From the Guidelines
Hip impingement, also known as femoroacetabular impingement (FAI), typically presents with pain in the groin or front of the hip that worsens with activity, especially movements involving hip flexion and rotation, as reported in the most recent study by 1. The symptoms of hip impingement can vary, but common symptoms include:
- A dull ache that may radiate to the outer hip or buttocks
- Stiffness after periods of inactivity
- A catching or locking sensation during movement
- Pain when sitting for prolonged periods, climbing stairs, or getting in and out of cars
- Exacerbation of symptoms with physical activities like squatting, pivoting, or high-impact sports
- A clicking or popping sensation in the hip joint As the condition progresses, range of motion becomes limited, particularly with internal rotation and flexion of the hip, and pain may initially be intermittent but can become more persistent over time, as noted in the study by 1. Hip impingement occurs when the ball of the femur (femoral head) abnormally contacts the hip socket (acetabulum) due to bone irregularities, causing damage to the labrum and cartilage, as described in the study by 1. Early diagnosis is important as untreated impingement can lead to labral tears and eventually osteoarthritis of the hip, highlighting the need for a comprehensive diagnostic approach that includes patient symptoms, clinical signs, and diagnostic imaging, as recommended by 1.
From the Research
Symptoms of Hip Impingement
- Hip impingement syndrome can cause persistent groin pain, limited hip range of motion, and pain during active and passive hip flexion, abduction, and external rotation 2
- Patients with hip impingement often report anterolateral hip pain, which can be aggravated by activities such as prolonged sitting, leaning forward, getting in or out of a car, and pivoting in sports 3
- The use of flexion, adduction, and internal rotation of the supine hip can typically reproduce the pain in patients with hip impingement 3
- Hip-related pain is an umbrella term that encompasses pain from non-arthritic hip joint pathologies, such as femoroacetabular impingement syndrome, hip dysplasia, and labral tears 4
- Exercise therapy is commonly recommended for hip-related pain, but the reporting completeness of these interventions is currently unclear 4
- Physiotherapist-led interventions may improve pain and function in young and middle-aged adults with hip-related pain, but high-quality randomized controlled trials are required to confirm this 5
Common Symptoms
- Groin pain
- Limited hip range of motion
- Pain during hip flexion, abduction, and external rotation
- Anterolateral hip pain
- Pain aggravated by activities such as prolonged sitting, leaning forward, and pivoting in sports
Diagnosis and Treatment
- Radiography, magnetic resonance arthrography, and injection of local anesthetic into the hip joint can confirm the diagnosis of hip impingement 3
- Treatment options include physical therapy, arthroscopy, and hip arthroscopic surgery 3, 5
- Exercise therapy protocols for hip-related pain are often inadequately described, making it difficult to replicate interventions and draw conclusions on efficacy and dose-response 4