Dealing with hip impingement? Exercises may help to reduce pain and keep symptoms at bay. Also known as femoroacetabular impingement (FAI), this type of hip pain is caused by a deformity or abnormalities of the hip joint itself; typically of the femoral head or labrum causing pinching within the hip joint or upper femur with hip flexion. Keep reading to learn the best hip impingement exercises and how to perform them.
When it comes to exercise for hip impingement, strengthening exercises typically focus on restoring muscle balance between a few key muscle groups. Hip strengthening should address the hip flexors, hip rotators (internal rotation and external rotation), hip abductors, and hip adductors.
Core strengthening is also a vital part in reducing hip pain since it helps control the coordination of the pelvis, where the socket of the hip is located. All of the best exercises below address these areas without aggravating symptoms by avoiding flexion biased movement.
This basic exercise primarily addresses the glutes and hamstrings while also encouraging appropriate core activation. Since the movement involves hip extension (the opposite of the painful flexion direction), it can also provide some secondary hip pain relief too.
This is another great combination move that addresses core strength and glute strength (more specifically the hip abductors and rotators) at the same time.
This is another exercise that addresses the hip abductor muscles. Having strong hip muscles, particularly the abductors, that can coordinate well with daily activities is essential for reducing overall strain on the hip. Weakness of these muscles is common with hip pain and impingement.
This more functional move addresses the hip abductor muscles in a standing position. It is a great movement when you’re ready since weight bearing positions will help better preserve your hip integrity.
This movement helps improve coordination of the pelvis by activating muscles in the lower back and hips all at once (including the large iliopsoas and quadratus lumborum stabilizing muscles). Oftentimes, hip pain and weakness can lead to poor pelvic stability that further aggravates the underlying issues. Learning to control and minimize unnecessary pelvic movement with weight bearing activities can help.
The exercise we just discussed above involves being able to coordinate the pelvis in a frontal plane (side to side). Now, this exercise will focus on pelvic stability in the lateral plane (front to back). Being able to “tilt” the pelvis is important for optimal core activation and trunk stability. If this exercise is too hard to start with, you can always start by lying down with your knees bent or sitting in a chair.
This full body core strengthening move is great when your hip pain is well managed and you want to optimize your overall coordination and strength with this classic move.
While no exercise is explicitly off the table for completing with hip impingement, there are definitely some specific movements to be wary of. In general, they all involve hip flexion, especially when weighted or near end range of motion because of the pressure these moves put on the acetabulum (aka the hip socket and local cartilage). Deep hip flexion can further compromise the affected tissues if done repeatedly. Below are some moves to consider avoiding, at least in the short term if not longer.
Keep the entire lower body strong and coordinated to prevent unnecessary strain to the hip. With the exercises listed above, they all help to promote optimal muscle balance and hip alignment. When utilized correctly, this can help with improving the mechanics of your daily activities like walking, squatting, running, and more. Plus, it can reduce discomfort with more aggravating passive activities like prolonged sitting. Overall, there is a lot to gain with consistent hip exercise.
Now that you know what exercises to focus on with hip impingement, there are a few key factors to keep in mind that can help maximize your efforts. Keep these tips in mind.
Exercises should not exacerbate hip pain and other symptoms. If symptoms like groin pain occur, it's a sign that you need to modify your exercises. You may be able to progress to it later or simply avoid it until further notice.
There are a lot of moving parts in the lower trunk that can feel overwhelming to coordinate at first. This is why many of the starting exercises above initially focus on one or two primary muscle groups at a time. Always focus on keeping a neutral spine and level pelvis as much as possible.
This can help warm up the muscles, boost hip mobility, and alleviate pain. You can also stretch after your strengthening exercises, or any other time of the day, if you notice any onset of muscle soreness or stiffness.
There are plenty of great options for pain management and treatment at home, such as heating pads, ice packs, massage tools, and more. Plus, use tools like bands, weights, balance pads, and exercise balls to progress your exercises and challenge your muscles.
If you aren’t sure whether you’re keeping good form or what exercises you should even be doing in the first place, it’s always best to get medical advice. A physical therapist is your best option for getting personalized exercise recommendations in addition to other potential beneficial treatment options.
With hip pain, getting started with an exercise program is an important first step in recovering and feeling your best. After a proper warm up, start here with these exercises and combine with conservative treatments for even more effectiveness. You’ll find that you are able to better manage and prevent symptoms including the onset of issues like osteoarthritis. If your symptoms aren’t improving, keep in mind it’s always best to get in touch with your physical therapist or orthopedic doctor for further medical advice and recommendations such as arthroscopic hip surgery.
Resources:Hip Pain Products