Hip impingement: causes and treatment

Next in our series of blogs looking at groin pain, this time it’s hip impingement.

Unlike the problems covered in our last two blogs (here and here), hip impingement is to do with the bones rather than muscle strains or tears.

What is a hip impingement problem?

Hip impingement (or femoroacetabular impingement/FAI) is related to the bones in the hip joint, a ball socket joint connecting the the femur (thigh bone) and the acetabulum (pelvis). The head and neck of the femur joins the hip-bone at the acetabulum,and this is where problems can occur.

There are two types of hip impingement; CAM and Pincer.

This video shows a CAM impingement.

This one shows a pincer impingement.

How does it happen?

Hip impingements can be the result of biomechanics (the way you move and how your muscles control that movement) or it can be congenital.

When muscles don’t take the strain they should, more weight gets put through the joint and your body may then lay down new bone to spread the load. This can lead to the pincer or CAM deformity which will exacerbate the problem.

It can also lead to a tear in the labrum, which is essentially like an octopus sucker around the joint that connects the bones together to improve stability.

If left untreated this can increase the chance of developing osteoarthritis in future.

What’s the treatment for hip impingement?

Stretching is a good first step to help manage tightness that can build over time. Known as a Japana, this stretch also gives you the range of movement necessary to perform some of the strengthening exercises that you will progress onto.

Hip impingement stretch

Alongside this, manual treatment is often used to help offload the hip-joint and loosen muscles around the hip and pelvis.

Strengthening exercises are key – if the underlying issue is a muscle control one then you need to both strengthen these muscles and also to train them to work at the right time.

This weight-shifting squat continues to improve flexibility whilst also improving muscle control in what is called the frontal or coronal plane.

Other exercises such as a single leg squat can be added later to further improve stability, along with work to improve control of the movement of the legs in running and walking.

As with all issues, the sooner you get this looked at the better. The good news is that, even if the issue is congenital, it’s possible to see a full recovery from symptoms and return to sports.

2 thoughts on “Hip impingement: causes and treatment”

  1. I practice martial arts, Tae Kwon Do, and since my teens I have had rubbish flexibility,,,,,,literally cant lift leg to 90deg of hip or can with a lot of warming up and stretyching. I am now 54 and the flexibiloity is still the same or worse but now I have pains and its difficult to tie laces on one foot without pain, a gasp and having to turn foot up closer…..plus by lower back is tight and also can be painful when stretching.

    Ive just done some googling and hip impingement might be the cause of my lack of flexibility even sine my youth.

    Pain is generally OK and only when I am trying to tie laces or doing martial Artss kicks etc,,,,which are rubbish, or if I lift my left leg above hip.

    What should I do…will I ever be more flexible and have good high kicks./

    1. Hi there Andrew,

      Sorry to hear about the troubles with your hip. There are a number of reasons why you may be experiencing those symptoms so the first thing would be to get an accurate diagnosis. There are some tests that can be done in clinic to identify the underlying cause, and from your description the most likely causes are either the hip joint or an issue with the hip flexor. These are fairly broad terms so the next question is exactly what it is e.g. a hip flexor tendinopathy, a hip impingement or arthritis. Do not worry if it is the latter, as even this can be treatable.

      Assuming it is a hip impingement there are some fairly simple manual techniques that can help improve the symptoms very quickly; these can be administered alongside the all important exercises, the specifics of which will depend on the assessment findings.

      I hope this helps, although I appreciate it’s not a simple answer as it’s difficult to say without seeing it. If you would like to discuss this further, send us an email with your phone number and we’ll call you back as soon as possible to discuss in a bit more depth; alternatively you can use the live chat on the website to send us these details

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