What We Treat · Koh Samui
Hip Impingement (FAI) Treatment in Koh Samui
A pinching pain at the front of the hip when you squat, sit low or bring your knee to your chest is the signature of hip impingement. At Body Tune Up we find out why your hip is pinching — which is very often about how the joint is being controlled, not just how it is shaped — then treat the cause so you can move deep again without bracing for it.
Hip impingement (femoroacetabular impingement, or FAI) is a pinching of tissue at the front of the hip when the thigh bone and hip socket come into contact too early in the movement. It commonly affects people who squat, lift, dance, practise yoga or play field sports. Our job is to work out how much of your pinch is about bone shape and how much is about joint position and muscle control — because the second part is very treatable.
Bone shapes associated with impingement show up on scans of plenty of pain-free hips. The pinch you feel is usually the combination of shape plus position plus control — and two of those three can change.
Book an assessmentThe basics
What is hip impingement?
Early, painful contact between the ball of the hip and the rim of its socket, typically felt as a pinch at the front or deep in the groin.
The hip is a deep ball-and-socket joint. In some hips, extra bone on the ball (“cam”), the socket (“pincer”) or both reduces the clearance available during deep flexion and rotation. But whether that shape actually pinches depends heavily on how the pelvis is positioned and how well the ball stays centred in the socket as you move.
When the deep hip stabilisers aren’t controlling the joint, the ball glides forward in the socket during flexion instead of staying centred — using up the clearance and creating a pinch that a well-controlled hip with the same anatomy wouldn’t feel. Over time, repeated pinching can irritate the labrum, the cartilage rim of the socket.
Signs & symptoms
How hip impingement feels
The pattern is quite specific. You may have some of these, not all.
Groin pinch in deep flexion
A sharp pinching at the front of the hip or deep in the groin when squatting low, lunging, or pulling the knee toward the chest.
The “C-sign”
Many people describe the pain by cupping a hand around the side of the hip from front to back — a classic sign of joint-driven hip pain.
Pain with sitting
Aching or pinching during long sitting, especially in low seats or cars, often eased by standing and moving.
Stiffness with rotation
Reduced or uncomfortable internal rotation of the hip — noticeable in yoga poses, martial arts kicks, or simply crossing the legs.
Root cause
Why it happens — the real cause
Impingement is a clearance problem, and clearance is only partly about bone. The rest is about pelvic position and joint control — which is where most untreated potential lies.
When the pelvis is held in an anteriorly tilted position — common with overactive hip flexors and back extensors and under-active glutes and deep core — the socket is effectively rotated forward, and the hip runs out of room earlier in every squat and step. When the deep stabilisers (like the deep gluteals) aren’t centring the ball in the socket, it translates forward during flexion, pinching the front of the joint. Add training that repeatedly loads deep flexion without addressing either factor, and the front of the hip gets irritated on a schedule.
This is why simply stretching the hip flexors or forcing deeper squats usually backfires. The joint doesn’t need more range forced through a pinch — it needs the position and control that make its existing range available.
Our approach
How we treat hip impingement at Body Tune Up
Assessment first, hands-on treatment second, corrective movement to make it last.
We begin with a Functional Movement Assessment of the pelvis, hip, spine and how you actually squat and hinge. Using NeuroKinetic Therapy (NKT®) we identify the muscle imbalances tilting your pelvis and letting the joint drift — typically overworking hip flexors and back extensors paired with inhibited glutes and deep core — then re-balance that relationship so the ball stays centred and the clearance you own becomes usable.
Hands-on treatment focuses on position, centring and irritated tissue, and may include:
Hip flexor & capsule work
Releasing the gripping muscles at the front of the hip and addressing capsular restriction so the joint can centre properly.
Pelvic re-positioning
Re-balancing the muscles that set pelvic tilt, changing where in range the hip meets its limit.
Deep glute activation
Waking the deep stabilisers that keep the ball seated in the socket through squatting, lunging and rotation.
We then use targeted end-range loading to expand controlled, usable range and build strength where your hip needs it most. You’ll also get clear guidance on how to modify (not abandon) squatting and training while the joint settles.
Book an assessmentWhat to expect
Your first session and beyond
Your first visit is mostly assessment. We take your history, test your hip’s rotation and control, screen your pelvic position and watch your squat pattern to see exactly where and why the pinch occurs. You will usually receive hands-on treatment in the same session and leave with one or two specific exercises.
Many people notice more room in the hip within the first sessions as position and control improve. Building the deep control that keeps it that way takes consistent work over weeks. If your presentation suggests significant labral involvement that isn’t responding, we will tell you honestly and help you seek the right imaging or specialist opinion.
Book an assessmentExplore more
Related conditions & services
These issues share the same movement chain and often travel together:
FAQ
Hip Impingement — common questions
Do I need a scan or MRI before you can treat my hip impingement?
No scan is required to begin. We start with a hands-on Functional Movement Assessment of your pelvis, hip and spine, and watch how you actually squat and hinge to see where and why the pinch happens. If your presentation suggests significant labral involvement that isn't responding, we'll tell you honestly and help you seek the right imaging or specialist opinion.
If a scan shows the bone shape linked to impingement, does that mean I need surgery?
Not necessarily. The bone shapes associated with impingement (cam and pincer) also show up on scans of plenty of pain-free hips, so shape alone doesn't decide the outcome. The pinch you feel is usually shape plus pelvic position plus joint control, and two of those three can change with the right treatment.
Can hip impingement really be treated without surgery?
For many people, yes. A large part of the pinch comes from how the pelvis is positioned and whether the deep stabilisers keep the ball centred in the socket, and both are very treatable. We rebalance those relationships and build controlled range, so you can often move deep again without forcing more range through a painful joint.
Why not just stretch my hip flexors or push deeper into squats?
Because that usually backfires. The joint doesn't need more range forced through a pinch; it needs the position and control that make its existing range usable. We release the gripping muscles, re-position the pelvis and wake the deep glutes so clearance returns, rather than grinding through the front of the hip.
How many sessions will I need, and do I have to stop training?
Many people notice more room in the hip within the first few sessions as position and control improve, while building the deep control that keeps it that way takes consistent work over several weeks. You usually won't need to stop training; we give clear guidance on how to modify squatting and lifting while the joint settles, rather than abandoning it.
What happens at my first visit and how do I book?
Your first visit is mostly assessment: we take your history, test your hip's rotation and control, screen your pelvic position and watch your squat. You'll usually receive hands-on treatment in the same session and leave with one or two specific exercises. We're open daily 10:00 to 20:00 in Koh Samui, so just book an assessment to get started.
Ready to move without pain?
Book your assessment today and take the first step toward lasting recovery and better movement.
Book Your Session Today