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Femoroacetabular impingement (FAI) is a condition where there is too much friction in the hip joint from bony irregularities causing pain and decreased range of hip motion. The femoral head and acetabulum rub against each other creating damage and pain to the hip joint. The damage can occur to the articular cartilage (the smooth white surface of the ball or socket) or the labral tissue (the lining of the edge of the socket) during normal movement of the hip. The articular cartilage or labral tissue can fray or tear after repeated friction. Over time, more cartilage and labrum are lost until eventually the femur bone and acetabulum bone impact on one other. Bone on bone friction is commonly referred to as osteoarthritis.
FAI impingement generally occurs as two forms: cam and pincer.
Cam impingement: The cam form of impingement is when the femoral head and neck are not perfectly round, most commonly due to excess bone that has formed. This lack of roundness and excess bone causes abnormal contact between the surfaces.
Pincer impingement: The pincer form of impingement is when the socket or acetabulum rim has overgrown and is too deep. It covers too much of the femoral head resulting in the labral cartilage being pinched. The pincer form of impingement may also be caused when the hip socket is abnormally angled backwards causing abnormal impact between the femoral head and the rim of the acetabulum.
Most diagnoses of FAI include a combination of the cam and pincer forms.
Symptoms of FAI
Symptoms of femoroacetabular impingement can include the following:
- Groin pain associated with hip activity
- Complaints of pain in the front, side or back of the hip
- Pain may be described as a dull ache or sharp pain
- Patients may complain of a locking, clicking, or catching sensation in the hip
- Pain often occurs to the inner hip or groin area after prolonged sitting or walking
- Difficulty walking uphill
- Restricted hip movement
- Low back pain
- Pain in the buttocks or outer thigh area
A risk factor is something that is likely to increase a person’s chance of developing a disease or condition. Risk factors for developing femoroacetabular impingement may include the following:
- Athletes such as football players, weightlifters, and hockey players
- Heavy laborers
- Repetitive hip flexion
- Congenital hip dislocation
- Anatomical abnormalities of the femoral head or angle of the hip
- Legg-Calves-Perthes disease: a form of arthritis in children where blood supply to bone is impaired causing bone breakdown.
- Trauma to the hip
- Inflammatory arthritis
Hip conditions should be evaluated by an orthopaedic hip surgeon for proper diagnosis and treatment.
- Medical history
- Physical examination
- Diagnostic studies including X-rays, MRI scans and CT scan
Conservative treatment options refer to management of the problem without surgery. Nonsurgical management of FAI will probably not change the underlying abnormal biomechanics of the hip causing the FAI but may offer pain relief and improved mobility.
Conservative Treatment Measures
- Activity modification and limitations
- Anti-inflammatory medications (NSAIDs: Motrin/ibuprofen, Aleve/naproxen, etc.)
- Physical therapy
- Injection of steroid and analgesic into the hip joint
Hip arthroscopy to repair femoroacetabular impingement is indicated when conservative treatment measures fail to provide relief to the patient.
Call to make an appointment with Dr. Bodendorfer today!
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A common cause of pain the shoulder is a rotator cuff tear. A rotator cuff is a group of muscles and tendons around the shoulder joint. When it is injured, it can weaken your shoulder and ache with pain. This type of injury is not only painful, but often inconvenient and makes daily activities difficult.
A torn rotator cuff can happen from an injury or degenerative issues. When it happens from an injury, it is commonly through repeated movements while playing sports, performing a job function or doing common household chores. Degenerative tears occur from the wearing down of the tendon that occurs slowly over time and naturally happens as we age.
Symptoms of a rotator cuff tear may include:
- A dull ache in your shoulder
- Pain with certain movements
- Limited range of motion
- Pain gets worse when you try to sleep on the injured side
- Muscle weakness in the arm
- Shoulder pain the worsens over time
- Crackling sensation when your shoulder moves in certain directions
Ways to help prevent a rotator cuff tear include:
- Exercise with focus on both the front muscles of the chest, shoulder, upper arm and back of the shoulder
- Stretch and warm up prior to activity
- Use proper form and safe lifting techniques
- Take frequent breaks
Treatment options for a rotator cuff tear:
Conservative treatments for a torn rotator cuff including rest, joint immobilization and physical therapy are sometimes all that is needed to find relief. Regenerative medicine is another non-invasive treatment option to talk with your doctor about. If the injury is severe, surgery may need to be considered.
Shoulder injuries such as a torn rotator cuff should be treated immediately to prevent further damage and to begin the healing process as soon as possible. See a physician right away if you have a sudden loss of motion after an injury, as you could have a substantial rotator cuff tear. If you have pain lasting longer than a few weeks or you’ve been formally diagnosed with a rotator cuff tear, you should see a shoulder specialist.
Contact us today to schedule your appointment.
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