Hip Impingement (FAI) Treatment
Hip impingement happens when the head of the thigh bone and the hip socket rub against each other during movement. Early treatment helps protect the cartilage.
Hip impingement, known medically as femoroacetabular impingement (FAI), is a common cause of groin pain, especially in young and active adults. Small differences in the shape of the bones that form the hip make them knock against each other during movement. Over time, this friction can wear the joint cartilage and the labrum, a rim of tissue around the socket.
What is hip impingement?
Three types are described:
- Cam type: The head of the thigh bone is not perfectly round, with extra bone at the neck.
- Pincer type: The hip socket covers the head of the thigh bone more than normal.
- Mixed type: Both features are present. This is the most common type.
These shape differences often develop in adolescence, especially in people who play a lot of sport.
Symptoms
- Deep pain in the groin, sometimes at the side of the hip
- Pain that increases after sitting for a long time, getting into a car or squatting
- Difficulty turning the hip inwards
- A catching or locking feeling during movement
- Symptoms that become more noticeable after sport
Diagnosis
Pain when the hip is bent and turned inwards (the impingement test) is an important finding on examination. Special X-ray views show the shape of the bones. MRI, or MR arthrography with contrast when needed, is used to assess the labrum and cartilage. It is also important to rule out other sources of pain, such as the lower back or a sports hernia.
Treatment options
Non-surgical treatment
Mild symptoms are first treated without surgery. This includes avoiding movements that increase the pain and deep squats, a physiotherapy programme that strengthens the hip and core muscles, and short courses of pain relief and anti-inflammatory medication. In some patients, an injection into the joint helps both diagnosis and treatment.
Hip arthroscopy
Hip arthroscopy may be recommended when symptoms continue and the cartilage has not yet been seriously damaged. A camera and fine instruments are passed into the joint through a few small incisions. Extra bone is reshaped and a torn labrum is repaired with stitches or, if necessary, trimmed. The aim is to remove the friction and protect the joint.
After surgery
Patients usually go home on the same or the next day after arthroscopy. Crutches are used for the first weeks and a hip-protecting exercise programme is started. Returning to daily life takes a few weeks, and returning to sport takes a few months, depending on what was done.
Everyday tips
Deep squats, sitting with the hip turned in and low chairs can increase impingement. Raising the seat height, taking breaks from long sitting and warming up the hip well before sport reduce symptoms.
Frequently asked questions
Does hip impingement lead to arthritis?
Long-standing friction can increase the risk of cartilage damage and, in later years, arthritis. This is why ongoing symptoms should be assessed.
Does everyone need surgery?
No. Many patients improve with physiotherapy and activity changes. Surgery is considered when pain and mechanical symptoms continue despite non-surgical treatment.
Can I return to sport after arthroscopy?
Most patients return to sport after completing rehabilitation. The timing depends on the procedure, the condition of the cartilage and the type of sport.
Can hip impingement be confused with a back problem?
Yes, the pain can be similar. Examination and, if needed, a diagnostic injection into the joint help identify the source.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.