Can Hip Impingement Be Fixed Without Surgery
When The Pinch In Your Hip Is Positional, Not Anatomical
Hip impingement (femoroacetabular impingement, or FAI) has become one of the most common diagnoses in the training population. You get an MRI, it shows a cam or pincer lesion, and you are told bone is impinging on bone. What the MRI often does not tell you is that the impingement may be positional, not structural.
What Is Hip Impingement
FAI occurs when the femoral head and acetabulum make abnormal contact during movement, typically producing a pinching sensation in the front of the hip during deep flexion. It is diagnosed via imaging that shows cam (bump on the femoral head) or pincer (overgrowth on the acetabular rim) morphology.
Structural vs Positional Impingement
Research consistently shows that cam and pincer morphology exists in 50 to 70 percent of asymptomatic athletes. The presence of bony morphology on an MRI does not mean that morphology is causing your symptoms. Many people with abnormal imaging have no pain, and many people with pain have normal imaging.
What The Research Says About Asymptomatic Cam Lesions
In the Left AIC pattern described by PRI, the left pelvis rotates forward, changing the orientation of the acetabulum. The socket rotates upward and forward, reducing the available space for hip flexion. The femoral head runs into the rim earlier than it should. You feel a pinch. It feels like bone on bone. But it is position on position.
The Quick Test For Positional Impingement
If corrective exercises that reposition the pelvis immediately reduce or eliminate the pinching sensation, the impingement is positional. Structural impingement from true bony abnormality does not change with a five-minute exercise. Positional impingement does. This distinction can save you from unnecessary surgery.
How Pelvic Repositioning Eliminates The Pinch
PRI corrective exercises reposition the pelvis, which changes the orientation of the acetabulum, which restores available space for the femoral head. MOVECHECK tests hip mobility in the context of pelvic position. When restricted hip flexion with a pinching quality is found alongside anterior pelvic tilt, the corrective protocol addresses the positional component first.
See This In Your Own Body
Every concept in this article is tested in the MOVECHECK assessment. Find out which patterns apply to you.
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