When the hip is healthy, the femoral head fits neatly into the acetabulum

Hip impingement, also known as femoroacetabular impingement (FAI), is a condition where the hip joint doesn’t fit together properly, causing pain, stiffness, and limited movement. This article aims to provide a clear overview of hip impingement, including its symptoms, causes, treatment options, and the management of hip replacement.

Hip impingement, a condition where the ball and socket of the hip joint don’t fit together properly, can cause pain and discomfort. If left untreated, it can lead to further damage and worsen symptoms over time. The treatment for hip impingement varies depending on individual circumstances, ranging from conservative measures to surgical intervention. In this article, we will explore the symptoms and management options for hip impingement to help readers better understand and address this condition should it arise.

(Left) Pincer impingement. (Center) Cam impingement. (Right) Combined impingement

Causes of Hip Impingement:

Hip impingement can happen for different reasons. One common cause is when the hip socket, called the acetabulum, doesn’t grow properly during childhood. This can lead to a condition known as acetabular retroversion, where the socket extends too far over the front of the hip ball. Secondly, the development of cam lesions on the head-neck junction of the hip ball, often during adolescence, can cause conflict between the ball and socket. Finally, an abnormal twist in the thigh bone, known as femoral retro torsion, can contribute to hip impingement. These factors can combine to varying degrees and result in impingement.

Symptoms and Complications:

Hip impingement can cause pain in the groin area, particularly during or after activities that involve flexing the hip, such as running, jumping, or prolonged sitting. Loss of internal rotation of the hip is a common symptom and can serve as a screening tool, especially in adolescents. Over time, impingement can lead to labral tears, which are tears in the fibrous ring of cartilage surrounding the hip socket. Additionally, the protective cartilage covering the ends of the bones in the joint, called articular cartilage, can be damaged, leading to hip osteoarthritis. Symptoms of osteoarthritis include hip pain, tenderness, stiffness, and loss of flexibility.

Symptoms of Hip Impingement:

  • Groin pain during or after activity, or when sitting for long periods.
  • Difficulty bending the hip beyond a right angle.
  • Stiffness in the hip.
  • Trouble going up stairs.
  • Limping.
  • Loss of balance.

Management Options:

The management of hip impingement depends on the severity of symptoms and individual factors. In mild to moderate cases, nonsurgical treatments may be effective. These can include activity modification, pain medication, physical therapy, and corticosteroid injections. These conservative measures aim to alleviate symptoms and improve hip function. In more severe or complex cases, surgical intervention may be recommended. Arthroscopic or open surgery techniques can be employed to reshape the bones, repair the labrum (a ring of fibrous cartilage around the edge of the joint surface of a bone), and address articular cartilage damage.

Consulting with a Specialist:

If diagnosed with hip impingement, it is important to seek the expertise of an orthopaedic physician. They will evaluate your specific situation, considering factors such as symptoms, desired activity level, hip bone anatomy, overall body mechanics, range of motion, and the extent of labral and cartilage damage. A customised treatment plan can then be devised to address your individual needs and provide the most effective management approach.

Hip impingement is a condition where the ball and socket of the hip joint do not fit properly, leading to pain and potential complications. Recognising the symptoms and understanding the available management options is essential for individuals who may experience hip impingement. Whether through conservative measures or surgical intervention, the goal is to alleviate pain, improve hip function, and prevent further damage. If diagnosed with hip impingement, consult with an orthopaedic specialist to determine the most appropriate treatment plan for your unique circumstances.

This article ” Understanding Hip Impingement: Symptoms and Management ”  does not provide medical advice and is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor for all medical advice. 

Meet Dr Peter Smith, a leading Orthopaedic Surgeon operating from the Mediclinic Milnerton in Cape Town, Western Cape. His practice is situated in the heart of this seaside town.  Dr Peter Smith not only offers patients the full spectrum of professional orthopaedic treatments, but specialises in total knee replacement, total hip replacement, sports injuries and the latest arthroscopic surgery techniques and computer guided surgery. He gained extensive experience in the latest arthroplasty techniques during his stay of 6 years in Australia where he performed more than a hundred primary and revision hip and knee replacements cases in a year.


  • https://orthoinfo.aaos.org/
  • https://www.pennmedicine.org/
  • https://mayoclinic.org/
  • https://www.hopkinsmedicine.org/
  • https://www.sports-health.com/

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