An impingement syndrome is when there is a tightness in a joint that is painful and leads to restricted movement or degeneration (wear) of the joint. In the hip, this constriction exists between the acetabulum, the socket formed by the pelvic bones, and the femur, the femur bone that forms the femoral head. It is also called femoro-acetabular impingement (FAI). Genetic or load-dependent changes in the joint can lead to a tightness in which the joint partners collide with each other. This can lead to injuries of the structures and to strong, mostly stabbing pain in the joint.
Physiotherapy
Hip impingement is often accompanied by gluteal muscles that are too weak (gluteal muscles). This stabilizes the hip and pelvis. There are also small short muscles that run very close to the hip joint and stabilize it.
This muscle group also needs to be strengthened through physiotherapy. If there is acute pain and inflammation in the area of the hip joint after an overload, no stressful, strengthening exercises should be performed. In this case, the joint must be relieved, protected and possibly cooled. Exercises that mobilize the hip joint are also part of physiotherapy for hip impingement (FAI). Passive techniques by the therapist (e.g. manual therapy) but also active exercises are suitable for this purpose.
Exercises
1.) Lunge For this the patient places one leg far forward from the upright position, while the other leg remains in place. The upper body and the pelvis are lowered in a straight line and form a straight line with the back thigh.
After the position has been held securely and stable for a few seconds, the patient returns to the starting position and then places the other leg forward. Lunge steps can also be performed to the rear. In this case the legs are alternately set back.
The upper body forms a straight line with the back leg again. Lungeing steps should be executed carefully and in a controlled manner. The technique always comes first!
16 (8 per side) repetitions in 3 sets should be executed. Between the sets there is a break of 30 seconds. If the exercise is performed with the accent on mobility, particularly wide movements should be performed.
The exercise can also be performed to strengthen the hip muscles, in which case it should be held longer. 2.) Bridge Another exercise for strengthening the hip joint stabilizing muscles is the so-called Bridge.
Here the patient lies on the floor in a supine position. The palms of the hands are pointing upwards, the arms are slightly spread apart beside the body. The legs are upright, the knees bent, the heels are placed on the floor, the toes pulled towards the body.
Now press the pelvis upwards so that it forms a straight line with the thighs and the trunk. The tension should be felt in the rear thigh and buttocks. The position can either be held for a long time (approx.
30 – 60 sec) or it can be performed dynamically. The buttocks are stretched upwards, held up for only a few seconds and then slowly lowered towards the floor. Before the pelvis is lowered, the next repetition begins and the pelvis is raised again.
The exercise is performed in 3-4 sets of 15-20 repetitions. Special emphasis can be placed on the training by shifting weight or using resistors and aids. There is a variety of other strengthening or mobilizing exercises that should be tailored to the patient’s complaints and conditions.
For this purpose, a detailed examination is performed at the beginning of the therapy and then a specific training plan is drawn up. In addition, electrotherapy, heat treatment and sling table are used in physiotherapy. Further exercises can be found in the articles:
- Hip Impingement – Physiotherapy
- Exercises for a hip impingement