HIP IMPINGEMENT & LABRAL TEAR
- Groin pain?
- Pinching in the front of the hip?
- Travels to the adductors area/medial thigh?
- May travel to the inner knee, but not past it?
- Deep ache in the side of the hip joint?
Hip impingement (AKA FAI) is something commonly found in individuals who participate in any high intense training such as: running, cross-fit, high intensity training, etc. Many people tend to fail conservative therapy due to a poor or cookie cutter approach to care. Within the last few years, experienced sports chiropractors and physical therapists have been able to help more athletes reduce hip impingements with experience in myofascial techniques combined with exercise focused therapy.
In many cases of hip impingement, specific corrective exercises are the cornerstone of recovery, with a sprinkle of myofascial therapy to get the hip area to feel looser. Rarely is surgery required if the right treatment plan is applied and completed.
Hip impingement can progress into a hip labral tear, if not addressed quickly.
**As a side note, change in skin sensations indicate there’s a nerve compression or tension aspect to your groin pain. It is not 100% joint or muscle-based.
What is Hip Impingement?
Hip impingement is a pinch point in your hip. It is a very simple an answer, but it is essential to understand what a pinch point is.
A pinch point is like trying to close a door when there is something near the corner of the door wedged where it should close. No matter how many times you attempt to close the door, it does nothing to properly close the door. This can eventually damage the hinges due to the increased stress of you pushing the door without moving whatever is causing it to not close.
Damage to the hinge of the door will inevitably increase, correct?
The same thing happens in Hip Impingement. The structure caught in the “door” or hip gets damaged every time you stretch it.
Some common real life maneuvers that cause this similar door analog scenario are:
- getting out of a car or chair
- gym exercise
Hip impingement occurs in the same region of the hip flexor syndrome (last email), so how can you tell if it is one or the other?
The easiest way is by describing how it feels.
If you bring your knee to your chest (via your arms) when lying on your back and there is a pinch in the front of your hip, then I would suspect hip impingement. This simple test takes the hip flexor out of the mix because you are lessening the tension of the hip flexor by pulling your knee to your chest.
What causes Hip Impingement?
Hip Impingement occurs as pelvic, and hip mechanics change.
Let’s go back to the door analogy:
Slowly, your hand inches closer and closer to the door, and finally, it’s close enough to be smashed.
Strength and motion coordination of the core and pelvic muscles usually are what will “move” your hand closer to the door or keep it from being smashed.
Note: the door didn’t move; it stayed where it always was.
Theoretically, the hip is supposed to operate in the same way.
Some issues can occur in the hip just as with the door. The hinges or the door jam could be falling off. This is similar to the hip lacking proper stability in the koint. For cases like these, we need to rehab the hip joint properly as well.
In other case where everything just feels tight, this is where the myofascial treatments are more effective.
Either way, its all about getting proper mobility in the hip coupled with proper stability in the pelvis and lumbar spine.
Hip Impingement Treatment Options
Here are some other treatments that can assist you in recovering from Hip Impingement:
- Active Release Technique – I have over 15 years of continued certification and experience
- Deep tissue massage
- Anti-inflammatory injections
- Chiropractic adjustments or mobilizations
- Strength training/ rehab – pelvic stability and hip mobility exercises
- PRICE therapy
- PRP injections
- Running gait training
I’d strongly suggest doing the active release technique combined with strength training/ rehab route. It works very well when you have a good doctor with a proper diagnosis.
Dr Derek Gearhart