If you are experiencing sharp pain in the front of your hip while running, squatting, pulling your knee to your chest, or doing other daily movements, you have come to the right place. While many medical journals will tell you what hip impingement is, how to test for it, what to avoid, and what surgeries can be done, we prefer a different approach. At Calispine, we aim to eliminate pain from hip impingement with proper movement patterns, tissue breakdown, and occasional adjustments. Our goal is to reeducate you on how to move properly during daily life so you can avoid surgery in the future.
What Is Hip Impingement and What Causes It?
Most causes of hip impingement are due to a femoral head or socket deformity. Boney structures and inflamed tissue will rub against the femoral head, causing a sharp stabbing pain in the front of the hip. Movements that cause the thigh to flex (squatting motions) will grind those bony and inflamed structures together. While you can stretch the muscles around the hip and strengthen the glutes and core to help reduce the frequency of these structures grinding into each other, the pain will be intense. Ultimately, avoiding motions that lead to sharp hip pain are crucial for recovery.
Stretches for Your Hips
Hip Flexor Stretch
These two stretches should be done for 1-2 minutes per side for a few weeks. If your hips are very loose, you may only want to do them for 1-2 weeks as you may have too much mobility in the hip and not enough stability. Dancers and yoga enthusiasts often fall into this category.
As shown in the left photo above, tuck your hips under so that you have a straight line from the knee to your shoulders. Slightly shift your knee and hip forward to get an intense stretch in the front of the hip. If your back is rounded like the right photo, you will NOT get the proper stretch. Hold for 1-2 minutes per side each day.
Pigeon (Piriformis) Stretch
Do this stretch as shown on a table, counter, or bed. Your knee may be more bent than shown in the photo, and it may not be touching the table. This is fine as long as you feel a deep stretch in the piriformis muscle in the glutes. Again, hold for 1-2 minutes per side each day.
Strengthening Exercises for Your Hips
These exercises can be done every day if you aren’t too sore from the previous day. Do 2-3 sets of each in a circuit. Most of these exercises should be done barefoot!
Clam Shell
This is a classic glute strengthening exercise used for rehabilitation. As silly as it looks, it is the easiest way to strengthen weak glutes and stabilize the femoral head in the hip joint.
To do this exercise, you will lie on your right side, stacking your feet and hips. Place your head on your right arm. Draw your knees in towards your body until your feet are aligned with your glutes. Place your left hand on your left hip. Engage your abs, keep your feet together, and then lift your left knee as far as you can without rotating your hip or lifting your right knee off the floor. Hold this position for a couple seconds, squeezing your glutes at the top of the posture, before lowering your left knee back to the starting position. Do 10-20 repetitions.
Single Leg Balance
This is a fun one! Doing 1-2 minutes of balance on each leg proves to be a major challenge for just about everyone. If you find it easy, stand on a foam pad, BOSU® ball, or other unstable surface. This exercise is excellent for glute strength and hip stabilization!
Stand with your feet hip-width apart and your weight equally distributed on both legs. Place both hands on your hips. Lift your left leg off the floor and bend it back at the knee. Hold the position as long as you can maintaining good form for up to 30 seconds.Return to your starting position and repeat this on the other side. As your balance improves, increase the number of repetitions.
The Glute Bridge
For this exercise, lie face up on the floor with your knees bent and your feet flat on the ground. Keep your arms by your sides with your palms faced down. Lift your hips off the ground engaging your glutes and hold the pose. You may want to stop lifting when your knees, hips, and shoulders form a straight line, but see what works best for you. Hold for a couple seconds and then slowly lower yourself down. Repeat 10 times.
The Single Leg Glute Bridge
The difference between these two variations is obviously the difficulty. The goal for both of these is to strengthen the glutes. Before you drive your hips up, flatten your lower back to the floor. If you are doing the double-leg glute bridge, put a band or belt around the knees to press against, activating your glutes more. For the single-leg bridge, try to keep your hips level the entire time. If you are unable to do so, consider going back to the double leg bridge and do more clam shells!
Single Leg Romanian Deadlift (S/L RDL)
The S/L RDL is another awesome exercise for hip stability and awareness. It will help loosen and strengthen your hamstring muscles. Do 10-20 reps per side. Try to keep your hips level with the floor and your toe pointed down to the floor the entire time. Keep your upper body and the elevated leg in line the entire time! Pretend you have a steel rod running from your head to toe, preventing you from bending at any point. People often have trouble with balance on this one, so hold onto something with one finger or a hand if you need assistance.
If you need help with your hip impingement, contact us online to schedule an appointment.