Femoroacetabular impingement (FAI) is a painful hip condition that occurs when there is abnormal contact between the femoral head/neck junction and the rim of the acetabulum (hip socket) during certain movements, especially hip flexion, internal rotation, and adduction (inward motion). While hip problems are often associated with older adults, the vast majority of FAI cases occur in active young and middle-aged individuals.

Essentially, the condition results from bone shapes that disrupt the normal smooth motion of the hip joint. The most common type is called cam morphology, in which the femoral head/neck junction is not perfectly round, creating a bony prominence that interferes with joint motion. Cam morphology accounts for roughly two-thirds to three-quarters of symptomatic FAI cases and is most common in active young men. Another type, pincer morphology, occurs when there is excess coverage of the socket’s rim and is seen more often in active middle-aged women. These morphologies usually develop during puberty, and while they are often symptom-free, they can lead to impingement when the hip is subjected to repetitive, high-force movements such as running, jumping, or kicking—which is why active individuals are more prone to the condition.

Surgical intervention may be considered as an early option, particularly in young athletes with severe, function-limiting symptoms and clear imaging evidence of impingement. However, randomized controlled trials show that while surgery can offer faster symptom relief in the short- to mid-term, the long-term differences compared to structured non-surgical care are small, and surgery carries greater cost and risk. For this reason, clinical guidelines recommend conservative care as the first-line approach, with surgery reserved for cases that do not improve.

Conservative chiropractic management of FAI may include activity modification, anti-inflammatory measures (such as ice, dietary adjustments, or supplements), and rehabilitative strategies like stretching tight hip flexors, strengthening the core and hip extensors, and improving postural control. Chiropractors may also employ modalities such as ultrasound, electrical stimulation, laser therapy, or pulsed magnetic field therapy, along with manual techniques to restore motion in the hip. A comprehensive evaluation also considers the kinetic chain—since altered mechanics in the feet, ankles, knees, or lower back can increase stress on the hip and worsen FAI.

As with most musculoskeletal conditions, early intervention improves outcomes. Addressing FAI promptly not only reduces the risk of joint degeneration but also prevents compensatory movement patterns that can strain other areas of the body and contribute to additional painful conditions.