Femoral Acetabular Impingement: An Epidemic in Hockey Players
History of groin strains? Femoral acetabular impingement (FAI) may be the underlying cause. But you’ve never heard of it, so what is FAI? FAI is due to a structural abnormality of either the femur, or thigh, or the pelvis where the femur attaches to form the hip joint. In young male athletes, the most common type of FAI is called CAM impingement which is characterized by an abnormal shape of the femoral head. Due to the abnormal shape, with movement, there is increased and abnormal contact with the acetabulum (area where the thigh connects to the pelvis to form the hip) which causes pain. The cause of FAI is unknown however, injury, genetics, or excessive exercise during early bone growth are common causes.
Groin pain that gets worse with activity or prolonged sitting is the most common complaint with FAI. Pain can also occur in the outside of the upper thigh, buttock and sacroiliac joint. Limited hip range of motion is a common partner to groin pain with FAI.
Hip labral tears are common with CAM impingement, specifically from the jamming of the femur in the pelvis. Labral tears in combination with FAI are especially common with hockey players, where skating incorporates high hip flexion and internal rotation movements at the hip. FAI may also result in damage to cartilage and early onset arthritis.
X-ray and MRI are used to diagnose hip impingement and distinguish where the abnormality is located. If you are diagnosed with FAI, surgery may be necessary to correct bone abnormalities and restore normal motion of the hip. With proper rehab, hockey players often return to their sport between three and four months after FAI hip surgery.
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