Hip Joint Impingement: Understanding the Causes, Symptoms, and Recovery Process

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre 

Pain in the front of the hip or groin can make walking, running, squatting, and sports uncomfortable. One common cause of these symptoms is hip joint impingement, also known as femoroacetabular impingement (FAI). Early diagnosis and appropriate treatment can help reduce pain, improve mobility, and prevent long-term joint problems. 

What Is Hip Joint Impingement? 

Hip joint impingement occurs when the ball (femoral head) and socket (acetabulum) of the hip do not fit together optimally. This can cause abnormal contact between the bones during movement, leading to irritation of the cartilage and labrum (the ring of cartilage that helps stabilize the hip) (Griffin et al., 2018). 

There are two primary types of FAI: 

• Cam impingement: Extra bone develops on the femoral head or neck, creating an irregular shape. 

• Pincer impingement: Extra bone extends along the rim of the hip socket. 

• Mixed impingement: A combination of both cam and pincer deformities. 

  
  

Many people have structural changes associated with FAI without symptoms, but others develop pain and movement limitations over time. 

What Causes Hip Impingement? 

Hip impingement typically develops due to changes in hip bone shape during growth and development. Symptoms often become noticeable during activities that involve repetitive hip flexion and rotation. 

Common contributing factors include: 

• Sports involving frequent squatting, pivoting, or kicking 

• Hockey, soccer, dance, and gymnastics participation 

• Repetitive hip loading during adolescence 

• Reduced hip mobility 

• Muscle weakness around the hip and pelvis 

• Previous hip injuries 

  
  

Research suggests that cam morphology is particularly common in athletes who participated in high-impact sports during skeletal development (Reiman et al., 2020). 

Common Symptoms 

Symptoms may develop gradually and can include: 

• Pain in the front of the hip or groin 

• Pinching sensation when squatting or sitting deeply 

• Stiffness in the hip joint 

• Reduced hip range of motion 

• Clicking, catching, or locking sensations 

• Pain during running, cutting, or pivoting movements 

• Discomfort after prolonged sitting 

  
  

Symptoms often worsen with activities that place the hip in deep flexion, such as squatting, lunging, or getting in and out of a vehicle. 

How Physiotherapy Can Help 

For many individuals, physiotherapy is the first line of treatment for symptomatic hip impingement. A physiotherapy assessment can identify: 

• Hip mobility restrictions 

• Muscle weakness and imbalances 

• Movement patterns contributing to symptoms 

• Sport- or activity-specific factors 

  
  

Treatment may include: 

• Hip mobility exercises 

• Gluteal and core strengthening 

• Pelvic stability training 

• Movement retraining 

• Activity modification strategies 

• Manual therapy techniques 

• Progressive return-to-sport programming 

  
  

When Should You See a Physiotherapist? 

Consider seeking assessment if you experience: 

• Persistent groin or hip pain 

• Pain with squatting, running, or sports 

• Hip stiffness that limits daily activities 

• Clicking, catching, or locking sensations 

• Symptoms that do not improve with rest 

At Waterloo Sports Medicine Centre, our physiotherapists develop individualized treatment plans designed to improve hip function, reduce pain, and help patients return safely to work, exercise, and sport. Early treatment can help improve function, reduce discomfort, and potentially slow the progression of joint irritation.