Femoroacetabular Impingement, Mississauga

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Femoroacetabular impingement (FAI) is a condition that affects the hip joint and can often lead to hip pain during certain movements or physical activities. The term impingement refers to a situation where soft tissues within the joint become pinched or compressed during movement. In this case, the pinching occurs where the femur, or thigh bone, meets the acetabulum, which is the socket of the hip joint.

When the structures of the hip do not fit together perfectly, abnormal contact may occur during movement. Over time, this repeated contact can irritate surrounding tissues and damage the joint.

Anatomy

The hip joint is formed where the round head of the femur fits into the acetabulum of the pelvis. This ball-and-socket structure allows the hip to move smoothly while supporting body weight and daily activities.

In femoroacetabular impingement, structural differences within the hip cause abnormal contact between the femur and the acetabulum. Two main types of impingement have been identified.

The first type is known as cam-type impingement. In this condition, the femoral head is not perfectly round. Instead, it may have an irregular shape sometimes described as a “pistol grip” deformity. Because of this altered shape, the femoral head does not move smoothly within the socket.

This abnormal movement can create a shearing force against the labrum and the articular cartilage. The labrum is a ring of fibrocartilage that surrounds the acetabulum and helps deepen the socket to stabilize the hip joint. Articular cartilage covers the surfaces of the joint and allows the bones to glide smoothly against each other.

Cam-type impingement often occurs independently but may sometimes be associated with other hip conditions such as Legg-Calvé-Perthes disease or slipped capital femoral epiphysis (SCFE). It tends to affect men more frequently than women.

The second type is called pincer-type impingement. In this situation, the acetabulum covers too much of the femoral head. As the hip moves, the labrum becomes compressed between the femoral neck and the edge of the socket.

Pincer-type impingement is more commonly observed in women and may develop due to structural conditions such as hip dysplasia, previous corrective surgery for hip dysplasia, or an abnormal orientation of the acetabulum known as retroversion.

Causes

For many years, the causes of femoroacetabular impingement were debated. Advances in medical imaging have shown that subtle variations in the shape of the femoral head or the orientation of the hip socket can contribute to the condition.

Normally, the femoral head moves smoothly within the socket. In individuals with FAI, structural differences cause the femur to press against the rim of cartilage surrounding the acetabulum. This repeated contact may pinch the labrum and surrounding cartilage.

In some cases, the acetabulum may be deeper than normal. The rim of cartilage may extend further over the femoral head than it should. When the hip bends or rotates inward, the labrum becomes trapped between the bones.

Over time, this repetitive pinching can cause fraying or tearing of the labrum. Degenerative changes may also occur in the articular cartilage at the site of impingement.

Changes in hip structure can also influence normal movement patterns. Individuals with FAI may develop altered hip mechanics such as excessive adduction or internal rotation. Muscle imbalances may further contribute to the problem.

Weakness in muscles responsible for hip stability, including the hip abductors, extensors, and external rotators, can increase abnormal stress within the joint. When these structural and muscular factors combine with repetitive movements, small injuries may accumulate within the hip.

In more severe cases, the labrum may partially tear or detach from the acetabular rim. A complete separation is referred to as a labral avulsion.

Symptoms

The most common symptom of femoroacetabular impingement is deep pain in the groin area. This discomfort is often triggered by activities that place stress on the hip joint.

Prolonged walking or standing may increase the pain. Although structural changes may occur in both hips, symptoms are frequently felt on only one side.

Some individuals notice discomfort after sitting for long periods and then standing up. A mild limp may develop as a result of pain or limited range of motion.

When impingement leads to a labral tear, additional symptoms may appear. Patients may experience clicking, locking, or catching sensations within the hip joint during movement.

Activities that involve pivoting or rotating the leg can also trigger pain. In some cases, a positive Trendelenburg sign may be observed, where the pelvis drops on one side when standing on the opposite leg.

If the condition progresses, other complications may develop. Hip bursitis may occur due to irritation of surrounding tissues. Muscles in the buttock region may become sore or fatigued as they attempt to compensate for abnormal joint movement.

Pain may eventually become constant and severe enough to limit sports participation and other recreational activities.

Diagnosis

Diagnosis usually begins with a detailed medical history and physical examination. The physician evaluates hip mobility, posture, and areas of tenderness around the joint.

During the examination, specific movement tests may be used to reproduce symptoms. One commonly used test involves bending the hip, rotating it inward, and bringing the knee toward the opposite leg. This position places the hip in a way that may reproduce the impingement pain.

Imaging studies are then used to confirm the diagnosis and evaluate the structure of the hip joint.

X-rays are often the first imaging test performed. They help reveal bone alignment, the presence of excess bone growth, and the shape of the femoral head. Certain radiographic signs may indicate abnormal orientation of the acetabulum.

Magnetic resonance imaging (MRI) can show damage to the labrum and surrounding soft tissues. MRI may also reveal swelling beneath the bone, which may require further investigation.

A specialized form of MRI known as magnetic resonance arthrography (MRA) involves injecting contrast dye into the joint to provide clearer images of the joint surfaces and labrum.

Computed tomography (CT) scans can provide detailed images of bone structure and may be used when surgical planning is required.

Treatment

Treatment depends on the severity of symptoms and the degree of structural changes within the hip joint. Some individuals respond well to conservative management, while others may eventually require surgical intervention.

Early diagnosis can be helpful because correcting the structural problem sooner may prevent further joint damage.

Nonsurgical Treatment

Conservative care often begins with physical therapy and activity modification. Avoiding movements that provoke symptoms, such as pivoting on the affected leg, may reduce irritation within the joint.

Physical therapy typically involves a detailed assessment of joint motion, muscle strength, posture, and movement patterns. Treatment programs are tailored to each individual.

Exercises may focus on strengthening the muscles that support hip stability, improving neuromuscular control, and correcting posture or alignment issues.

Stretching programs may also be used to lengthen tight muscles surrounding the hip. Although stretching does not change the shape of the bones, it may reduce contact between structures during movement and decrease impingement.

Some individuals may benefit from injections that combine a numbing medication with an anti-inflammatory agent. These injections may help reduce inflammation and provide temporary symptom relief.

Physical therapy before surgery can also be beneficial for individuals who eventually require surgical treatment. Strengthening muscles and correcting movement patterns can improve surgical outcomes.

Rehabilitation

The goal of conservative rehabilitation is to reduce pain and improve hip function by addressing muscle imbalances and movement patterns.

When muscle strength becomes balanced between both legs, many individuals can return to daily activities and recreational exercise without significant discomfort.

Younger or more active individuals may gradually resume sports participation once symptoms improve and hip function is restored.

Older adults with labral tears related to impingement may regain the ability to perform daily activities comfortably. However, they may still need to limit prolonged sitting, standing, or repetitive hip movements.

Our Osteopathic services

Our osteopathy services in Mississauga focuses on hands on care to restore movement, reduce pain, and improve physical function. Each session includes a full assessment of posture, mobility, and injury history to guide precise treatment. Care targets joint restriction, muscle tension, and circulation limits to support faster recovery and daily comfort. Services support injury recovery, chronic pain relief, postural correction, and long term physical balance.

About City Of Mississauga Ontario

Mississauga, Ontario, is a thriving city located along the shores of Lake Ontario, just west of Toronto. As one of Canada’s largest and fastest-growing cities, it is home to a diverse and multicultural population. With Pearson International Airport, the country’s busiest airport, and major corporate headquarters, Mississauga has established itself as a key business and economic hub in Canada. The city’s modern skyline, featuring high-rise condominiums and commercial developments, is complemented by green spaces, waterfront parks, and vibrant cultural attractions.

One of Mississauga’s most notable landmarks is Square One Shopping Centre, one of the largest malls in Canada, attracting millions of visitors each year. The downtown core is rapidly evolving, with new residential and commercial projects reshaping the city’s landscape. Meanwhile, neighborhoods like Port Credit offer a charming, lakefront lifestyle with boutique shops, cafes, and marinas, making it a popular destination for both residents and tourists. Historic Streetsville, with its small-town charm, provides a glimpse into Mississauga’s past while offering modern amenities.

Mississauga is also a city committed to education and innovation, with top-rated schools, colleges, and easy access to leading universities in the Greater Toronto Area. The city’s public transit system is expanding, with new LRT and GO Transit projects aiming to enhance connectivity and reduce congestion. With a strong focus on community development and sustainability, Mississauga continues to improve its infrastructure, recreational spaces, and public services to meet the needs of its growing population.

Beyond its economic success, Mississauga is a welcoming and family-friendly city with a strong sense of community. The city hosts numerous cultural festivals, outdoor events, and recreational activities, celebrating its diverse population. Whether enjoying waterfront trails in Lakeview, exploring Erin Mills and Meadowvale’s parks, or experiencing arts and performances at the Living Arts Centre, Mississauga offers something for everyone. With its blend of urban convenience and suburban comfort, it remains a top choice for those looking to live, work, and thrive in a dynamic and inclusive environment.

Major Street Intersections

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Postal Codes

Central Mississauga

L4Z,
L5B,
L5C

North Mississauga

West Mississauga

East Mississauga

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Square One Shopping Centre

Heartland Town Centre

Toronto Pearson International Airport

References

American Academy of Orthopaedic Surgeons – Femoroacetabular Impingement https://orthoinfo.aaos.org/en/diseases–conditions/femoroacetabular-impingement/

Cleveland Clinic – Hip Impingement (Femoroacetabular Impingement) https://my.clevelandclinic.org/health/diseases/hip-impingement-femoroacetabular-impingement

Physio-Pedia – Femoroacetabular Impingement https://www.physio-pedia.com/Femoroacetabular_Impingement

StatPearls – Femoroacetabular Impingement https://www.ncbi.nlm.nih.gov/books/NBK547699/

The Radiology Assistant – Femoroacetabular Impingement Syndrome https://radiologyassistant.nl/musculoskeletal/hip/femoroacetabular-impingement-syndrome

Cleveland Clinic. (n.d.). Osteopathic manipulation treatment (OMT). https://my.clevelandclinic.org/health/treatments/9095-omt-osteopathic-manipulation-treatment

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