Hip and Groin Pain – Exploring FAI and Dysplasia. Two Common Causes
Hip and groin pain can be debilitating, affecting one’s quality of life and mobility. Two very common conditions associated with this discomfort are Femoroacetabular Impingement (FAI) and Hip Dysplasia (DDH). In this comprehensive blog post, we will delve into these conditions, exploring their causes, symptoms, diagnosis, and potential treatment options to help you gain a better understanding of these two common causes of hip and groin pain.
First let’s take a deeper look into the hip joint itself in order to gain a better understanding of how it works, the structures surrounding it and possible causes for symptoms coming from the hip. Like we spoke about in the Shoulder Blog post, the hip is a ball and socket joint which is composed of the head of the femur (the ball) and the acetabulum of the pelvis (the socket).
Being a ball and socket joint, the hip joint moves in all planes of motion, which is initiated by the muscles surrounding the hip joint. Some examples of these muscles include the hip extensors, hip flexors, hip abductors, hip adductors and the hip internal and external rotators.
The passive structures of the hip include the ligaments surrounding the head of the femur and the femoral labrum, which like the shoulder joint, provides more depth to the ball and socket of the hip creating for more stability.
There are two structural causes for pain to occur in the hip joint; first lets take a look at Femoroacetabular Impingement, or FAI.
Femoroacetabular Impingement (FAI)
Femoroacetabular Impingement, commonly known as FAI, is a condition where there is abnormal friction between the hip’s ball and socket joint. This friction typically occurs when the hip’s ball (femoral head) or the socket (acetabulum) has an irregular shape, causing them to rub against each other during movement.
This is often caused throughout childhood development and is directly related to the activity that was completed during development of the bones. When in development, the body’s natural response to excessive loading is to throw more bone structure down in order to provide more support to the hip joint, however this can become problematic in the later stages of life.
There are three primary types of FAI:
- Pincer Impingement: This occurs when the acetabulum (the socket) has an overgrowth of bone around the top of the femoral head, leading to a pinching effect during movement due to the bone pinching on the head of the femur.
- Cam Impingement: In cam impingement, the femoral head is not perfectly round and has bumpy and protruding parts which affects the normal smooth movement of the ball in the socket and may lead to grinding against the acetabulum, or restricting the overall movement of the joint.
- Combined Impingement: As the name suggests, this type combines both pincer and cam impingement, making it a more complex condition.
Symptoms of FAI typically include hip and groin pain, limited range of motion, and discomfort during specific activities. Diagnosis involves a thorough examination of medical history, physical assessment, and imaging studies like X-rays and MRI scans to identify impingement types and assess joint damage. However it is important to note that most people scanned that have a pincer or cam morphology have no symptoms (asymptomatic).
Treatment options for FAI range from conservative approaches, such as physiotherapy and anti-inflammatory medications, to more invasive methods like arthroscopic surgery.
Generally when first diagnosed, by improving the strength and range of motion of the hip joint symptoms will often decrease depending on the severity. Where symptoms are not improving or conservative management isn’t working, arthroscopic surgery may be an option or total joint replacement can also be considered. However most patients get significant outcomes with physiotherapy and have no need for surgery
The goal is to alleviate symptoms, improve hip function, and, when necessary, reshape the joint to mitigate impingement. Timely intervention is crucial to managing FAI effectively and restoring patients to an active and pain-free lifestyle.
Hip dysplasia is a developmental disorder affecting the hip joint’s structure, where the hip socket (acetabulum) is abnormally shallow, leading to instability. Generally this is diagnosed in babies at birth, but can also be missed and only present symptoms later in life.
This condition often manifests as a misalignment and a shallow surface between the femoral head (ball) and acetabulum, causing increased friction, movement and potential joint damage if left untreated. This lack of congruence can result in joint instability slipping and feelings of clicking, popping and a feeling of instability throughout the hip joint. While some individuals with hip dysplasia may remain asymptomatic, others may experience pain, instability, and reduced range of motion.
Diagnosis involves a combination of physical examinations and imaging studies like X-rays and MRI scans to assess hip joint stability and identify the degree of dysplasia. Symptoms of hip dysplasia can vary, including hip or groin pain, a sense of joint instability, and limitations in daily activities.
Treatment options for hip dysplasia depend on the severity of the condition. Conservative approaches may include physiotherapy and lifestyle modifications, while more severe cases may require surgical interventions like pelvic or periacetabular osteotomy to improve joint stability and function. Early detection and appropriate management are crucial in addressing hip dysplasia, aiming to relieve symptoms and enhance the overall quality of life for individuals affected by this condition.
Hip and groin pain can have a significant impact on one’s daily life, but with a better understanding of conditions like FAI and hip dysplasia, individuals can seek early diagnosis and appropriate treatment. Whether it’s through conservative management, physiotherapy and strengthening, or surgical interventions, there are options available to alleviate pain and improve hip joint function.
If you’re experiencing hip and groin pain, it’s essential to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan. Remember that addressing these issues promptly can help you maintain an active and pain-free lifestyle and reduce the risk of complications later on in life.