Hi – I’m also a 46 year old male and I had hip impingment and many other right hip problems (torn labrum, arthritis…) For years they were asymptomatic and I was able to do lots of road and trail running. Then on a typical long run it got wonky and I couldn’t run properly any more. PT and strengthening & balance exercise made it much better (I did a lot of stair climbing and walking up and down hills). I still couldn’t run, but I was able to power-hike two 100-mile races that year. In the fall of 2018 I consulted with Dr. Thomas Gross (http://grossortho.com/) and had hip resurfacing surgery in Feb 2019. Six months later I was able to resume running and in Nov 2019 dd the Pinhoti 100. Individual results of course vary, but the surgery has been great for me.
Hopefully your’s will improve sufficiently with PT, but if not, do not give up hope.
Andy Jones Wilkins has written good articles about being a runner with bad hips
https://www.irunfar.com/2018/03/going-under-the-knife-part-2.html