Femero Acetabular Impingement Syndrome CASE FILEFemero Acetabular Impingement Syndrome case file gives a broader perspective on this condition which is so treatable especially if caught in the early stages. Mr S is a 55-year old man with a three year history of increasing groin and stiffness. For the last three months putting on his socks is most difficult - he just can't flex the hip sufficiently now to reach his feet - yet he has minimal arthritis in the hip. Golf has become increasingly difficult, and when he first consulted me (six weeks ago) had to use a little car, and take two anti-inflammatories before playing a round of golf. This is an X-ray of one of his hips. The other is very similar.
Orthopaedic surgeonHis orthopod has declared that he has hip arthritis, and that he will have two hip replacements within 2-3 years. It was not yet bad enough.But bad enough that he woke every time he turned in bed, and on the golf course he felt like an old man. True, he does have early Cox arthritis duplex. EARLY. The real underlying complaint is
FEMERO ACETABULAR IMPINGEMENT SYNDROME >> Mixed type - CAM + PINCERThe arrows clearly indicate that he has both the CAM and PINCER type of FAIS.What is noteworthy is that there is minimal hip degeneration. Slight loss of joint space but no erosions, no cysts, no laying down of calcium in the roof of the acetabulum, and a nice smooth surface of the ball of the femur. But clinically, severe stiffness is a characteristic of every Femero Acetabular Impingement Syndrome case file. Mr S could not flex his hips more than 90* in the beginning, and the Faber test was strongly restricted, as in internal rotation and adduction were sharply decreased. Diagnosis: FAIS. After only four treatments he says he can feel 'meer ruimte' (more space or room) in the hips when he does the exercises I gave him, he can put on his socks again, and last weekend he played 9 holes, walked the distance, with no anti-inflammatories. Admittedly, after he had swallowed a few painkilling pints at the Nineteenth hole, he had marked difficulty getting off the stool, but it lasted less than a day. Aachen and Cologne weren't built in a day, as we say in Holland. Sadly, he said after seven treatments over a four week period that the range of motion had improved (he could put is socks on) but there was no significant reduction in the pain, so he was stopping with the treatment. His insurance paid for seven treatments. In two years that will be paying for a two total hipreplacements, and 1000 euros per year for Chiropractic was out of the question. Until we can produce the research that we can maintain a condition like FAIS.
Treatment in our Femero Acetabular Impingement Syndrome CASE FILEThe treatment protocol that I have developed for Femero Acetabular Impingement Syndrome case file involves exercises done several times a day, mobilisation of the hip (by me), distraction of the hip, painful treatment of the groin muscles and adjustments of the Sacro-iliac joints. To be honest, it's not rocket science, just plain chiropractic applied specifically to the hip joint.Miracles are not to be expected, and it remains to be seen what progress we as Chiropractors can achieve in the treatment of FAIS. But the early signs are encouraging. Very encouraging. Oh yes, and the chicken bones bouillon that has been researched to help with cartilage wear-and-tear.
Chicken bones soup, proven relief of arthritis.
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