Editorial Commentary: A-version to a Pain in the Butt-Structural and Dynamic Determinants of Posterior Hip Pain

Ischiofemoral impingement is becoming a more recognized source of buttock pain that occurs as the lesser trochanter of the femur approximates the lateral margin of the ischium. Abnormal bony structure and alignment of the hip joint and/or faulty dynamic movement patterns may decrease the ischiofemoral space and compress the structures that are found within the space, including the quadratus femoris, proximal hamstring tendons, and sciatic nerve. The ischiofemoral space is reduced by structural factors including an increase in femoral anteversion and femoral neck angle. Dynamic assessment of the hip region may include the Craig test and total rotational range of motion of the hip joint, as well as the ischiofemoral impingement test and the long-stride walking test. The combination of structural and dynamic assessment of the hip region may help determine the presence of ischiofemoral impingement and direct appropriate management of the condition.