Clinical Pilates in Practice: FAI Morphology & Adolescent Spine Patients

This study compared spinopelvic parameters in asymptomatic scoliosis and asymptomatic patients with radiographic evidence of femoroacetabular impingement.

Nabi, Vugar, Halil Demirkiran, Bulent Atilla, Mazhar Tokgozoglu, and Omur Caglar. "The prevalence of radiographic femoroacetabular impingement morphology in adolescent spine patients." Medicine Science | International Medical Journal 10, no. 2 (2021), 524. doi:10.5455/medscience.2021.04.108

Key Points: Fai Morphology & Adolescent Spines

• There is a significant association between between spinal deformity and the presence of femoroacetabular impingement morphology.

There was no relationship between femoroacetabular impingement morphology and spinopelvic parameters.

• Abnormal morphology or biomechanics in the pelvis or spine inherently affect each other by way of the lumbosacral junction.

• Changes in spinal alignment alter hip biomechanics and may also predispose an individual to hip pathologies.

• Sagittal balance about the lumbo-sacral pelvic junction plays an important role in hip disorders.

• Changes in pelvic tilt alter acetabular coverage in terms of lateral centre-edge angle, acetabular crossover, or Tonnis angle.

• In this study, hips with signs of femoracetabular impingement showed a higher alpha angle (p=0.001), Tonnis angle (p=0.001), centre-edge angle, cross-over sign, coxa profunda, and ischial spine sign (p=0.001).

Radiographic measurements related to femoracetabular impingement morphology (Nabi et al, 2021); a) Radiograph showing an example of alpha angle measurement on Antero-posterior pelvic imaging. b) Tonnis angle. c) Measurement of LCEA. d) Crossover sign and Ischial spine sign evaluation. e) The assessment of coxa profunda. f) The evaluation of spinopelvic parameters.

Clinical Pilates in Practice

• Femoral, sacropelvic, and lumbar spine movements cannot be decoupled.

  → Observe for subtle changes in alignment and assess how these impact dissociated and functional movements.

• Pre-Pilates exercises can be used as movement assessments for hip/pelvis/lumbar pathologies:

  → Pelvic Clocks.

  → Pelvic Press.

  → Bent Knee Fall Outs.

  → Mermaid Prep.

  → Side to Side.