Yoga for a hip labral tear and hip impingement (FAI): the pinch, the poses to avoid or change, what the evidence shows, and a class

Common on scans of hips that don't hurt

On MRI (magnetic resonance imaging), 69% of 45 volunteers without hip symptoms had a labral tear, and pooled across studies, 54% of people without hip pain had one, against 62% with pain. Impingement is only diagnosed when symptoms, examination and imaging all fit.

Sources 1, 2, 3

Exercise first, for at least 3 months

An international expert group recommends exercise-based treatment for at least 3 months and staying active, sport included, and Canadian sports doctors agreed unanimously that it's reasonable to try non-surgical care first in almost everyone.

Sources 4, 5

Surgery helps a little more, on average

In UK FASHIoN (348 people), keyhole surgery scored 6.8 points better than physiotherapy on a 100-point hip score at a year, just over the 6.1 points patients notice, and the FAIT trial also favoured surgery. People knew which treatment they had, and no sham-controlled trial has reported.

Sources 6, 7, 8

Strengthening and stretching programmes both helped

In a 2026 trial of 154 adults with impingement, a physiotherapist-led strengthening programme and a stretching programme both improved hip scores by about 20 points over 6 months, though more people in the strength group felt their pain had improved.

Source 9

No yoga trial, and some poses pinch

No trial has tested yoga for a labral tear or impingement. In a lab study, downward dog, forward folds, seated twists and pigeon took the hip deep into bending, and eagle and seated twists added crossing the thigh.

Sources 10, 11

Up to the pinch, not into it

The US physiotherapy guideline advises limiting forceful end-range bending and turning-in stretches with impingement. In yoga: stop at the first pinch in the front of the hip (our suggestion).

Source 12

The labrum, and a tear

The labrum deepens the hip socket and helps seal the joint. Canadian experts agreed that pain at the front of the groin, pain when the hip is bent right up, and a sharp catching pain on turning make a labral tear more likely, and the US orthopaedic surgeons' patient page says turning, twisting and squatting may cause a sharp, stabbing pain. Because the labrum has a poor blood supply, a tear may not heal, but pain and function improve with exercise, as our hip labral tear guide explains.

Sources 5, 13

Impingement (FAI)

In impingement, the ball (a cam shape) or the rim of the socket (a pincer shape) is shaped so they meet early when the hip bends. An international consensus renamed it FAI syndrome to put the symptoms at the centre: the diagnosis needs the right symptoms, examination signs and imaging together. Experts also warn not to confuse labral or cartilage problems that cause symptoms with the incidental findings on scans of people who have none.

Sources 3, 14

Scans of hips that don't hurtStrong evidence

Labral tears showed on MRI in 69% of 45 volunteers aged 15 to 66, in 38.6% of 70 young volunteers, and in 44% of 63 volunteers against 61% of matched patients, a difference that wasn't significant. Cam shapes were found in 37% and pincer shapes in 67% of hips without symptoms.

Sources 1, 15, 16, 2, 17

How it usually goes without surgeryMixed evidence

In 52 people treated without surgery for a year, hip scores rose and 71.2% were satisfied, though 48.1% reported no improvement in their pain. In 35 people treated with physiotherapy, scores rose over about 5 months and 22.9% went on to surgery, more often those with the most severe tears. These are small studies without comparison groups, and a review rated them low quality.

Sources 18, 19, 20

The positionEmerging evidence

The pinch position is the hip bent deeply with the knee drawn across the body and turned in; it is also the clinic test. In a CT (computed tomography) simulation, hips with impingement reached bony contact at about 110 degrees of bending, against about 125 degrees in hips without it, and in a deep squat, people with a cam shape couldn't squat as low and moved their pelvis less.

Sources 14, 21, 22

Which yoga poses take you thereEmerging evidence

In a lab study of 11 poses in 20 healthy practitioners, downward dog, forward fold, seated twist and pigeon took the hip deep into bending; eagle and the seated twist added crossing the thigh; and half moon, eagle and triangle turned the hip in more. The US physiotherapy guideline, which is expert opinion, advises limiting forceful end-range bending and turning-in stretches with impingement.

By the same logic, garland squat, happy baby, child's pose with the knees together and twisted lunges combine deep bending with crossing or turning in. That is our reading, extended from this one lab study and the guideline; no study has measured these poses in people with impingement.

Sources 11, 12

Flexible hips aren't protected hipsMixed evidence

In professional ballet dancers with normally shaped hips, typical ballet movements produced impingement and partial slipping of the joint. Yet labral tears were as common in 49 professional dancers as in other sports people (51% of hips) and weren't linked with pain, and a review of 35 low-level studies suggests more joint damage in dancers. A study of flexibility-sport athletes, yoga practitioners among them, with a slightly shallow hip socket found they did as well after surgery as those without. More range isn't the goal.

Sources 23, 24, 25, 26

Yoga and hip injuriesMixed evidence

Labral tears were among the tears seen on scans of 38 people hurt in yoga at one centre, and in US emergency department records, hip injuries made up a bigger share of yoga injuries in people aged 45 or over. Neither gives a rate per person practising, so neither shows that yoga is risky for hips.

Sources 27, 28

Exercise firstStrong evidence

International and Canadian consensus statements put at least 3 months of exercise-based care first, with staying active and sport included. The Canadian list covers range of movement, strength, trunk and buttock strength, movement retraining, easing symptoms, changing activities and education. The same experts note that strong trial evidence for physiotherapist-led treatment is lacking: a review of 14 studies found no full-scale placebo-controlled trial.

Sources 4, 5, 29, 30

Surgery against physiotherapyEmerging evidence

In UK FASHIoN (348 people at 23 NHS hospitals), the hip score at 12 months was 6.8 points better after keyhole surgery than after personalised physiotherapy, just above the 6.1 points patients notice; when only the best-delivered physiotherapy was counted, the difference was smaller and not significant. Its authors say the advantage might come from the operation, the placebo effect of surgery, the rehabilitation after it, or a mix.

FAIT (222 people) also found surgery better on a hip score at 8 months, against up to eight physiotherapy sessions. In an 80-person US military trial there was no difference at 2 years, but most of those offered physical therapy had surgery, and an Australian trial found no difference in cartilage health at a year.

Sources 6, 7, 31, 32

Over the longer termEmerging evidence

Meta-analyses put surgery's advantage at about a year around or below the smallest difference patients notice, with less certainty after 2 years, and a few different results could change some trials' conclusions. FAIT's follow-up at about 3 years still leaned towards surgery for symptoms and found no difference in joint space on X-ray; a 2025 correction to that paper couldn't be read, so we give only its direction. Between 1 and 3 years in UK FASHIoN, 24% of the physiotherapy group chose surgery, and 12% of the surgery group had a second arthroscopy. The only sham-controlled trial has published its plan but no results.

Sources 33, 34, 35, 36, 37, 38, 8

Over 40Mixed evidence

In a single-surgeon trial of people over 40 with a labral tear, surgery plus therapy did better than therapy alone, but 71.1% of the therapy-alone group crossed over to surgery, and trying physiotherapy first didn't spoil the results of later surgery.

Sources 39, 40

Strengthening and stretching both helpedEmerging evidence

In PhysioFIRST (154 adults aged 18 to 50 with impingement), a progressive hip, trunk and jumping programme and a standardised hip and leg stretching programme, each with up to 15 sessions over 6 months, both improved the hip score by about 20 points, with no difference between them; 72% of the strength group felt their pain had improved, against 52% of the stretch group. A light home programme added to usual care did no better than usual care. Neither was yoga.

Sources 9, 41

No yoga trialStrong evidence

Our searches of PubMed and Europe PMC found no trial of yoga in a hip labral tear or impingement.

Source 10

Getting back to yoga after surgeryMixed evidence

Of 42 yoga practitioners who had keyhole surgery for impingement, 71% had stopped yoga beforehand because of the hip; 93% returned, at an average of 5.3 months, and 45% at a higher level. That is one surgeon's series, without a comparison group. Across flexibility sports, most athletes returned at the same or a higher level.

Sources 42, 43

Arthritis laterEmerging evidence

A cam shape goes with a higher chance of hip arthritis later (1.87 times the odds in 23,886 mostly older hips), but surgery hasn't been shown to prevent it: FAIT found no difference in joint space on X-ray at about 3 years, and the Australian trial no cartilage benefit at a year.

Sources 44, 45, 34, 32

Our hip labral tear guide's rule

"During the exercise, pain up to about 5 out of 10 is acceptable. It should settle within an hour or so, and your hip should be no worse that night or the next morning. If it is, do less next time (fewer repetitions, a smaller range, a lighter load), not nothing."

A sharp pinch, catch or click is different: make the movement smaller rather than pushing through. The guideline asks clinicians to avoid exercises and ranges that bring on impingement, and the NHS programme in UK FASHIoN left out painful, hard end-of-range stretches.

This rule comes from tendon and arthritis programmes; it has not been tested in labral tears.

In yoga

In any pose, stop at the first pinch in the front of the hip; holding there, or letting gravity or a hand take you deeper, is the part to leave out (our suggestion, from our hip impingement guide's rule to work up to the pinch, not into it). A bony block doesn't stretch: the US guideline says people with a hard, bony end to their range may not benefit from stretching.

Source 12

Your team's plan comes first

After keyhole hip surgery, your surgical team's plan and precautions come first, and our hip arthroscopy guide covers the recovery. Yoga comes back when your team agrees.

Getting back to yogaMixed evidence

In one surgeon's series of 42 yoga practitioners, classes were held back for the first 6 weeks because of the extreme ranges yoga asks for; sitting poses with extreme outward turn and bending, such as butterfly and cow face, waited up to 12 weeks; and patients were told to avoid any pose in deep bending and turning that brought on groin or front-of-hip pain. 93% returned to yoga, at an average of 5.3 months.

Source 42

After a fall or injury

Call 999 or go to A&E: severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may be at an odd angle or look shorter. Don't drive yourself.

Call 999 or go to A&E: tingling or loss of feeling in the hip or leg after an injury.

Source 46

Back, bladder or bowel symptoms

Call 999 or go to A&E if you have sciatica on both sides, weakness or numbness in both legs that's severe or getting worse, or numbness around or under your genitals, or around your bottom (anus); if you find it hard to start peeing, cannot pee or cannot control when you pee; or if you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. These could be symptoms of a serious back problem that needs to be treated in hospital as soon as possible.

A lump in the groin

Call 999 or go to A&E now if you have a femoral hernia (a small lump at the top of your thigh, in your groin) and very bad tummy pain, you feel sick or you're being sick, you cannot fart or poo, you have a high temperature or you feel hot, cold or shivery, or you've suddenly become confused. Do not drive to A&E. With any other hernia and pain in or around it, a bloated tummy, feeling or being sick, vomiting blood or vomit that looks like coffee grounds, constipation, a high temperature or feeling hot, cold or shivery, or sudden confusion, get help from NHS 111.

A lump in the groin, upper thigh or tummy, especially one that appears when you cough or strain and goes when you lie down: see a GP, as it may be a true hernia. A femoral hernia (a small lump at the top of the thigh, mainly in women over 50, though it can happen to anyone) needs treating in hospital.

Sources 47, 48

A hot, swollen hip or a fever

Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a high temperature can be a joint infection.

Sources 46, 49

Groin pain in a runner

Same day, and stop running now: groin or front-of-hip pain in a runner, sometimes felt in the thigh or knee, that builds with running, hurts with every step or at night, or hurts when the hip is turned to the end of its range. Keep weight off the leg, using crutches if you have them, and get an urgent GP appointment or help from NHS 111 the same day: a stress fracture of the hip (femoral neck) needs urgent imaging.

A child or teenager

Call 999 or go to A&E if your child gets sudden pain in their hip, knee or thigh (hip problems can sometimes be felt in the thigh or knee) or cannot put any weight on their leg. If your child is limping, ask for an urgent GP appointment or get help from NHS 111 the same day. This applies to teenagers too, and in some children knee pain is the only sign.

Labral tears and impingement are diagnosed in teenagers too, but a teenager with new hip, thigh or knee pain and a limp needs the children's route first, because a slipped growth plate at the hip can look like a groin strain; our slipped upper femoral epiphysis guide covers it (our suggestion).

Sources 50, 51

See a GP or physiotherapist

• Hip pain that stops normal activities or disturbs sleep, keeps getting worse or keeps coming back, or has not improved after 2 weeks of looking after it at home.
• Stiffness lasting more than 30 minutes after waking.
• Pain that builds with running and hurts to hop on (a stress fracture can look normal on an early X-ray).
• Pain that has not improved after a good 3 months of exercise-based treatment: ask about seeing a hip specialist.

Sources 46, 52

Very flexible joints

If you're hypermobile, don't use mobility work to push further: the NHS says "do not overextend your joints just because you can". See a GP if you think you have joint hypermobility syndrome: for example, your joints keep dislocating, or you keep getting sprains, strains, pain or stiffness.

A slightly shallow hip socket (hip dysplasia) is a different problem, and more range isn't the goal: our hip dysplasia guide covers it (our suggestion).

Source 53

Chest pain or fainting: call 999

Call 999 if:

• You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
• The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
• You have chest pain and feel sweaty, sick, light-headed or short of breath.
• Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.

Sources 54, 55

Unusual breathlessness

Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.

Source 56

During yoga

A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans). Muscle soreness for a day or two after something new is normal. In a hot class, stop if you feel dizzy, sick or unwell; our hot yoga guide lists the signs of heat illness.

You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.

Before you start

The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.

"A labral tear means no more yoga"Mixed evidence

In one surgeon's series, 93% of 42 yoga practitioners went back to yoga after keyhole surgery. Most people start with at least 3 months of exercise instead, and yoga that builds strength and avoids the pinch can be part of it.

Sources 42, 4

"The tear on my scan is the cause of my pain"Strong evidence

More than half of people without hip pain have a labral tear on MRI, and a scan finding is only the diagnosis when the symptoms and examination fit.

Sources 1, 2, 3

"A torn labrum needs surgical repair"Strong evidence

The trials and consensus statements say exercise first, for at least 3 months, with surgery a reasonable option if that hasn't helped, for a modest average advantage.

Sources 4, 5, 6

"Hip openers fix impingement, so stretch through the pinch"Emerging evidence

A bony block doesn't stretch: the US guideline says people with a hard, bony end to their range may not benefit from stretching, and advises limiting forceful end-range bending and turning-in stretches. Gentle, general stretching helped in PhysioFIRST, but that programme didn't stretch into the pinch.

Sources 12, 9

"Surgery stops arthritis later"Emerging evidence

A cam shape is linked with later arthritis, but no trial has shown that surgery prevents it, and follow-up so far is short.

Sources 45, 34, 32

"Flexible people can't have impingement"Emerging evidence

Extreme ranges produced impingement even in dancers' normally shaped hips, and surgeons say impingement is most often diagnosed in athletes who bend and turn the hip repeatedly.

Sources 23, 42

"Rest it until the tear heals"Emerging evidence

A tear may not heal, because the labrum has a poor blood supply, but pain and function often improve with exercise, and experts recommend staying active, sport included.

Sources 19, 18, 4