Hip ROM Changes Over 2 Years in Adolescent Elite Skiers With/Without Cam Morphology

Overview

This prospective cohort study investigated hip and lumbar spine range of motion (ROM) changes over two years in adolescent elite alpine skiers with and without MRI-verified cam morphology. Results indicated that skiers with cam morphology exhibited decreased hip internal rotation and flexion compared to those without cam, suggesting progressive functional limitations associated with cam morphology during continued high-impact sports.

Background

Femoroacetabular impingement syndrome (FAIS) is a clinical disorder characterized by abnormal hip joint morphology, notably cam and pincer types, which can cause hip pain and reduced range of motion. Cam morphology, an abnormal femoral head-neck junction shape, is prevalent in young athletes engaged in high-impact sports and is linked to cartilage damage and osteoarthritis risk. Alpine skiing, a high-impact sport, has been associated with a higher prevalence of cam morphology in elite youth skiers. Understanding how cam morphology affects hip and lumbar spine ROM over time is critical for managing and preventing hip joint pathology in this population.

Data Highlights

Key Findings

• Young elite alpine skiers with cam morphology showed a significant decrease in hip internal rotation and flexion over two years.
• Skiers without cam morphology maintained stable hip ROM during the same period.
• Cam morphology was present in 49% of elite adolescent skiers, higher than the 19% prevalence in controls.
• Reduced hip ROM in cam morphology skiers may predispose to hip joint damage and osteoarthritis.
• Clinical tests such as the FADDIR test showed higher frequency of pain/discomfort in cam morphology subjects.

Clinical Implications

Clinicians should monitor hip ROM, especially internal rotation and flexion, in adolescent athletes engaged in high-impact sports like alpine skiing, as decreased ROM may indicate cam morphology and risk for FAIS. Early identification and management strategies could help prevent progression to hip joint damage and osteoarthritis. MRI assessment of cam morphology can aid in risk stratification and guide clinical decision-making.

Conclusion

Continued elite alpine skiing in adolescents with cam morphology is associated with decreased hip joint range of motion over two years, underscoring the importance of early detection and monitoring of cam morphology to mitigate long-term hip joint complications.

References

1. Agnvall et al. 2019 -- Hip ROM and Cam Morphology in Adolescents
2. Agricola et al. 2013 -- Cam Morphology and Osteoarthritis Risk
3. Nötzli et al. 2002 -- α-Angle Measurement for Cam Morphology
4. Regional Ethical Review Board Gothenburg 2014 -- Study Approval