Is Hip Impingement Holding You Back? Denver PTs Explain What You Need to Know

If you’re an active adult in Colorado, whether you're lifting, running, biking, or climbing, hip impingement pain can be a serious roadblock. 

One of the most common complaints we hear at Rise Rehab and Sport Performance is that familiar pinch in the front of the hip: tight, sharp, and limiting. 

Sound familiar? You may be dealing with femoroacetabular impingement (FAI), commonly referred to as hip impingement.

But here’s the good news: hip impingement doesn’t have to be a long-term sentence. In fact, many patients improve dramatically, even without surgical treatment, when the root causes are addressed through targeted physical therapy.

Let’s walk through what hip impingement really means, what causes it, and how many active adults recover through mobility, control, and strength, without needing hip arthroscopy or other surgical procedures.

What Is Hip Impingement (Femoroacetabular Impingement)?

Hip impingement refers to abnormal contact between the ball and socket joint of the hip, specifically where the femoral head (top of the thigh bone) meets the acetabular rim (hip socket). 

When this contact becomes excessive or misaligned, it can irritate the labrum and articular cartilage, causing discomfort and reduced range of motion.

The Two Main Types: Cam and Pincer Impingement

• Cam impingement happens when a bony bump or cam lesion develops at the femoral head neck junction, making the femoral head less round and more likely to jam into the acetabular rim during movement. 

• Pincer impingement occurs when the hip socket covers too much of the femoral head, creating extra bone or a pincer lesion that limits movement and compresses surrounding structures. Many people experience combined impingement, a mix of both.

Here’s the twist: many people with these anatomical features never feel pain at all. That’s why structure alone doesn’t tell the whole story.

Typical Symptoms of Hip Impingement

Hip impingement occurs most commonly during movements that require deep hip flexion. If you’ve noticed the following typical symptoms, your affected hip may be showing signs of FAI:

• Pain in the groin or front of the hip, especially during squats, sitting, or lifting the leg

• A pinching or dull ache during hip movements like bringing the knee toward the chest

• Clicking, stiffness, or catching in the hip joint

• Reduced range of motion or strength

These symptoms tend to show up in activities that place the hips flexed, think sitting long hours, lunging, sprinting, or hiking uphill.

At Rise Rehab and Sport Performance in Denver, we combine precise physical examinations, expert movement assessments, and custom care plans to treat impingement syndrome at the root.

Let’s get your hips moving, the right way. Get in touch today!

It’s Not Just About Bone Shape

Some people are genetically predisposed to conditions like FAI. Others may develop excess bone growth due to activities or conditions like slipped capital femoral epiphysis, acetabular retroversion, or Perthes disease. 

But not all of these lead to hip impingement diagnosed by a physician.

What you do with your hip bones plays just as big a role as their shape. We've seen people with significant cam impingement or pincer lesion continue to play sports pain-free, and others with relatively normal imaging who feel pain every time they move. 

So how do we help repair hip impingement and relieve pain without surgical intervention?

Key Areas We Focus on in Physical Therapy

Anterior Hip Mobility

Tissues around the anterior inferior iliac spine, such as the psoas, rectus femoris, and hip capsule, can become stiff and limit hip movements. 

When these tissues are tight, they increase joint compression at end ranges. Improving anterior mobility can:

• Decrease pressure on the articular cartilage

• Improve tolerance for squats and lunges

• Allow freer extension and rotation of the hip joint

Joint Arthrokinematics

Even if a physical examination shows full range of motion, internal joint mechanics might be off. If the femoral head doesn’t glide properly in the hip socket, it can cause early contact and pain. 

Manual techniques improve posterior and inferior glides, reduce capsule tension, and decrease guarding.

Motor Control and Muscle Activation

A healthy hip uses coordinated movement patterns. If the glutes, deep rotators, and core aren’t doing their part, you’ll rely too much on the hip flexors, increasing the load on the affected hip. 

When motor control improves, dynamic activities become smoother and more balanced.

Gross Strengthening

Stretching alone doesn’t fix impingement syndrome. To reduce symptoms and build resilience, we target:

• Posterior chain: glutes and hamstrings

• Core: especially anti-extension control

• Single-leg strength and pelvic stability

• Deep hip rotators: obturator internus, gemellus, etc.

Stronger muscles support the joint and reduce dependency on passive structures, which are often the ones that get injured.

Try These Physical Therapist Approved Movements

These four exercises are often part of our nonsurgical treatment plans:

1- 90/90 Hip Mobilizations

Encourages posterior capsule glide and external rotation. Stay tall through the spine and hinge forward with control.

2- Wall-Assisted Hip CARs

Strengthens joint control across all planes. Keep the rest of your body still as you rotate the femoral head in the socket.

3- Rear-Foot Elevated Split Squat

Targets glutes and quads while encouraging hip extension without compressing the front of the hip joint.

4- Cable or Band-Resisted Lateral Step-Throughs

Reinforces lateral stability, pelvic alignment, and deep rotator strength.

Ready to Move Again?

Whether you want to hit the trail, rack a PR in the gym, or just get through your day without nagging groin pain, you don’t have to live with limitations. 

At Rise Rehab and Sport Performance in Denver, we combine precise physical examinations, expert movement assessments, and custom care plans to treat impingement syndrome at the root.

Let’s get your hips moving, the right way. Get in touch today!