This seems to be the best evidence based resource I've seen for anyone dealing with what seems to be a FAI issue
My interpretation of this is kinda "there's a good chance you're just fucked".
I have not had the so-called diagnostic MRI yet.
I have seen some significant improvement with PT strengthening exercises over the past few weeks but I don't know if this is from quitting surfing, running, and hiking or the exercises are actually helping.
I have never had any pain in this hip with running or hiking. It was surfing that was killing me. Pain is in the outer hip just below the greater trochanter. Pain is in my front leg with
- the offload during pumping
- the offload during backside turns
- the pop up
Things kept flaring up and calming down until they became intolerable a few weeks ago.
The interesting thing is at this point what really irritates me is the groin twinge I get from internal rotation. This is something that started back in January when I got back on my board after what was a pretty benign wipeout at a slab reef. A super sharp, stabbing pain that happens out of nowhere, lasts about a 1/4 of a second, and catches me completely off guard and makes me want to say "OW!!". It's like a surprise quick kick in the nuts and can be pretty awkward around other people. It's subtle movements that seem to trigger it especially when theres a little surprise movement of the leg under water, like getting rolled a bit during a duckdive. From diagnostic movements elciting the pain PT (who is a surfer) said he can almost guarantee that pain is from impingement. The pain in my outer hip he said he isn't so sure.
The PT I did a few years back worked magic on my other hip (which wasn't nearly as bad) so keeping my fingers crossed with this one.
Best of luck figuring it out.