Dr Alan Cheung
Senior Consultant Orthopaedic Surgeon in Singapore
MBBS (London), MRCS (England), FRCS (Trauma and Orthopaedics, England), Diploma in Sport and Exercise Medicine (UK), Fellow of the European Board of Orthopaedics and Traumatology, American Academy of Orthopaedic Surgeons (AAOS)
Has sitting through a long meeting, driving for extended periods or going for your usual walk suddenly brought on hip pain that was not there before? At first, it may be easy to brush it off as overuse or a minor strain. But when the sensation lingers, or quietly worsens over time, it can start to interfere with daily routines in ways that are hard to ignore. For many people, this is how hip impingement, also known as femoroacetabular impingement (FAI), begins to make itself known.
Hip impingement occurs when the bones of the hip joint do not fit together as smoothly as they should. Over time, this abnormal contact can irritate the cartilage and surrounding tissue, leading to pain and restricted movement. While symptoms often develop progressively, recognising the warning signs early and knowing when discomfort warrants assessment can make a meaningful difference to long-term joint health.
Signs and Symptoms of Hip Impingement
The signs of hip impingement vary in severity and often progress gradually as joint irritation increases. These can include:
Pain
One of the most noticeable signs of hip impingement is persistent pain in the joint that develops over time. This discomfort is often felt deep in the groin or at the front of the hip and may worsen during activities that involve bending or rotation. Many people first notice hip joint pain while sitting, particularly during long meetings, extended drives or desk work. As the condition advances, hip pain while walking may also become more apparent, especially after covering longer distances or moving uphill.
Tightness and Reduced Ease of Movement
Stiffness in the hip joint is another warning sign, particularly after periods of rest. You may feel tightness when standing up after sitting or when getting out of bed in the morning. This stiffness can make the first few movements feel awkward or restricted before the joint gradually loosens. When stiffness is paired with recurring hip pain, it often signals underlying irritation within the joint rather than simple muscle fatigue.
Clicking or Popping Sensation
Have you ever noticed a clicking or popping sound in your hip when you stand up from a chair, turn quickly or walk after sitting for a while? While joint noises are not always a cause for concern, repeated clicking accompanied by discomfort may indicate that the cartilage or labrum is being affected by abnormal contact within the joint.
Limited Mobility
As irritation within the hip persists, range of motion may decrease. This is often noticed during hip rotation, when standing up from a seated position or when changing direction while walking. Over time, everyday actions such as bending forward, sitting cross-legged or climbing stairs may become more challenging.
Understanding the Different Forms of Hip Impingement
FAI can affect the hip joint in different ways, and understanding the type you have can explain your symptoms and guide treatment options. Below, we break down the most common types to give you a clearer picture of what may be happening in your hip.
Cam Impingement
Cam impingement occurs when the femoral head is not perfectly round. This irregular shape can rub against the hip socket during movement, gradually damaging cartilage. It is most commonly seen in younger, active individuals and may first show up as hip pain while walking or stiffness during activity.
Pincer Impingement
Pincer impingement develops when the hip socket covers too much of the femoral head. This causes the labrum to become pinched during movement, leading to discomfort and a reduced range of motion. Activities such as bending forward, twisting or pivoting can trigger this catching or pinching sensation in the joint.
Mixed impingement
Many people experience a combination of both cam and pincer changes. Mixed impingement often results in more pronounced symptoms and may progress more quickly without appropriate care.
What Are the Treatment Options for Hip Impingement?
Managing FAI usually involves a mix of non-surgical strategies and, in more severe cases, surgical intervention. The best approach depends on the severity of your symptoms and how much the joint is affected.
Non-Surgical Approaches
Many people find relief from FAI through conservative treatments that aim to reduce pain, improve flexibility and support the hip joint without going under the knife.
- Strengthening and Stretching Exercises: Stretching routines improve flexibility and range of motion, while focusing on the hip flexors and surrounding muscles helps ease tension and minimise discomfort in everyday activities.
- Medication: Mild to moderate hip pain can often be managed with over-the-counter pain relievers like acetaminophen or ibuprofen. These medications help reduce discomfort and inflammation, and NSAIDs in particular, can ease swelling within the hip joint, making movement less painful.
- Injections: Administered directly into the hip joint, corticosteroid injections help decrease inflammation and provide short-term pain relief, while other treatments such as physiotherapy continue to improve hip function.
Surgical Approaches
When conservative care is insufficient, surgery may be recommended to correct structural issues within the hip.
- Hip Arthroscopy: During this minimally invasive procedure, a small camera is inserted into the joint through tiny incisions, allowing the hip specialist to remove excess bone from the femoral head or socket and repair or trim damaged cartilage. This approach helps restore hip function while reducing ongoing pain.
- Open Surgery: A larger incision gives the surgeon direct access to the joint, enabling bone reshaping or tissue repair. Procedures such as osteotomy can realign the hip bones, improving joint mechanics and relieving impingement.
- Periacetabular Osteotomy (PAO): PAO involves repositioning the acetabulum to correct abnormal socket orientation that contributes to impingement. By improving the alignment between the socket and the femoral head, PAO can reduce abnormal joint contact and help preserve long-term hip function in selected cases.
When to Seek Professional Assessment for Hip Impingement
If hip discomfort persists beyond a few weeks, continues to worsen, or begins to interfere with everyday activities such as walking, sitting, or bending, it may be time to seek professional assessment. Recurring pain that does not improve with rest, stiffness that limits movement, or clicking sensations accompanied by discomfort can all signal ongoing joint irritation. Early evaluation is particularly important if symptoms are affecting your mobility or quality of life, as timely care can help reduce further joint damage and support long-term hip health.
Taking the Next Step for Your Hip Health
Staying mobile starts with understanding why the hip is hurting in the first place. With appropriate assessment, treatment can be aligned with your activity demands and long-term goals, whether that is conservative management or surgery when required. The focus is preserving range of motion, easing pain, and supporting everyday movement.
Don’t let ongoing hip pain limit how you move or live. At the International Orthopaedic Clinic, we take the time to understand your condition through careful assessment and thoughtful treatment planning. Get in touch today to begin a considered path towards improved mobility and comfort.
