Background Increased alpha angle of the hip is associated with femoroacetabular impingement (FAI). Decreased hip range of motion (ROM) and hip adductor/abductor muscular imbalances are reportedly associated with FAI.

Objective To determine if there is a relationship between decreased hip ROM and hip muscle imbalances with the degree of observed alpha angle.

Design Prospective screening study.

Setting Clinical centre screened elite major midget youth hockey players.

Participants 20 asymptomatic male (average age of 17.6 years, SD=0.5) ice hockey players who had signed IRB approved consent.

Assessment of risk factors Participants underwent hip ROM and strength assessment prior to an MRI (3T) to determine hip alpha angle.

Main outcome measurements Positive clinical findings of abduction/adduction strength imbalance and decreased ROM correlate with a high alpha angle.

Results The degree of hip alpha angles as determined by MRI were not related to hip abduction/adduction ROM (r2=0.075, p=0.24), flexion/extension ROM (r2=0.012, p=0.64), or external rotation/internal rotation ROM (r2=0.115 p=0.14). Additionally the degree of alpha angle was not related to abduction/adduction strength imbalance (r2=0.013, p=0.64). All 20 participants screened displayed acetabular labral pathology on 3T MRI.

Conclusion We found no relationship between hip ROM or abduction/adduction strength imbalances of the hip with the degree of alpha angle in asymptomatic elite major midget hockey players. Therefore, it is important to inspect for muscle weakness and pain in assessing whether patients have clinical symptoms of FAI and not rely solely on MRI for the diagnosis of FAI.