This page is awaiting validation. It does not replace a consultation or a programme adapted to your situation.
What exactly are we talking about?
The head of the femur articulates with the socket in the pelvis. The labrum is a ring of tissue located on the edge of this socket; it contributes to the functioning of the joint. Certain shapes of the head-neck junction of the femur or the edge of the socket modify the contacts during movements, particularly when the hip bends and rotates.
We can read the terms cam, for a shape on the femoral side, or pincer, for coverage on the pelvic side. These are anatomical descriptions. Femoroacetabular impingement syndrome, or FAI, combines symptoms, examination signs and compatible images. The word impingement does not mean that every movement damages your hip.
Chapter sources [1]
Understand the picture
Connect three pieces of information
Bone shape
Contact depends on shape and movement.
Labrum
This ring is located at the edge of the socket.
Clinical situation
Your symptoms and the exam give meaning to the images.
Chapter sources [1]
What complaints can lead to a review?
Pain may be felt in the groin or around the hip during a deep squat, pivot, running, or prolonged sitting. Some people describe stiffness, catching, or difficulty getting into a car. Others report a clicking sound, but a noise alone does not prove a painful lesion.
A real blockage, which suddenly prevents movement, deserves an opinion. It is also necessary to specify whether the pain appeared after trauma or gradually. The tendons, back, and other structures can produce similar sensations. Describe the movement, its depth and the reaction after exercise rather than trying to recognize a diagnosis from a video.
Why might a picture and symptoms differ?
Bone shapes vary from person to person. People without pain have images depicting a cam morphology or labrum abnormality. Conversely, feeling very unwell does not always come down to a single image. Muscle capacity, activities and joint sensitivity are part of the assessment.
A labrum injury may accompany impingement, dysplasia, or another situation. These terms are therefore not interchangeable. Dysplasia corresponds to insufficient coverage and requires its own analysis. The goal of the review is to understand what is relevant to you, not to correct every word in the report or make all hips the same.
What examination and imaging is useful?
The professional explores mobility, strength and problematic movements. Some tests bring the joint surfaces together and can reproduce the discomfort, but no single test is enough to decide. It takes into account your history, possible trauma and other areas that may be contributing to the pain.
An x-ray can describe the bone shape and look for other changes. An MRI may be chosen for a question regarding tissues, particularly the labrum. More specialized examinations depend on the decision being considered. Ask why an image is proposed and what it might change. Doing more and more tests does not guarantee a better explanation of pain if the results are not related to your situation.
Chapter sources [1]
When is medical help first needed?
After an accident or fall, inability to bear weight on the leg, deformation or very intense pain requires urgent evaluation. A painful hip with fever or altered general condition should also be evaluated quickly. Deep pain that increases with running and becomes present with walking may require investigation of a bone lesion.
Do not attribute new symptoms to an already known impingement without reporting them. Genital pain, an inguinal lump or urinary problems follow another direction. Outside of an emergency, consult if the hip becomes blocked, if mobility decreases or if the discomfort continues to severely limit your daily life despite adaptations.
What are the options without surgery?
Treatment may combine explanation, temporary modification of certain actions, exercise program and medical pain management if necessary. The physiotherapist looks for skills to improve and positions that allow you to work without constantly provoking the same reaction. The goal is not to force a hip to reach an arbitrary range of movement.
Adapting a squat by reducing its depth, changing the seat height or taking breaks during a long journey can make an activity more accessible. These adjustments do not change bone shape; they can nevertheless improve functioning. Personalized rehabilitation is different from an identical list of stretches given to everyone. Additional techniques should have an explained purpose and be reevaluated.
In everyday life
Making a sports movement accessible
Observe
Identify the movement and depth that triggers the discomfort.
Adapt
Temporarily modify the range of movement or load and keep the training tolerated.
Reassess
Compare function and reaction before reintroducing a greater demand.
When can an arthroscopy be discussed?
An arthroscopy is a procedure using small openings and a camera in the joint. It may target certain bone or labrum abnormalities in selected patients. The assessment must specify the indication, the condition of the cartilage, the possible presence of dysplasia and the chances of achieving your objectives.
In the UK FASHIoN trial, surgery and personalized management without surgery both improved hip-related quality of life; the average favored surgery at twelve months in the population studied. This does not make an operation necessary for every scan showing impingement-related changes. Also discuss possible complications, rehabilitation, professional constraints and the uncertainty of the individual outcome.
How to exercise the hip without trying to force it?
The program can work on muscle strength around the hip and core, movement control and endurance. A useful movement is chosen according to your function: getting up, walking longer or controlling a landing. The range of movement and resistance are adjusted according to the assessment. Cracking or strongly stretching the hip is not a goal in itself.
Report deep, intensifying pain, blockage, or lasting reaction after the session. The professional can reduce the range of movement, choose another exercise or review the load. The absence of pain during a slow movement is not enough to validate a rapid sporting movement. After an operation, the protocol depends on the procedure performed: the general exercise page does not replace these instructions.
Sitting, driving, work and sport: how to test an adaptation?
Identify a specific situation. If sitting for a long time becomes painful, try a slightly higher seat, a less flexed position or a regular break. Change one thing at a time and see if it helps. There is no universal sitting angle or rule that says you should never squat again.
In sports, flexion depth, pivots and repetition of efforts can be adjusted. You can sometimes keep a different activity during recovery. For physical work, discuss carrying loads, low positions and temporary organizational possibilities. Accommodation should support your participation and be re-evaluated, without becoming a long list of permanent bans.
How can we judge progress and the need for a new opinion?
Choose observable goals: driving time, walking, work movement or training session. The follow-up focuses on their achievement, the pain and the subsequent reaction. The result of a program is judged on an evolution, not on a single day. The length of time needed depends on the situation and what you want to return to.
If the limitations remain significant despite well-monitored care, a new opinion can clarify the diagnosis and options. Ask what has been tried, what has changed, and what questions remain open. Improvement does not necessarily require a new MRI. Conversely, a worsening or new blockage may justify a re-evaluation even before the planned date.
Chapter sources [1]
Your questions
Does a cam shape mean my hip is bad?
No. The syndrome is defined by combining symptoms, clinical signs and images. A particular shape without pain or discomfort is not enough to decide on a treatment. We must avoid transforming a radiological word into a certain prediction of deterioration.
Chapter sources [1]
Can the labrum be abnormal without hurting?
Yes. Some abnormalities are present in people without symptoms. This does not mean that a labrum injury is never important. The professional must check if it corresponds to the complaints and if other factors, such as the shape of the hip, change the choices.
Should we ban squats?
Not systematically. Depending on your situation, the depth, load or way of organizing the exercise can be adapted. Do not force a movement that causes a repeated painful catch. After an operation, prescribed restrictions take precedence over any general advice.
Chapter sources [1]
Does an operation surely prevent osteoarthritis later?
We cannot guarantee it. A surgical decision first focuses on a precise indication, symptoms and current objectives. Long-term results are subject to uncertainties. Ask the specialist to distinguish between demonstrated benefits, possibilities and unproven promises.
Sources and references
- [1] Griffin et al. — Warwick Agreement on FAI syndrome
- [2] AAOS OrthoInfo — Snapping hip
- [3] Royal National Orthopaedic Hospital — Hip dysplasia in teenagers and young adults
- [4] NHS — Hip pain in adults
- [5] AAOS OrthoInfo · Stress fractures
- [6] NHS — Pelvic pain
- [7] Griffin et al. — UK FASHIoN trial
Text updated on
Medical review: awaiting Hasib Selimovic.