A finding on a scan isn’t a reason to operate
A labral tear or “hip impingement” (cam morphology, FAI) on imaging doesn’t, on its own, mean you need surgery. These structural findings are extremely common in people with no pain at all. A proper diagnosis needs three things to line up: the imaging, the clinical picture, and a real functional deficit. Imaging alone isn’t enough.
Why it’s there
Cam morphology often develops during adolescence in people who load their hips hard through sport. It’s frequently an adaptation to loading rather than a disease, which is why around three-quarters of completely symptom-free athletes have it and never know.
What actually works
For most people, structured conservative care does the job. The majority of athletes return to sport without surgery when they follow a progressive loading program, not rest alone. Outcomes track with the quality of the rehab far more than with what the scan shows.
Rough shape of it: settle the irritation and restore pain-free movement, then progressively load and strengthen the hip through the ranges and patterns your sport demands, then build capacity beyond those demands. Give it a genuine 8-12 weeks before drawing conclusions.
When surgery is on the table
Only after a real, progressive conservative trial has failed, when the clinical findings genuinely match the imaging, and when there’s significant functional loss affecting daily life, not just sport. It’s worth knowing that revision rates for hip arthroscopy aren’t trivial, so it deserves a considered decision, not a reflex one.