This problem often affects active people and athletes, especially with deep flexion, twisting, or repeated change-of-direction tasks. Some people also notice symptoms alongside a hip labral tear or other causes of hip pain.

Femoroacetabular Impingement Syndrome (FAIS): What it is

This condition develops when the shape of the femoral head, the acetabulum, or both creates mechanical conflict during hip movement. As a result, the labrum and cartilage may become irritated, particularly during bending, twisting, prolonged sitting, or deep squatting.

Many people describe deep groin pain, stiffness, clicking, or a catching sensation. Symptoms often increase during sport, stairs, getting in and out of cars, or sitting for long periods.

Common Causes

Hip shape variations often form during growth. Genetics and adolescent training loads may influence how the joint adapts over time.

Secondary causes may include previous hip conditions or trauma such as:

• Perthes disease
• Slipped capital femoral epiphysis (SCFE)
• Previous femoral or pelvic fracture

Symptoms

Common symptoms include:

• Deep groin or front-of-hip pain
• Hip stiffness or restricted movement
• Pain with prolonged sitting or walking
• Discomfort during sport, squatting, or crossing legs

Some people also report buttock pain or outer hip symptoms, which can overlap with gluteal tendinopathy or greater trochanteric pain syndrome (GTPS). If pain spreads down the thigh, a clinician may also screen for sciatica or lumbar referral.

Diagnosis

Diagnosis combines:

• Your symptom history
• A detailed physical examination
• Medical imaging where appropriate

Clinical testing may reproduce symptoms during combined hip flexion and rotation. Imaging such as X-ray and MRI helps assess joint shape and check for labral or cartilage irritation.

Clinical Signs

A physiotherapy assessment may identify:

• Limited hip flexion or internal rotation
• Pain during the FAIR or FABER tests
• Reduced hip muscle strength or control

These findings also help rule out other sources of hip and groin symptoms, including hip flexor (iliopsoas) groin pain, groin strain, and hip adductor tendinopathy.

People also ask: Can this cause buttock or lower back pain?

Sometimes. Hip irritation can change how you load your pelvis and spine, which may trigger buttock discomfort or lower back symptoms. However, referred pain can also come from the spine itself, so assessment matters.

Types of Hip Impingement

Cam impingement involves a bony prominence on the femoral head-neck junction.

Pincer impingement occurs when the socket covers too much of the femoral head.

Mixed type includes features of both cam and pincer patterns.

Treatment Options

Many people start with non-surgical management. Physiotherapy may help by:

• Improving hip joint mobility
• Restoring muscle flexibility
• Strengthening hip and trunk muscles
• Improving movement control during sport and daily tasks

Many plans also target hip load tolerance and tendon capacity, especially when symptoms overlap with tendinopathy. Pain relief may include activity modification and short-term medication advice from your GP.

For a broader overview, see: What Causes Hip and Groin Pain?

When is Surgery Considered?

If symptoms persist despite well-guided rehabilitation, your physiotherapist may discuss referral to an orthopaedic surgeon. Hip arthroscopy may be considered in selected cases.

Rehabilitation After Hip Surgery

Rehab supports movement, strength, and confidence. Timeframes vary, although many people build back to higher function over several months. If imaging shows arthritic change, management may also overlap with hip arthritis care.

What to Do Next

If hip or groin pain limits your movement, sport, or work, a physiotherapy assessment may help identify the driver and map out a practical plan.

Related Articles

• What is Hip Impingement?
• Hip Labral Tear
• Hip Adductor Tendinopathy
• Hip Flexor: Iliopsoas Groin Pain
• Gluteal Tendinopathy

References

1. Reiman MP, Agricola R, Kemp JL, et al. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults.
   Br J Sports Med. 2020.
2. Kemp JL, et al. Physiotherapist-led treatment for femoroacetabular impingement syndrome (PhysioFIRST study): protocol for a randomised controlled trial.
   BMJ Open. 2021.
3. Pasculli RM, et al. Non-operative management and outcomes of femoroacetabular impingement syndrome.
   Curr Rev Musculoskelet Med. 2023.