Femoroacetabular (Hip) Impingement: What You Need to Know (2025)

Femoroacetabular impingement, more commonly called hip impingement, is a condition where the ball of your hip (femoral head) pinches the socket (acetabulum). A combination of genes and activity-related factors likely plays a role in its development.

Hip impingements are common. Experts estimate they affect 10% to 15% of adults. Despite their prevalence, the term “femoroacetabular impingement” wasn’t coined until 2003. Health professionals now know that hip impingements are one of the leading causes of early osteoarthritis.

Read on to learn more about hip impingements, including the different types, typical symptoms, and treatment options.

Experts generally define hip impingement as irregular contact between the ball and the socket of your hip joint. A structural change in either of these parts of your hip causes the condition. A combination of genes and activity-related factors likely play a role in its development.

Doctors tend to diagnose hip impingement in young, healthy people. Athletes may develop symptoms more often and younger than people in the general population due to vigorous exercise.

People of Caucasian background seem to have hip anatomy that predisposes them to hip impingements more than people of other backgrounds.

Some research suggests people who have a sibling with hip impingement have twice the risk of developing an impingement versus a person in the general population.

There are three types of hip impingements. Doctors classify them based on which structure is affected.

Pincer impingement

In a pincer impingement, an extra piece of bone extends over the edge of your hip socket. This bone can cause your femur to rub against the layer of cartilage that lines the outside of your hip socket, called your labrum. This can cause degeneration.

Pincer impingements seem to be more common in women.

In a 2015 review of studies, researchers found the prevalence of pincer impingement among 2,114 people without hip symptoms was 67%.

Cam impingement

A cam impingement develops when the head of your femur isn’t perfectly round and doesn’t move smoothly inside your hip socket. Over time, this can cause a bump to form on your femur head that grinds down your hip’s labrum.

In the same 2015 review, researchers found cam impingement in 37% of people without hip symptoms.

Incidence was higher (54.8%) in athletes without hip symptoms. A 2016 study identified soccer and martial arts as the most common activities in athletes with hip symptoms.

Combined impingement

A combined (or mixed) impingement is when you have features of both other types of impingements. Studies have reported the incidence of combined impingement to be between 13.7% and 44.5%.

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Hip impingements often don’t cause any symptoms. When symptoms develop, it usually means there’s damage to the cartilage or labrum in the joint. You may experience:

  • hip pain or groin pain that worsens with physical activity or sitting, often with referred pain in the buttocks, thighs, or knees
  • stiffness
  • limping
  • clicking, catching, or locking of the joint
  • decreased range of motion, especially when:
    • bringing your knee toward your chest
    • rotating the front of your knee to the midline of your body

Over time, continuous rubbing of the cartilage in the joint can lead to a labral tear or the early development of hip osteoarthritis.

Hip impingement vs. hip flexor strain

A hip flexor strain is an injury of the muscle that pulls your thigh toward your chest. Symptoms can be similar to those of hip impingement, but the underlying cause is muscular as opposed to structural.

A trained health professional such as a physiotherapist can help you figure out which hip condition you have.

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The diagnostic process starts with a doctor, physiotherapist, or other qualified professional considering your medical history and family history. They’ll also perform a physical exam.

During the physical exam, the health professional will likely perform the FADDIR test, which stands for flexion, adduction, and internal rotation. During this test:

  1. You will lie on your back. The practitioner will raise your affected leg so that your knee and hip are at 90 degrees.
  2. They will push your thigh across the midline of your body.
  3. Next they will move your foot and lower leg away from the midline of your body. Pain in the groin area is indicative of hip impingement.

A 2022 review found that the negative FADDIR test results (meaning you don’t have a hip impingement) were accurate 60% to 100% of the time.

Imaging can help a health professional confirm a diagnosis.

They’ll first obtain X-rays. These can help your doctor see the impingement. They may also help detect other hip conditions like arthritis and hip dysplasia, which is when the socket doesn’t fully cover the head of the femur.

Computed tomography (CT) scans can give your doctor a more detailed look at your hip. Magnetic resonance imaging can also identify labrum and cartilage tears.

Mild cases of hip impingement usually don’t need surgery. Conservative treatment options include:

  • physical therapy
  • reducing activity that causes pain
  • nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain medications
  • injection of a steroid and anesthesia

If conservative methods fail to provide pain relief, a doctor may recommend surgery — which is usually performed with an arthroscope. During this procedure, they’ll make a small incision in your hip and use a long tube with special tools to fix the cause of your impingement.

Exercises to treat hip impingement

It’s essential to seek a proper diagnosis and treatment plan from a trained medical professional before starting an exercise routine. Many conditions can cause symptoms similar to hip impingement but may need different treatment.

Some of the types of exercises a healthcare professional may recommend are:

  • core exercises
  • hip flexor stretches
  • groin stretches
  • hip flexor exercises
  • glute exercises

A 2020 review of studies found that a supervised physiotherapy routine, focused on active strengthening exercises and building core strength, can be more effective than unsupervised programs without those qualities.

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Here are some frequently asked questions about hip impingements.

Can hip impingement heal on its own?

The actual impingement won’t heal on its own, but conservative treatments like activity modification might be all you need to relieve symptoms.

What activities or exercises should I avoid if I have hip impingement?

It’s a good idea to avoid activities that cause discomfort. You may find that squatting, prolonged sitting, or sudden twisting of your hip causes sharp pain.

Can back pain be a sign of hip impingement?

Hip impingement often causes pain localized to the groin. But it can also cause pain in areas like your outer hip, thigh, lower back, or buttocks.

Can hip impingement cause knee pain?

Some people with hip impingement experience referred pain in their knee. Referred pain means the pain comes from somewhere other than where you feel it.

Many people with hip impingements also have limited internal rotation, which may increase ACL injury risk. Your ACL is one of the main ligaments of your knee.

Hip impingement is when the ball and socket of your hip joint don’t fit together properly due to a structural difference. It’s a common condition prevalent among active people and athletes.

It’s important to visit a medical professional for a proper diagnosis and treatment plan. Without proper management, hip impingement can lead to degeneration of the cartilage in your hip and put you at risk of developing osteoarthritis.

Femoroacetabular (Hip) Impingement: What You Need to Know (2025)

FAQs

Femoroacetabular (Hip) Impingement: What You Need to Know? ›

Femoroacetabular impingement (FAI), also known as hip impingement, is a common cause of hip and groin pain, especially among people between the ages of 20 and 45. It occurs when the bones of the hip joint are not shaped properly, causing them to rub against one another.

What are red flags for hip impingement? ›

Symptoms include a dull, aching pain in the groin that may get worse during movement and exercise, the sensation or sound of clicking or popping in the hip joint during movement, and stiffness in the thigh, hip, or groin.

What can you not do with hip impingement? ›

Our specialists can also identify movements that should be avoided, such as turning, twisting, and squatting.

How serious is hip impingement? ›

Hip impingement causes friction and abnormal wear and tear on the joint. Overtime, this can lead to osteoarthritis and the need for a hip replacement.

How do I know if I need hip impingement surgery? ›

If hip impingement syndrome causes significant pain and symptoms don't improve with nonsurgical treatment or therapeutic injections, our orthopedic surgeons may recommend surgery.

What is the fastest way to fix hip impingement? ›

Treatment for hip impingement should begin with:
  1. Resting the affected hip.
  2. Modifying your activities to avoid moving the joint in a way that causes pain.
  3. Exercising as recommended by your doctor or physical therapist to strengthen the muscles that support the hip.
Nov 17, 2022

What can be mistaken for hip impingement? ›

Many other disorders of hip joint can superficially mimic impingement and dysplasia but they do not depend on articular deformity. Among these, we can list rheumatological diseases, osteonecrosis of femoral head, transient hip osteoporosis, stress fractures, infiltrative bone disease, articular hyperlaxity.

Is walking ok for hip impingement? ›

If you enjoy running, you could consider incorporating some walking or swimming into your routine to limit how often your hips go into a flexed position. Or, you could decrease the time or distance of your runs until your symptoms begin to improve, and gradually increase from there.

Should you massage hip impingement? ›

Massage the muscles around the joint.

Massage helps relieve pain and stiffness. Your healthcare provider or a physical therapist can show you how to do this. Another person may need to help you massage the area.

Is sitting bad for hip impingement? ›

Most patients with FAI experience pain or stiffness in the groin or front of the thigh. This often occurs or is made worse with bending up of the hip or at the waist, such as when riding a bike, tying shoes or sitting for long periods of time.

How I cured my hip impingement? ›

Physical therapy is the most effective hip impingement treatment that your doctor may recommend, alongside enough rest if you suffer from mild symptoms. In addition, you can take part in PT for hip impingement through exercises or manual therapy.

What is the average age for hip impingement? ›

FAI commonly presents in healthy, active adults, most frequently between the ages of 25 and 50 years.

Can a chiropractor fix hip impingement? ›

Manual adjustments are a key component of chiropractic care for hip impingement. Our chiropractors use their hands to apply precise pressure to the hip joint to realign it and reduce pressure on the affected area. This can help to alleviate pain and improve the range of motion.

How to sleep with hip impingement? ›

The best solution? Sleep on your back. If changing your sleep position is hard, try putting a pillow between your knees or slightly behind your back to relieve pressure and keep your hips aligned. A mattress topper or more supportive mattress might also help.

Is FAI surgery worth it? ›

Here are multiple studies on the question of whether hip arthroscopy surgery to treat FAI is effective: The satisfaction rate for hip arthroscopy to treat FAI in patients >50 years old is a very low 54%. 27% of cases went on to other surgeries like hip replacement (12).

Can you live with hip impingement without surgery? ›

This condition can often be resolved with rest, modifying activity behaviour to adapt to change in hip structure, physical therapy input and/or appropriate painkillers. Conservative treatment can be successful in reducing pain and swelling in the joint, thus reducing symptoms.

Where does it hurt when you have a hip impingement? ›

What are the signs and symptoms of hip impingement? Most patients with FAI experience pain or stiffness in the groin or front of the thigh. This often occurs or is made worse with bending up of the hip or at the waist, such as when riding a bike, tying shoes or sitting for long periods of time.

What are the 10 red flag symptoms? ›

Examples of red flag symptoms in the older adult include but are not limited to: fever, sudden unexplained weight loss, acute onset of severe pain, neural compression, loss of bowel or bladder function, jaw claudication, new headaches, bone pain in a patient with a history of malignancy or that awakens the patient from ...

When should I see a doctor for hip impingement? ›

Seek immediate medical attention

Inability to bear weight on the affected leg. Intense pain. Sudden swelling. Fever, chills, redness or any other signs of infection.

Is walking OK for hip impingement? ›

If you enjoy running, you could consider incorporating some walking or swimming into your routine to limit how often your hips go into a flexed position. Or, you could decrease the time or distance of your runs until your symptoms begin to improve, and gradually increase from there.

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