Hip impingement: understanding your pain and getting back to your activity

What is hip impingement?

Femoroacetabular impingement anatomy

Hip impingement, or femoroacetabular impingement, is an abnormal contact between the head of the femur and the rim of the socket that receives it (the acetabulum), during certain hip flexion and rotation movements. It’s linked to a particular bone shape (extra bone on the femoral neck or the acetabular rim), present in many athletes without necessarily causing symptoms.

Why does this impingement become painful?

Pain appears when repeated hip flexion and rotation movements, particularly in a deep squat position or during extreme movements, cause repeated painful contact between the bony structures. Sports with a large hip range of motion (football, dance, martial arts) particularly expose athletes to this type of impingement.

Which sports contribute to symptomatic hip impingement?

All sports with a large range of hip flexion and rotation are particularly concerned:

• Football (kicking, changes of direction)
• Ice hockey
• Dance
• Martial arts
• Climbing
• Weight training with deep squats

Treating hip impingement in rehab with a sports physio

The goal of treatment is to optimise the hip’s available mobility and strengthen the stabilising muscles to limit the repeated strain causing the pain.

1. 1Reducing pain and managing load
2. 2Recovering available mobility
3. 3Isometric strengthening
4. 4Progressive concentric strengthening
5. 5Hip proprioceptive work
6. 6Closed-chain strengthening (weight-bearing)
7. 7Optimising the sporting movement
8. 8Strengthening under sport-specific load
9. 9Progressive return to your sport
10. 10Return to competition

Why the physio’s initial assessment matters

During the initial assessment, the physiotherapist aims to identify the movements that reproduce the pain (deep flexion, rotation), the sport practised, and how long the symptoms have been present and how they’ve progressed.

“Hip impingement is managed by optimising the available mobility, not by trying to force the limited range of motion.”

Strengthening and available mobility, the cornerstones of treatment

The work focuses on optimising the hip’s genuinely available mobility, without forcing the range limited by the bony impingement, combined with strengthening the stabilisers to reduce repeated strain on the joint.

In brief

• Optimising available mobility
• Strengthening the stabilising muscles
• Correcting sporting technique if needed
• Gradual return: mobility, then load, then sport

Should you rest or keep playing sport?

Total rest is generally not necessary. It’s better to temporarily adapt the deep flexion and rotation movements that clearly reproduce the pain, while starting rehab as soon as possible.

When should you see a specialist for hip impingement?

If pain persists for more than four to six weeks despite rehab, or if mechanical locking is very marked, a medical opinion is recommended to precisely assess the bone shape and discuss further options.

The HOPP care programmes to treat your hip impingement and get back to sport

This impingement requires suitably managed mobility and load. HOPP offers you a precise exercise programme, allowing you to get back to your activities as quickly as possible.

The programme runs from 3 to 9 weeks depending on the injury and ends with a reconditioning phase allowing a return to competition in the best possible conditions. Each programme is designed by the HOPP team, made up of two sports physiotherapists who are experts in assessing and treating athletes. You’ll also find theoretical content throughout your progression, so you master every aspect of your recovery and can adjust your treatment independently. If needed, our team of physiotherapists is on hand to support you.

A programme that adapts to you every day

Every day, how you feel (RPE) is factored in to automatically adjust the rest of your programme: more load if all is well, a bit less if your hip is complaining. This daily personalisation is what makes the difference compared to a fixed, paper-based programme.

Ready to start your programme?

Join the HOPP support programme designed by sports physios.

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