What is femoroacetabular impingement?

Femoroacetabular impingement (FAI), also known as hip impingement, happens when one or more of the bones in your hip joint have an unusual shape, allowing them to pinch or rub against each other. Over time, this friction can cause damage, resulting in hip and groin discomfort and limiting your flexibility and mobility.

Left untreated, FAI can damage the cartilage that cushions the hip joint, leading to arthritis or painful joint deterioration. Surgery is sometimes required to repair the damage. Hip impingement can cause pain at any age, but it’s most common in people from their mid-teens to their 40s or 50s.

middle-age couple exercising in the park

Types of hip impingement

The conditions that cause hip impingement are typically present at birth, but they can show up later in life. There are three types of hip impingement:

Hip impingement symptoms

Hip impingement often starts with mild symptoms, which can remain minimal for years, but as it progresses, pain and limitations can interfere with daily activities.

Common signs include pain in the groin or hip, which may also extend to the buttock, knee, lower back or thigh. Pain is often triggered by exercise or sitting cross-legged.

Signs and symptoms may include:

  • Clicking, popping or catching sensation in the hip
  • Pain
  • Limping

What causes hip impingement?

The hip joint is made up of a ball and a socket. The ball—the rounded head of the femur—fits inside the socket —the acetabulum. Hip impingement happens when either the ball or socket, or both, are irregularly shaped and rub against one another, damaging the protective layer of cartilage and causing pain.

man stretching hips before exercise

Hip impingement risk factors

It’s not totally clear what causes the irregular shape of the hip bones associated with hip impingement. Genetic factors may play a role. Another risk factor may be excessive athletic activity in childhood when bones are still growing.

Hip impingement is common in competitive athletes, and some sports may aggravate hip impingement than others. But you don’t have to be a professional athlete or even a serious amateur to develop hip impingement. It can impact anyone at any age, especially if you’re in your 20s to 40s.

Risk factors for hip impingement include:

  • Participation in intense sports, such as martial arts, ballet, football, hockey, baseball, rugby and soccer, especially in childhood
  • Activities that require deep squats, such as powerlifting
  • High physical activity level

How is hip impingement diagnosed?

To diagnose hip impingement, your provider will perform a physical exam and may order imaging tests to look for damage in the joint.

Hip impingement treatment

Hip impingement treatments vary by person depending on the severity of pain and level of damage to the hip. Medications, physical therapy, rest and surgery, if necessary, are all options.

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