Hip check

Your son thought the stiffness in his hip would go away, so he kept playing competitive soccer. After several weeks, it was even too painful for him to flex his hip beyond a right angle. What could cause a healthy young athlete to be so disabled with hip pain? His orthopedist suspected your son might have hip impingement, a condition that commonly affects active adolescents and young adults.

What causes hip impingement?

Hip impingement is a mechanical or structural disorder of the hip that may be caused by a misshapen femoral head, deformed femoral neck, or a hip socket that covers too much of the femoral head.

In people who are not physically active, this condition might go unrecognized for years. Over time, repetitive bumping or impingement of the femur on the rim of the acetabulum leads to cartilage and labral damage. Hip impingement occurs when the structural anatomy of the hip prevents the smooth, painless, and free movement of the ball-and-socket joint.

John Clohisy, MD, professor of orthopedic surgery and director of the Center for Adolescent and Young Adult Hip Disorders, explains “People with hip impingement may have been born with a structurally abnormal ball-and-socket joint. In other cases, the hip joint may have become structurally abnormal during development.

Repetitive activity involving recurrent movement of the legs beyond the normal range of motion may cause hip impingement, which has been observed in certain athletes (football, baseball, soccer, tennis, hockey, lacrosse players, dancers, and golfers). An injury may also cause symptoms of hip impingement.”

What are symptoms of hip impingement?

In the early stages, there may be no symptoms associated with hip impingement or symptoms may be mild or vague. Some typical symptoms may include:

  • Stiffness in the thigh, hip, or groin
  • The inability to flex the hip beyond a right angle
  • Pain in the groin area, particularly after the hip has been flexed (such as after running or jumping or even extended periods sitting down)
  • Pain in the hip, groin, or lower back that can occur at rest as well as during activity

Diagnosis and treatment

An accurate diagnosis of hip impingement is important, because cartilage damage and osteoarthritis may occur if left untreated.
Dr. Clohisy says, “The Washington University Center for Adolescent and Young Hip Disorders offers comprehensive diagnostic services for hip impingement. Our experienced team of pediatric orthopedic specialists, physiatrists, adult reconstructive surgeons, physical therapists, nurses and medical assistants work together to accurately diagnose and deliver the full spectrum of both non-surgical and surgical solutions. Commonly, our young patients are athletes and we are fully committed to returning them to their sport and recreational activities.”

Diagnosis begins with a complete medical history and a physical examination. During the physical exam, range of motion of the hip joint and presence of impingement will be assessed. Other tests may be required, including x-rays, magnetic resonance imaging (MRI) or computed tomography (CT) scan.

Some patients are able to successfully manage hip impingement with conservative, non-surgical therapies that include:

  • Reducing certain types of physical activity
  • Physiotherapy
  • Pain management
  • Injections

In other cases, surgical intervention is recommended. Such surgery may be minimally invasive (arthroscopic) or open, depending on the hip impingement disease pattern.

For more information on the diagnosis of hip impingement and treatment options, please call 314-514-3500 for an appointment with one of our orthopedic hip specialists.

Patients are seen at these convenient locations:

Orthopedic Surgery Center
Center for Advanced Medicine
4921 Parkview Place, 6th floor, Suite A

Washington University Orthopedics
14532 Outer Forty Drive

St. Louis Children’s Hospital
One Children’s Place, Suite 1B

Shriners Hospital for Children
4400 Clayton Ave.