What is hip impingement and how is it treated?

Hip impingement occurs when the ball and socket of the hip make abnormal contact during movement. Treatment may include activity modification, physiotherapy and pain management. Surgery may be considered when symptoms persist and imaging confirms a structural problem that can be treated.

Can hip impingement get better without surgery?

Yes. Many patients can manage symptoms with activity modification, physiotherapy, improved hip and core strength, posture adjustments and medication where appropriate. Surgery is considered when symptoms continue despite appropriate non-surgical treatment.

Why does hip impingement hurt when I sit for a long time?

Sitting keeps the hip in a flexed position for a prolonged period. In people with hip impingement, this position can increase contact between the femoral head and socket and reproduce groin pain. Discomfort may also be noticed when standing up after sitting.

Does everyone with a cam-shaped hip need treatment?

No. Some people have a cam-shaped hip without experiencing any symptoms. Treatment is based on the patient's symptoms, physical examination and imaging findings rather than the shape seen on an X-ray alone.

Can hip impingement damage the cartilage?

Repeated abnormal contact can damage the labrum and may also affect the cartilage lining of the hip. The extent of damage varies between patients. MRI or MR arthrogram can help assess associated labral and cartilage problems when clinically appropriate.

Can I return to sport after hip arthroscopy?

Many patients can return to sport after hip arthroscopy. Recovery is gradual and involves restoring hip movement, strength and control. Return to sporting activity should be based on recovery milestones and functional readiness rather than a fixed date.

Hip Impingement (FAI) Treatment in Mumbai

Introduction

Hip impingement, also known as femoroacetabular impingement (FAI), occurs when the ball and socket of the hip do not move together smoothly. Abnormal contact during movement can cause persistent groin pain, stiffness and reduced hip movement, particularly in younger and active adults.

Dr. Vaibhav Bagaria, Director of the Department of Orthopaedics at Sir H. N. Reliance Foundation Hospital, Mumbai, assesses and treats hip impingement. Identifying the cause of symptoms early can help protect the labrum and cartilage and guide treatment before significant joint damage develops.

What is hip impingement?

The hip is a ball-and-socket joint in which the femoral head normally moves freely inside the socket. In hip impingement, the shape of the ball, socket or both causes abnormal contact during certain movements.

There are three common patterns. Cam impingement occurs when there is extra bone around the femoral head-neck junction. Pincer impingement occurs when the socket provides excessive coverage of the femoral head. Mixed impingement contains features of both.

Repeated contact can irritate or damage the labrum and, over time, may affect the cartilage lining of the joint. Not everyone with an impingement-shaped hip has symptoms, so diagnosis depends on the combination of symptoms, examination and imaging.

Symptoms

✓ Deep pain in the groin or front of the hip
✓ Pain after sitting for prolonged periods
✓ Pain with squatting or deep hip flexion
✓ Difficulty sitting cross-legged or getting into a car
✓ Clicking, catching or locking sensations
✓ Stiffness and reduced hip rotation
✓ Pain during running, twisting or sporting activity
✓ Difficulty sitting or driving for long periods

What causes hip impingement?

1. Bone shape developed during growth

Cam-type impingement can develop from the shape of the femoral head and neck during the adolescent growth years.

2. Repetitive sporting activity

Repetitive loading and movements involving deep hip flexion during the growing years may be associated with cam morphology.

3. Childhood hip conditions

Conditions affecting hip development during childhood can alter the shape of the joint and contribute to impingement.

4. Previous hip injury or surgery

An injury or previous procedure can change the shape or mechanics of the hip and contribute to abnormal contact.

5. Socket anatomy

Increased coverage of the femoral head by the socket can contribute to pincer-type impingement.

6. Mixed morphology

Some patients have both cam and pincer features, creating abnormal contact from more than one part of the joint.

When should you see a doctor?

✓ Persistent groin pain, particularly in a younger or active adult
✓ Pain when squatting, sitting cross-legged or bending the hip deeply
✓ Clicking, catching or locking in the hip
✓ Reduced hip rotation compared with the other side
✓ Groin pain that continues despite rest or activity modification
✓ Hip symptoms that repeatedly interfere with sports or daily activities

When is hip pain an emergency?

Seek urgent care for severe hip pain following significant trauma, inability to bear weight after an injury, obvious deformity or shortening of the leg, or sudden severe pain with a suspected fracture or dislocation.

Hip pain accompanied by fever, a hot or swollen joint, or a sudden major change in the ability to move the hip also requires prompt medical assessment.

How hip impingement is diagnosed

Medical history

The doctor reviews the location and pattern of pain, activities that trigger symptoms, sporting history, sitting tolerance and any previous hip injury or childhood hip condition.

Physical examination

Hip movement is assessed on both sides, including rotation and flexion. Specific impingement manoeuvres may reproduce symptoms. The spine and surrounding structures may also be assessed.

Imaging and tests

X-rays assess the shape of the femoral head, neck and socket.
MRI or MR arthrogram can identify labral tears and cartilage damage.
CT may be used when detailed assessment of the bone anatomy is required, particularly before surgery.

Why early assessment matters

Hip impingement can exist for some time before symptoms become significant. When persistent symptoms are present, assessment can help identify associated labral or cartilage damage and determine whether joint-preserving treatment is appropriate.

Hip impingement treatment in Mumbai

Non-surgical treatment

Treatment is initially focused on reducing symptoms and improving hip function:

✓ Activity modification to reduce painful hip positions
✓ Physiotherapy focused on hip and core strength
✓ Improving movement patterns and hip control
✓ Adjusting posture and seating positions
✓ Medication where appropriate
✓ Diagnostic or therapeutic hip injection in selected cases

When surgery is considered

Surgery may be considered when symptoms continue despite appropriate non-surgical treatment, particularly when pain or mechanical symptoms continue to limit work, sport or daily activities and imaging confirms a correctable structural problem.

The condition of the joint matters. Where significant established arthritis or advanced cartilage loss is present, hip arthroscopy may not provide the expected benefit and another treatment option may need to be considered.

Surgical options

✓ Hip arthroscopy — a minimally invasive procedure used to address the abnormal bone shape and treat associated labral problems.
✓ Labral repair — repairing and preserving the labrum where it is suitable for repair.
✓ Labral reconstruction — considered in selected cases where the labrum cannot be adequately repaired.
✓ Hip replacement — considered where hip impingement has progressed to significant arthritis and joint-preserving surgery is no longer appropriate.

The appropriate procedure depends on the severity of the impingement, the condition of the labrum and cartilage, the patient's symptoms and activity requirements.

Related conditions treated

Hip osteoarthritis

Avascular necrosis of the hip

Sports injury and arthroscopy

About Dr. Vaibhav Bagaria

Dr. Vaibhav Bagaria is Director and Head of the Department of Orthopaedics at Sir H. N. Reliance Foundation Hospital, Mumbai, and one of the earliest surgeons in India to adopt robotic joint replacement. Over twenty-two years of practice he has treated patients across the full range of bone and joint conditions, with a particular focus on robotic knee and hip replacement, partial knee replacement, sports injury and arthroscopy, and complex pelvic and acetabular reconstruction.

Name

Dr. Vaibhav Bagaria

Experience

20+ Years

Qualifications

MS (Ortho) FASSI, FNUS, FNAMS..

Speciality

Specialist in Robotic Knee & Hip Replacement
Specialist in Sports Injury, Arthroscopy & Complex Trauma

Practice

President & National Delegate SICOT India
Director & Head Department of Orthopaedics — Sir H. N. Reliance Foundation Hospital, Mumbai

Dr. Vaibhav Bagaria, Director of Orthopaedics at Sir H. N. Reliance Foundation Hospital

Consultation

02261305757

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Hip Impingement (FAI)
Treatment in Mumbai