Prevalence and Functional Consequences of Femoroacetabular Impingement in Young Male Ice Hockey Players

Background: Femoroacetabular impingement (FAI), which is highly prevalent in adult ice hockey players, is often associated with negative clinical and functional outcomes. It is unclear, however, whether FAI-related bony deformities and symptoms may lead to functional alterations as reflected in hip muscle strength, range of motion (ROM), and on-ice physical performance in youth ice hockey players. Hypothesis: Compared with players with neither structural signs nor symptoms related to FAI, players with symptomatic FAI would show hip muscle weakness and reduced hip ROM, which would in turn affect ice hockey physical performance. Study Design: Controlled laboratory study. Methods: A total of 74 young male ice hockey players were evaluated bilaterally for passive hip internal rotation ROM by use of a hip examination chair. Only the side with less internal rotation ROM was further investigated. FAI-related bony deformities were evaluated with magnetic resonance imaging (MRI). The involved hip was classified as symptomatic or asymptomatic based on the presence of hip pain during exercise and results from the flexion/adduction/internal rotation (FADIR) provocation test. Hip muscle strength, passive hip ROM, and on-ice physical performance were compared between players with no FAI, players with asymptomatic MRI-positive FAI, and players with symptomatic FAI. Results: Fifty of 74 players (68%) had FAI-related bony deformities, of whom 16 (22%) were symptomatic. Hip muscle strength, hip ROM, and on-ice physical performance did not differ significantly between players with no FAI and those with asymptomatic or symptomatic FAI. Conclusion: Despite a high prevalence of FAI-related bony deformities, youth ice hockey players with asymptomatic or symptomatic FAI did not show functional impairments in terms of hip muscle strength, hip ROM, or on-ice physical performance. Clinical Relevance: Hip muscle strength, passive hip ROM, and on-ice physical performance do not seem to discriminate for FAI-related signs and symptoms in young male ice hockey players.