Hip Impingement & Labral Pathology at Foot Foundation
Hip impingement (femoroacetabular impingement, FAI) happens when the hip joint bones make abnormal contact, restricting movement and causing pain. Over time, this can also damage the labrum, the cartilage ring that stabilises the hip socket. Patients often feel pain deep in the groin or outer hip, with stiffness, catching, or clicking during activity.
While the structural issue is at the hip, the way the feet and legs move often influences symptoms. Flat feet, excessive pronation, or leg length differences can alter pelvic tilt, increasing stress on the hip joint and worsening impingement or labral strain.
At Foot Foundation, we address these biomechanical factors with orthotics, footwear optimisation, and gait retraining to reduce joint stress and protect long-term hip function.
What is Hip Impingement &
Labral Pathology?
Hip impingement (femoroacetabular impingement, FAI) occurs when the bones of the hip joint are shaped in a way that causes abnormal contact between the femur and the acetabulum (hip socket). This leads to restricted movement, pain, and sometimes tearing of the labrum (the cartilage ring around the socket that stabilises the joint).
While the structural changes occur at the hip, symptoms are often influenced by the way the feet and legs move. Flat feet, excessive pronation, or leg length differences can alter pelvic tilt and hip loading, worsening impingement symptoms and labral strain.
At Foot Foundation, we address these foot-driven mechanics with orthotics, footwear optimisation, and gait retraining, reducing stress on the hip joint and supporting long-term function.
Causes & Risk Factors
Structural bone changes – cam (extra bone on femoral head) or pincer (extra bone on hip socket) impingement
Excessive pronation or flat feet – increasing pelvic tilt and rotational hip stress
Leg length discrepancy – uneven hip loading over time
High arches (cavus feet) – poor shock absorption transmitting higher loads to the hip
Repetitive hip flexion sports – football, hockey, netball, dance, martial arts
Previous injuries – hip, pelvis, or lower limb trauma
Genetics – some people are predisposed to abnormal bone shapes
Treatment at Foot Foundation
Foot & Biomechanical Correction
Custom orthotics – reduce pronation, improve alignment, and reduce hip stress
Heel lifts – for leg length discrepancies causing pelvic tilt
Footwear advice – supportive, cushioned shoes to improve shock absorption
Load & Activity Management
Modifying training to reduce repetitive deep hip flexion movements
Avoiding positions that aggravate impingement (e.g., deep squats)
Rehabilitation
Referral to physiotherapy for:
Hip and core strengthening
Gluteal activation for pelvic stability
Controlled mobility work to restore safe hip movement
Adjunct Therapies
Shockwave therapy may help with associated soft tissue pain
Manual therapy – soft tissue release for surrounding muscles
Surgical referral – for persistent impingement or significant labral tears requiring arthroscopy
Symptoms
Pain deep in the groin or outer hip during activity
Stiffness or reduced range of motion in the hip
Clicking, catching, or locking sensations (labral tear)
Pain worsens with squatting, twisting, or prolonged sitting
Referred pain into the thigh, buttock, or knee
Weakness or instability in advanced cases
Diagnosis
At Foot Foundation, diagnosis includes:
Comprehensive biomechanical assessment – foot posture, leg alignment, and gait analysis
Functional testing – squats, single-leg stance, hip impingement tests (FADIR)
Differential diagnosis – excluding bursitis, groin strain, or lumbar spine referral
Referral for imaging – MRI (to detect labral tears) or X-ray (to confirm cam/pincer morphology)
Hip Impingement &
Labral Pathology – FAQs
Yes. Flat feet or excessive pronation can rotate the leg inward, altering hip joint mechanics and worsening impingement.
Orthotics improve alignment, reducing abnormal rotational stress at the hip joint and improving pelvic balance.
Minor tears may settle with conservative care, but significant tears often persist and may require surgery.
No. Impingement is abnormal contact of bone leading to labral/cartilage damage, while arthritis is progressive joint degeneration.
Shockwave may help with secondary soft tissue pain, but the primary management is biomechanics and rehab.
Yes. Podiatrists treat the foot mechanics that drive hip stress, often a key factor in hip impingement symptoms.
If hip pain is persistent, aggravated by walking, or worsens by activity despite rest, podiatry assessment is recommended.
Why Choose Foot Foundation?
At Foot Foundation, we approach hip impingement and labral pathology from the ground up. By correcting foot mechanics, footwear, and gait, we reduce abnormal stress on the hip and support long-term joint health.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert hip and lower limb care is available across New Zealand.
