Hip impingement can cause groin pain, hip pinching, stiffness, clicking, catching, and pain with sitting, squatting, twisting, or pivoting.
Dr. Siefferman explains hip impingement, how it can cause hip and groin pain, and personalized treatment options to restore mobility and improve function.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. Hip impingement refers to the labrum of the hip getting caught between the bone of the joint. If we look at a hip where there’s the ball and the socket, the labrum is a cartilage ring that runs circumferentially, almost like a gasket on the joint. When the hip comes into this position, if there’s an extra bit of bone here on the femoral head or an extra bit of bone here on the acetabulum, the labrum can get caught in between. It gets pinched and that’s why we call it impingement.
Typically, this happens when the hip is flexed and internally rotated, and we will find this on exam. When we see this on exam, we want to do some imaging, usually X-ray and MRI, because we want to know if there’s actual cartilage erosion or not. We want to know if there’s actually bony impingement or just a labral tear because how we approach treatment varies greatly. If you’re having hip impingement, we will work it up, we will guide you on treatment, and discuss all the options.
Hip impingement, also called femoroacetabular impingement or FAI, occurs when the ball and socket of the hip do not move smoothly together. This can create painful pinching or abnormal contact inside the joint, especially during deep hip flexion, squatting, twisting, pivoting, sports, stairs, or prolonged sitting.
Symptoms often include groin pain, hip stiffness, clicking, catching, or reduced range of motion. FAI can contribute to labral tears or cartilage irritation over time, but hip pain should not be assumed to come from impingement based on imaging alone. The pain generator may also involve a labral tear, tendon pain, sacroiliac referral, spine referral, pelvic pain, or hypermobility-related instability.
At Manhattan Pain Medicine, evaluation begins by determining whether hip impingement is truly the source of pain or whether another condition is contributing.
For patients looking for hip impingement treatment in Manhattan, MPM evaluates groin pain, hip pinching, range of motion, clicking, catching, stiffness, gait, hip strength, pelvic mechanics, imaging findings, labral pathology, sacroiliac joint referral, spine referral, tendon pain, and hypermobility.
Care may include diagnostic ultrasound, ultrasound-guided injections, steroid injections, medication management, PRP, BMAC, prolotherapy, regenerative medicine, and orthopedic referral when structural correction or arthroscopy may be appropriate.
Many patients are told they have hip impingement after an X-ray or MRI shows cam, pincer, or mixed FAI anatomy. Imaging can be helpful, but it does not always prove that impingement is the main pain generator. Some people have hip shape changes without significant symptoms. Others have groin pain or pinching that comes from a labral tear, tendon irritation, hip arthritis, sacroiliac joint dysfunction, lumbar radiculopathy, pelvic floor tension, or hypermobility-related instability.
MPM’s diagnosis-first approach asks a more precise question: is the pain actually coming from the hip joint? In selected cases, diagnostic injections may help clarify whether the hip joint is the pain source. Hip joint injection with anesthetic and corticosteroid can provide pain relief and diagnostic information in patients with FAI symptoms that do not respond to initial care.
Hip impingement fits within MPM’s Musculoskeletal issues Zone of Expertise, with important overlap in Hypermobility when joint laxity, instability, labral stress, or compensatory muscle guarding are present. This matters because hip pain is not always isolated to the hip joint. A patient may have FAI anatomy, but the pain may also involve pelvic mechanics, sacroiliac joint dysfunction, spine referral, muscle guarding, tendon irritation, or hypermobility-related instability.
MPM uses the Zones of Expertise framework to evaluate whether symptoms appear joint-based, labral, tendon-related, nerve-related, pelvic, instability-related, or referred from the spine. This helps guide whether the next step should be rehabilitation, injection, diagnostic ultrasound, regenerative discussion, orthopedic referral, or broader coordinated care.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
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This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
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Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
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Dr. Siefferman is a genius. He is very informed and listens attentively.
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Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
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Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
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Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
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Hip impingement, also called femoroacetabular impingement or FAI, occurs when the femoral head and hip socket do not move smoothly together. This can create abnormal contact inside the joint, especially with positions that bring the hip into deep flexion or rotation. Patients may feel pinching, stiffness, groin pain, or reduced range of motion. FAI may be cam type, pincer type, or mixed. Over time, restricted motion and abnormal contact may contribute to labral or cartilage irritation in some patients.
Hip impingement often causes pain in the groin, although some patients feel pain on the outside of the hip, buttock, thigh, or low back. Symptoms may include hip pinching, stiffness, clicking, catching, locking, limping, or sharp pain with turning, twisting, squatting, pivoting, sitting, stairs, or sports. AAOS notes that FAI pain often occurs in the groin and may become sharp or stabbing with turning, twisting, or squatting. Symptoms should be evaluated because similar pain can also come from labral tears, tendons, SI joint dysfunction, pelvic pain, or spine referral.
No. Hip impingement and a labral tear are related but not the same. Hip impingement refers to abnormal contact between the ball and socket of the hip. A labral tear involves injury to the ring of cartilage that helps stabilize and cushion the hip socket. FAI can contribute to labral tears, and Cleveland Clinic describes FAI as the most common cause of hip labral tears. However, a patient can have FAI without a symptomatic labral tear, or a labral tear with other pain drivers.
Hip impingement is evaluated through medical history, physical examination, hip range-of-motion testing, impingement maneuvers, gait assessment, imaging review, and sometimes diagnostic injections. X-rays may show cam or pincer anatomy. MRI may help evaluate the labrum, cartilage, or other soft tissue structures. Diagnostic ultrasound may be useful for evaluating nearby soft tissue or guiding injections, but it does not replace all imaging. In selected cases, a hip injection with anesthetic may help determine whether pain is coming from inside the hip joint.
Some patients with hip impingement can manage symptoms without surgery through activity modification, physical therapy, movement retraining, medication management, and selected injections. Conservative care may focus on reducing painful hip positions, improving strength and control, and addressing pelvic or spine mechanics. However, structural impingement may continue to cause symptoms in some patients, especially when mechanical catching, labral pathology, cartilage damage, or severe functional limitation persists. In those cases, orthopedic referral may be appropriate. The goal is to determine which pathway fits the patient’s anatomy, symptoms, and goals.
Steroid injections may help selected patients with hip impingement by reducing inflammation and providing short-term pain relief. They may also provide diagnostic information when clinicians need to know whether pain is coming from inside the hip joint. HSS notes that an injection of anesthetic and corticosteroid into the hip joint may provide pain relief and additional diagnostic information. A steroid injection is not a structural correction for FAI, and it should be considered in the context of imaging, exam findings, medical risks, and the broader care plan.
PRP, BMAC, and prolotherapy may be discussed for selected hip pain patterns after diagnosis, anatomy, imaging findings, severity, risks, and goals are reviewed. These regenerative options should not be presented as guaranteed treatments for hip impingement, labral tears, or cartilage damage. They do not replace structural correction when surgery is medically indicated. MPM considers these options only when the clinical picture supports them, such as selected soft tissue, ligament, joint, or chronic musculoskeletal pain patterns. The decision should be individualized and based on careful evaluation.
A hip surgeon may be appropriate when symptoms persist despite appropriate nonsurgical care, when mechanical catching or locking is significant, when imaging shows labral or cartilage damage that matches symptoms, when hip function is severely limited, or when structural impingement may require correction. Surgical evaluation may also be needed for progressive arthritis, severe instability, trauma, suspected fracture, or inability to bear weight. MPM can help evaluate nonsurgical options and coordinate orthopedic referral when the findings suggest that surgery or arthroscopy should be considered.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Hip impingement, also called femoroacetabular impingement or FAI, occurs when the ball and socket of the hip do not move smoothly together. The femoral head may have extra bone shape, the socket may provide extra coverage, or both may be present. These patterns are often called cam, pincer, or mixed impingement.
When the hip moves into certain positions, especially deep flexion or rotation, the femoral head and acetabulum can make abnormal contact. This may cause groin pain, hip pinching, stiffness, reduced range of motion, clicking, catching, or pain during sitting, squatting, twisting, pivoting, stairs, or sports.
The labrum is a ring of cartilage around the hip socket that helps cushion and stabilize the joint. Hip impingement can place stress on the labrum and cartilage over time.
That relationship matters, but it should not be oversimplified. A labral tear may appear on imaging but may not be the only pain source. A patient may also have tendon pain, hip flexor irritation, sacroiliac joint dysfunction, lumbar referral, pelvic floor tension, muscle guarding, arthritis, hypermobility, or peripheral nerve irritation. Diagnosis-first care helps determine which finding is clinically meaningful.
X-rays, MRI, and other imaging can help identify FAI anatomy, labral tears, cartilage injury, arthritis, or other structural concerns. However, imaging findings must be interpreted with the patient’s symptoms and exam. Some patients have FAI anatomy without pain. Others have groin pain from something outside the hip joint.
MPM evaluates the full pattern. This includes where pain is located, what movements trigger it, whether the hip catches or locks, how long symptoms have been present, what activities are limited, and whether prior physical therapy, injections, medications, or rest have helped. The exam may assess hip range of motion, strength, gait, impingement signs, pelvic mechanics, spine referral, and sacroiliac joint contribution.
Hypermobility can make hip symptoms more complex. Patients with EDS or hypermobility spectrum disorder may have increased joint laxity, instability, muscle guarding, and altered load transfer. In these patients, hip pain may involve both impingement-like symptoms and instability-related stress.
Pelvic mechanics can also affect the hip. Anterior pelvic tilt, sacroiliac joint dysfunction, pelvic floor tension, and lumbar spine referral can all change how the hip feels during sitting, squatting, walking, or rotation. MPM evaluates these overlapping contributors so treatment is not focused only on the hip joint if the pain pattern is broader.
Treatment depends on the diagnosis. Some patients begin with activity modification, physical therapy coordination, strengthening, movement retraining, and medication management. Therapy may focus on avoiding provocative positions, improving hip and core control, addressing pelvic mechanics, and gradually returning to activity.
In selected cases, an ultrasound-guided or image-guided hip injection may be considered. A corticosteroid injection may help reduce inflammation and provide temporary pain relief. A diagnostic anesthetic injection may help determine whether pain is coming from inside the hip joint. HSS notes that hip joint injection with anesthetic and corticosteroid can provide pain relief and diagnostic information in patients whose FAI symptoms do not respond to initial care.
Some patients ask about PRP, BMAC, prolotherapy, or regenerative medicine for hip impingement or labral tear pain. These options may be considered only after careful review of diagnosis, anatomy, imaging, severity, goals, risks, and evidence. They should not be described as guaranteed cartilage repair, labral healing, arthritis reversal, or a substitute for surgery when structural correction is medically indicated.
MPM uses regenerative discussions carefully. The question is not whether a treatment exists, but whether it matches the pain generator and the patient’s goals.
Some cases of hip impingement require orthopedic evaluation. Surgery may be considered when mechanical symptoms, labral tears, cartilage damage, or structural impingement continue to cause pain and functional limitation despite appropriate nonsurgical care.
MPM does not frame surgery as failure. For selected patients, hip arthroscopy or other orthopedic care may be the appropriate next step.
Hip pain should be evaluated when it persists, worsens, limits walking or activity, causes catching or locking, follows trauma, or is associated with weakness, numbness, fever, severe night pain, unexplained weight loss, inability to bear weight, or rapidly worsening function. Hip pain can overlap with labral tears, hip arthritis, stress fracture, tendon injury, bursitis, sacroiliac dysfunction, lumbar radiculopathy, pelvic pain, infection, inflammatory arthritis, or vascular causes.
MPM approaches hip impingement through a diagnosis-first, coordinated model. The evaluation considers FAI anatomy, labral tears, cartilage injury, tendon pain, sacroiliac referral, spine referral, pelvic mechanics, hypermobility-related instability, muscle guarding, and chronic musculoskeletal pain contributors.
For patients looking for hip impingement treatment in Manhattan, MPM offers a careful, nonsurgical pain medicine perspective that can work alongside physical therapy, orthopedics, sports medicine, pelvic pain care, and rehabilitation. The goal is to identify the true pain source, clarify whether the hip joint is the main driver, and build a treatment plan that matches the patient’s anatomy, symptoms, risks, and goals.
