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Ischiofemoral Impingement

A healthy hip relies on a variety of bony, soft tissue, and cartilage based structures to allow the hip to move smoothly. When thinking about a healthy hip, many people focus on the acetabulum (socket of the hip) and femoral head (ball of the hip), but forget to consider the position of the ischium to the femur. The ischium and femur need to have proper spatial arrangement to allow painless range of motion.

However, strenuous activity, abnormal pelvic structure, and injury can result in the ischium and femur to align too close to each other and compress soft tissues. This entrapment of soft tissues can result in pain.

At the American Hip Institute, an orthopedic specialists can carefully diagnose ischiofemoral impingement and offer patients a variety of treatment options for this condition. When discussing treatment, it is important to understand various factors that contribute to ischiofemoral impingement.

Here are essential points covered on this page:

  • What is Ischiofemoral Impingement?
  • Symptoms of Ischiofemoral Impingement
  • Diagnosis of Ischiofemoral Impingement
  • Treatment Options for Ischiofemoral Impingement
  • Surgery for Ischiofemoral Impingement

What is Ischiofemoral Impingement?

Ischiofemoral Impingement

Ischiofemoral Impingement is a potential cause of pain near the hip. Ischiofemoral impingement can lead to inflammation of nerves and soft tissue near the hip joint. This type of impingement can be caused by osteoarthritis, strenuous activity, or bony growths developed into adulthood. In some cases this condition could occur after a hip replacement. This condition is more commonly seen in women who are physically active as well.

Ischiofemoral Impingement is caused by a narrowing of space between the ischium femur. Over time as this space narrows, soft tissues and nerves become compressed and aggravated under the hip. This results in a pain that is oftentimes described as under and behind the hip joint itself.

Symptoms of Ischiofemoral Impingement

Patients with an ischiofemoral impingement may or may not experience symptoms. However, if you experience any of the symptoms below, it may indicate that you have ischiofemoral impingement:

  • Pain in the lower buttock, groin, and inner thigh
  • Sensations of clicking, popping, and snapping when walking
  • Pain that is similar to sciatica
  • An altered gait with back pain

Diagnosis of Ischiofemoral Impingement

Diagnosing ischiofemoral impingement in the hip can involve an assessment of medical history, physical examination, and diagnostic tests. Our providers at the American Hip Institute may utilize any of the following tests to diagnose your condition:

X-Rays: Providers can rule out other possible underlying conditions that may contribute to the pain you're experiencing. Using X-rays, structural abnormalities and fractures can be seen.

Magnetic Resonance Imaging (MRI): This imaging test can be used to evaluate the condition of the sciatica nerve and surrounding soft tissues between the femur and ischium.

Physical Examination: Various physical examination maneuvers can test range of motion, joint stability, and pain with specific tests that are sensitive to ischiofemoral impingement or other conditions of the hip. These tests for different types of impingement, muscle strains, and tests different types of range of motion.

Medical History: Our certified medical practitioners will also inquire about your medical history, including lifestyle, previous surgeries, and current symptoms.

Diagnostic Injection With Local Anesthetic: In some cases, a diagnostic injection using a local anesthetic may be administered into the joint space to determine whether a patient’s pain is stemming from damage to structures within the hip joint or structures like the lumbar spine.

Treatment Options for Ischiofemoral Impingement

Treatments for ischiofemoral impingement vary depending on how severe symptoms are. Minor cases of ischiofemoral impingement may require rest for a few weeks and never require surgical intervention.

Here are some of the conservative treatment options available to you at the American Hip Institute:

Activity Modification and Rest: Doctors may recommend avoiding certain activities and opting for rest to help reduce symptoms.

Physical Therapy: Physical therapy can help improve your range of motion and strengthen the muscles supporting your hip joint.

Medications: Non-steroidal anti-inflammatory (NSAID) medications can reduce pain and inflammation.

Cortisone Injections: Cortisone injections can alleviate pain by decreasing inflammation.

Surgery for Ischiofemoral Impingement

When conservative treatment options fail to provide relief a variety of surgical options can be offered. Considering MRI results, X-Rays, and physical assessments, specific treatments can be offered to address irritation of certain tissues surrounding the hip. Surgical options can be done with minimally invasive arthroscopic techniques that make use of key hole incisions and an arthroscope to visualize the hip. Below are possible surgical interventions that could be used to treat cases of ischiofemoral impingement:

  • Gluteal or other tendon repair or transfer
  • Femoral osteotomy
  • Decompression of lesser trochanter of femur
  • Hamstring debridement and repair

All of these procedures aim to restore and repair different parts of the hip that can be involved in a case of ischiofemoral impingement. These arthroscopic procedures generally have quicker recovery times than open procedures. Depending on the surgical procedure, within the first three months patients may likely have restrictions with weight bearing. Immediately after the procedure, physical therapy can be used to regain strength, mobility, and function to the hip.

Come Visit the American Hip Institute

If you think you are suffering from any of the symptoms mentioned above, you may be experiencing ischiofemoral impingement. Experts from the American Hip Institute lead the field in providing cutting-edge and personalized treatment plans for hip issues. Our team is highly trained in diagnosing, treating, and helping people get their lives back. Contact us today to schedule a consultation.


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