GROIN PAIN
WHAT YOU NEED TO KNOW / FEMORAL HIP
IMPINGMENT
The groin
pain requires the common medical consultation, both at the level of general
medicine, specialties physicians, professional Sports physiotherapists and sports therapists in Manchester.
When the hip
impingement causes the first symptoms, it might be announced as a hip
impingement syndrome, the principal symptoms are pain in the groin zone, particularly
at the moment when you flexing the hip or walking and it’s reduced the range of
movement in the hip.
Meanwhile, at
first time you can just feel the pain when you move the hip close to its
limits.

(Jack
Grealish: Aston Villa Midfielder – Copyright)
There are
different kinds of hip impingement CAM,
PINCER AND FAI, they can also be treated at MY Sport Injury & Osteopathy | Manchester City Centre with the
assistance of certified professionals, guaranteed specialists on www.mysportsinjury.co.uk The
Team can assist in providing specialized treatment from a sports physio Manchester through conducting full medical assessment
and customized approach to rehabilitation in the elite field of sports.
How could I know or suspect if I am
suffering of a hip impingement?
·
Pain in the groin or gluteal region.
·
Sciatic and knee pain after sports.
·
Cracks in the hip with movement.
·
Limitation of hip movements.
If you are
feeling these symptoms first of all you may attend to a professional medical consultation,
after a medical examination the procedure to follow and the treatment will be
indicated with a customized sports injury rehabilitation program.

One of these plans
of action could be to have direct sports therapy with a professional Sports
physiotherapist including a
sports therapy or sports massage in Manchester.
What happens with my body when a hip
impingement occurs?
Actually, hip
impingement occurs when the ball and socket of the hip joint do not fit
properly. Limited movement damages the cartilage and can lead to pain and
arthritis in young adults.
Furthermore,
femoro-acetabular or hip impingement is an anatomical disturbances or hassle of
the hip, brought about by a deformity or an abnormality of the femur bone,
acetabulum or both that causes an unnatural contact between both structures during motion and gliding of the joints.
Which other causes can inguinal pain be
confused with?
It can be
mistaken with several other causes such as facet syndromes, renal colic,
hernias, etc.

Patients at MY
sport Injury & Osteopathy Manchester
with this condition are generally young people or sports athletes with groin
pain that may show up after a minor trauma.
Types of hip impingement
PINCER
It is the
result of a linear contact between the acetabular rim and the femoral head-neck
junction. The first structure to fail in these cases is the acetabular labrum.
The continuous impact leads to degeneration of the labrum, and ganglions or
ossification of the rim leading to a deepening of the acetabulum, worsening the
over-coverage.
Pinching
"in pincers" has a frequency of 9% and is more common in middle-aged
women with some degree of sports activity.
CAM
It is caused
by entrapment of an abnormal femoral head with an increasing radius in extreme
motion, especially flexion. The underlying cause for the abnormal morphology in
cam pinching (cam) is not clearly understood.
The resulting
frictional forces lead to an outside-to-inside abrasion of the acetabular
cartilage or avulsion of the labrum and subchondral bone in a relatively
constant anterior superior area. Cam pinching, with a frequency of about 6%, is
more common in young, athletic males.

How to diagnose a hip impingement?
Advances in
recent years, especially in the study of images, have made it possible to
identify anatomical abnormalities that until now had been underdiagnosed or
unknown, such as those found in femoroacetabular impingement syndrome.
Imaging studies
The
complementary study of images is very important for the identification of
anatomical abnormalities associated with impingement and to rule out other
pathologies.
Plain
radiographs remain the most accessible and widespread method for the diagnosis
of this pathology and should always be the initial examination.
Magnetic
resonance imaging is very useful to evaluate the acetabular labrum and
articular cartilage.
Treatment of hip impingement
In a
palliative way, anti-inflammatories and kinesiotherapy at sports therapy Manchester can be prescribed with emphasis on
exercises to strengthen the periarticular muscles.
In the first
instance, a kinesiotherapy program is recommended based on sports physio Manchester, especially in acute cases where there is
no advanced damage. Having a Sports Massage is highly recommended to
loosen the gluteal muscles around the hip joint which can be effective in
treating the overall symptoms of the Hip.

(Mykonos Performance: Kyle Walker Peters: Southampton Footballer
Strength & Conditoning) Copyright
Rehabilitation
focuses on improving hip stability and muscle management of the segment
characterized by the presence of contractures or altered patterns. It is
accompanied with activation exercises and stretching that seek to improve hip
mobility.

In those
cases where there is not response to the kinesiological treatment at MY sports therapy | Manchester or in those
patients where there is an advanced pathological process, surgical resolution
is indicated by means of a hip arthroscopy that seeks to restore normal
morphology in the hip with an opinion by an orthopedic hip consultant.
Physiotherapy treatment pre-medical
operation
The
rehabilitation program must be developed in a specific and comprehensive way
for each patient, and from a very complete analysis of the history, the operation,
the clinical charts and evolution, all this to define the approach with
appropriate methods and techniques by a Sports physiotherapist at MY Sports Injury & Osteopathy | Manchester
city Centre.

Kinesiotherapy Program
·
Isometric exercises, both quadriceps
and glutes, the patient in a supine position with a towel in the popliteal
region, the physiotherapist will ask the patient to press the towel and the tip
of the foot upwards, so that they perform exercises isometric quadriceps
holding a contraction for 6 seconds and relaxation for 3 seconds.
·
Isometric adductor exercises with a
ball between the knees, the patient is asked to press the ball for 8 seconds,
repeating the exercise 10 times, leaving 10 seconds of rest between contractions,
the physiotherapist checks that there are no compensations.
·
Likewise, it is important to know
that there are certain devices to perform aerobic physical activity that imply
greater stress on the hip and knee joints, being the cases of the stationary
bicycle.

(Deli Ali & Kyle Walker Peters: Footballers Mykonos Performance Elite Sports)
·
Patient in a standing position
leaning on the stretcher will perform hip extension with resistance from the
theraband, while the physiotherapist stabilizes hips avoiding compensations for
medius gluteus (3 series of 10 repetitions each).
·
Active ankle mobilizations both
flexion-extension, abduction-adduction and inversion-eversion, the
physiotherapist at sports massage
Manchester city Centre applies resistance to each movement respectively. In
addition, the patient will perform circumduction movements. Perform 3 sets of
10 repetitions each.
·
Accelerate the learning process of
rehabilitation, for a correct preoperative education consists of: carrying out
functional activities, going up and down stairs, moving from your chair to the
bathroom, transfers and independent ambulation.
Physiotherapy
treatment post-medical operation
Kinesiotherapy Program
· In a
sitting position we will perform progressive quadriceps toning exercises,
requesting the patient to perform knee flexion-extensions, hip elevation with
knee in extension, triple reflection to tone anterior tibialis and psoas, with
the placement of manual resistances by the physiotherapist.
· Isometric
ankle exercises (no adduction and internal rotation).
· Isometric
hip abduction-adduction exercises. It is considered the most important type of
exercise (especially abduction), since they help the patient to walk without
lameness, however, they should be avoided if the patient has undergone a
trochanteric osteotomy.
· It is
recommended to start doing them in supine position, with a ball between the
knees, performing adductor isometrics and maintaining a contraction of the same
for 3 seconds and relaxation for 3 seconds, while the physiotherapist controls
that there are no compensations.
· Both
active and assisted hip abduction exercises will be performed.
· Advanced
training, specificity for return to sport.

High demand single limb dynamic lumbo-pelvic stability
and optimize functional strength, endurance and power within the lower kinetic
chain.
References
Leunig M, Ganz
R. Femoroacetabular impingement: a common cause of hip complaints leading to
arthrosis. Unfallchirurg 2005; 108: 9-17.
Kassarjian A,
Yoon L, Belzile E, Connolly S, Millis M, Palmer W.Triad of MR arthrographic
findings in patients with Cam type femoroacetabular impingement. Radiology
2005; 236: 588-92.
Ganz R, Gill TI, Gautier E, Ganz K, Krugel L,
Berlemann U. Surgical Dislocation of the adult hip: a technique with full
access to femoral head and acetabulum, without the risk of avascular necrosis.
J Bone Joint Surg Am 2001; 83: 1119-24.
Beall Dp, Sweet CF, Martin HD. Imaging finding of
femoroacetabular impingement syndrome. Skeletal Radiol 2005; 34:691-701.
Jager M, Wild A, Westhoff B, KrauspeR.
Femoroacetabular impingement cause by a femoral osseous head-neck bump
deformity: clinical, radiological and experimental results. J Orthop Sci 2004,
9:256-263.
Notzli HP, Wyss TF, Stoecklin CH, Schmid MR,
Treiber K, Hodler J: The contour of the femoral head-neck junction as a
predictor for the risk of anterior impingement. J Bone Joint Surg Br 2002; 84:
556-560.
Blankenbaker DG, Tuite MJ. The painful hip: new
concepts. Skeletal Radiol. 2006; 35 (6): 352-70.
Schmid MR, Notzli HP, Zanetti M, Wyss TF, Hodler J.
Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography.
Radiology. 2003; 226(2):382-6.
Byrd JWT. Physical
examination. In: Byrd JWT, editor. Operative hip arthroscopy. 2nd edition. New
York: Springer; 2005. p. 36-50.