Hip Impingement

UI Health Care orthopedic surgeons offer the full range of treatments for hip impingement, including physical therapy, steroid injections, and hip arthroscopy.

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Even though hip pain is often associated with aging, it also occurs in younger people. One common cause of hip pain in people under age 40 is a joint abnormality called hip impingement.

Hip impingement—also known as femoroacetabular impingement, or FAI—is the result of a misshapen bone. That means it won’t go away on its own. Over time, the pain caused by hip impingement can make it hard to run, squat, or sit.

Fortunately, orthopedic specialists with University of Iowa Health Care routinely treat this condition. We work with people whose mild symptoms can be managed with nonsurgical therapies. Patients who fail nonsurgical treatment may be candidates for hip arthroscopy to re-shape and correct hip impingement.

Hip impingement symptoms and diagnosis

With hip impingement, one of the two bones that forms your hip joint has an abnormal shape. This means the bones don’t fit together properly. Instead of gliding smoothly during movement, they grind against each other.

This structural problem can be congenital (present at birth). It can also develop as your bones grow through childhood and adolescence.

Hip impingement symptoms

Most people with hip impingement develop one or more of the following symptoms:

Hip pain that gets worse when you flex your hip (movements that bring your knee up closer to your chest). For example, you may feel pain when you ride a bike or squat to tie your shoe.
Pain deep in your groin.
Pain that gets worse with prolonged sitting (such as riding in a car).
Stiffness in the hip or groin that limits movement.

Hip impingement symptoms may come on gradually and get worse over time. The constant friction caused by your hip bones rubbing together damages the labrum and causes a labral tear.

Over time, this can lead to problems like early osteoarthritis or cartilage tears.

Hip impingement diagnosis

If you have symptoms of hip impingement, turn to UI Health Care. Our providers specialize in distinguishing hip impingement from other conditions that cause hip pain, including hip dysplasia and iliotibial (IT) band syndrome.

In most cases, we can diagnose hip impingement using one or more of the following tests:

A physical examination to assess your hip structure, stability, and flexibility.
A diagnostic hip injection that uses medicine to numb the hip. If your pain goes away after the injection, it helps confirm that the source of your pain is inside the joint.
Imaging tests such as an X-ray or MRI scan. These help us determine the shape of your hip bones and whether you have cartilage damage.

Because our orthopedic specialists have treated so many people with hip impingement, they’re skilled at making treatment recommendations. They have a deep understanding of which treatment options are best suited to your age, symptoms, anatomy, and activity level.

Hip impingement treatment from UI Health Care

The pain caused by hip impingement doesn’t have to hold you back. With prompt diagnosis and treatment, you can get your symptoms under control and get back to your regular activities.

Nonsurgical treatments for hip impingement

Some people with hip impingement can reduce or relieve their symptoms with nonsurgical therapies. These include:

Activity modification

Your provider may ask you to avoid certain activities that trigger your hip pain, or they may ask you to try different types of exercise. For example, you may find relief by switching from cycling to swimming.

Medicine

Anti-inflammatory medicines (like ibuprofen) and injection therapy, including corticosteroid or biologic medicines, can reduce hip pain and inflammation.

Physical therapy

Our physical therapists can teach you exercises that improve your hip strength, flexibility, and range of motion. We can also help you strengthen nearby muscle groups, which creates extra hip support.

Hip impingement surgery

If your pain (or joint damage) is severe—or nonsurgical treatments don’t help— your provider may recommend surgery. You may also be a good candidate for surgery if you’re highly active, which adds to the wear-and-tear on your hip joint.

With hip impingement surgery, we usually have two goals:

Fixing cartilage: Many people with hip impingement develop a cartilage injury called a torn labrum. Your surgeon will repair any damaged cartilage within the joint.
Reshaping the bone: Your surgeon will also correct the abnormal bone that’s causing your hip impingement. This usually involves removing small amounts of excess bone until it achieves a more natural shape (and fits better within the joint).

In most cases, we use a minimally invasive type of surgery called hip arthroscopy (or arthroscopic hip surgery). With this approach, we only need to make a couple of small incisions around the joint. We use a tiny camera and miniature surgical tools to repair the hip through those incisions.

We also offer “open” surgery (called a surgical hip dislocation) for some people with severe hip impingement.

No matter which surgical approach we use, you can have confidence in our orthopedic surgeons. We perform hundreds of traditional and minimally invasive hip surgeries every year.