The anatomy of the bones is slightly altered, so that the joint partners do not slide optimally into each other, but bump into each other when moving. There are two different forms of hip impingement: pincer impingement and cam impingement. Pincer impingement is a malformation of the acetabulum on the pelvic bone.
The hollow hemisphere is too deep, so that there is no guide and the femur hits the edge of the acetabular cup during movements. In cam impingement, the malformation lies at the head of the femur. The end of the thigh is not completely round and thus jams when moving in the socket.
Even a minimal deviation in the shape leads to the described clinical picture. Frequently affected are young to middle-aged athletes with extreme stress on the hip joint. Footballers are frequently affected.
Physiotherapeutic therapy
A slightly pronounced form of hip impingement can initially be treated conservatively, i.e. without surgery. For this purpose the patient is referred to a physiotherapist. In physiotherapy, individually adapted goals are worked out together and suitable therapy measures are selected.
Pain should be reduced, mobility increased, evasive movements and relieving postures avoided, muscles built up and stretched, movement sequences optimized. Posture and gait are worked on, as well as specific movement sequences in sports or other situations that cause complaints in everyday life. To achieve these goals, various manual measures are used to mobilize the joint, as well as active exercises to stretch and strengthen surrounding muscles, some of which are presented below.
It is important to relieve the joint and to refrain from the original triggering activity such as sport for a while. During therapy, especially passive mobilization, it must be ensured that the already irritated joint is not subjected to any more unnecessary movement, for example, movement in strong flexion, during which the bones collide during hip impingement. Therapeutic methods without surgery in more severe cases are quite limited, since this is a manifest bony malformation.
Further information can be found under:
- Physiotherapy for a hip impingement
- Physiotherapy for hip diseases
- Physiotherapy for hip pain
- Physiotherapy after hip surgery
Recommended exercises to treat impingement in the hip are first and foremost strengthening exercises around the joint and hip as well as general body stabilization. In this way, the joint can be kept stable by surrounding structures instead of sliding more and more into the wrong position. It is important not to train into the pain, as it is always a warning signal from the body.
Since hip impingement is particularly painful when it comes to flexion, the hip and buttock muscles can be trained with exercises in the direction of stretching, which simultaneously relieves the overly tight joint and opens it to the front. 1) From an upright position, for example, an exercise using a Theraband is suitable. Tie this around the lower legs while standing with your hips wide.
How tight, depends on the individual strength. Now slowly spread one leg outwards and return it with counteracting force. Without putting the leg down, this movement is performed 10 times and is repeated three times with short pauses.
Train both sides. To strengthen the opposite side, the inside of the leg, the Theraband is knotted around a leg and a stable object like a table leg. Now the leg is pulled inwards against resistance.
2) To strengthen the gluteal muscles, the so-called bridging is suitable. In the supine position, the feet are positioned hip-wide. The tips of the feet are lifted and the heels are pressed into the ground to build up body tension.
The lower back and the arms that lie along the sides of the body are also pressed to the floor. Now the pelvis is lifted slowly and under tension until the upper body forms a diagonal with the thighs. Keep the position short, breathe deeply into the abdomen and lower the pelvis again without putting it completely on the floor – body tension is maintained the whole time.
The pelvis is raised and lowered about 10 times. Do three sets of this exercise.3) In order to stretch the tensed front and create space, a heel is lifted towards the buttocks in a hip-wide stance, the lower leg is grasped with the hand on the same side and pressed slightly closer to the body. The pelvis is pushed forward until a feeling of stretching is felt on the front of the hip and the front of the thigh. Hold the stretch for about 30 seconds to achieve an effect. More exercises can be found under:
- Exercises for a hip impingement
- Physiotherapy for a hiptimingement
- Exercises from physiotherapy for the hip
