Overview
what it is and why it mattersImage pendingLabeled diagram of the hip joint showing the femur, femoral head, acetabulum, and surrounding ligaments.
Hip impingement (sometimes called FAI, for femoroacetabular impingement) is when extra bone on the ball or rim of your hip joint catches and grinds during movement instead of gliding smoothly. The bumpy edge can be on the ball at the top of your thigh bone (cam type), on the rim of the socket in your pelvis (pincer type), or both. Each time the bone catches, it tears the labrum (the cartilage seal around the socket) and gradually wears down the smooth cartilage underneath.
Hip impingement is one of the most common causes of hip pain in active adults in their 20s through 40s. The unusual bone shape is often something you were born with — pain only shows up when increased demand (sports, sustained sitting, certain occupations) starts irritating the tissue. Left alone, the labral tear and cartilage damage tend to progress, and can speed up the development of hip arthritis.
When to be seen
Deep groin pain with hip flexion activities, prolonged sitting, or getting in and out of a car — especially in an active adult — warrants evaluation for FAI.
Symptoms
what you may noticeThe hallmark of hip impingement is a deep ache in the front of your groin — patients often cup their hand in a C-shape around the hip crease to show where it hurts (orthopedists call this the "C sign"). The pain comes on with deep bending: getting in and out of a car, squatting, sitting cross-legged, or any movement that drives the thigh bone up into the socket. After sitting for a while, the hip feels locked up for the first few steps when you stand.
You may also notice a catching or clicking sensation deep in the joint, especially when you pivot or twist. Athletic activity — running, cutting sports, kicking — tends to flare the pain, and you might realize you can't flex your hip as far or rotate it inward the way you used to. Over time the symptoms become more frequent and take longer to settle, a sign that the labrum and cartilage are accumulating damage.
Diagnosis
exam first, imaging secondHip impingement usually causes deep groin pain — patients often describe a C-shaped ache wrapped around the front of the hip. Your surgeon will use the FADIR test (bending the hip, bringing it across the body, and rotating it inward) — if that reproduces your pain, it's a strong sign. Standing X-rays show the bony bumps. The gold-standard imaging study is MR arthrography — an MRI taken after injecting contrast directly into the hip joint to highlight the labrum and cartilage.
Treatment Path
how care progresses at OSI1
Activity modification
Cutting back on the activities that drive deep bending of the hip (deep squats, prolonged sitting, high-impact running) reduces how often the joint catches and lets the inflamed tissue calm down.
2
Physical therapy
Targeted strengthening of the deep hip rotators and the core, plus retraining how you move (squat technique, hip mechanics during sport), reduces how hard the bones impinge on each pass.
3
NSAIDs
NSAIDs like ibuprofen or naproxen interrupt the pain-inflammation cycle around the irritated joint.
Intra-articular injection
An corticosteroid injection placed into the hip joint, guided in real time by X-ray or ultrasound — gives months of relief AND confirms the hip itself is the pain source before any surgical conversation.
Surgical Options at OSI
if non-operative care isn't enoughSurgery is considered when a labral tear is confirmed on imaging, when pain hasn't improved after a real trial of non-operative care, and when you want to get back to activities the hip is keeping you from. The procedure (hip arthroscopy) shaves down the bony bumps and repairs or trims the torn labrum through small incisions.
Providers Who Treat Femoroacetabular Impingement (FAI)
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: