Hip pain that develops during activity, particularly in younger and more active adults, is not always straightforward to explain. When the discomfort seems to be connected to certain movements bending the hip deeply, sitting for long periods, or returning to sport after time away it may prompt a visit to an orthopaedic specialist.
Hip impingement is one condition that may be identified in this context. Understanding what it is, how it is assessed, and what the management options are can help patients approach the process with greater clarity.
What Is Hip Impingement?
Hip impingement is a term used when certain changes in the hip may be associated with discomfort during particular movements. It is also referred to in clinical practice as femoroacetabular impingement, or FAI. These changes involve the shape or relationship of the structures that make up the hip joint, which may lead to contact between the components of the joint during movement.
Not everyone with these changes will necessarily experience symptoms. The presence of discomfort, its pattern, and how it affects the individual are all factors that form part of the clinical assessment.
What Symptoms Could Be Associated With Hip Impingement?
The most commonly described symptom is pain or discomfort in the groin, which may also extend to the outer hip or thigh. This discomfort tends to occur during or after activities involving hip movement particularly those requiring the hip to bend deeply.
Sitting for extended periods in a low chair, getting in and out of a car, certain sports movements, and activities such as squatting or climbing may all produce or aggravate symptoms in some patients. A clicking or catching sensation in the hip is sometimes described alongside the pain.
The pattern and location of symptoms are part of what an orthopaedic specialist will consider during an assessment.
What Could Contribute to Hip Impingement?
A number of factors may be relevant when considering hip impingement, including the individual's usual level of physical activity and the specific movements involved in their daily life or sport. A thorough assessment considers the individual's history alongside the examination and imaging findings.
When Should Hip Pain Be Assessed?
Hip or groin pain that is persistent, is getting worse rather than settling on its own, is associated with a clicking or catching sensation, or is affecting the ability to participate in sport, work, or daily activities is worth having assessed by an orthopaedic specialist.
Younger and more active patients who notice groin or hip discomfort that does not settle with rest may wish to have it assessed by a doctor.
How Is Hip Impingement Assessed?
Assessment typically begins with a detailed clinical history and physical examination. The orthopaedic specialist will ask about the location and pattern of the symptoms, the activities that aggravate or ease them, and how they are affecting daily life. A physical examination of the hip includes specific movements designed to identify positions that reproduce the discomfort.
Imaging plays an important role in confirming the diagnosis. X-rays are usually the starting point, and in some cases further imaging such as an MRI may be recommended to provide a more detailed picture of the structures involved.
Can Hip Impingement Be Treated Without Surgery?
For many patients with hip impingement, non-surgical management forms the first step in treatment. The aim is to manage symptoms, support hip function, and allow the individual to continue with their daily activities and, where relevant, their sport or exercise.
Whether non-surgical treatment is appropriate, and what it involves, depends on the individual's symptoms, imaging findings, the impact on daily life, and other factors that will be discussed during the consultation. Not every patient with hip impingement will require surgery, and the treatment approach is always determined individually.
What Role Can Physiotherapy Play?
Physiotherapy is often an important part of non-surgical management for hip impingement. A physiotherapy programme will typically focus on strengthening the muscles around the hip and pelvis, improving movement control, and helping the patient manage activities in a way that reduces symptom aggravation.
The specific content of a physiotherapy programme depends on the individual's assessment findings, their usual activities, and what they are trying to achieve. Progress may be gradual, and the programme may be adjusted over time based on how the individual is responding.
Patients who want to understand whether a specific activity is appropriate at a particular stage of management are encouraged to raise this directly with their physiotherapist or treating team.
When Could Surgery Be Discussed?
For patients whose symptoms do not respond to non-surgical management, or where the assessment findings suggest that structural changes within the hip are contributing significantly to the condition, surgery may become part of the discussion.
Surgery for hip impingement is typically performed arthroscopically through small incisions and aims to address the specific structural changes identified during assessment. The decision to proceed with surgery is made based on the individual's clinical picture, the assessment findings, and the patient's goals and preferences.
What Could Hip Impingement Surgery Involve?
Arthroscopic surgery for hip impingement involves the use of a small camera and instruments inserted through small incisions around the hip. The surgeon addresses the specific changes identified during the pre-operative assessment. The procedure is typically performed under anaesthesia, and the length of hospital stay depends on the individual and the hospital.
What Could Recovery Look Like?
Recovery after hip impingement surgery varies between patients and depends on what was addressed during the procedure. Physiotherapy forms an important part of recovery, supporting the gradual return of movement and strength and guiding the patient's return to daily activities and sport.
The pace of recovery and the timeline for returning to specific activities will be guided by the treating team based on the individual's progress. Each patient's recovery follows its own course, and the instructions provided by the treating team are the most relevant reference.
What Should You Discuss During Your Consultation?
When attending a consultation for hip pain, it is helpful to describe the location of the symptoms, what aggravates and eases them, how long they have been present, and what activities they are affecting. Any previous investigations such as X-rays or MRI scans are useful to bring along.
Questions about the assessment findings, the management options, what treatment would involve, and what expectations are realistic are all appropriate to raise during the consultation.
Consult Dr. Chintan Patel for Knee and Hip Care
If hip or groin pain has been affecting daily activities, exercise, or sport, a professional assessment can help identify the underlying cause and discuss the most appropriate management options.
Dr. Chintan Patel is a robotic orthopaedic surgeon specialising in knee and hip replacement. He consults at Sanjeevani Healthcare in Ghatkopar, Mumbai, as well as other prominent locations.
An individual consultation can help patients better understand their condition and the treatment options available.
Frequently Asked Questions
Q: Can hip pain have causes other than hip impingement?
A: Yes. Hip or groin discomfort, stiffness, clicking and catching can occur with different hip conditions. An assessment can help consider the symptoms and findings together.
Q: What should I discuss before returning to exercise with hip impingement?
A: You can discuss the specific activities you want to return to, including exercise, sport or other regular movements. Your treating team can explain what may be appropriate according to your symptoms and treatment plan.
Q: Could physiotherapy be part of treatment for hip impingement?
A: Yes. Physiotherapy may form part of treatment in some situations. Whether it is appropriate can depend on the symptoms, assessment findings and activities that are important to the individual.
Q: What questions should I ask if surgery is being considered for hip impingement?
A: You may want to ask why surgery is being considered, what the proposed procedure is intended to address, whether other options remain available and what recovery and return to activities may involve.
Q: Does hip impingement always require surgery?
A: No. Surgery is not automatically required simply because hip impingement is suspected or diagnosed. Depending on the individual situation, non-surgical treatment options may be discussed.