--- title: "Hip Impingement (Femoroacetabular Impingement Syndrome)" description: "Femoroacetabular impingement causes groin pain in active young adults. Symptoms, diagnosis and treatment options." date: 2026-10-24 lastmod: 2026-11-02 canonical: https://drmotiva.com/en/articles/hip-impingement/ lang: en --- # Hip Impingement (Femoroacetabular Impingement Syndrome) Femoroacetabular impingement (FAI) syndrome is a motion-related condition in which abnormal contact between the head of the thigh bone and the hip socket causes pain [1]. It is most common in active young and middle-aged adults. ## Symptoms - Groin pain, sometimes on the outer hip or buttock - Pain with deep bending, sitting for long periods, or twisting - Clicking, catching or stiffness According to international consensus, diagnosis requires symptoms, clinical signs and imaging findings together, because impingement shapes on imaging are also seen in people without pain [1]. Further reading: the [guide “Hip Pain”](https://drmotiva.com/en/guides/hip-pain/) and the articles [Knee Osteoarthritis Treatment Without Surgery](https://drmotiva.com/en/articles/knee-osteoarthritis-without-surgery/) and [Hyaluronic Acid Injections for Knee Osteoarthritis](https://drmotiva.com/en/articles/hyaluronic-acid-knee-injections/). ## Treatment - **Conservative care:** education, activity modification and physiotherapy focusing on hip and core strength and movement control - Pain medicines and, in selected cases, injections - **Hip arthroscopy:** a randomised trial found greater improvement in hip-related quality of life with arthroscopy than with best conservative care at 12 months [2] The choice depends on symptoms, findings and patient goals [3]. ## What happens in the hip The hip is a ball-and-socket joint. In FAI syndrome, the shape of the ball (femoral head), the socket (acetabulum) or both allows them to contact abnormally during certain movements: - **Cam morphology:** extra bone at the junction of the femoral head and neck, so the ball is less round - **Pincer morphology:** the socket covers too much of the ball - **Mixed:** both features together Repeated contact can irritate or damage the labrum (the ring of cartilage around the socket rim) and the joint cartilage. ## Who is affected FAI syndrome is seen mainly in active adolescents and adults, particularly in sports involving deep hip bending and rotation, such as football, ice hockey, martial arts and dance. Hip shape develops during growth, and high levels of sport during adolescence may play a role in cam morphology. ## Assessment Assessment includes your history, examination of hip movement and specific provocation tests, such as bringing the knee towards the opposite shoulder while rotating the hip inwards. A standard X-ray shows the bone shape. MRI or MR arthrography (MRI with contrast in the joint) can show labral and cartilage damage. A diagnostic injection of local anaesthetic into the joint can help confirm that the pain comes from inside the hip. Other sources of groin pain, such as the lower back, hernia and tendon problems, are also considered. ## Conservative management in practice - Understanding which positions provoke pain and adapting them temporarily - Strengthening the hip abductors, extensors and trunk muscles - Improving movement control in sport-specific tasks - A programme of at least several months, supervised by your physical medicine and rehabilitation specialist and the physiotherapist, before considering surgery in most cases The international consensus recommends that both conservative care and surgery have a role, depending on the individual [1]. ## Home measures - Avoid very low chairs and deep squats while symptoms are irritable - Take breaks when sitting for long periods - Choose activities such as cycling with a raised saddle or swimming, if they are comfortable - Keep up the strengthening exercises you have been taught ## Red flags Seek urgent care for severe hip pain after a fall, inability to bear weight, fever with hip pain, or pain at rest and at night that keeps getting worse. ## When to see your physical medicine and rehabilitation specialist Seek assessment if pain is severe, keeps getting worse, wakes you at night or does not start to improve within a few weeks; if numbness, weakness or any warning sign appears; or if you are unsure what your test results mean. Your physical medicine and rehabilitation (PM&R) specialist, a doctor trained to diagnose and treat musculoskeletal and nerve problems without surgery, examines you, explains the findings and plans treatment together with the physiotherapist. Whether injections or other advanced treatments are suitable for you is decided by a PM&R specialist after examination. Prof. Dr. Engin Çakar works in this field and can be consulted online or in person; otherwise, please consult a PM&R specialist near you. To make the most of the consultation, it helps to bring: - A short timeline of your symptoms and what makes them better or worse - A list of your medicines and other health conditions - Previous imaging (the images themselves, not only the reports), test results and treatment summaries - Your questions and goals, such as returning to work, sport or a particular activity ## Frequently asked questions **Does every impingement shape on X-ray need treatment?** No. Only symptomatic FAI syndrome is treated. **Can I keep doing sport?** Often with modifications; a physiotherapist can guide activity. See [Hip pain causes](https://drmotiva.com/en/articles/hip-pain-causes/). **Does impingement cause hip osteoarthritis?** Cam morphology is associated with a higher risk of hip osteoarthritis, but not everyone with it develops osteoarthritis. Whether treatment prevents osteoarthritis has not been proven. **Is surgery the only definitive solution?** No. Many people improve with conservative care. Arthroscopy may help selected patients, but outcomes cannot be guaranteed and the decision is individual. ## Assessment and contact You can request an appointment or a second-opinion review of existing reports and imaging: [Contact & second opinion (WhatsApp)](https://drmotiva.com/go/wa?l=en&t=&loc=inline_contact&p=%2Fen%2Farticles%2Fhip-impingement%2F). This page is general health information. Diagnosis and treatment decisions are made individually after examination. ## Sources 1. Griffin DR, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016. [PMID: 27629403](https://pubmed.ncbi.nlm.nih.gov/27629403/) 2. Griffin DR, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018. [PMID: 29893223](https://pubmed.ncbi.nlm.nih.gov/29893223/) 3. Trigg SD, et al. Femoroacetabular Impingement Syndrome. Curr Sports Med Rep. 2020. [PMID: 32925375](https://pubmed.ncbi.nlm.nih.gov/32925375/)