HIP AND GROIN – Young Adult (FAIS)

Are you a young adult struggling with pain at the front of the hip or groin area?

Especially when it is sport time or when at the gym?

There are many causes for hip and groin pain – some bony and some muscular causes. This blog explains one of the bony causes for hip pain in a young adult, particularly a condition known as ‘Femeroacetabular Impingement Syndrome’ (FAIS).

DEVELOPMENT

• Between the age of 10-14, the hip joint can start to change shape in reaction to the high loads placed upon it during twisting and pivoting sports. This can occur as the growth plate in the hip, known as the ‘physis,’ is not fused yet and reacts to the loads by creating extra bony outgrowth.
• At around the age of 16, the bone fuses into its adopted shape and you may present with a ‘Cam lesion.’ A ‘Cam lesion’ is where the extra bone on the femoral head-neck (the ‘ball’ of the hip) creates a bump.
• You are at risk of developing this ‘Cam lesion’ if you are NOTadjusting your training load accordingly as a teenager (especially if performing ≥4 training sessions per week in sports that involve running, kicking and change in direction).

SIGNS & SYMPTOMS

• In adulthood, you may then start to experience a deep pain at the front of the hip or groin with certain positions and movements. This is due to early unscheduled bony contact in the joint during demanding activities requiring large hip motions.
• Pain can arise during sports or activities that involve KICKING, RUNNING, JUMPING, SQUATTING, CHANGING DIRECTION and SITTING
• You may also experience stiffness and a restriction in hip motion
• Many patients can have a ‘Cam lesion’ on X-ray, however are not diagnosed with ‘FAIS’ unless they have symptoms of pain and stiffness correlating with assessment findings from a physiotherapist.

MANAGEMENT

Physiotherapy aims to monitor and adjust your load by looking at:

• How FREQUENTLY you are training and playing sport in the week
• The INTENSITY of the session
• The DURATION of the session
• Your RECOVERY timeframe
• The POSITIONS the hip joint is being placed in

Addressing these fundamentals for training and games is important so the hip can load/perform optimally without flare ups of pain.

REHABILITATION

• Muscle STRENGTH is vital for joint protection and minimising any provocative joint loading. Therefore, it is also important to ensure appropriate muscle strength and technique is adopted for sport, which will aid in how the hip joint is loaded.
• A physiotherapist can:
  • Manage the loads that go through the hip as mentioned above
  • Design and modify a training program/schedule
  • Design a strengthening program tailored specifically to your sport and impairments found during assessment.

IMPORTANCE

• It is important to manage your training loads early as a teenager and young adult, as if the hip is continually being provoked in the presence of a Cam lesion, it can heighten the risk of early hip osteoarthritis.(1)

Contact our clinic and make an appointment with Monica, our physiotherapist who has a strong interest in sporting injuries, hip and groin pain and adolescent injuries, to assess and treat your hip and groin pain.

References

1. Saberi Hosnijeh F, Zuiderwijk M, Versteeg M, Smeele H, Hofman A, Uitterlinden A et al. Cam Deformity and Acetabular Dysplasia as Risk Factors for Hip Osteoarthritis. Arthritis & Rheumatology. 2016;69(1):86-93. doi 10.1002/art.39929