What Is Hip Impingement (FAI in Hip)?
Femoroacetabular impingement (FAI) is also called hip impingement. It occurs when the ball of your thigh bone (femur) can’t move smoothly in your hip socket. Causes can include extra bone growing around the ball or a different angle in the socket. These issues can cause the femur to bump into or pinch the rim of the socket.
When the ball of your femur hits the rim of the hip socket, it can damage the cartilage and labrum in the joint. These tissues cushion the bones in your hip socket. This damage can cause pain as the tissues start to tear and deteriorate. These tears may lead to osteoarthritis over time if symptoms continue.
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Hip Impingement Symptoms
Hip impingement can develop at any age. It is more common in patients between 16 and 50 years old. You might experience common symptoms of hip impingement:
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Catching or popping sensation in your hip
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Dull ache in your groin when sitting or squatting
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Difficulty walking uphill
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Pain in the front of your hip or groin
What Does Hip Impingement Feel Like?
Having a hip impingement can feel different for each person. Most people with hip impingement feel discomfort or pain in their hip and groin. You could experience symptoms during specific activities:
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Jumping
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Squatting
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Sitting for a long time
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Twisting or turning
Types of Hip Impingement
There are three types of hip impingement:
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Cam impingement is a bump of extra bone growth on the ball or neck of your thigh bone. The growth stops the head of your thigh bone from fitting in the socket. When you move your hip, the extra bone forces itself into the socket and pinches the joint.
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Pincer impingement happens when the hip socket is too deep or covers too much of your thigh bone. A deep socket will pinch sooner than a normal socket. It can also wear down your joint’s protective tissue (cartilage) lining.
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Combined impingement means you have both cam and pincer impingements.
Hip Impingement Causes
Two factors commonly cause hip impingement:
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Bone abnormalities in your hip joint are the most common cause of hip impingement. You can be born with bone abnormalities or develop them as you grow older.
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An injury or repetitive motion can also cause hip impingement. Activities like golf, lacrosse, hockey, soccer or basketball have repetitive motions.
You’re more likely to experience painful symptoms if you have a combination of these factors.
Hip Impingement Treatment: Non-Surgical
Your provider will likely recommend non-surgical treatment options first. They may start with a few different treatments to see if your symptoms improve:
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Anti-inflammatory medications, like ibuprofen or aspirin
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Avoiding physical activities that worsen your symptoms
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Injections with steroids, platelet rich plasma (PRP) or hyaluronic acid to relieve pain, swelling, and irritation
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Physical therapy exercises to build strength and improve range of motion
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Rest
These treatments can improve symptoms in many cases. However, if your pain is caused by structural problems in your bones, it may come back.
Does Hip Impingement Go Away?
A hip impingement may not go away on its own. An untreated hip impingement may cause many symptoms and conditions:
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Hip and joint tissue damage
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Cartilage damage
Hip Impingement Surgery
Some patients try non-surgical treatments but still have pain. In that case, they often consider surgery. Surgery can improve your hip’s function, decrease pain, and allow you to return to your activities pain-free.
Patients have different options for hip impingement surgery:
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Arthroscopy—If you have cam impingement and mild cartilage damage, you may consider arthroscopy. This surgery is minimally invasive. Your surgeon makes small “keyhole” incisions (cuts) on the side of your hip. They can shape or remove the extra bone and damaged tissue.
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Surgical dislocation and osteochondroplasty—In this procedure, your surgeon makes an incision (cut) on your hip. They carefully cut your thigh bone and bring it out of the joint for better access. Your surgeon trims and reshapes the head of your thigh bone and the rim of your hip socket to fit together correctly. Your surgeon uses screws to hold the bone back together. Surgeons use this method for more complex problems, like Perthes disease and slipped capital femoral epiphysis (SCFE).
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Hip replacement (arthroplasty)—You may need a total hip replacement for severe joint damage. Your surgeon removes the damaged bone and replaces the end of your thigh bone and the hip socket with an artificial joint.
Hip Impingement Surgery Recovery
Each person recovers differently from hip impingement surgery. Your recovery will depend on the type of procedure you have. Most people can walk immediately after arthroscopic surgeries, using crutches for comfort. Some more complicated surgeries may require you to use crutches for a few months. Physical therapy exercises can help you regain joint strength and movement.
During the first three months after arthroscopic surgery, most patients can return to low-impact activities, such as walking, stationary biking, and swimming. After three months, you can expect to do higher intensity activities such as jogging, running, and jumping. If you have a more complicated surgery with a slower recovery, it may take six months to return to everyday activities. Your provider will schedule follow-up appointments to ensure your hip heals properly.
Make an Appointment With a Hip Specialist
If you have hip pain, call 801-587-7109 to request an appointment with our hip specialists.
You don’t need a referral to see one of our specialists for hip pain. However, some insurance plans may require a referral to see a specialist. Please check your insurance company before you make an appointment.
Hear From Our Patients
National champion speed skater, Blair Cruikshank, started experiencing persistent, worsening hip pain that interfered with her training. After she was diagnosed with femoroacetabular impingement syndrome (FAI), she and her family sought treatment for her condition at the Hip Preservation Program. Today she is back on the ice at full speed after undergoing a successful hip arthroscopy procedure.
