Just another iHealthSpot WP02 site

CORONAVIRUS 2019 (COVID-19): IMPORTANT INFORMATION FOR OUR PATIENTS: We are open for appointments and elective surgeries.
For information about Check-in and appointment Protocols, PLEASE READ!

SEARCH

REQUEST AN APPOINTMENT

PATIENT RESOURCES

PATIENT PORTAL

ONLINE BILL PAY

CALL TODAY: (913) 362-8317

STAY CONNECTED 

Employment Application

READ OUR BLOG

  • Home
  • About Us
  • Meet Our Team
    • Providers
    • Staff
  • General Orthopedics
    • Joint Replacement
    • Physical Therapy
  • Sports Medicine
    • Hip Arthroscopy
  • Blog
  • Contact & Locations

FAI – Mechanical hip impingement and its treatment

July 13, 2020

in Hip Impingement, Orthopedics
July 13, 2020
Tagged With: Hip Impingement, joint pain, Midwest Orthopaedics, orthopaedics, Orthopedic Doctor, orthopedic doctor near me
 

By Matt Stensrud, PT, Clinic Director

Midwest Orthopaedics Physical Therapy

  1. Neutral Pelvis Position                             2. Anterior Pelvic Tilt

Many individuals we see in our practice get diagnosed with Femoral Acetabular Impingement (FAI).  There are two main reasons for this impingement including structural changes in the joint and poor mechanical positioning/neuromuscular control of the joint.  Most cases we see involve both structural and mechanical reasons for the pain, but in varying degrees.  The above pictures show positions of the pelvis including:

  1. Neutral pelvis on the left with normal resting tone of the quads and hamstrings to allow for balanced anterior chain and posterior chain activity.
  2. Anterior pelvic tilt on the right 2 pictures with increased tone of the quads, hip flexors and lower back muscles with inhibited or weak hamstrings and abdominals.

If someone presents to physical therapy with a “pinch” in the front of their hip it is very common they are presenting with the pattern of an anterior pelvic tilt on one or both sides of their pelvis.  The below picture shows how this anterior tllt position can lead to “pinching” in the front of the hip with sitting or squatting as the front of the pelvis quickly impacts the femur.  On the right, the posterior rotated pelvis allows for more room during sitting and squatting reducing the chances for impingement complaints.

Most individuals with FAI will have some deformity of their hips on radiographs, but it is very important to correct the mechanical reasons for impingement through proper muscle integration even if the case will end up being surgical (usually involves reshaping a malformed socket or neck of the femur).  If the mechanics are corrected, you can see how much more space there can be in the front of the hip when learning to squat or sit with a neutral to posterior tilt biased position of the pelvis.  This allows for abolishment of the impingement and inflammatory condition or improves mechanics so that a post-operative FAI patient will already have a good movement foundation to maximize their recover after surgery.

Below are a few good exercises to learn to get this proper posterior pelvic tilt with abdominal integration and during deep squatting to reduce anterior impingement.

  1. Short seated balloon – works to integrate abdominals with posterior pelvic tilt position to reduce lower back tension
    1. Sit on a 6 inch step and rock back to feel your sit bones
    2. Take a breath in through your nose and slowly exhale for 6-8 seconds
    3. Pause 3 seconds without pinching the balloon
    4. Inhale again without pinching the balloon (feel upper back expand)
    5. Slowly exhale again for 6-8 seconds without using neck or cheeks
    6. Repeat for 1 more breath focusing on filling your back with air during inhalation
    7. Relax and repeat 4 more times.

  1. All Fours “Cat” breathing – Focus is on feeling outer abdominals and buttock work to maintain a rounded back and posterior pelvic tilt
    1. Start on your hands and knees with your nose over your fingertips. Do not tuck your chin during this exercise.
    2. Maximally round out your spine by arching your back upwards while you tuck your bottom under (posterior pelvic tilt).
    3. Hold this position for 4-5 deep breaths (in nose out mouth) focusing on filling the back of your chest wall with air during inhalation.
    4. Relax and repeat 4 more times

  1. Full deep squat with breathing – focuses on posterior pelvic tilt, strength to get up from a squat with this posterior pelvic tilt position and stretching of the back
    1. Squat down as far as you can without letting your heels come up from the floor while keeping your back rounded and pelvis tucked under you
    2. Hold this position for 4-5 deep breaths (in nose out mouth) focusing on filling the back of your chest wall with air during inhalation.
    3. On the final exhale, focus on pushing through your heels as you keep you back rounded and bottom tucked under you.
    4. Relax and repeat 4 more times.

Footer

Patient Education

We invite you to explore our comprehensive list of resources and educational materials designed to help educate you more about Orthopedics and Sports Medicine.

 READ MORE

Home
About Us
Meet Our Providers
Meet The Staff
Joint Replacement
Physical Therapy
General Orthopedics
Sports Medicine
Hip Arthroscopy
Contact & Locations

Blog
Patient Resources
Patient Education
Privacy Policy
Sitemap

Request an Appointment
Patient Portal
Online Bill Pay

Midwest Orthopaedics PA
7450 Kessler Street, Suite 140
Merriam, KS 66204
Phone: (913) 362-8317

iHealthspot Medical Website Design and Medical Marketing by iHealthSpot.com


Copyright © Midwest Orthopaedics PA. All Rights Reserved.

At Midwest Orthopaedics, our board-certified orthopaedic surgeons treat a wide range of general orthopedic issues, including Joint Replacement Physical Therapy General Orthopedics Sports Medicine Hip Arthroscopy.