Hip Impingement (FAI): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
Hip impingement, or femoroacetabular impingement (FAI), is when the bones of the hip joint contact each other earlier than normal during movement — usually because of subtle differences in their shape — causing pinching groin pain with deep bending, squatting, or prolonged sitting. It's common in active people and often linked to labral irritation. Physical therapy that strengthens and improves hip control is first-line; surgery is for select cases.
What is hip impingement?
FAI describes extra bone or shape differences on the ball or socket that cause earlier-than-normal contact at end range, pinching the soft tissues (including the labrum).
Symptoms
The classic feature is pinching groin or deep front-of-hip pain with deep flexion — squatting, sitting low, getting in a car — sometimes with clicking and stiffness. Athletes in pivoting or deep-flexion sports are commonly affected.
What causes it / risk factors
Largely the shape of the hip bones (often present since skeletal maturity), combined with high-demand activities that repeatedly load the end range.
How it's diagnosed
A clinician reproduces symptoms with specific positions; imaging confirms bone shape and any labral involvement when relevant.
Physical therapy treatment
What a PT does. Your therapist strengthens the hip and core, improves movement control to avoid pinching positions, and modifies aggravating activities. Exercises & progression (overview). Gluteal and deep-hip strengthening, motor control, and activity modification. Many people manage FAI well without surgery. Recovery timeline. Many improve over 3 months with consistent rehab.
Treatment options compared
PT and activity modification are first-line. Surgery (to reshape bone or repair the labrum) is considered for persistent, function-limiting symptoms unresponsive to rehab.
Red flags
Seek prompt care for a hip that locks, inability to bear weight after injury, or a hot feverish joint.
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Frequently asked questions
Many people manage it well with strengthening and movement changes.
Sources (5)
- Griffin DR, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018. — PubMed
- Griffin DR, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016. — PubMed
- AAOS OrthoInfo: Femoroacetabular Impingement. — AAOS OrthoInfo
- Kemp JL, et al. Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions. Br J Sports Med. 2020. — BJSM
- Enseki K, et al. Nonarthritic hip joint pain: clinical practice guidelines. J Orthop Sports Phys Ther. 2014. — JOSPT
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.