Overview
Femoroacetabular impingement is a hip problem caused by abnormal contact between the ball of the thigh bone (femoral head/neck) and the socket (acetabulum). This extra contact can irritate the labrum (a rim of cartilage around the socket) and wear the joint lining over time, leading to pain and stiffness. Patients often notice pain during activities that put the hip in deep flexion and twisting positions. With ongoing irritation, symptoms may gradually worsen and limit how comfortably you move and exercise.
Symptoms
Pain is often felt in the front of the hip or groin, and it may also be noticed in the buttock or outer hip in some people. Symptoms commonly flare with getting into a car, sitting for long periods, squatting, climbing stairs, or athletic movements that involve bending the hip deeply. Some people notice clicking, catching, or a feeling that the hip is "stuck," along with reduced hip range of motion. Over time, the irritation can lead to difficulty with athletic activity, limping, and discomfort that lingers after activity.
Causes
Femoroacetabular impingement typically develops when the hip bone shapes are predisposed to abnormal contact, such as a "cam" shape on the femur or a "pincer" shape in the acetabulum. In many cases, the bone morphology is present from development, and symptoms emerge when activity or loading brings the joint into irritating positions. Repeated mechanical stress can inflame the labrum and joint lining, and it may contribute to cartilage wear. Trauma or changes in biomechanics can also aggravate symptoms in someone who has underlying bone shape features.
Risk Factors
You are at higher risk if you have anatomic variants like cam or pincer morphology, which can be present from adolescence. Sports or job activities that repeatedly load the hip in deep flexion and twisting-such as soccer, hockey, hockey skating, ballet, or heavy lifting-can bring symptoms out. Limited hip mobility, weak hip and core strength, and movement patterns that increase internal rotation or adduction can increase irritation. Age-related cartilage changes and increased body weight can also worsen symptoms by adding stress to the joint.
Prevention
You can reduce flare-ups by avoiding repeated end-range hip positions that trigger pain, especially deep hip flexion with internal rotation or crossing the legs. Regular strength training for the hip and core, along with mobility work for the hips and pelvis, helps improve movement control under load. Gradually increasing training volume and intensity can reduce sudden spikes in joint stress. Maintaining a healthy body weight can also lower the overall mechanical load on the hip joint.
How the Diagnosis Is Evaluated
Diagnosis usually starts with a detailed history of where the pain is felt, what movements trigger it, and whether there is catching, stiffness, or functional limits. Physical examination commonly includes range-of-motion testing and impingement maneuvers such as FADIR (flexion, adduction, internal rotation) to reproduce symptoms. X-rays are often used to look for cam or pincer morphology and joint shape issues. If there is concern for labral injury or cartilage damage, or if symptoms persist despite initial treatment, an MRI or MR arthrogram may be considered for additional detail.
Nonsurgical Treatment Options
Nonsurgical treatment focuses on reducing painful impingement and calming irritated tissues while restoring strength and motion. Physical therapy is usually the cornerstone and may include activity modification, guided stretching, and progressive strengthening of the hip abductors, extensors, and core to improve mechanics. Anti-inflammatory medicines such as NSAIDs can help manage pain for short periods, and a temporary reduction in aggravating activities can prevent repeated flare-ups. An image-guided intra-articular corticosteroid injection can be used to decrease inflammation and improve symptoms, helping you participate more effectively in rehab. Some patients consider biologic or pain-modulating injections such as platelet-rich plasma (PRP) or hyaluronic acid (for example, orthovisc) to support symptom control, though responses vary by individual. Bracing, temporary use of a cane, and structured return-to-sport planning may be added when needed to control loading during recovery.
When to Seek Medical Attention
Seek prompt medical evaluation if you cannot bear weight, if pain rapidly worsens, or if the hip feels unstable or suddenly locks so you cannot move it. Get urgent care if you develop fever, major swelling, redness, or severe night pain that is accompanied by feeling unwell. Contact a clinician urgently if you notice progressive numbness, new weakness in the leg, or any sudden loss of function. If symptoms persist beyond several weeks despite conservative care, a sports medicine or orthopedic evaluation is recommended to refine the diagnosis and treatment plan.
Frequently Asked Questions
Activities that place the hip in deep flexion with twisting-such as sitting long periods, squatting, getting in and out of cars, and certain sports-often trigger groin pain.
Clinicians typically use a history and exam to reproduce symptoms, and X-rays to identify cam or pincer bone shape; MRI may be added if labral or cartilage injury is suspected.
Injections may provide temporary symptom relief, but rehabilitation is still important to restore mechanics and reduce the chance of ongoing irritation.
Next Steps
If your hip pain is repeatedly triggered by specific motions or you suspect impingement, start with a focused evaluation by an orthopedic or sports medicine clinician. Begin conservative care with activity modification and a physical therapy program tailored to hip mechanics, and consider image-guided options like a corticosteroid injection if symptoms limit rehab participation. If symptoms do not meaningfully improve after a reasonable trial of nonsurgical treatment, ask about further imaging and refinement of the diagnosis.