Could your hip pain be FAI?

Are you getting hip or groin pain when squatting or twisting during your workouts? It could be hip impingement, also known as femoroacetabular impingement (FAI) – particularly common among active individuals. Here, DR BENJAMIN ANG from Activ Orthopaedic Centre shares his insights on the condition.

What exactly is femoroacetabular impingement (FAI)?

Femoroacetabular impingement is a medical condition where, as the name implies, there is impingement between the femoral head (ball) and the acetabulum (socket) of the hip joint. This results in labral tears and cartilage damage, which may result in groin or hip pain, ache and discomfort.

What causes femoroacetabular impingement, and is anyone at a higher risk of getting it than others?

FAI is most commonly caused by abnormal bone at the femoral head-neck junction (cam deformity) and/or the acetabulum (pincer deformity). These are multifactorial and may be the result of genetic predisposition, athletic activities or other developmental issues during adolescence. Young adults who are active in sports are at increased risk of FAI. Genetic factors also play a role, so those with a family history of hip problems may have a higher risk.

What symptoms should people look out for, and when should they see a doctor or orthopaedic specialist?

Early on, FAI may be asymptomatic. With persistent impingement, labral tears and/or cartilage damage may result in groin or hip pain. Groin or hip pain, ache and discomfort are the most common presenting symptoms of FAI. These symptoms may be exacerbated by certain activities such as squatting or in certain positions. Occasionally, the pain may be along the side of the hip or even at the buttocks. These symptoms may start off as mild and are easily ignored. However, if the symptoms are persistent, it would be prudent to see an orthopaedic surgeon for assessment.

What are the treatment options for femoroacetabular impingement, and when is surgery necessary?

Conservative treatment with physiotherapy, medication and activity modification is the first-line treatment. Various injections may also provide some temporary relief. These options are good for mild cases of FAI or labral tears, as they aim to control the symptoms without addressing the underlying cause.

In more severe cases, conservative management may not be as effective and addressing the root cause would be recommended. When these less invasive methods fail, hip arthroscopy (keyhole surgery) may be performed to repair the torn labrum and to remove the offending bone which causes the impingement. Hip arthroscopy is a highly specialised procedure with a steep learning curve, thus fewer surgeons are trained to perform it.

What happens if femoroacetabular impingement is left untreated?

If untreated, FAI will lead to further labral tears or degeneration and cartilage damage. This results in worsening hip pain and discomfort. Ultimately, due to the persistent impingement, the progression to osteoarthritis will be accelerated and end-stage osteoarthritis may occur at an earlier age, which may necessitate a total hip replacement in the future. Early treatment is recommended to address the impingement and to reduce the rate of progression to osteoarthritis.

About the doctor

Dr Benjamin Ang is a senior consultant orthopaedic surgeon at Activ Orthopaedic Centre. He previously led the Hip Preservation Service at Singapore General Hospital.

Activ Orthopaedic Centre
• #03-19 Gleneagles Medical Centre, 6 Napier Road | 6298 2713
• #17-09 Mount Elizabeth Medical Centre, 3 Mount Elizabeth | 6734 9394
appointments@activortho.sg | activortho.sg

This article on femoroacetabular impingement (FAI), hip pain and Activ Orthopaedic Centre first appeared in the May 2026 issue of Expat Living magazine. You can buy the latest mag or an annual subscription, or read the digital version for free now.

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