Ischiofemoral impingement

Ischiofemoral impingement (IFI) is a condition in which the space between the sit bone and the lesser part of the femoral neck (lesser trochanter) is reduced. The soft tissue in between can become compressed, causing complaints in the buttock, especially when extending and outwardly rotating the hip.

Unlike femoroacetabular impingement, the conflict here is not within the hip joint itself, but behind it.

Possible causes and risk factors:

• Overload from sports involving extensive hip extension (dance, ballet, martial arts)
• A wider or thicker sit bone or femoral neck
• Increased tension of the deep gluteal muscles
• Trauma or previous surgery in the hip region

Typical symptoms of ischiofemoral impingement include: deep buttock pain or pain at the back of the hip, radiating pain to the back of the thigh (sometimes down to the knee), pain when extending the hip, walking, squatting or sitting for long periods, pain when climbing stairs or walking uphill, a feeling of pinching or stiffness at the back of the hip. The symptoms can resemble those of deep gluteal syndrome or can come from the lower back. A targeted clinical examination and imaging help to differentiate.

Treatment initially focuses on reducing the pinching and improving mobility and muscle function: load and lifestyle adjustment, targeted exercise therapy (strengthening of the gluteal muscles and pelvic tilt exercises) or an injection in case of persistent inflammation.