Hip impingement, technically known as femoroacetabular impingement, is a mechanical disorder that can cause stiffness and pain. The problem concerns the way the ball, or rounded top of the thigh bone, fits into the socket of the pelvis. When the ball and socket don't fit well together, there is friction in the joint, and this can cause pain and injury to surrounding structures.
In a normal hip, there is a smooth gliding motion of the top of the thigh bone within the socket. When there is impingement, the gliding motion is disturbed and normal hip motion is restricted. The problem can go unrecognized for years, since it is generally not painful in its early stages.
To better understand impingement, it helps to understand the anatomy of the hip. To provide stability in the joint, a layer of cartilage called the labrum lines the rim of the socket like a gasket. A joint capsule surrounds the entire joint and provides more stability and ease of movement. Articular cartilage lines both the ball and the socket to provide shock absorption. When someone has hip impingement, problems with the bone, cartilage and capsule can cause pain and limited movement due to friction within the joint.
Often an impingement can be a result of a bony abnormality occurring on either the ball or socket side. When it occurs on the ball side, it is commonly referred to as a CAM lesion. If it occurs on the socket side, it is commonly referred to as a pincer or rim lesion. This problem can occur in either the lead or rear leg during the golf swing and may restrict movement, lead to stiffness or a feeling of tightness, cause a clicking or locking sensation, or it can cause pain alone. Activities of daily living can be affected, and individuals may have trouble standing, walking more than a short distance, sitting, squatting or attempting to put on shoes.
Precautions for Golfers
Impingement can occur in several locations within the joint, and therefore can affect the ability of the leg to rotate inward or outward, thus affecting either leg in the backswing or downswing. Golfers may feel pain or experience limited movement when they try to squat to read a putt, tee up or get their ball out of a hole. Golfers should not try to push through the restricted motion, as this can result in increased damage to the joint.
Hip impingement is actually a mechanical problem. Think of a pebble in a shoe. When you take out the pebble, the problem is solved. Once the mechanical problem causing impingement is fixed, sometimes with surgery, there is a much greater chance for pain-free movement, increased strength and restored function.
Modifications on the Golf Course for Golfers with Hip Impingement
- Position feet to avoid pain with rotation and allow for the greatest available range of motion in the swing path
- Invest in a device that allows you to avoid squatting to tee up your ball or pick it up out of the hole. (see photo)
- Keep in mind that the distance you can hit with each club may change after a hip injury surgery, so you may have to select a different club to hit the same distance as before.
- Be certain to play in comfortable and supportive shoes with soft spikes.
- Wear neoprene or compression shorts, as they may provide additional support and comfort.
- If you tend be very flexible, try to avoid extra motion in another part of the body, as this can cause a problem.