Hip impingement, or femoroacetabular impingement (FAI) syndrome, is hip pain caused by abnormal contact between the ball and socket of the hip, linked to differences in bone shape. An international consensus states that diagnosis needs the right symptoms, examination findings and imaging together. Options include rehabilitation, activity changes and, for some people, hip arthroscopy.
Also known as femoroacetabular impingement syndrome, FAI, FAIS, cam impingement, pincer impingement
Symptoms
- Deep groin pain, sometimes felt at the side of the hip or buttock
- Pain with deep squatting, bending or bringing the knee to the chest
- Pain with twisting, pivoting or kicking
- Discomfort after long periods of sitting
- Clicking, catching or a feeling of stiffness in the hip
- Reduced hip movement, especially turning the leg inwards
Causes and risk factors
- Cam shape: extra bone where the ball meets the thigh bone
- Pincer shape: a socket that covers too much of the ball
- High-level sport in adolescence involving deep hip flexion and twisting
- Repeated deep bending and pivoting movements
- Family history of hip shape differences
What the evidence says helps
- The Warwick Agreement, an international consensus, states that FAI syndrome is diagnosed only when symptoms, clinical signs and imaging findings occur together. A hip shape seen on a scan is not a diagnosis on its own.1
- The consensus recognises conservative care, rehabilitation and surgery as appropriate treatment options.1
- In a UK trial, a personalised, physiotherapist-led exercise programme improved hip-related quality of life. Hip arthroscopy gave a greater average improvement at 12 months, though surgery carries more risk of side effects.2
- A second UK trial in people referred to hospital clinics found better hip function at 8 months after arthroscopy than after physiotherapy and activity modification.3
- At three-year follow-up, that trial found no difference in X-ray signs of arthritis between surgery and physiotherapy, though function scores remained higher after surgery.4
Things you can try at home
- Reduce positions that trigger pain, such as very deep squats or low seats, for a while
- Take regular breaks from long periods of sitting
- Keep active with lower-provocation exercise such as cycling with a raised seat or swimming
- Strengthen the hip and trunk muscles gradually
- Build up sport and training load step by step rather than in big jumps
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A hot, swollen hip with fever – get same-day medical help or call NHS 111
- Sudden severe hip pain and being unable to bear weight – go to A&E or call 999
- Hip or groin pain in a young athlete that persists at rest or at night, which could suggest a stress fracture – see your GP urgently
- Hip pain with unexplained weight loss or night sweats – see your GP urgently
- A child or teenager with a new limp or knee or hip pain – see your GP the same day
How Apollo can help
We take a detailed history and examine your hip, back and movement, and we can use VALD strength testing to measure hip strength objectively. We explain what impingement is and help you adjust training and daily positions. Our team guides a progressive rehabilitation programme and return to sport, and if your symptoms persist we will help you get an orthopaedic opinion and support your rehabilitation before and after any surgery.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Does a cam or pincer shape on my scan mean I need surgery?
No. Many people have these bone shapes without any pain. Consensus guidance says FAI syndrome is diagnosed only when symptoms, examination findings and imaging all fit, and treatment is guided by your symptoms.
Can hip impingement get better without surgery?
Many people improve with a structured rehabilitation programme. In UK trials, physiotherapy-led care improved symptoms, although surgery led to greater average improvement for people already referred to hospital clinics.
Will hip impingement lead to arthritis?
Hip shape differences are thought to be one of several risk factors for later arthritis, but the link is not fully understood. One UK trial found no difference in X-ray signs of arthritis three years after surgery or physiotherapy.
References
- Griffin DR, Dickenson EJ, O'Donnell J, et al. (2016). The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. British Journal of Sports Medicine, 50(19), 1169–1176. View source
- Griffin DR, et al. (2018). Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. The Lancet. View source
- Palmer AJR, et al. (2019). Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. BMJ. View source
- Palmer AJR, et al. (2024). Medium-term results of arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of femoroacetabular impingement syndrome: a multi-centre randomised controlled trial. British Journal of Sports Medicine. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
