HYPERMOBILE HIP DYSPLASIA CAM FAISFEMERO ACETABULAR IMPINGEMENT SYNDROME CAM
HYPERMOBILE HIP DYSPLASIA CAM FAIS
WHEW, what a mouthful. It's all about hip and groin pain, nasty stuff. Shall we discover what these terms mean? Understanding your hip pain can make the difference between a hip op, or not. Yes, it's worth trying to grasp this stuff. DEVELOPMENTAL HIP DYSPLASIAHip dysplasia is characterised by a shallow acetabulum (hip socket) that slopes upwards. The roof is not fully formed. In addition, a part of the ball of the hip is improperly roofed. It's caused by the foetus lying in-utero in the wrong postion. For more details of this phenomenon, and info about the Pavlik harness, see
DEVELOPMENTAL HIP DYSPLASIA (DDH) ...
Searching for something specific? Say, " Pincer deformity in the hip ". Just type it in here...  Custom Search Clinically, there is a greatly INCREASED range of motion of the hip, in both the child and the young adult, with or without pain. Sitting in the lotus postion is readily done, and they often make great gymnasts and sportsmen and women. A clicking sound may be heard or felt as the ball subluxates in and out of the socket, depending on the shallowness of the socket, and the slope of the acetabular roof. Beyond the immediate concerns of pain in the upper leg and hip, there is an increased tendency for hip arthritis due to decreased area of contact between hip and acetabulum. Careful management of hip dysplasia is vital, and it fits well within the chiropractic domain, as it often has a knock-on affect on the sacro-iliac joints. However, the chiropractor must also address the hip joint itself and, in the infant with a clicking hip, in my opinion a paediatrician should be consulted. Daily exercises are vital to strengthen the buttock and upper leg muscles to reduce the tendency of the hip to subluxate. Periodically, even in the young child, walking may be painful, either in the groin, or on the side of the hip, giving concern about an even more serious condition, Perthe's disease.
PERTHES DISEASE ... HYPERMOBILE HIPThe hypermobile hip likewise has an increased range of motion, but without the developmental changes of the socket seen in DDH. Clicking sounds are unlikely, but there may still be pain in the hip. The pain may radiate towards the knee and the inner thigh muscles (the adductors are often extremely tender on palpation).This may be generalised hypermobility of all the joints of the body or, if it's limited to one (or both) hips, then we may think of it as a Grade I Development Hip Dysplasia. A mild case of HDD, but enough to cause pain. Only an X-ray can distinguish between hypermobility and hip dysplasia. ASIDE: There is some debate between chiropractors as to whether hypERmobility (increased movement, highly flexible) is more serious or hypOmobility (stiff joints). Both are a concern, but in my opinion, it's easier to loosen up stiff joints than to stabilise hypermobile joints. Both, unmanaged, lead to a higher incidence of arthritis. CASEFILEA young woman, 16-years old, I couldn't call her a child! recently consulted me with lower back, sacroiliac joint and groin pain particularly on standing and slow walking.She had a long history, her mother told by a paediatrician when the lass was 4 that she urgently needed an operation on her hip for HDD, and at 5 by a professor of child orthopaedics that there was no sign of HDD on X-ray, but that she was merely hypermobile. New X-rays confirmed the learned professor's advice: no hip dysplasia. But on examination, indeed a grossly increased hip range of motion and a sacro-iliac joint syndrome. It's going to take careful chiropractic management, and a vigorous exercise programme to keep this young woman from a life-long hip pain and ultimately perhaps hip arthritis. FEMERO ACETABULAR IMPINGEMENT SYNDROMEIn general FAIS on the other hand we generally think of causing a DECREASED range of motion in the hip (hypOmobility). It always comes as a surprise to find the appearance of stiffness of the advanced arthritis in the examination of the hip of a young person. But no, not hip arthritis, but FAIS...FAIS comes in two kinds and a mixture of the two:
For more about FAIS...
FEMERO ACETABULAR IMPINGEMENT SYNDROME Because of a change of gait, FAIS also affects the sacroiliac joint anatomy ... and the buttock and lower back muscles. Another asideThere are concerns that once you start with chiropractic, you become a life-long captive. It is a legitimate concern, and the truth there is nothing more that some chiropractors would like than to make you into a life long patient. Same as the pharmaceutical companies want you to take their medications, like Statins for example to lower your cholesterol instead of making the simple dietary changes necessary. FOODS THAT LOWER CHOLESTEROL ...Both are completely unethical. Good doctors try to get you to make lifestyle changes, not take medicines for life, and good chiropractors try to persuade you to start exercising regularly, losing weight if necessary and perhaps going for a massage occasionally... instead of manipulation every few weeks.
Nevertheless, the truth is some conditions are serious and incurable and there is no alternative to becoming a lifelong patient. It's as true of diabetes in the medical realm and these FEMERO ACETABULAR IMPINGEMENT SYNDROME CAM deformities in the chiropractic realm. We can't cure you, nobody can, but we can ease the pain and disability, and do our level best to prevent it developing into a full-blown
hip arthritis ... For the ethical doctor, dentist, chiropractor it's not about money. We earn quite enough. It's about an ounce of prevention, always better than a pound of cure. But, it's true, there are rotten apples in every barrel. Greed prevails in every aspect of health care... carefully assess your doctor - is s/he interested in you, or your money? A hard question.
Mixed HYPERMOBILITY with a CAM deformityOccasionally at the Chiropractic Coalface one comes up with bizarre cases of INCREASED range of motion with a FAIS deformity (expecting decreased ROM). It's unlikely to be a Mixed FAIS but more likely a CAM deformity.The long and the short of it is that hip and groin pain comes in any number of shapes and sizes. All of these conditions, poorly managed, are far more likely to progress to premature hip arthritis and total hip replacement. CASE FILEMrs B, 50 years old, has had bilateral knee pain since she was 16 years old, lower back, midback and neck pain since she was 30 years old, and left hip and groin pain for some five years.She was diagnosed with "hypermobility" as a teen, and responded reasonably well to chiropractic treatment of her neck and back by another chiropractor, who did however not address her hip and knee problems. X-ray of her knees revealed a condition called Chondrocalcinosis which causes
PATELLO FEMORAL PAIN SYNDROME - kneecap pain However, her hip shows no signs of chondrocalcinosis or chronic arthritis. What it does show is HYPERMOBILE HIP DYSPLASIA CAM FAIS - a mixture of hypermobility and a CAM deformity. Ranges of motion of the hip were grossly increased and she had marked pain in the groin (capsule) as the CAM deformity came into contact with the labrum of the acetabulum; the lateral hip and the adductor muscles were very tender. The Fabere test was not limited, but painful in the groin.
X-raysX-rays of her pelvis revealed no true hip dysplasia, perhaps a slight unroofing of the ball, but a CAM deformity, all aggravated by a short leg causing a lumbar scoliosis.She responded well to sacroiliac joint adjustments, mobilisation of the hips, soft tissue therapy applied to the capsule and adductor muscles and a vigorous rehab program. It remains to be seen what the long term prognosis is. What is uncertain is what effect increasing the magnesium in her diet will have on all her joints. Only research in which patients with chondrocalcinosis are treated in different ways, one of which is an increase in mangnesium will reveal the overall effect of the mineral supplementation. Orthotics to address the leg length discrepancy in the future is likely.
HYPERMOBILE HIP DYSPLASIA CAM FAISHave A Great Story About This Topic?Do you have a query or comment about upper leg pain or, for that matter, tingling in the legs and feet? What Other Visitors Have SaidClick below to see contributions from other visitors to this page...
Upper leg pain, Inner thigh and groin pain.
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