient is another common clinical procedure used to diagnose FAIS

Loss of internal rotation ROM unilaterally suggests FAIS.

03

What are the signs of Hip Impingement 

Patients with FAI routinely demonstrate decreased ROM in flexion, abduction, and internal rotation. Interestingly, when the hip is flexed to 90°, the loss of internal rotation becomes profound

02

What are the two types of Hip Impingement 

Cam lesions are the result of the non-spherical shape of the femoral head, often referred to as a “pistol-grip” deformity, which causes abrasions to the acetabular cartilage and subsequent avulsion from the labrum and subchondral bone

 

Pincer lesions, on the other hand, are the result of excessive coverage of the femoral head-neck junction by the acetabular rim and can lead to labral tearing

04

What are the Treatments of Hip Impingement 

Chiropractic Therapy 

Massage Therapy 

Rest 

Ice 

Activity Modifications

Physiotherapy

FAQ about Hip impingement 

Common Questions and Answers with Hip Impingement 

5

Associated Conditions 

Athletic Pubalgia- Groin Pain (pain in your adductors potentially from the rectus abdominis muscle or internal oblique muscle 

Iliopsoas Impingement 

Internal snapping hip syndrome, this leading to a decrease in range of motion in external rotation and abduction. 

Will I need surgery for hip impingement 

Hip arthroscopy appears to be an efficacious treatment for hip and/or groin pain, caused by pathologies such as FAI or labral tears, in elite athletes in the shorter term

6

How Common is Hip Inpingement 

In athletes with hip pain, nearly 90% had radiographic signs of hip impingement 

04

What are some tests the Chiropractor will do to diagnose hip impingement 

1.Flexion, adduction, internal- rotation test

2.Supine log-roll test

3.Drehmann sign

4.C-palpation sign

5.Dynamic internal-rotatory impingement test

6. Hip Scouring 

Soccer game

What is Hip Impingement 

Femoral Acetabular Impingement 

Known as Femoroacetabular impingement , it is a gradual onset problem withouth a specific injury. It is more common in those who require to do hyperflexion and a wide range of motion at the hip joint . Common Symptoms are clicking, catching, locking, restricting and stiffening of the hip with movement

Who Gets Hip Impingement ?

Lets discuss 

Femoroacetabular impingement (FAI) is the most common cause of hip pain in both professional and recre- ational athletes Athletes typically become symp- tomatic after reaching skeletal maturity and common- ly describe deep groin pain that worsens with activities such as squatting, cutting, or pivoting motions For this reason, sports such as hockey, football, and soccer can be particularly irritating to an athlete with FAI. The development of symptoms in FAI results from abnormal contact between the proximal femur (head, neck and head-neck junction) and the acetabular rim, which causes labrum and cartilage tears. It is classified as either the cam or pincer type on the basis of the underlying anatomic deformity. Patients complain of groin pain that occurs during athletic activities or prolonged sitting. Episodes of locking may occur, mainly related to unstable labral tears.

Basketball
Physical Therapy Session
Physical Therapy Session

How to Prevent Hip Impingment 

Things to Avoid 

Activities such as deep flexion, positions that provoke symptoms, squats and heavyweight strength training should be avoided.

Return To Play Advice with hip Impingement 

When will you play sport again ?

9/10 Players return to sport 

8/10 Players will be able to play at full capacity 

The time from diagnosis to return to sports ranges from 3 to 6 months depending on Surgery VS non-surgery. 

Physiotherapy

Rehab Advice 

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Exercise One 

Rehab hip impingement coming soon

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Exercise One 

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Exercise One 

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Exercise One 

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Exercise One 

Physical Therapy Session

Rehab Hip Impingement 

A quick guide to what to expect with Hip Impingement rehab 

Phase 1 

Weeks 1-4 

Stationary Bike 

Ankle Pumps 

Passive ROM- Internal Rotation, circumduction and prone lying 

Piriformis Stretch 

Heel Slides 

Hip Joint Mobilisations 

Uninvolved Knee to Chest 

Phase 2 

Weeks 5-7

Wall Sits with Abductor band 

Stationary biking with resistance 

kneeling hip flexor stretch 

involved knee to chest 

adductor stretch 

seated resisted internal and external rotation 

leg press 

single leg bridge

Stairclimber machine  

Phase 3 

Weeks 8 -12 

Standing resisted Hip External Rotation 

lunge 

Lunge with Trunk Rotation 

core ball stabilisation 

Progression with running 

Phase 4 

12 Plus weeks 

Starting sport-specific drills 

Resume activity if there is full ROM and pain free joints 

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