Hip Impingement (FAI)
Femoroacetabular impingement is one of the most common drivers of hip and groin pain in young athletic adults. Joint Freedom offers regenerative and movement-based protocols for non-surgical management.
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Understanding Hip Impingement
FAI does not have to mean an operating room. Structured non-surgical care is the right first step for most patients.
Femoroacetabular impingement occurs when bony irregularities of the femoral head (cam), acetabulum (pincer), or both cause abnormal contact during hip motion. This repeated impingement can damage the acetabular labrum and, over time, the underlying cartilage. It is the most common structural cause of hip and groin pain in active adults under 50.
The bony morphology in FAI is usually developmental rather than traumatic. Symptoms arise when the demand placed on the hip (sport, activity, posture) exceeds the body's ability to tolerate the impingement. Not all patients with FAI morphology develop symptoms, and not all symptomatic FAI requires surgery.
At Joint Freedom, we assess impingement pattern, labral status, and cartilage health together, and build a protocol that reduces pain and dysfunction while preserving the joint. Surgery is discussed when conservative care does not provide sufficient improvement.
Source: Orthopedic and sports medicine literature on femoroacetabular impingement and non-surgical management.
Who Gets Hip Impingement?
Young athletes in high-demand sports are the most common presentation, but FAI affects adults of all activity levels when the bony morphology is present and symptomatic.
Common Risk Factors
- Young male athletes in contact or high-load sports
- Female athletes in sports requiring deep hip flexion (gymnastics, dance, rowing)
- Participation in high-volume youth sport during skeletal development
- Hip dysplasia or prior pediatric hip conditions
- Family history of hip impingement or early hip osteoarthritis
- Occupations requiring sustained deep hip flexion
Symptoms and When to Seek Treatment
FAI produces a characteristic groin pain pattern that is reliably provoked by specific hip positions and movements.
Common Symptoms
- Groin pain that is worse with hip flexion, squatting, or sitting for long periods
- Anterior or lateral hip pain during athletic activity
- Stiffness at the end of hip range of motion
- Clicking or catching in the hip during movement
- Pain when getting in and out of low chairs or cars
See a Specialist If...
- Hip and groin pain persists beyond six weeks of rest and conservative care
- MRI or X-ray has confirmed cam or pincer deformity
- Athletic performance or daily function is significantly affected
- Pain is worsening despite rest and activity modification
If you are unsure, schedule a free consultation. We will tell you honestly whether conservative care can address your FAI presentation.
Common Types of Hip Impingement
FAI is classified by the location of the bony abnormality causing the impingement.
CAM IMPINGEMENT
Femoral Head Shape Variant
Extra bone at the femoral head/neck junction creates an aspherical femoral head that jams against the acetabular rim and labrum during hip flexion. Cam impingement is more common in young male athletes.
PINCER IMPINGEMENT
Acetabular Over-Coverage
Excess bony coverage of the acetabulum causes the acetabular rim to contact the femoral neck during hip flexion. Pincer impingement is more common in middle-aged women.
COMBINED
Mixed Cam-Pincer Pattern
Most patients with symptomatic FAI have features of both types. Combined impingement is the most common pattern seen in clinical practice.
How We Diagnose Hip Impingement
Identifying the impingement type, quantifying bony morphology, and assessing labral status are all part of the evaluation.
Clinical Exam and Impingement Testing
We assess FADIR and FABER provocation tests, hip range of motion, and strength to identify the impingement pattern and concurrent labral involvement.
X-Ray and MRI Review
X-ray quantifies cam and pincer morphology (alpha angle, lateral center edge angle). MRI characterizes labral and cartilage status. We review existing imaging and can order additional studies.
Treatment Plan
We build a conservative regenerative and movement protocol appropriate for the impingement pattern and degree of labral involvement. Surgical consultation is coordinated when indicated.
Clinical Exam and Impingement Testing
We assess FADIR and FABER provocation tests, hip range of motion, and strength to identify the impingement pattern and concurrent labral involvement.
X-Ray and MRI Review
X-ray quantifies cam and pincer morphology (alpha angle, lateral center edge angle). MRI characterizes labral and cartilage status. We review existing imaging and can order additional studies.
Treatment Plan
We build a conservative regenerative and movement protocol appropriate for the impingement pattern and degree of labral involvement. Surgical consultation is coordinated when indicated.
What You Can Do at Home
Load management and hip strengthening at home reduce impingement provocation and support recovery.
What Helps
- Hip and core strengthening within pain-free range
- Activity modification to reduce deep hip flexion provocation
- Ergonomic adjustment for sitting position to reduce impingement
- Low-impact movement (swimming, cycling at comfortable resistance)
- Anti-inflammatory nutrition during acute flares
What to Avoid
- Deep squatting and heavy hip flexion through pain
- High-impact rotational sports through significant pain
- Ignoring progressive hip stiffness or motion loss
- Assuming surgery is the only option before a conservative trial
How We Treat Hip Impingement
Two evidence-based options, combined with a structured movement protocol based on FAI type and labral status.
REGENERATIVE MEDICINE
PRP Therapy
Platelet-rich plasma injected under ultrasound guidance into the hip joint. Reduces intra-articular inflammation and supports labral and periarticular tissue health. Primary regenerative treatment for symptomatic FAI.
LIGHTFORCE XLi
Laser Therapy
Class IV deep-tissue laser reduces periarticular inflammation and supports tissue recovery. Used alongside PRP and a structured movement protocol as part of the comprehensive FAI management approach.
Which Treatment Is Right for Your Hip?
Impingement type, labral involvement, and degree of functional limitation determine the protocol.
01
SYMPTOMATIC FAI WITHOUT SIGNIFICANT LABRAL TEAR
Laser and Movement
Class IV laser series with structured hip and core strengthening protocol. Goal is reducing impingement provocation through improved mechanics.
02
FAI WITH LABRAL TEAR
Add PRP
PRP plus laser with a more intensive movement protocol. See our hip labral tear page for related context.
03
FAI NOT RESPONDING TO CONSERVATIVE CARE
Surgical Consideration
When significant labral or cartilage damage is present and conservative care has not produced sufficient improvement, surgical consultation is appropriate.
How Joint Freedom Compares
What you are actually weighing when you consider your options for hip impingement.
 | Hip Arthroscopy | Cortisone Shot | |
|---|---|---|---|
| What it does | Reduces joint inflammation, supports periarticular tissue healing, structured movement protocol to reduce impingement provocation | Reshapes the femoral head or acetabular rim and addresses labral pathology | Reduces joint inflammation temporarily |
| Recovery time | None to minimal | 3 to 6 months | None |
| Addresses root cause | Yes (mechanical contributors addressed) | Yes (bony correction) | No |
| Long-term results | Durable improvement for many patients; appropriate surgical referral when indicated | Good outcomes for appropriate candidates; risk of progression if not followed by structured rehab | Temporary relief; does not address bony impingement or labral pathology |
| Risk of side effects | Minimal | High (surgical risk, anesthesia, extended rehab) | Moderate; not appropriate for repeated use |
| Hip Arthroscopy | Cortisone Shot | |
|---|---|---|---|
| What it does | Reduces joint inflammation, supports periarticular tissue healing, structured movement protocol to reduce impingement provocation | Reshapes the femoral head or acetabular rim and addresses labral pathology | Reduces joint inflammation temporarily |
| Recovery time | None to minimal | 3 to 6 months | None |
| Addresses root cause | Yes (mechanical contributors addressed) | Yes (bony correction) | No |
| Long-term results | Durable improvement for many patients; appropriate surgical referral when indicated | Good outcomes for appropriate candidates; risk of progression if not followed by structured rehab | Temporary relief; does not address bony impingement or labral pathology |
| Risk of side effects | Minimal | High (surgical risk, anesthesia, extended rehab) | Moderate; not appropriate for repeated use |
Real Hip Impingement Patients. Real Results.
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Questions About Hip Impingement
Answers from our clinical team.
Not necessarily. Many patients with imaging-confirmed FAI do well with structured non-surgical care, particularly when symptoms are addressed early and movement patterns are modified. Surgery is appropriate for patients who have failed comprehensive conservative care, particularly when significant labral or cartilage damage is present.
The bony shape itself does not change without surgery. What can change is symptoms, function, and progression. Many patients with FAI live decades without surgery by managing symptoms and modifying activity.
FAI is associated with increased risk of hip osteoarthritis over time, particularly when symptomatic. Early intervention reduces progression risk.
Often yes, with modification. Many athletes manage FAI through career-long mechanical and strengthening work without surgery.
Often with modification. Many FAI patients can squat to depths that do not provoke impingement, with attention to mechanics. Some need to limit depth permanently.
Most patients note initial improvement within 6 to 8 weeks, with full effect often by 12 weeks. Combining PRP with structured movement work produces better results than either alone.
Yes. Post-arthroscopic recurrent symptoms are common in our practice.
Pricing
PRP is the primary investment for FAI management when labral tissue involvement is present. Laser is included as part of the comprehensive protocol. Exact pricing provided at your free consultation.
Payment Options
- HSA and FSA payments accepted for eligible treatments
- Joint Freedom does not bill insurance directly
- PRP and Class IV laser are typically self-pay
- Transparent pricing provided during consultation
- Payment plans available for qualifying treatment plans
- All major credit cards accepted
Your First Visit
Your first visit is a free consultation. We review imaging, assess impingement provocation, evaluate labral status, and build a plan appropriate for your FAI pattern and functional goals.
What to Bring
- Prior imaging (X-rays, MRI, CT) if available
- A list of medications and supplements
- Your sport, activity history, and functional goals
- Any previous treatments tried (PT, cortisone, etc.)
- Comfortable clothing that allows us to examine your hip and assess movement
Related Conditions We Treat
Hip impingement shares roots with several other hip conditions we treat.
PARENT CONDITION
Hip Pain
Hip impingement is one of the most common diagnoses in athletic hip and groin pain. The hip pain overview covers the full range of conditions at Joint Freedom.
CLOSELY RELATED
Hip Labral Tear
FAI is the most common driver of acetabular labral tears. Evaluating impingement is central to understanding and treating labral pathology.
RELATED HIP
Hip Bursitis
Altered hip mechanics from FAI can contribute to secondary trochanteric bursitis through compensatory loading patterns.
LONG-TERM RISK
Arthritis
Untreated FAI with labral damage is a risk factor for early hip osteoarthritis. Early intervention aims to reduce this progression risk.
FAI does not have to mean an operating room.
For most patients, structured non-surgical care is the right first step. The first conversation is free.
Address
2301 N Parham Rd, Ste 1Henrico, VA 23229
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Monday – Thursday: 9:30am – 4:30pm · Friday: 9:00am – 1:00pm · Saturday & Sunday: Closed
We proudly serve patients throughout the Richmond metropolitan area, including Richmond, Henrico, Glen Allen, Short Pump, Midlothian, Mechanicsville, and Chesterfield, and surrounding Virginia communities.