Femoroacetabular impingement (FAI), a condition affecting the hip joint, can cause discomfort and limit mobility for those who suffer from it. It’s crucial to have a well-rounded understanding of FAI and the appropriate exercises to strengthen and improve hip function. A proper exercise routine can alleviate pain, enhance overall hip mobility, improve joint stability, and allow people to return to normal activities.
Those who focus on strengthening, motor control, and movement patterns rather than the range of motion appear to relieve pain in some patients with FAI. When in doubt, get stronger first.
Combining various exercises, resistance band workouts, strength training, and the occasional stretching exercises will help improve your pain threshold, decrease pressure on the hip, and improve normal mechanics while preventing future flare-ups.
In this article, we’ll review the best strengthening exercises to help with hip FAI and anterior impingement. If you’re ready to get your hip and life back, take the dive and keep on reading.
Key Takeaways
- Strengthening exercises can help manage Hip FAI symptoms and improve mobility and stability.
- Physical therapy and a customized exercise plan are crucial for effective treatment and return to prior levels of function.
- Combining strength training, flexibility, and resistance band workouts promotes hip health and may prevent surgery.
Understanding Hip FAI
FAI is a condition that affects your hip joint, causing pain and limited mobility. It occurs when the bones of your hip joint – the Femur (thigh bone) and the Acetabulum (hip socket) – don’t fit together perfectly. This can result in friction during hip movements, damaging the joint’s cartilage and the labrum, a rim of fibrous cartilage surrounding the hip socket.
There are three main types of FAI: cam, pincer, and combined.
In cam impingement, the femoral head is not perfectly round, causing it to rub against the hip socket. Pincer impingement occurs when the hip socket covers too much of the femoral head, leading to pinching of the labrum. Combined impingement is a mix of both cam and pincer impingements.
Some common symptoms of FAI include hip pain, stiffness, and a limited range of motion. You might also experience a locking or catching sensation in the hip joint. Pain and symptoms can be exacerbated by activities that involve a lot of hip movement, such as running, squatting, or even sitting for extended periods.
Although the exact cause of FAI is poorly understood, some factors that may contribute to its development include genetic factors, sports participation, repetitive hip movements, or previous hip injuries. Over time, untreated FAI can lead to joint damage and, potentially, early-onset arthritis in the hip.
Treating FAI typically involves a combination of approaches, such as modifying activity levels, pain management, and physical therapy to strengthen your hip muscles and improve flexibility. Surgery may sometimes be necessary to address structural issues contributing to the impingement, but we always have surgery as a last resort.
By understanding your hip’s anatomy and the possible causes of FAI, you can take steps to manage the condition and work towards improving your hip joint health and overall quality of life.
Physical Therapy and Treatment Options
When dealing with hip FAI, it’s essential to start with physical therapy and conservative measures as the first line of treatment. Physical therapy is an effective approach to help manage pain and address the symptoms. Just take this step seriously and ensure you have a good physical therapist. We are not all created equal, and if your PT has 2 other patients simultaneously, move on to another clinic.
Your physical therapist will work with you on a customized program designed to strengthen your hip muscles, improve your range of motion, and gradually relieve your pain. Pain from FAI takes a while to develop, and it will also take some time to dissipate.
Some common exercises you might be introduced to include stretching for FAI, range of motion, and, most importantly, strengthening exercises.
In addition to the exercises prescribed by your physical therapist, you may be advised to focus on general conditioning and low-impact activities such as swimming and cycling to build up your overall fitness. These activities can help decrease the stress on your hip joint and relieve pain.
Maintaining open communication with your physical therapist throughout your treatment program is essential. They can monitor your progress, adjust your treatment plan as necessary, and provide additional pain relief recommendations.
Remember, it’s important to approach your physical therapy and treatment for hip FAI with a friendly attitude and a willingness to commit to your program. You can improve your hip strength, mobility, and overall quality of life with consistent effort and determination.
One great resource for FAI syndrome exercises is available in this article, which demonstrates various exercises that can help with your hip impingement.
Strength Training for FAI
Always warm your muscles before diving into specific exercises to prepare them for activity. Start with 5 to 10 minutes of light aerobic exercise, such as walking or jogging in place. Research has shown a focused 5-minute warm-up can decrease the risk of injury with activity by more than 50%.
We recommend a dynamic warm-up that gets the blood flowing and the muscles ready to work. Check out one of our favorite dynamic warm-ups here.
Phase 1 Strengthening for FAI
The goal of the first strengthening phase is to get the muscle working properly without causing pain. These exercises are focused on muscle activation, high reps, and well-rounded stability.
One effective hip-strengthening exercise is the clamshell. To perform this exercise, lie on your side with your hips and knees bent to 90 degrees. Keep your feet together while you lift your top knee, ensuring your hips stay stacked on top of each other. Perform 3 sets of 8-12 repetitions on each side, and feel free to add a resistance band around your thighs for an extra challenge.
The single-leg glute bridge is another great exercise to target your hip and core strength. Lie on your back with your knees bent and feet flat on the floor. Extend one leg toward the ceiling while keeping your core engaged. Press through your grounded heel to lift your hips off the ground, forming a straight line from your shoulders to your knees. Hold the position for a few seconds, then lower your hips to the floor. Repeat this for 8-12 reps on each side and try to perform at least 3 sets.
Single-leg balance is essential for hip Stability. A standing single-leg balance with hip abduction is an excellent way to improve hip strength and corrective strategies. Stand with your hands on your hips and feet hip-width apart. Balance on the affected leg and kick the other leg out sideways. To make this harder, try with a resistance band. Even though the non-injured leg is doing the moving, it’s the stance leg that is getting the workout. Try to complete 15-20 reps without putting the foot back down and balancing on one leg the entire time. The side of the glute will be burning.
Try and complete the phase 1 exercises every other day for at least 2-3 weeks. Don’t progress to phase 2 exercises until you can perform all the exercises without pain and proper form.
Phase 2 Strengthening for FAI
Phase 2 of the hip FAI strengthening program advances the exercises’ difficulty by incorporating more single-leg activity and challenging the resistance. The goal of this phase is all about building strength and gaining muscle. During this phase, be sure to watch your form. If there is pain, don’t stop the exercise, don’t go as deep into the movement, or do fewer repetitions.
Our first exercise in phase 2 is the lateral step-down. This exercise targets the gluteus medius and helps to improve hip stability during weight-bearing activities. It’s much more challenging than it looks or sounds.
To perform the exercise, stand on a step or raised platform with one foot while the other hangs off the edge. Slowly lower the hanging foot towards the ground while keeping the knee aligned with the toes and maintaining control through the hip. Return to the starting position and repeat for several repetitions before switching legs.
Another exercise included in our phase 2 strengthening program for hip FAI is the single-leg Romanian deadlift (RDL). This exercise targets the hamstrings, glutes, and lower back muscles, which are important for hip stability and control. This is absolutely one of our favorite exercises because of how many muscles it works.
To perform the exercise, stand on one leg with a slight bend in the knee and hinge forward at the hips while keeping the back straight. Reach towards the ground with the opposite hand while the other leg extends behind you. Return to the starting position and repeat for several repetitions before switching legs.
The Bulgarian split squat is the third exercise in our phase 2 strengthening program for hip FAI. This exercise targets the quadriceps, glutes, and hamstrings and helps to improve balance and stability in the hip joint. The goal of this exercise is all about building strength and stability.
To perform the exercise, stand with one foot on a bench or raised platform behind you while the other foot remains on the ground in front of you. Slowly lower your body towards the ground by bending the front knee while extending the back leg. Return to the starting position and repeat for several repetitions before switching legs.
Strength training is vital for overall hip health. Be consistent with your exercises; over time, you will notice improvements in your hip strength, confidence in movement, and, by now, a probable reduction in pain levels.
Regularly include these exercises in your routine, and enjoy the benefits of increased hip mobility and core strength.
Specific Exercises for Hip FAI
In addition to the 2 phases of strengthening exercises listed above, doing more strengthening is always good. Listed below are more ideas to help with strength gains with using other exercises.
Core and Hip Strengthening
Focusing on core and hip strengthening exercises is important when dealing with hip FAI. Building strength in these muscle groups will improve your hip’s stability and overall functioning. Try incorporating the following exercises into your routine:
- Squats: Stand with your feet shoulder-width apart and slowly lower yourself into a squat, keeping your chest up and your knees aligned. Hold for a moment before rising back up. Repeat for 8-10 reps.
- Bridges: Lie on your back with your knees bent and feet flat on the floor. Push through your heels and lift your hips, squeezing your glutes. Hold for a few seconds before lowering your hips back down. Perform 10-12 reps.
- Lunges: Stand tall and step one foot forward, lowering your hips until both knees are bent at approximately 90 degrees. Push through your lead foot and return to the starting position. Alternate legs and complete 8-10 reps on each side.
Hip Stabilization
To further address hip FAI, performing hip stabilization exercises that target smaller muscles around the joint is crucial. These exercises can help improve your hip’s resilience to stress and injury:
- Clamshells: Lie on your side with your knees bent and your legs stacked. Keeping your feet together, lift your top knee while keeping your hips stable. Lower the knee back to the starting position and perform 12-15 reps on each side.
- Hip Circles: Stand with your feet shoulder-width apart and place your hands on your hips. Slowly make circles with your hips, moving clockwise, then counter-clockwise. Repeat for 8-10 reps in each direction. See if you can balance on one leg the entire time!
- Donkey Kicks: Get on your hands and knees, ensuring your wrists are under your shoulders and your knees under your hips. Keeping your right knee bent at a 90-degree angle, lift your right leg while squeezing your glutes. Lower the leg and repeat for 10-12 reps before switching to the left leg.
Hip Focused Functional Mobility
Practicing hip-focused functional mobility exercises helps maintain a healthy range of motion and reduces the risk of impingement. Here are a couple of exercises to try:
- Single Leg Bridge: Lie on your back with your knees bent and feet flat on the floor. Extend one leg straight while keeping the other foot planted. Push through your planted foot and lift your hips, squeezing your glutes. Hold for a few seconds before lowering your hips back down. Perform 8-10 reps on each side.
- Lunge with Rotation: Insert your right foot forward into a lunge position. Hold your hands together before your chest and twist your upper body to the right, keeping your lower body stable. Return to the center and repeat for 8-10 reps before switching to the left side.
Incorporating these focused exercises into your routine strengthens and stabilizes your hips, helping you better manage and prevent hip FAI.
Hip Flexibility and Stretches
When it comes to improving your hip FAI, strengthening takes the cake for being the most important aspect to focus on. However, adding stretching can also help decrease pain levels.
It’s not uncommon for people with hip FAI to experience tightness and discomfort in the hip flexors, piriformis, and groin muscles.
Incorporating specific stretches into your routine is beneficial to alleviate this discomfort and improve your range of motion. Here are some friendly recommendations for hip flexibility and stretching exercises targeting those common areas.
First, let’s work on your hip flexors. A simple yet effective exercise is the hip flexor stretch. To perform this stretch, kneel on one knee with the other foot flat on the ground in front of you. Gently push your hips forward until you feel a stretch in the front of your hip and thigh. Hold for 20-30 seconds, and repeat on the other side.
Next, stretch your piriformis muscle with the piriformis stretch. Lie on your back and cross one ankle over the opposite knee. Grasp your hands behind the thigh of the lower leg and gently pull it towards your chest. You should feel a stretch in your buttocks and hip area. Hold for 20-30 seconds before switching to the other side.
To target your groin muscles, try the groin stretch. Sit on the ground with your knees bent and the soles of your feet together, forming a diamond shape. Grasp your feet with your hands and gently pull them towards your body. While keeping your back straight, lean your torso forward and gently push your knees toward the ground. Hold this stretch for 20-30 seconds, and remember to keep your movements smooth and controlled.
Regularly practicing these stretches can improve your hip flexibility and mobility, helping alleviate pain and discomfort associated with hip FAI. Just remember that more flexibility doesn’t mean less pain. Shoot for a symmetrical range of motion instead of pushing for more range of motion for optimal hip health.
Exercises to Avoid For FAI
When dealing with hip FAI, it’s essential to know which exercises to avoid to prevent further injury and discomfort. Certain movements can exacerbate your pain and hinder the healing process.
Jumping and high-impact activities should be an activity that you proceed with caution since they can put unnecessary pressure on your hips. This includes exercises like high box jumps and plyometrics such as bounding and squat jacks. It’s best to go slow with these exercises to allow your hips to recover.
Running can also be problematic for those experiencing hip FAI pain, but this depends on the impingement’s location. The repetitive impact of running can irritate your hip joint, leading to more discomfort. In some people running causes no issues. Alternatively, you can try low-impact cardio options like swimming or biking.
Another exercise to steer clear of is deep squats. These can strain your hip joint, especially when performed with improper form or in variations such as sumo squats. Be cautious of other leg exercises, like lunges, leg presses, and deadlifts.
Squats are great exercises, and you should continue to perform them. Just don’t go too deep into pain.
Lastly, be mindful of any movements that require excessive hip bending. This can worsen your FAI pain and prolong your recovery. Make sure to understand your body’s limits and avoid pushing yourself into positions that may cause further damage to your hip joint.
Incorporating Resistance Band Workouts
Resistance bands are a versatile and budget-friendly way to strengthen and improve hip mobility, especially if you have hip FAI. Gently and progressively, they help to target the muscles around your hips, so let’s explore how you can incorporate some effective exercises into your routine.
Lateral band walking focuses on your hip abductor muscles and helps maintain stability. Place the resistance band around your thighs, just above the knees. Keeping your feet shoulder-width apart and your knees slightly bent, step out to the side and follow with your other leg. Continue alternating steps for the desired distance, and make sure not to let your knees cave inwards as you walk.
Abduction and adduction exercises offer a wider range of motion to your hips, ensuring good hip mobility and flexibility. To work on hip abduction, loop the resistance band around your ankles and stand with your feet shoulder-width apart. With one foot planted, lift the other leg out to the side while keeping your toes pointed forward. Lower the leg and repeat before switching sides.
To work on hip adduction, loop the resistance band around one ankle and a solid surface such as a dining room table or a bedpost. With one foot planted, lift the other across your planted leg while keeping your toes pointed forward. Lower the leg and repeat before switching sides.
Preventing and Managing Flare-Ups
Living with hip FAI can be challenging, but there are ways to reduce and manage flare-ups. By practicing these simple techniques, you can minimize your risk of hip, back, and knee pain and boost your overall well-being.
Always pay attention to your body when exercising. Strengthening your core muscles to support your hips and avoid unnecessary strain is vital. Incorporate physical therapy exercises into your routine to help manage hip pain and improve mobility. Engaging in strengthening exercises not only helps with hip impingement but can also alleviate discomfort in other joints, such as your knees and back.
Sitting for extended periods can aggravate hip FAI and lead to flare-ups. Try setting a timer to remind yourself to stand up and move around at least once an hour. Gently stretching your hips, knees, and back can also be beneficial during these breaks.
If you’re experiencing flare-ups, it’s essential to prioritize rest and recovery. Modify your activities as needed, and consider using ice to reduce inflammation. Remember, pushing yourself through pain can worsen symptoms and prolong recovery.
Frequently Asked Questions
Conclusion
In summary, committing to a consistent strengthening exercise routine for hip FAI can help alleviate pain and improve overall hip function. Some helpful exercises include the hip flexor stretch, piriformis stretch, and groin stretch, which can enhance your range of motion while helping you maintain muscle strength.
As you embark on this journey, remember to be patient with yourself and always listen to your body. By doing so, you’ll be able to determine which exercises work best for you and modify them as necessary. It’s also important to note that half of the patients with FAIS benefit from exercise therapy in the short term, so you’re not alone in seeking relief from FAI through these conservative treatments.
Have you been able to strengthen your hip and improve your quality of life with FAI? Let us know in the comments below.
