Hip Impingement (Femoroacetabular Impingement): Symptoms, Causes, Treatment & Exercises

Key Takeaways

• Hip impingement is a condition where the hip bones don't fit together properly, causing pain and stiffness.

• Common symptoms include hip pain, stiffness, and difficulty with certain movements.

• Causes often include abnormal bone development or repetitive movements.

• Treatment options range from physical therapy to surgical intervention.

• Regular exercises focusing on strengthening and stretching can help alleviate symptoms.

• The MSK Doctors team combines orthopaedic expertise with advanced AI technology to analyse movement patterns and create personalised treatment plans that resolve hip impingement issues. 

Overview of Hip Impingement

What is Hip Impingement?

Hip impingement, also known as femoroacetabular impingement (FAI), is a condition that affects the hip joint, causing discomfort and restricting movement. It occurs when the bones of the hip joint come into abnormal contact, leading to joint damage over time (image courtesy of Cleveland Clinic).

This can be due to a misshapen femoral head, a condition known as cam impingement, or an overgrowth of the acetabular rim, known as pincer impingement. Sometimes, both conditions are present, which is referred to as mixed or combined impingement. 

Over time, this abnormal contact can lead to damage in the hip joint, causing pain and restricting movement.

Impact on Daily Life

The condition often leads to persistent pain, especially during activities like walking, sitting for long periods, or engaging in sports. It can make everyday tasks difficult, affecting your quality of life. 

Common Symptoms

Sharp or Aching Pain in the Groin or Front of the Hip 

• This pain typically manifests during or after physical activities, especially those involving hip flexion or rotation. Many patients describe it as a deep, persistent ache that worsens with prolonged activity. 

• The pain often radiates from the groin to the lateral hip or buttock region and can be particularly pronounced when transitioning from sitting to standing.

Catching, Locking, or Clicking Sensation 

• When the abnormally shaped femoral head or acetabular rim make contact during movement, patients often experience mechanical symptoms. This can feel like the hip momentarily getting stuck before releasing - producing audible or felt clicking. 

• These sensations typically occur during specific movements like getting in and out of a car or pivoting during sports.

Limited Range of Motion 

• Hip impingement restricts movement, particularly in flexion (bringing knee toward chest), internal rotation (turning leg inward), and adduction (bringing leg across midline). 

• Athletes might notice they cannot achieve positions they once could, while non-athletes may struggle with everyday movements like putting on socks or shoes.

Stiffness and Discomfort after Prolonged Sitting or Walking 

• After maintaining one position for an extended period, patients often experience significant stiffness and discomfort. This is especially noticeable in the morning or after sitting in meetings, long car rides, or at a desk. 

• Many describe needing to loosen up their hip before being able to move normally, and the stiffness typically returns quickly after periods of inactivity.

Causes of Femoroacetabular Impingement

Abnormal Bone Development

Abnormal bone development is one of the leading causes of hip impingement. This occurs when the bones in the hip joint don't develop properly during childhood, leading to irregularities in their shape. 

For example, in cam impingement, the femoral head is not perfectly round, which causes it to jam against the acetabulum. On the other hand, pincer impingement involves an overgrowth of the acetabulum, leading to excessive coverage over the femoral head. 

These structural issues cause the bones to rub together, resulting in damage to the cartilage and labrum over time.

Repeated Movements

Engaging in repetitive movements, particularly those that involve twisting or pivoting, can contribute to the development of hip impingement. 

Athletes, especially those involved in sports like soccer, hockey, or dance, are at a higher risk. These activities place significant stress on the hip joint, leading to wear and tear over time. 

The repetitive motion can exacerbate any existing bone abnormalities, accelerating the onset of symptoms.

Genetic Factors

If there is a family history of hip issues, there may be a higher likelihood of developing similar conditions. Genetic predisposition can influence the shape and development of the hip bones - making some individuals more susceptible to impingement. 

While you can't change your genetic makeup, being aware of your family's medical history can help you take preventive measures such as: 

• Regular check-ups if you have a family history of hip problems.

• Engage in exercises that strengthen the hip joint.

• Avoid activities that place excessive stress on the hips.

Treatment Options

Non-Surgical Treatments

These treatments focus on alleviating symptoms and improving joint function without invasive procedures. They include:

• Physical Therapy: Specific exercises like clamshells and bridges help strengthen the muscles around the hip, improving stability and reducing pain.

• Medications: Over-the-counter pain relievers like ibuprofen can help manage pain and inflammation.

• Activity Modification: Avoiding activities that trigger symptoms can prevent further damage.

Surgical Interventions

When non-surgical treatments do not provide sufficient relief, surgical intervention may be necessary. Surgery aims to correct the structural issues causing the impingement. The most common procedures include:

• Arthroscopy: A minimally invasive surgery where small instruments are used to trim or reshape the hip bones.

• Open Surgery: In more severe cases, open surgery may be required to correct the bone deformities.

Surgery can provide significant relief and improve joint function, but it requires a thorough discussion with your healthcare provider to weigh the benefits and risks.

Exercises for Better Hip Health

Regular physical activity can strengthen the muscles around the hip joint, providing better support and reducing pain. However, performing exercises correctly to avoid further injury is important.

Strengthening Routines

Strengthening exercises focus on building the muscles that support the hip joint, such as the glutes, quadriceps, and core muscles. Stronger muscles can help stabilise the joint and reduce stress on the bones.

Examples of effective strengthening exercises include:

Clamshells are a type of strengthening exercise where you lie on your side with knees bent, and lift the top knee while keeping your feet together (image courtesy of Hinge Health).

Bridges are a type of strengthening exercise where you lie on your back with knees bent, lift your hips towards the ceiling, and squeeze your glutes (image courtesy of Hinge Health). 

Leg Raises are a type of strengthening exercise you perform while lying on your side or back to target different muscle groups (image courtesy of Men’s Journal).

These exercises should be performed regularly, with attention to proper form and technique to maximise benefits and minimise the risk of injury.

Stretching Techniques

Stretching is essential for maintaining flexibility in the hip joint, which can help alleviate some of the discomfort and stiffness associated with hip impingement. Focus on gentle stretches that target the hip flexors, hamstrings, and glutes.

Effective stretching exercises include:

• Hip Flexor Stretch: Kneel on one knee with the other foot in front, and gently push your hips forward to stretch the hip flexor.

• Hamstring Stretch: Sit on the ground with one leg extended, reach towards your toes to stretch the back of your thigh.

• Glute Stretch: Lie on your back, cross one ankle over the opposite knee, and gently pull the uncrossed leg towards your chest.

Perform these stretches slowly and hold each position for 20-30 seconds. Consistent stretching can significantly enhance your hip mobility and reduce the risk of further injury.

Exercise Precautions

While exercise is beneficial for managing hip impingement, take precautions to avoid exacerbating the condition. Here are some tips to keep in mind:

• Always warm up before exercising to prepare your muscles and joints.

• Avoid high-impact activities that place excessive stress on the hips.

• Listen to your body and stop any exercise that causes pain.

• Work with a physical therapist or healthcare provider to develop a personalised exercise plan.

How Can MSK Doctors Help with Hip Impingement?

You could be experiencing early symptoms or have been struggling with hip pain for some time, at MSK Doctors we provide expert care without the wait—no GP referral needed. 

At MSK Doctors, we provide comprehensive hip impingement care without the traditional NHS waiting periods. 

Our specialist orthopaedic consultants use advanced diagnostic technologies, including our advanced MAI-Motion movement analysis platform, to precisely identify musculoskeletal issues. 

From conservative management with targeted physical therapy to advanced surgical options like minimally invasive arthroscopy, we offer the full spectrum of evidence-based treatments.

Ready to find relief with specialists who understand the complexity of hip impingement? Book your consultation with MSK Doctors today.

Frequently Asked Questions (FAQ)

What is the best exercise for hip impingement?

The best exercise for hip impingement often involves a combination of strengthening and stretching routines. Exercises like clamshells and bridges are highly effective for strengthening the muscles around the hip joint. 

How long does it take to recover from hip impingement?

With consistent non-surgical treatment, individuals may notice improvement within a few weeks to months. Surgical recovery can take longer, often requiring several months of rehabilitation to regain full function.

Can hip impingement cause arthritis?

Yes, if left untreated, hip impingement can lead to osteoarthritis in the hip joint. The constant friction and wear on the cartilage can cause it to deteriorate over time, leading to arthritis. 

Do I need surgery for hip impingement?

If the pain persists and significantly impacts daily life, surgical options like arthroscopy or open surgery may be recommended to correct the structural issues in the hip joint.

How can MSK Doctors help with hip impingement?

At MSKDoctors, we offer comprehensive care for individuals with hip impingement. We focus on improving your quality of life by addressing the root cause of the condition and guiding you through the recovery process.