Expert Sports Injury
Care in San Diego

Athletes who develop a deep ache in the groin after running, squatting, or cutting usually assume it is a pulled muscle. But when that pain keeps returning, especially with hip flexion or rotation, femoroacetabular impingement (FAI) becomes a more likely scenario. While many think this is a condition that only affects older people, FAI syndrome is identified in over 60% of patients with hip pain who did not have hip arthritis. 

Because the symptoms of FAI can be similar to other conditions, learning to recognize the symptoms and where to get an expert evaluation is important. Read on to learn more about the symptoms of hip impingement in athletes and what modern treatments are available from the best hip surgeon in Orange County. 

What Does Hip Impingement Feel Like in an Athlete?

FAI causes deep pain in the groin, although some athletes feel discomfort on the outside of the hip or toward the front of the thigh. The pain may initially appear only during demanding activities and then become noticeable during everyday movements.

Additionally, you may also notice symptoms like:

• Deep groin or hip pain
• Pain with squatting or lunging
• Discomfort when sitting for long periods
• Pain during cutting, pivoting or changing direction
• Hip stiffness or reduced range of motion
• Clicking, catching or a sensation of the hip giving way
• Pain that returns after activity

One reason FAI is frequently mistaken for a muscle strain is that athletes may not feel much pain when they are resting. 

Why Are Athletes More Likely to Develop FAI?

There are two primary forms of FAI: cam impingement and pincer impingement. Some people have a combination of both:

• Cam impingement: The femoral head has an extra prominence that interferes with the hip's normal movement
• Pincer impingement: Extra bone around the acetabular rim can cause abnormal contact. Repetitive contact can place stress on the labrum and the cartilage lining the joint.

Athletic activity does not necessarily create the underlying bone shape. Instead, athletes may notice symptoms earlier because their hips are repeatedly exposed to high ranges of motion, force, and rotation. 

How Is Hip Impingement Diagnosed?

Diagnosing FAI requires more than looking at an MRI or X-ray. To ensure an accurate diagnosis and proper treatment, the best hip surgeon in Orange County combines three pieces of information:

1. Symptoms: Where the pain occurs and which activities reproduce it.
2. Physical examination: Hip motion, strength, and provocative tests can help identify whether the joint is the likely source of pain.
3. Imaging: X-rays show the shape of the bones, while MRI can evaluate the labrum and cartilage.

X-rays are particularly useful for assessing the overall structure of the hip. However, an MRI can provide additional information about soft tissues, including labral tears and cartilage damage.

Can Hip Impingement Get Worse If You Ignore It?

Repeated abnormal contact between the femur and acetabulum may injure the labrum and damage the articular cartilage. Over time, those changes can contribute to degenerative disease in the hip. That does not mean every athlete with FAI will develop arthritis or that hip surgery is automatically required. In fact, many people have FAI morphology without symptoms and remain active. However, if an athlete continues experiencing pain, loss of motion, or mechanical symptoms, repeatedly modifying activities to avoid discomfort may not address the underlying structural problem.

The practical takeaway is simple: persistent symptoms deserve a thorough evaluation and treatment before joint damage becomes more advanced.

When Does Hip Impingement Require Surgery?

Surgery is generally considered when an athlete has symptoms that persist despite appropriate nonsurgical treatment and testing shows that FAI is responsible for those symptoms. Initial treatment may include:

• Activity modification
• Anti-inflammatory medication when appropriate
• Physical therapy
• Exercises to improve hip mobility and strength
• Modification of movements that repeatedly provoke symptoms

If pain continues and there is structural impingement with associated labral or cartilage pathology, hip arthroscopy is a great treatment option. During arthroscopy, the best hip impingement surgeon in Orange County can use small incisions and specialized instruments to address the abnormal bone, repair the labrum, and treat other problems inside the joint.

Where to Find the Best Hip Surgeon in Orange County for Athletes

Persistent groin pain should not be accepted as the price of being an athlete. For those in Leucadia, Del Mar, Solana Beach, Cardiff, Carlsbad, Oceanside, Torrey Pines, and throughout North San Diego County and Southern California, Dr. Sanjum Samagh offers a sports-focused approach to orthopedic care. 

Trained in orthopedic sports surgery and sports medicine at Northwestern University, Dr. Samagh is an expert in sports hip arthroscopy and has worked with athletes from the Chicago Cubs, Chicago Blackhawks, and Northwestern football program. He now treats athletes of all levels, including professional and Olympic competitors, at his Encinitas clinic.  

Ready to get an accurate diagnosis for your hip pain from the best hip surgeon in Orange County?