The hip joint is a ball-and-socket joint formed by the ball-shaped end of the thigh bone and the hip socket. Under normal conditions, the ‘ball’ moves smoothly within the socket, allowing a wide range of motion. Sometimes the smooth movement of the hip is prevented by a condition known as hip impingement. Some causes of hip impingement are:
Deformity of the ball (cam impingement): An abnormally shaped ball at the upper end of the thigh bone can cause bumping and grinding between the ball and the hip socket. This prevents smooth hip movement and can cause pain or a restricted range of motion in the hip.
Deformity of the socket (pincer impingement): There can be over-coverage of the ball of the thigh bone by the rim of the hip socket. Like with cam impingement, this can cause pain, catching and grinding, and restriction of motion in the hip.
Deformity of both the ball and the socket of the hip joint is known as combined impingement. Hip impingement can cause pinching or entrapment of the labrum, which can cause a labral tear; hip impingement also increases the likelihood of hip osteoarthritis developing in the future.
Athletes and active individuals are at a higher risk for developing hip impingement because of the demand placed on their hips during sports and other types of activities that involve repetitive hip movements. Groin pain and limited hip mobility that are exacerbated by weight-bearing activities are common signs of hip impingement. If left untreated, impingement can cause hip pain when sitting for prolonged periods of time or even when lying down to sleep at night.
In the early stages of hip impingement, nonsurgical treatment such as physical therapy, anti-inflammatory medication, and activity modification may be beneficial for relief of symptoms, but these treatments do not correct the underlying problem.
In cases where localized bony abnormalities are determined to be the cause of hip impingement, hip arthroscopy can be performed to shave off the excess bone and smooth the joint surfaces, allowing athletes and active individuals to return to the activities they enjoy with minimal delay.
For an in-depth evaluation of your hip condition and a personalized treatment recommendation, book an appointment with The American Hip Institute.
FAQs
Q1: What is hip impingement and what causes it?
Hip impingement, also known as femoroacetabular impingement (FAI), occurs when abnormal contact between the ball and socket of the hip joint prevents smooth movement. It can result from a deformity of the ball (cam impingement), over-coverage of the ball by the socket rim (pincer impingement), or a combination of both. These structural abnormalities cause bumping, grinding, and catching in the joint that can damage the labrum, restrict range of motion, and increase the risk of developing hip osteoarthritis over time.
Q2: What are the symptoms of hip impingement?
The most common symptoms of hip impingement include groin pain, limited hip mobility, and pain that worsens with weight-bearing activities like walking, running, or climbing stairs. In more advanced or untreated cases, pain can also develop during prolonged sitting or even at rest while lying down at night. Athletes and active individuals often notice symptoms earlier due to the greater demands placed on their hips during sports and repetitive movement activities.
Q3: Who is most at risk for developing hip impingement?
Athletes and physically active individuals are at higher risk for hip impingement because repetitive hip movements in sports place greater stress on the joint and accelerate the symptoms associated with structural abnormalities. However, hip impingement can affect anyone with underlying bony deformities of the ball or socket, regardless of activity level. The condition is often present from birth or develops during growth, with symptoms emerging later as activity levels increase.
Q4: Can hip impingement be treated without surgery?
In the early stages, nonsurgical treatments such as physical therapy, anti-inflammatory medications, and activity modification can help relieve pain and improve function. However, these conservative approaches manage symptoms only and do not correct the underlying bony abnormality responsible for the impingement. If structural deformities are confirmed as the source of ongoing symptoms, surgical correction through hip arthroscopy is typically needed to address the root cause and prevent progressive joint damage.
Q5: What does hip arthroscopy for impingement involve and what is recovery like?
Hip arthroscopy for impingement is a minimally invasive procedure in which the surgeon uses small incisions and specialized instruments to shave off excess bone and smooth the joint surfaces, eliminating the abnormal contact causing symptoms. Because it avoids large incisions and significant muscle disruption, recovery is generally faster than with traditional open surgery. Most athletes and active patients are able to return to their activities with minimal delay following appropriate rehabilitation, making it an effective option for restoring pain-free hip function.