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Sharp Health News

Hip impingement in kids

July 25, 2018

Hip impingement in kids

16 year-old Evan and his Sharp Chula Vista physical therapist, Jennard Bernales.

It was the beginning of a new football season when 16-year-old Evan began experiencing severe pain near his hips. After a trip to his doctor and an X-ray, he learned he might have hip dysplasia and femoroacetabular impingement, also known as FAI, in both hips.

FAI is a condition that consists of extra bone growth — or bone spurs — along one or both of the bones that make up the hip joint. This extra bone prevents the hip from moving smoothly during activity and results in pain and limited activity; however, a serious long-term effect of FAI is osteoarthritis.

There are three types of FAI:

  • Pincer — extra bone extends out over the normal rim of the hip’s acetabulum
  • Cam — the femoral head of a hip is not round and cannot rotate smoothly inside
  • Combined — both pincer and cam types of FAI are present

In Evan’s case, he was diagnosed with FAI cam.

Evan received a cortisone injection and physical therapy to help manage his inflammation and pain; however, these treatment options proved unsuccessful, which led him and his parents to Dr. Michael Muldoon, a board-certified orthopedic surgeon affiliated with Sharp Memorial Hospital.

“After meeting Evan, we sent him to undergo a 3D CT scan of his right hip and an MRA (magnetic resonance angiogram) of his left hip,” explains Dr. Muldoon. “Soon after his results arrived, we determined he was a candidate for surgery due to large bone spurs and torn labrums that were a result of his hip impingement.”

According to Dr. Muldoon, adolescents who are involved in contact sports such as football or hockey are more prone to developing FAI. However, treatment and surgery can help.

Soon after surgery for each hip, Evan began his physical therapy. Dr. Muldoon coordinated to have it done at the outpatient physical therapy department at Sharp Chula Vista Medical Center because it was closer to home. He says this is often done to ensure the best experience for each patient.

“Evan’s been doing really well with his physical therapy; he’s a natural athlete,” says Jennard Bernales, Evan’s physical therapist at Sharp Chula Vista. “His therapy begins with hands-on, manual techniques; this is followed by functional movements like squatting and lunging, along with hip, core and lower-extremity stability exercises. Eventually his therapy will turn into sports-specific exercise so we can get Evan back to his prior level of function.”

In the next few months, physical therapy will be complete and Evan can get back to playing the sports he loves — baseball and football.

“It’s been interesting to receive care at different Sharp facilities and to see them work together in the best interest of a patient outcome. We’ve had a true ‘Sharp Experience,’” explains Tina, Evan’s mom, who also works at Sharp Grossmont Hospital as a data analyst in the hospital’s heart and vascular program.

“We count our lucky stars for Dr. Muldoon, the outpatient surgery department at Sharp Memorial and Evan’s therapist, Jennard. They all are truly invested in Evan’s recovery and ability to return to what he loves.”

For the news media: To talk with Dr. Muldoon about hip impingement in kids caused by contact sports for an upcoming story, contact Erica Carlson, senior public relations specialist, at

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