Can Hip Impingement (FAI) Be Fixed Without Surgery?
Rheannon Reid
If you have been diagnosed with femoroacetabular impingement (FAI), there is a good chance you have already gone down the internet rabbit hole. One article says surgery is inevitable. Another says stretching will fix everything. Then you find someone online saying they had surgery and finally got their life back.
It gets confusing fast, and the truth is more nuanced than most people realize.
Some people with FAI improve significantly with physical therapy, strength training, and better movement habits. Others eventually choose surgery because the hip continues to pinch, lock up, or become painful despite months of rehab.
The important thing to understand is this: exercise cannot remove extra bone growth inside the hip joint, but improving how your body moves, how your hips handle force, and how much stress the joint is under may still reduce pain and improve function for many people.
That is why non-surgical treatment is often recommended before surgery is considered.
If you are dealing with ongoing hip discomfort, it also helps to understand how the hips connect to the pelvis, spine, and lower body as a whole. Our guide on hip pain and movement compensation patterns breaks down how these areas influence each other.
What Is Hip Impingement (FAI)?
Hip impingement happens when the ball and socket of the hip joint do not move together smoothly.
Normally, the hip joint has enough space for the leg to bend, rotate, squat, walk, and move without the bones pinching together. With FAI, the shape of the joint changes in a way that can create extra pressure and compression during movement.
Over time, this may irritate:
- The cartilage inside the joint
- The labrum, which helps stabilize the hip socket
- The surrounding muscles and soft tissue
This can lead to:
- Groin pain
- Pinching in the front of the hip
- Stiffness
- Reduced mobility
- Pain during squatting, running, or sitting
Studies and Dr. Mike’s own data suggest that individuals with hip impingement often exhibit a greater-than-average anterior pelvic tilt, sometimes up to 5 extra degrees, or 33% more than average. (That’s like having an extra 33% tilt on a pair of old shelves - the contents aren’t staying put for long.)
This tilt can place excess strain on the hips and lower back, making realignment and stabilization key parts of the solution as well as prevention.
What Is a CAM Deformity?
A CAM deformity is one of the most common forms of hip impingement.
In simple terms, extra bone develops around the ball at the top of the thigh bone. Instead of being perfectly round, the ball becomes slightly misshapen.
When the hip bends deeply, that extra bone can pinch against the edge of the socket.
Researchers believe CAM deformities often develop during the teenage years while the body is still growing, especially in athletes who repeatedly load the hips through deep bending and twisting movements.
Genetics, activity level, and joint loading likely all play a role.
Once a CAM deformity exists, exercise cannot remove the extra bone growth. Surgery is the only way to physically shave down or reshape the bone itself.
However, that does not automatically mean surgery is necessary for everyone.
Can You Have a CAM Deformity Without Pain?
Yes. Many people have signs of hip impingement visible on X-rays or MRIs without ever developing symptoms. That is important because scans do not always tell the full story.
Two people can have similar hip anatomy while having completely different experiences:
- One person may have severe pain
- Another may continue playing sports with no symptoms at all
Pain often depends on several factors working together, including:
- How the hip moves
- How much stress the joint handles
- Muscle strength
- Hip mobility
- Training volume
- Recovery
- Daily movement habits
This is one reason many doctors and physical therapists recommend trying non-surgical treatment first before jumping into surgery.
If your hips constantly feel stiff or restricted, these hip mobility self-tests you can do at home may help you better understand where movement limitations are showing up.
Common Symptoms of Hip Impingement
FAI symptoms usually develop gradually over time.
Common signs include:
- Sharp pain in the front of the hip or groin
- Pain during deep squats
- Pinching when bringing the knee toward the chest
- Clicking or catching sensations
- Hip stiffness
- Reduced range of motion
- Pain after sitting for long periods
- Pain during sports involving running, twisting, or pivoting
Some people also notice low back pain or compensation patterns while walking and exercising.
If the hips and low back both feel involved, it is common for movement compensation to spread between these regions. Our guide on lower back and hip pain together explains why that happens.
What Makes Hip Impingement Worse?
Hip impingement symptoms are often aggravated by repeated movements that force the hip into compressed positions. Common aggravating activities include:
- Deep squatting through pain
- Aggressive hip stretching
- Repetitive twisting movements
- High-volume sports without adequate recovery
- Sitting for long periods
- Forcing mobility into painful ranges
This does not mean movement is bad. It means the hip usually responds better to controlled strengthening and gradual progressions rather than repeatedly forcing the joint into painful positions.
For example, someone with hip impingement may tolerate:
- Controlled strength training
- Moderate squat depth
- Glute strengthening
- Core work
- Walking
These are far better than aggressive mobility drills or deep loaded positions that repeatedly pinch the front of the hip. Our coaches always tell members that while we want you to challenge your capacity, pushing into pain is counterproductive.
Poor pelvic positioning can also increase stress at the front of the hip. If you tend to stand with an excessive arch in the lower back, our article on anterior pelvic tilt and hip mechanics may help connect some dots.
How Is FAI Diagnosed?
Doctors and physical therapists usually diagnose hip impingement using both movement testing and imaging.
Movement Testing
One common test involves bringing the knee toward the chest and rotating the hip inward. If this recreates pain or pinching in the front of the hip, it may suggest FAI.
A provider may also look at:
- Hip mobility
- Walking mechanics
- Squat patterns
- Pelvic control
- Strength
Imaging
X-rays and MRIs can help identify:
- CAM deformities
- Extra bone growth
- Labral irritation
- Cartilage damage
But again, imaging findings alone do not determine whether someone needs surgery.
Can Exercise Help Hip Impingement?
Exercise may help improve symptoms, movement quality, and strength around the hip. But the goal is not to “unstick” or permanently reshape the joint.
The goal is to improve how the body handles movement and force.
For many people, that means:
- Building stronger glutes
- Improving core control
- Reducing excessive stress on the front of the hip
- Improving hip stability
- Gradually increasing movement tolerance
A good rehab program should challenge the body without constantly reproducing sharp pinching pain.
Weak glutes are often part of the picture when the hips lose stability during walking, squatting, or single-leg movement. Here’s a deeper look at how weak glute muscles can affect hip mechanics.
Exercises That Help Hip Impingement
The best exercises depend on your anatomy, symptoms, and current pain level. Some people tolerate certain movements well, while others need modifications.
These are commonly used starting points because they focus more on control and strength than aggressive stretching.
Pelvic Tilt with Deep Core Engagement
This helps improve pelvic control and awareness.
- Lie on your back with knees bent.
- Flatten your lower back against the floor by engaging your core and tilting your pelvis slightly upward.
- Hold for 5 seconds, then release. Repeat 10–15 times.
Glute Bridge with External Rotation
Exercises targeting the side glutes can help improve hip stability during walking, running, and single-leg movements.
- Lie on your back with feet hip-width apart.
- Push through your heels to lift your hips while squeezing your glutes.
- At the top, press your knees outward slightly to activate the glute max. A resistance band placed just above your knees will provide greater challenge. Lower and repeat for 3 sets of 10.
Hip Flexor Stretch
Tight hip flexors may contribute to poor pelvic positioning and excessive pressure at the front of the hip. Gentle mobility work may help, especially when combined with strengthening and core control.
- Kneel on one leg with the other foot forward in a lunge position.
- Tuck your pelvis under and shift your weight slightly forward until you feel a stretch in the hip flexor. Reach overhead and tilt your torso slightly away from the back leg to increase the stretch. Remember to breathe.
- Hold for 20–30 seconds per side. Repeat 2–3 times.
- 90/90 Hip Switches
90/90 Hip Switches
Gentle hip rotation exercises may help improve movement tolerance without forcing the joint into painful ranges. The goal is smooth, controlled motion.
- Sit on the floor with knees bent at 90 degrees, one leg in front and one behind. The back leg will be internally rotated and the front will be externally rotated.
- Rotate on your hips and swivel the knees over to switch sides, keeping your spine tall and chest lifted.
- Perform 10–12 slow, controlled repetitions.
Clamshells with Resistance Band
- Lie on your side with heels aligned with your hips and head with your knees bent and a resistance band around your thighs.
- Keep your heels together as you raise your top knee like you’re opening a book, engaging the glute medius.
- Lower with control and repeat for 3 sets of 12–15 reps per side.
When Is Surgery Necessary for FAI?
Surgery may be considered when:
- Pain remains significant despite rehab
- Daily function continues declining
- The hip repeatedly locks, catches, or pinches
- Imaging shows substantial joint damage
- Sports and normal activity remain limited after months of treatment
Hip arthroscopy is the most common surgery for FAI. During the procedure, the surgeon reshapes the bone and may repair damaged tissue inside the joint.
For some people, surgery works very well. For others, symptoms improve only partially or not at all, especially if joint damage is already advanced or movement habits never change afterward.
That is why we encourage our members to do all they can to improve their bodies before resorting to surgery and why rehabilitation matters, whether surgery happens or not.
So, Can Hip Impingement Be Fixed Without Surgery?
Sometimes yes. Sometimes no.
If the question is: “Can exercise remove a CAM deformity?” The answer is no.
If the question is: “Can non-surgical treatment reduce pain and improve function enough to avoid surgery?” For many people, yes.
The best approach usually involves understanding your anatomy, improving how your body moves, strengthening the hips and core, and finding the right balance between activity and recovery.