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Resolving anterior hip pain in a young male footballer following arthroscopic surgery for Femoroacetabular Impingement Syndrome: A case report

Journal article
Authors Carl Todd
Jón Karlsson
Adad Baranto
Published in Journal of Bodywork and Movement Therapies
ISSN 1360-8592
Publication year 2019
Published at Institute of Clinical Sciences, Department of Orthopaedics
Language en
Links dx.doi.org/10.1016/j.jbmt.2019.05.0...
Keywords Femoroacetabular impingement syndrome, Hip flexor, Neuromuscular movement control, Psoas
Subject categories Orthopedics

Abstract

Background: There appear to be limited studies available regarding the conservative management of patients following hip joint arthroscopic surgery, or investigating reasons for which patients still report hip and groin pain post surgery. Objectives: Treatment was applied to restore spino-pelvic mechanics and to reduce soft tissue restrictions in hip joint motion. Neuromuscular movement control and work capacity exercises were encouraged to support the integrity of the hip joint and spino-pelvic complex. Clinical features: A 22-year-old male footballer, (height 190cm and weight 82kg) presented reporting an eighteen-month history of hip and groin pain, having previously undergone bilateral arthroscopic surgery twelve months earlier for Femoroacetabular Impingement Syndrome. Strength measurements were recorded using the MicroFET 2 Wireless Digital Handheld Dynamometer. Trunk muscular endurance was evaluated with Sorenson test. Results: Five treatment consultations over a five-week period resulted in pain reduction, (Visual Analogue Scale 8/10 to 0/10). Improvement in range of motion, right hip flexion (70–100°) and left (80–100°), right internal rotation (30–45°) and left (40–45°). Improvement in strength, specifically right hip flexion (0.29–0.43Nm/kg, 48%) and right hip abduction (0.35–0.46Nm/kg, 31%). Improvement in trunk muscular endurance increased 41% from 170 seconds to 240 seconds. Conclusion: This case report supports the rationale that the post arthroscopic management of Femoroacetabular Impingement Syndrome, should include both treatment to address spino-pelvic restrictions, if appropriate, combined with exercises that specifically target hip flexor strength. However, a larger randomized study would provide a clearer understanding for the management of this particular subset of patients. © 2019 Elsevier Ltd

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