Injury Highlight: Hip Impingement in Runners

Hip pain can sneak up on runners after miles of pounding the pavement, especially when they’re pushing mileage or intensity. Sometimes, it starts as a dull ache and becomes a sharp pain with hip flexion, uphill running, or sprinting. If this sounds familiar, hip impingement might be to blame. Also known as femoroacetabular impingement (FAI), hip impingement happens when there’s abnormal contact between the bones of the hip joint during movement.

If left unchecked, hip impingement can interfere with your training and lead to labral tears, a more serious injury that can sideline you for months. By understanding how impingement develops and knowing when to seek treatment, you can reduce your risk of long-term hip problems and keep running pain-free.

What is Hip Impingement?

Hip impingement occurs when the femoral head (the ball of your hip joint) and the acetabulum (the socket) don’t fit together properly. Instead of moving smoothly, the bones bump into each other, irritating the cartilage and labrum. The labrum is a ring of cartilage that helps stabilize your hip and cushions the joint during movement. Over time, the repeated friction from impingement can damage the labrum and cause persistent hip pain.

There are two types of hip impingement:

Cam Impingement: This happens when the femoral head isn’t perfectly round. As you flex your hip—think uphill running or squatting—the uneven shape grinds against the socket, putting stress on the labrum.
Pincer Impingement: This occurs when the hip socket has too much bone coverage, which can trap and pinch the labrum during movement.

Some runners may experience both cam and pincer impingements, which increases their risk of developing labral tears. The only way to know if you have a cam or pincer impingement is through imaging, such as X-rays or an MRI, performed by a running medicine specialist or orthopedic MD.

How Hip Impingement Leads to Labral Tears

Running involves repetitive hip flexion and rotation with every stride. If you have hip impingement, these movements can cause abnormal bone contact, which puts extra stress on the labrum. Over time, this repeated stress can cause the labrum to tear. Once that happens, you may experience sharp hip pain, instability, or even clicking and catching sensations in the joint.

When to See a PT vs. When to Consider Surgery

Hip impingement doesn’t always mean surgery is necessary. In fact, many runners can manage symptoms and return to running pain-free with a solid PT program focused on strengthening the glutes, improving core stability, and working on hip mobility. All good surgeons will suggest PT and perhaps orthobiologics before surgery.

Start with PT: If your pain is mild to moderate and hasn’t significantly limited your running, physical therapy is the first step. Strengthening your glutes and core helps stabilize the pelvis, while mobility drills improve how your hip moves. Be patient—consistent PT can reduce symptoms and improve your running mechanics over time. It is not something that will get better over night- it can take severla months, but it is worth it in the end!
Consider Surgery When: If PT doesn’t lead to improvement after several months, or if imaging shows a significant impingement causing persistent pain, surgery may be needed. Hip arthroscopy, a minimally invasive procedure that reshapes the bone and repairs the labrum, has shown good outcomes for runners. Research shows that 78% of runners return to running within five years after arthroscopy. The key is finding. asurgeon who does a lot of labral repairs and understands runners.

Things You Can Do if you Have Hip Impingement

Strengthen: We know we also talk about strength, but stength is important for all runners no matter what! You can start by working on strengthening your glutes- strong glutes stabilize your pelvis, reducing the load on your hip joint. Include exercises like glute bridges, clamshells, and single-leg deadlifts in your routine.
Work on Core Stability A stable core helps control movement and prevents excessive stress on the hips. Exercises like planks, bird dogs, and Pallof presses are great for building core strength.
Improve Hip Mobility Dynamic warm-ups, such as leg swings and walking lunges, prepare your hips for running. After your run, focus on static stretches like the figure-four stretch and kneeling hip flexor stretch to maintain flexibility.

Need Help with Hip Pain?

The RUNsource app offers hip-strengthening routines, mobility drills, and expert guidance to help runners prevent or recover from hip impingement and labral tears. Whether you’re aiming to stay ahead of injury or come back stronger, the RUNsource app has what you need to keep running pain-free.

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Citations

Brooks AG, Domb BG. Acetabular labral tear and postpartum hip pain. Obstet Gynecol. 2012;120(5):1093-1098. doi:10.1097/AOG.0b013e31826fbcc8.
Chen AW, Craig MJ, Domb BG. Five-year outcomes and return to sport of runners undergoing hip arthroscopy for labral tears with or without femoroacetabular impingement. Am J Sports Med. 2019;47(6):doi:10.1177/0363546519836429.