Hip & Thigh

What It Is

Hip impingement is a condition where extra bone grows along one or both of the bones that form the hip joint, giving them an irregular shape. Because the bones don't fit together perfectly, they rub against each other during movement, and over time this can damage the joint and cause pain (American Academy of Orthopaedic Surgeons, n.d.).

Also known as femoroacetabular impingement (FAI), the pain is mostly felt in the groin, although it can also be felt towards the outside of the hip (American Academy of Orthopaedic Surgeons, n.d.).

FAI happens because the hip bones do not form normally during the growing years in childhood (American Academy of Orthopaedic Surgeons, n.d.). Exercise does not cause FAI, but people who are very active work their hips harder, so they may start to notice pain earlier than people who are less active (American Academy of Orthopaedic Surgeons, n.d.). Some people have FAI all their lives and never have any problems (American Academy of Orthopaedic Surgeons, n.d.).

It's the deformity of a cam bone spur, a pincer bone spur, or both together, that leads to pain and damage to the joint. When the bones are abnormally shaped, there is little that can be done to prevent the impingement from occurring (American Academy of Orthopaedic Surgeons, n.d.).

Hip Impingement Anatomy

The hip is a ball and socket joint connecting the thigh bone (femur) to the pelvis. The ball is the femoral head, at the top of the femur, and the socket (acetabulum) is part of the pelvis. Both are covered with smooth, slippery cartilage that helps the bones glide against each other. The socket is ringed by strong fibrocartilage called the labrum, which forms a seal around the socket and helps keep the joint stable (American Academy of Orthopaedic Surgeons, n.d.).

As the thigh bone moves into flexion, the ball can pinch against the socket. People with hip impingement may get pain when they bend the hip (as if taking the knee towards the chest), and turning, twisting and squatting may cause a sharp, stabbing pain (American Academy of Orthopaedic Surgeons, n.d.). Pincer impingement is when extra bone extends out over the normal rim of the socket, and the labrum can be crushed under it. Cam impingement is when the ball is not perfectly round, and a bump on the edge of the ball grinds against the cartilage inside the socket. Combined impingement means both types are present (American Academy of Orthopaedic Surgeons, n.d.).

Over time, impingement can lead to tears of the labrum and to the breakdown of the joint cartilage (osteoarthritis) (American Academy of Orthopaedic Surgeons, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Hip Impingement

Specific exercises can improve the range of movement in your hip and strengthen the muscles that support the joint, which can relieve some of the stress on the labrum and cartilage (American Academy of Orthopaedic Surgeons, n.d.). I can guide you through these exercises, alongside hands-on work for the muscles around your hip and help changing the movements that bring on your pain. See the My Approach tab for how I work.

1. Activity Change

The first thing that is often recommended is to change your daily routine and avoid the activities that bring on your symptoms (American Academy of Orthopaedic Surgeons, n.d.). Cut back on any high-impact training that brings on your pain.

2. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons says over-the-counter anti-inflammatory medicines, such as ibuprofen and naproxen, may help to relieve the pain (American Academy of Orthopaedic Surgeons, n.d.). (This medicine information comes from the American Academy of Orthopaedic Surgeons, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) Use them for short-term relief, and don't come to rely on them; seek other help if the problem persists.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Prescription-strength anti-inflammatory medicine: a doctor may prescribe a stronger form of anti-inflammatory medicine to help reduce pain and inflammation (American Academy of Orthopaedic Surgeons, n.d.).
Scans: X-rays show the shape of the hip bones, a CT scan shows the exact shape in more detail, and an MRI scan shows damage to the labrum and cartilage (American Academy of Orthopaedic Surgeons, n.d.).
Diagnostic injection: a numbing medicine injected into the hip joint; if it gives temporary relief, this helps confirm FAI as the cause of the pain (American Academy of Orthopaedic Surgeons, n.d.).
Surgery: if tests show joint damage and non-surgical treatment has not relieved the pain, keyhole (arthroscopic) surgery can repair or clean out damage to the labrum and cartilage and trim the extra bone on the socket rim and the ball. Some severe cases need an open operation with a larger cut (American Academy of Orthopaedic Surgeons, n.d.).

How I can help (see the My Approach tab)

Exercises to improve your hip's movement and strength
Hands-on work for the muscles around your hip, low back and thigh
Help changing the activities and positions that bring on your pain

Tips

When symptoms first begin, try to identify the activity that may have caused the pain. Change your activities, let your hip rest, and see if the pain settles (American Academy of Orthopaedic Surgeons, n.d.).
The longer painful symptoms go untreated, the more damage the impingement can cause in the hip (American Academy of Orthopaedic Surgeons, n.d.).
Pain often starts in the groin area, but it can be felt towards the outside of the hip (American Academy of Orthopaedic Surgeons, n.d.).
Pain when twisting, turning and squatting needs to be checked by a medical professional. Hip impingement is diagnosed from your symptoms, a clinical examination and imaging together (Griffin et al., 2016). X-rays show the bone shape, and an MRI scan shows any damage to the labrum and cartilage (American Academy of Orthopaedic Surgeons, n.d.).

Treatment

My Approach

Hip impingement comes from the shape of the hip bones. As a massage therapist I can't change that shape, but I can ease the pain and the tight, overworked muscles that come with it, take stress off the joint, and build strength and control around your hip so it copes better with what you want to do.

I start by assessing how your hip moves and which movements bring on the pain, the strength of your hip and core muscles, and how you walk, squat and balance on one leg. I'll also ask about your sport, training and long spells of sitting.

When It's Sore

Changing the activities and positions that pinch, such as deep squats, low seats or pulling the knee hard towards the chest, rather than stopping everything
Hands-on work for the hip flexors, buttock, thigh and low back muscles that tighten around a sore hip
Gentle joint mobilisation, including a slow, sustained pull along the leg to ease the feeling of compression
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home

Building Strength and Control

Exercises for the buttock, deep hip and core muscles, starting with gentle holds, bridges and side-lying work
Building to single-leg balance, step-ups, lunges and squats to a comfortable depth, and gym-based work if you lift
Stretches chosen to avoid the pinching position, and a home programme between visits
A gradual return to sport

Work on the buttock and hip muscles, or near the groin, is only with your informed consent and a written consent form, and you can say no at any time. After surgery, I need your surgeon's okay before hands-on treatment.

If the pain keeps getting worse, or your hip starts locking or giving way, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 6 weeks, then less often as you take over the home programme. Most people notice the pain easing over 6 to 12 weeks of regular exercise, and it's usually worth giving it about 3 months before judging how well it's working.

What I Focus On

Assessment

Activity Changes

Hip & Low Back Release

Hip & Core Strength

Gradual Return to Sport

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Femoroacetabular impingement. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/femoroacetabular-impingement/ (Accessed: 7 October 2026).
Griffin, D.R. et al. (2016) 'The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement', British Journal of Sports Medicine, 50(19), pp. 1169–1176. doi: 10.1136/bjsports-2016-096743

Massage therapy · Kitchener–WaterlooHip Impingement

What It Is

Hip Impingement Anatomy

Self-Care & Treatment

How to Treat a Hip Impingement

1. Activity Change

2. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

Building Strength and Control

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooHip Impingement

What It Is

Hip Impingement Anatomy

Self-Care & Treatment

How to Treat a Hip Impingement

1. Activity Change

2. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

Building Strength and Control

Typical Course

References

Related Conditions

Adductor Tear

Adductor Tendinopathy

Biceps Femoris Tendinopathy

Femoroacetabular Impingement (FAI)

Book a session