Hip Impingement (FAI): Why Not All Hip Impingement Is Permanent or Anatomical — And How Apex Can Help You
If you’ve ever felt pinching in the front of your hip when squatting, running, sitting, or getting out of the car, you may have been told you have hip impingement, also known as Femoroacetabular Impingement (FAI).
But here’s something many people don’t realize:
👉 Not all hip impingement is caused by bone structure.
In fact, many cases are actually functional hip impingement, meaning the problem comes from poor movement mechanics, muscle imbalance, joint restriction, or instability — not just anatomy.
That distinction matters because functional FAI is often highly treatable without surgery.
At Apex Sports Medicine in Leander, we specialize in identifying the why behind hip impingement and using our three-prong approach to restore mobility, improve mechanics, and get patients back to pain-free movement.
What Is Hip Impingement (FAI)?
FAI occurs when the ball-and-socket joint of the hip doesn’t move smoothly, causing pinching or compression in the front of the hip joint.
Common symptoms include:
- Pinching in the front of the hip
- Pain with squatting or lunging
- Hip stiffness
- Clicking or catching sensations
- Pain with prolonged sitting
- Reduced hip mobility
FAI is especially common in:
- Athletes
- Weightlifters
- Runners
- CrossFit athletes
- Active adults who sit frequently
(Hospital for Special Surgery – FAI Overview)
Anatomical vs Functional Hip Impingement
This is where things get really important:
Anatomical FAI (Structural Impingement)
Anatomical FAI occurs when there are actual bony changes in the hip joint.
The two most common types are:
Cam Impingement
The femoral head isn’t perfectly round, causing abnormal contact during hip flexion.
Pincer Impingement
Extra bone coverage on the socket creates compression during movement.
These structural changes are visible on imaging like X-rays or MRI.
(AAOS – Femoroacetabular Impingement)
However — and this is critical — many people have structural FAI on imaging with zero pain.
Research shows imaging findings alone do not predict symptoms.
(British Journal of Sports Medicine – Imaging Findings in Asymptomatic Athletes)
Functional FAI (Movement-Based Impingement)
This is the type we commonly treat at Apex.
Functional FAI happens when the hip is mechanically forced into impingement because of:
- Poor pelvic control
- Hip instability
- Limited ankle mobility
- Weak glutes
- Stiff surrounding muscles
- Poor squat or hinge mechanics
- Lumbar/pelvic compensation patterns
In other words:
👉 The hip itself may not be the true problem — the movement pattern is.
And the good news?
Functional FAI often responds extremely well to conservative treatment.
Why Functional FAI Is More Common Than People Think
Modern lifestyles create the perfect environment for hip dysfunction.
Long periods of sitting, poor movement variability, repetitive training patterns, and weak stabilizers all contribute to abnormal hip loading.
Over time:
- The pelvis loses control
- The hips lose rotation
- Muscles become overactive or underactive
- The front of the hip gets compressed repeatedly
That repetitive pinching creates irritation, inflammation, and eventually pain.
At Apex, we look beyond imaging and evaluate:
- How you squat
- How your pelvis moves
- Hip rotation mobility
- Glute activation
- Core stability
- Walking and loading mechanics
Because treating movement is often the missing piece.
How Apex Treats Functional Hip Impingement: The Three-Prong Approach
1. Chiropractic Adjustments: Restore Hip & Pelvic Motion
Hip impingement is rarely just a “hip problem.”
Restricted motion in the:
- Lumbar spine
- SI joints
- Pelvis
- Ankles
can all force the hip into poor mechanics.
Adjustments help:
- Improve hip joint motion
- Restore pelvic positioning
- Improve force transfer through the lower body
- Reduce compensatory movement patterns
Better motion = less pinching in the front of the hip.
2. Soft Tissue Therapy: Reduce Compression & Improve Mobility
Soft tissue restrictions often pull the hip into impingement positions.
At Apex, we use:
- Instrument-Assisted Soft Tissue Mobilization (IASTM)
- Active Release-style techniques
- Myofascial release
- Dry needling
to address:
- Tight hip flexors
- Overactive TFL
- Adductors
- Deep glute restrictions
- Capsule-related stiffness
Dry needling can be especially effective for reducing tone in chronically overactive hip musculature and restoring mobility.
Soft tissue therapy improves tissue extensibility and decreases mechanical compression around the joint.
(Journal of Orthopaedic & Sports Physical Therapy)
3. Rehab & Corrective Exercise: The Most Important Piece
This is where lasting change happens.
Functional FAI improves when we retrain:
- Hip control
- Pelvic stability
- Glute activation
- Core coordination
- Squat and hinge mechanics
Our rehab programs often include:
- Hip CARs (controlled articular rotations)
- Glute medius strengthening
- Core stabilization drills
- Hip mobility exercises
- Split squat/lunge progressions
- Movement retraining
Research consistently supports exercise therapy as a first-line treatment for FAI.
(British Journal of Sports Medicine – Conservative Management of FAI)
Why This Integrated Approach Works
Functional hip impingement is usually a combination of:
- Poor mobility
- Poor stability
- Faulty movement patterns
- Soft tissue restriction
So treating only one piece rarely works.
Adjustments restore motion → improving mechanics
Soft tissue therapy reduces compression → improving mobility
Rehab retrains movement → preventing recurring impingement
That’s why the Apex three-prong approach is so effective.
When Should You Get Evaluated?
You should consider an evaluation if you experience:
- Front-of-hip pinching
- Pain with squats or lunges
- Hip stiffness after sitting
- Clicking or catching
- Limited hip mobility
- Pain during workouts or running
The earlier functional FAI is addressed, the easier it is to correct movement before chronic irritation develops.
Move Better with Apex Sports Medicine
Hip impingement doesn’t automatically mean surgery — and it definitely doesn’t mean you have to stop being active.
At Apex Sports Medicine in Leander, we identify whether your impingement is structural, functional, or a combination of both — then build a plan designed to restore movement and keep you doing what you love.
👉 Book your appointment today and let’s get your hips moving the way they were designed to.
