Wednesday, August 10, 2022

Can Hip Impingement Cause Knee Pain

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Can Osteoarthritis Be Prevented

HIP IMPINGEMENT & KNEE PAIN: (Causes & Solutions)

Although OA is not an inevitable part of the aging process, the condition is a result of a combination of factors, many of which can be modified or prevented. Doctor recommendations to reduce the risk of OA or delay its onset include:

  • Maintaining a healthy weight. Extra weight puts added pressure on weight-bearing joints, such as the hips and knees. In addition, fat produces cytokines, destructive proteins that stimulate inflammation throughout the body, alter cartilage cells and destroy joint tissue. In short, if you are overweight, losing just a few pounds can reduce stress and inflammation.
  • Controlling your blood sugar. High blood sugar levels can cause cartilage to harden more quickly, while diabetes can trigger inflammation that leads to cartilage loss.
  • Staying active. Keep joints healthy from the get-go. Even just 30 minutes of moderately intense exercise five times a week strengthens the muscles that support and stabilize your hips and knees and helps joints stay limber.
  • Protecting your joints. Of course, injuries cant be completely avoided, but be careful when lifting heavy objects, and take breaks when you are doing something that puts stress on your hips or knees.
  • Keeping a healthy lifestyle. The best defense is offense. Sleep, healthy diet, exercise and stress management all can contribute to keeping your joints healthy.

Recovery From Femoroacetabular Impingement Surgery

Recovery from hip impingement surgery will be different for each person and will depend on what type of procedure you have. Most surgeries will require you to use crutches for a few months after your procedure and perform physical therapy exercises to regain strength and range of motion in your joint.

Most patients are able to return to their normal activities within six months, but you should continue to follow up with your doctor to make sure your hip continues to heal properly and symptoms do not return.

Hear From Our Patients

National champion speed skater, Blair Cruikshank, started experiencing persistent, worsening hip pain that interfered with her training. After she was diagnosed with femoroacetabular impingement syndrome , she and her family sought treatment for her condition at the Hip Preservation Program. Today she is back on the ice at full speed after undergoing a successful hip arthroscopy procedure.

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What Is The Treatment Of Fai

When symptoms first occur, it is helpful to try and identify an activity or something you may have done that could have caused the pain. Sometimes, you can reduce your activities, let your hip rest, and see if the pain will settle down. Over-the-counter anti-inflammatory medicines may be helpful.

If the pain continues despite the initial treatment, seeking a physician knowledgeable about painful hip conditions can help. Most patients can be diagnosed with a good history, physical exam, and plain x-ray films. A careful history of the patient can key the clinician to possible diagnoses. The physical exam will generally confirm the patients history and eliminate other causes of hip pain. The plain x-ray films are used to determine the shape of the ball and socket as well as assess the amount of joint space in the hip. X-rays can also show signs of arthritis and the existence of bony overgrowth. However, many times patients are seen by hip specialists who have X-rays that were previously read as normal, when in fact they do have FAI. If the clinician reading the X-ray films is not trained/skilled in looking for FAI, it can easily be missed.

If you have hip or groin pain or any orthopedic injury, contact the experts at Nirschl Orthopaedic Center in Arlington, Virginia. Schedule an appointment with our orthopaedists today by calling 703-525-2200.

In The News

Improve Movements To Eliminate Hip Pain

Hip Impingement Treatment at Harris &  Ross

The back, hip, and lower extremity work as a comprehensive unit allowing for many of the repetitive tasks you complete at home, work, and during recreational activities. Injuries to one area of the musculature often indicates that additional damage has been incurred by adjacent muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles. Isometric exercises are often the initial treatment exercises, followed by single plane rubber band exercises for the hip, knee, and ankle: flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable the surface, the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

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Pain That Originates From The Side Of The Hip

Certain conditions may cause hip pain to originate from the side of the hip and travel down to the thigh. A few examples are discussed below.

External snapping hip

When a muscle or tendon slides over the bony protrusion at the top of the thigh bone , it creates a snap, pop, or clicking sound. This condition causes pain that increases with direct pressure over the side of the hip. The pain may also travel down the side of the thigh.1

Read more about 3 Types of Snapping Hip Syndrome on

Hip bursitis

Inflammation of the large trochanteric bursa located on the side of the hip joint may cause hip pain. The pain typically increases upon direct pressure on the side of the hip and may travel down the side of the thigh.1,7

See Hip Bursitis

Both these conditions belong to a spectrum of hip disorders called the greater trochanteric pain syndrome. This syndrome also includes tears of the gluteus minimus and/or medius muscles located on the side and back of the hip that may cause pain in these areas.1

Can A Torn Meniscus Cause Calf Pain

The location of the tear will dictate the symptoms that a person would encounter. Anterior knee pain, pain on the inner or outer side of the knee, and even pain in the calf region are all symptoms that a meniscus may be damaged. Calf and hamstring soreness is caused by movements that require pushing off or extreme knee bending.

Rupture usually occurs after a deep knee bend, however, it can sometimes happen without it. The fluid induces tissue inflammation, resulting in pain, calf edema, heat, and redness.

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It Still Hurts Whom Should I Talk To

You need to see a pediatric orthopedic surgeon who sub-specializes in the treatment of FAI. We will ask you several questions to better understand your pain.

Exam of the hip: our clinicians will examine your hip, knees, and back to determine the source of your pain. I will put your hip through a range of motion and perform tests to see where the pain is coming from. The impingement test is a way to maneuver the hip that will help us understand if FAI is a likely cause of your pain.

X-rays An x-ray of your pelvis will be reviewed, with an additional x-ray which shows the profile of the hip. This is the BEST way to evaluate the shape of the ball and socket.

MRI : If your history, exam, and x-rays indicate you have FAI, an MRI of the hip may be ordered to further assess the extent of the damage. This test is the best way to look at the labrum to see if it is torn and damaged. The MRI requires an injection of fluid into the hip. This helps us in two ways. First, it is the best way to see the labrum. Second, a numbing medication is put into the hip as part of the fluid. The medication works for an hour or two. If your pain significantly improves during that time, we can conclude you pain is indeed coming from the hip joint.

Hip Joint Stretch Into External Rotation

What Is Causing Your Hip Pain, Femoroacetabular Impingement, Labral Tear, How to tell
  • Lay on your back with 1 knee bent so that your foot is next to your knee.
  • Let the bent knee gently drop out to the side and hang.
  • For a more intense stretch you can add a 2-3 kg weight or do a similar stretch lying on the stomach with the foot locked under the other thigh.
  • You should feel a stretch in the front of the hip and groin.
  • Holds for 5-10 minutes morning and night.
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    What You Need To Know

    • The exact cause of hip impingement is usually unknown.
    • There are two main types of hip impingement defined by where deformity occurs in the joint: the femoral head or acetabulum.
    • A physical exam, X-rays and oftentimes an MRI scan are required to diagnose hip impingement.
    • Nonoperative and surgical treatment options are available to treat hip impingement.

    What Is A Labrum

    The labrum is a rim of cartilage that surrounds the hip joint. It attaches to the socket of the acetabulum. If you have friends who had a knee arthroscopy for torn cartilage, they had a meniscal tear of the knee. The meniscus of the knee and the hip labrum are made up of the exact same type of cartilage.

    Figure 1: Arthroscopic picture of a normal posterior labrum. The labrum attaches smoothly to the acetabular articular cartilage. The femoral head is on the bottom right of the picture.

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    There Are Three Types Of Fai:

    • Cam impingement is caused by irregularities in the shape of the femoral head which prevents the ball from moving smoothly in the socket. These irregularities grind against the socket, damaging the cartilage that lines the joint.
    • Pincer impingement occurs when bony growths form on the rim of the socket part of the joint. These growths can wind up damaging the cartilage ring that surrounds the socket and holds the ball portion in place.
    • Combined impingement involves irregular bone growth on both parts of the hip joint.

    If you have FAI, you may have symptoms of pain and joint stiffness that can result in a limp or other gait problems. Discomfort can range from a dull ache to a stabbing, sharp pain, and it can occur in the groin or toward the outer portion of the hip. Turning or pivoting the hip can cause symptoms to become worse.

    How Is A Labral Tear Of The Hip Diagnosed

    Femoroacetabular Impingement Syndrome

    A medical professional can suspect a labral tear based on a patients symptoms and history. Clinically, the doctor can do provocative tests, such as the anterior and posterior impingement test, the McCarthy test, and the FABER exam, to further investigate. Many times, X-rays are very useful. FAI is a radiographic diagnosis, and usually can be easily seen on plain X-rays. With severe FAI, a labral tear can be inferred.

    Figure 2: On left side of screen, normal acetabulum. The anterior wall and posterior wall do not cross. On right, there is pincer type FAI, where the red and blue lines cross.

    Figure 3: Typical cam type FAI X-ray finding. The yellow outline shows what the contour of a normal hip would look like.

    MRI directly shows the cartilage of the hip. While a labral tear can be diagnosed with a plain MRI, an MRI arthrogram is more sensitive to labral tears. An MRI arthrogram does involve an injection directly into the joint, but then the dye can easily be seen leaking into a labral tear, making the diagnosis clearer.

    Figure 4: MRI arthrogram of a left hip labral tear. Arrow points to the dye leaking between the labrum and the articular cartilage.

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    Symptoms Of Hip Impingement

    You may have pain when you bring your knee close to your chest or lifting your knee up then rotating the femur. The main ones people describe to me are:

    • Deep squats
    • Getting in and out of a low car
    • Running drills with high knees
    • Getting out of a low chair
    • Putting on shoes or socks or tying shoelaces

    As I mentioned before, usually you feel pain in the groin region at the front. Less often youll feel pain in the buttock and rarely in the knee or thigh. Often the symptoms have been gradually coming on over time and get a little better with rest but come back once you return to the activity that was causing the impingement.

    What Are The Symptoms Of Hip Impingement

    Some people with a hip shape that may cause impingement may never experience pain or other symptoms. Others, especially people who are active, develop symptoms as early as their teens. If and when symptoms appear, they are usually a sign that the labrum or cartilage has been damaged.

    If your child has symptomatic hip impingement, early diagnosis will give them the best chance of a successful recovery and full return to activities, including sports.

    Signs and symptoms of hip impingement can include:

    • pain in the groin or hip
    • pain from activity or prolonged sitting
    • difficulty flexing the hip

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    Hip Impingement Symptoms What Does Hip Impingement Feel Like

    Hip impingement symptoms depend on the severity of the condition. Common hip impingement symptoms include stiffness in the upper thigh, in the hip, and around the groin. Pain in these areas is also common.

    Range of motion is often limited for individuals with hip impingement, and sufferers may have difficulty flexing the hip near or beyond a right angle. Its also typical for hip impingement to become more pronounced during exercise and activity. Movements that include twisting or squatting may result in a sharp or radiating pain along the affected area. In less severe cases of hip impingement, patients often report a dull aching sensation during these motions. Extended sitting may also cause hip impingement symptom flare-ups. FAI symptoms can also include lower back pain, and this pain may be present during inactivity or more pronounced following strenuous activity.

    A Common Cause Of Knee And Hip Pain And How To Treat It

    How He Fixed Hip Impingement (FAI) & Knee Pain (MICHAEL’S STORY!)

    Oh for the days of yore, when the words joint and pain werent used together in your vocabulary. As time passes though, your joints lose their get-up-and-go, and simple movements especially in your knees and hips become painful. One of the most common conditions that causes both hip pain and knee pain is osteoarthritis , a form of degenerative joint pain caused by wear and tear on your joints.

    As you age, the cartilage that cushions your joints starts to wear down, causing the bones to rub together. The bone-on-bone action leads to inflammation of the joints. OA most commonly affects the joints in your arms and legs, including your fingers, wrists, knees, ankles, and hips and even your lower back.

    At the outset of OA, the cartilage between your joints becomes worn and torn as well as inflamed. The wear-and-tear process leads to loss of water in the joint, causing the cartilage to harden, which makes moving the surrounding joint more difficult.

    As the loss of cartilage is a slow process, some people have early OA symptoms for years before the disease progresses.

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    Hip Joint Surgery In Nd

    At The Bone & Joint Center, our board-certified and fellowship-trained physicians are experts in the diagnosis, treatment, and rehabilitation of patients with a wide range of orthopedic conditions. Our very own Dr. Brian P. Dahl, MD, and Dr. Timothy J. Bopp, MD have a special interest in hip and knee surgeries, including surgeries for generalized arthritic conditions, and have helped restore the normal hip function of patients with hip impingement syndrome.

    To schedule a consultation with a hip and knee orthopedic surgeon, call The Bone & Joint Center at 946-7400 / 900-8650 or request an appointment online now.

    Can A Torn Meniscus Cause Groin Pain

    Knee and groin pain can strike anyone at any time. Athletes and persons who are physically active are more prone to have groin or knee discomfort, or both.

    Groin discomfort is most commonly cause by a strained muscle in the lower abdominal hip area. If not treated properly, groin injuries can progress to other ailments around the hip area.

    However, hip pains can generally be cause due to muscle tears in the knees. Therefore, there is a possibility of groin pain happening due to torn meniscus. Moreover, meniscus tear pain level increases or worsen with factors like age.

    Moreover, if you are facing intolerable pain due to the meniscus tear, then you should definitely go for meniscus tear treatment in Patna by one of the most trustable doctors in Patna, Dr. Ramakant Kumar.

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    How Do You Fix Hip Flexor Pain Or An Impingement

    As always, all of the above conditions are caused by overload, or too much water in the damaged tissues bucket.

    In order of severity, hip flexor pain starts as tight muscles that the body conserves energy from by laying down adhesion . Adhesion is present over months to years before there ever is a more significant pathology. Eventually, an individual does something that uses the hip flexors more and either strains or tears the tissue.

    Notice the distance of the canyon in B. The body can cross small chasms and repair them.

    Notice the distance of the canyon in C. Only if the tear is significant and the body cannot traverse the canyon-sized ravine is surgery required for a tear.

    In all of the above cases, removing the adhesion from the psoas, iliacus, or rectus femoris with manual adhesion release is the sweet-spot solution. If there is a strain or acute tear, then inflammation is present and time is required in addition to deloading the muscles.

    In hip impingements, the adhesion needs to be removed in the adductor magnus and posterior hip capsule. If an individual has been active from adolescent years, especially hockey, basketball, or soccer, or has been involved in significant loading of the hip joint over years, then a CAM/Pincer malformation is a possibility to contribute to the symptoms. In these instances, extra bone has been laid down as a protective mechanism and pinches the labrum and articular cartilage.

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