Hip pain in athletes — femoroacetabular what?

Dr. Sanjeev Bhatia is an orthopaedic specialist with Mercy Health. He treats a variety of sports medicine injuries and has office hours in Blue Ash and Montgomery and has written this piece on hip pain:

The hip is a ball and socket joint that allows for remarkable leg range of motion in a variety of sports. Unfortunately, sometimes hip joint pain can limit athletic performance due to a common condition called femoroacetabular impingement, or FAI for short.

FAI is a common condition where the femoral head (the ball), acetabulum (the socket), or both do not fit normally in place due to an alteration in the shape of the femoral head shape or rim of the acetabulum. The result is increased contact (impingement) as the hip is placed through a range of motion. Many athletes with FAI complain of pain in the front of the hip or groin during sports, after prolonged sitting or any activity that requires deep flexion or rotation of the hip. Sometimes, there is a popping or clicking in the front of the hip. FAI is diagnosed with a simple clinical visit which includes a hip examination, along with imaging studies such as X-ray and MRI.

Diagnosis and treatment: The first step in treating FAI is usually quite conservative. Rest from the sport or activity causing the pain, as well as anti-inflammatory treatment can significantly control the symptoms. Physical therapy to correct weakness or imbalance in the hip and core musculature is also usually prescribed. The nonsurgical approach can be successful in some cases. However, there are some cases where bony joint asymmetry is simply too much and the impingement will continue to cause pain and joint degradation when the young athlete attempts to return to sports. In those cases, arthroscopic surgery can be done.

What if conservative measures don’t work? During hip arthroscopy, the goal is to tailor the procedure to the exact type of problem in each hip. For younger athletes I have a strong preference for performing the most conservative procedure that results in restoration of as close to normal anatomy as possible. This typically includes removal of the impinging bone spurs to restore the natural shape of the ball and socket, repairing the ring of tissue around the socket (called the labrum), and tightening loose ligaments. The surgery is done on an outpatient basis with patients returning home on the same day. For a typical FAI surgery, most patients can expect to be on crutches and in a hip brace for 2-3 weeks after surgery. Physical therapy is an essential component of recovery and usually occurs for 3-4 months postoperatively.

Outcomes and return to sports Fortunately, FAI in athletes has been studied very extensively. A review of our results from FAI surgery across all age groups showed that 90% of athletes from various levels including recreational, high school, college and professional have successfully returned to sports with excellent pain relief, function and performance. Most athletes undergoing hip arthroscopy are able to return to their pre-injury level in 4-6 months on average.

Dr. Bhatia is an orthopaedic specialist with Mercy Health. He treats a variety of sports medicine injuries and has office hours in Blue Ash and Montgomery. To schedule an appointment call 513-347-9999.

Sports Medicine Staff

 

battagliaAthletic Trainer Barbara Battaglia is a native of Chicago, and has a master’s degree in Developmental Kinesiology from Bowling Green University, and received her degree in Athletic Training in 2012 from Xavier University. While at BGSU, she worked primarily with the women’s basketball team and men’s and women’s golf teams. She also had responsibilities surrounding Falcon football. As an undergraduate at Xavier University, she worked with the Musketeers’ men’s basketball, women’s volleyball, tennis, track and cross country programs, and also gained experience working with the St. Xavier High School football team.

 

kyle hickeyAthletic Trainer Kyle Hickey is a 2013 graduate of the Xavier athletic training program, where he served as the primary athletic trainer for the women's soccer team. He also joined the sports medicine team as an intern athletic trainer in 2015. Prior to his return to Xavier, Hickey received his master's degree in sports administration from the University of New Mexico, where he served as a graduate assistant athletic trainer with primary team responsibility  with the women's soccer team, while assisting with sports medicine coverage for Lobo track and field, swimming and football. He also served as a preceptor for students in the athletic training program. Hickey is certified by the National Athletic Trainers Board and is a licensed athletic trainer in the state of Ohio. He is also a certified kinesiotape practitioner. Kyle currently resides in Cincinnati.

 

nayakDr. Suresh Nayak is the Turpin Athletics Team Physician from Wellington Orthopaedics & Sports Medicine and Mercy Health. He has been striving for excellence in Orthopaedic Surgery since 1995. His practice involves Sports Medicine and Joint Replacement surgery. This includes arthroscopic surgery of the hip, knee and shoulder. Surgeries include, for the hip: labral repair, FAI surgery. Shoulder: rotator cuff repair; instability reconstruction, SLAP lesion repair. Knee: meniscal repair, ligament reconstruction. Cartilage preservation procedures are also a keen interest. In joint reconstruction, state of the art procedures such as Anterior Approach Total Hip Replacement, Hip Resurfacing and Computer Navigated Total Knee Replacement are routine. Shoulder replacement surgery proceeds from Hemi-cap to Total Shoulder Replacement and includes the Reverse Ball and Socket, Delta prosthesis.These surgeries are married with the latest techniques in post surgery pain management protocols and with Implants that have proven longevity.