Femoroacetabular Impingement (FAI): Groin Pain in Young Adults
Abnormal contact between the hip joint surfaces, stressing the cartilage and labrum.
Femoroacetabular impingement (FAI) describes abnormal contact between the edge of the socket and the femoral head–neck junction during movement. This repeated contact stresses the cartilage ring around the socket (the labrum) and the joint cartilage. It is a common cause of groin pain in young, active adults.
Symptoms and Types
- Groin pain, particularly after prolonged sitting and on flexing the hip
- Difficulty squatting, getting in and out of a car, and tying shoes
- Sharper pain on rotating the hip inward
- Catching, snapping or locking in some patients
- Reduced performance in athletes, with pain easing as they warm up
Three patterns are described: cam (insufficient concavity at the head–neck junction, common in young men and athletes), pincer (over-coverage by the socket rim) and mixed, which is the most frequent.
Diagnosis and Treatment
Examination reproducing groin pain with hip flexion and internal rotation is the key finding. X-rays show the bony anatomy and MRI demonstrates the labrum and cartilage. A diagnostic intra-articular injection may be used to confirm the source of symptoms.
First-line treatment is non-surgical: activity modification, a programme strengthening the hip and core muscles, and pain management. When symptoms persist despite adequate treatment, or when a labral tear or cartilage damage is present, hip arthroscopy is considered; the bony prominence causing impingement is reshaped and the labrum repaired.
Untreated impingement may accelerate cartilage wear and predispose to early hip osteoarthritis.
If you are young and have groin pain that increases after prolonged sitting, struggle with squatting, or feel catching in the hip, arrange an assessment.
Frequently Asked Questions
Does FAI always require surgery?
No. Patients with mild symptoms who respond to conservative treatment do not need surgery. The decision considers symptom duration, imaging findings and activity level.
Can I return to sport?
Most athletes return to activity after arthroscopic treatment with a staged rehabilitation programme; the timeline depends on the procedure performed and any associated damage.
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