Rehabilitation & Recovery

6 Best Femoroacetabular Impingement Exercises For Hip Pain

femoroacetabular impingement exercises

Femoroacetabular impingement (FAI) is a condition that affects the hip joint.

It occurs when there is abnormal contact or friction between the hip bones which may result in pain, a limited range of motion and tight hip flexors.   

If it’s left untreated it can damage the articular cartilage of the hip joint which may result in further complications such as hip osteoarthritis, labral tears and degradation of the joint.  

In this article we’ll suggest some hip impingement exercises which may help to improve muscle strength, hip mobility and reduce discomfort.  

But before that, let’s look in more detail as what FAI is and the potential causes and treatments.  

What Causes Hip Impingement (FAI)?

FAI can occur due to several factors as mentioned below: 

Developmental Abnormalities 

This happens during hip joint formation when the ball and socket joint of the hip don’t grow correctly.  

This usually means that symptoms worsen over time and as we age.  

Genetic Predisposition

If there is a history of FAI syndrome within your family, then you may have a higher chance of developing the condition.  

In this instance, it’s important to address any early symptoms and get a proper diagnosis by way of a hip impingement test.  

Repetitive Movements 

Repeated movements that involve the hip joint could increase the likelihood of developing FAI.  

This may include daily activities such as running and jumping meaning that some athletes, such as football players, could be predisposed to the condition.

Different Types of Hip Impingement (FAI)

FAI is typically classified into two main types: cam impingement and pincer impingement.

Cam Impingement

With cam impingement, there is an abnormality in the shape of the femoral head or femoral neck, causing it to be slightly misshapen.

This abnormality can lead to friction and limited movement within the hip joint.

Pincer Impingement

Pincer impingement occurs when there is an over-coverage of the acetabulum, causing it to extend too far over the femoral head.

This excessive coverage can result in pinching or compression of the soft tissues in the joint during certain movements.

Symptoms of Femoroacetabular Impingement 

Diagnosis of FAI will usually involve a combination of a physical exam, a review of your medical history, and imaging tests such as X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans.

Typical symptoms of fai may include the following.  It’s worth noting that symptoms can vary from person to person.  

Hip Pain

Groin pain is a common symptom of FAI.  This pain may also be felt at the front of the hip, to the side of the hip, or deep within the hip muscles.

It’s usually described as a dull ache, a sharp or stabbing sensation (especially during sudden movements), or a feeling of catching or pinching.

Limited Range of Motion

People who suffer with hip impingement may also experience a limited range of motion to the hip joint.  

Movements such as hip flexion (bringing the knee towards the chest), internal rotation (rotating of the inner thigh), and performing deep squats may be difficult and painful.  

Stiffness and Tightness

The hip joint may feel stiff, and people may experience a sensation of tightness to their hip flexors and perhaps muscle weakness.  

This is especially true after long periods of inactivity or upon waking up in the morning.

Clicking or Snapping Sensations

Some people with FAI report a clicking, snapping, or popping sensation in the hip joint when they perform certain movements.

These sounds can occur due to the improper contact between the femoral head and the acetabulum.

Pain with Activity

The pain and discomfort that comes with FAI often worsens with physical activity.  

Especially activities that involve repetitive hip movements, such as running, jumping, or pivoting.  

Walking for extended periods or sitting for a long time may also aggravate symptoms.  

Treatment for Hip Impingement Pain

Treatment options for hip impingement can vary depending on the severity of symptoms, your age and activity level.

 Non-surgical treatments often include rest, physical therapy, change to activity levels, nonsteroidal anti-inflammatory drugs, and targeted exercises to improve hip strength and flexibility.

hip impingement pain

Based on a systematic review undertaken in 2016, this showed that people suffering from FAI typically have a weakness to the hip muscles meaning that a focus on strength based exercises could have a positive effect on symptoms.  

In the most severe cases, surgical intervention may be suggested.

 Arthroscopic hip surgery is a common, minimally invasive surgical procedure which is used to treat FAI.

It involves reshaping the femoral head or acetabulum, repairing labral tears, and addressing any other joint abnormalities.

Best Femoroacetabular Impingement Exercises

Below we suggest some of the best exercises that may help to reduce painful symptoms associated with FAI.  

Before doing so, it’s a good idea to seek the advice of a physical therapist to ensure exercise is the best approach to take.  

​Split Squat

The split squat is a versatile exercise that can help to train hip and knee extension.  

To decrease hip flexion during this exercise, you can maintain a more upright position of your torso making it easier to perform.  

If you want to make it more challenging, hold a weight in each hand. 

single leg split squat
  1. Start by standing with your feet hip-width apart. T
  2. Take a step forward with one foot, slightly beyond a regular stride length. 
  3. Keep the toes of your front foot pointing forward, and the heel of the back foot should be slightly lifted off the ground.
  4. Maintaining an upright posture and engaged core, lower your body by bending your knees. 
  5. The front knee should track in line with the toes and not extend beyond them.  Your front thigh should be parallel to the ground. 
  6. The back knee should be lowered towards the ground so that you have a 90-degree angle at both knees. 
  7. Try and keep your weight evenly distributed between your front and back foot.
  8. From here, push through the heel of the front foot to drive yourself back up to the starting position. 
  9. Perform 2 to 3 sets of 10 repetitions then switch legs to repeat.  

Hamstring Eccentric Slide

This exercise focusses on the hamstring muscles during the eccentric portion of the movement, that is lengthening the legs and lowering them towards the ground.  

A good progression of this exercise would be the Nordic hamstring curl which is significantly more challenging.  

  1. Lie down on the ground and position your arms down by your sides.  
  2. Bend your knees and keep your feet flat on the floor.  
  3. Raise your hips towards the ceiling as though performing a glute bridge.  
  4. Lift your toes away from the ground and contract your hamstrings.  
  5. Slowly slide your heels away from you so that your body lowers towards the ground.  
  6. Complete 3 sets of 10 to 12 reps.  

Isometric Single Leg Bridge

The isometric single-leg bridge is an exercise that will activate the glutes, hamstrings, and abdominals.  

It involves lifting and holding the hips away from the ground whilst balancing on one leg

isometric single leg bridge
  1. Start by lying on your back with knees bent and feet flat on the floor.
  2. Keeping one knee bent, extend the other leg out straight. 
  3. Engage your core and lift your hips off the ground by pushing through the heel of the foot that is on the ground. 
  4. Your body should form a straight line from your shoulders to your lifted leg.
  5. Once your hips are raised, focus on balancing and stabilizing your body on the foot that remains on the ground and don’t allow your hips to sag.  
  6. Maintain this position for approximately 30 to 60 seconds and repeat 8 to 10 times before switching to the other leg. 

Copenhagen Side Plank

The Copenhagen plank is a challenging isometric movement that works the core muscles, groin muscles, hip adductors, and hip stabilizers.

It’s named after the city of Copenhagen, where it became popular as a method to rehabilitate groin and hip injuries.

  1. Start by sitting on the ground next to a weight bench. 
  2. Place one knee on the bench at a 90-degree angle and one hand on the ground.  Your elbow should be directly under your shoulder. 
  3. Raise your hips off the ground, creating a straight line from your head to your knees. Simultaneously, position your lower leg underneath the bench so that it mirrors the top leg.  
  4. Engage your core muscles to maintain stability.
  5. Hold this position for around 20 to 60 seconds, while maintaining proper form and stability.
  6. Perform the exercise 3 times on one side and then switch sides to work the other side of your body.

Isometric Ball Squeeze

The isometric ball squeeze is an exercise that activates the muscles of the inner thigh, specifically the adductor muscles.

It involves using a small exercise ball (or similar) to create resistance by squeezing the ball between your thighs.

  1. Start by lying down on a mat with your knees bent and feet flat on the ground. 
  2. Place an exercise ball between your thighs so it’s around the mid-thigh area.
  3. Gently squeeze the ball between your thighs by contracting your inner thigh muscles. 
  4. Maintain a constant, firm squeeze throughout the exercise for between 20 to 30 seconds.  
  5. Then relax before repeating.  Aim to complete 8 to 10 repetitions.  

Side Plank Hip Abduction

The side plank hip abduction is an exercise that combines the benefits of a regular side plank with a hip abduction movement.

It primarily targets the core, hip muscles, glutes, and hip abductors.  

side plank hip abduction
  1. Start by lying on your side with your legs stacked on top of each other. 
  2. Support yourself by propping up on your lower forearm making sure that your elbow is directly below your shoulder. 
  3. Raise your hips away from the ground, creating a straight line from head to foot. Brace your core muscles to maintain stability.
  4. Whilst holding this position, slowly lift your top leg away from the bottom leg. Keep the leg straight or with a slight bend at the knee. 
  5. Lift the leg as high as possible without compromising on form.  
  6. Briefly hold this position so that you feel a contraction in your hip muscles. 
  7. Then, using control, lower your leg back down to the starting position.  
  8. Complete 10 reps for 3 sets on either side.  

Final Thoughts

Early detection and appropriate management of hip impingement is important to prevent further joint damage and maintain long-term hip function and health. 

Building up strength to the hip muscles is an important part of this.  

Why not have a read of our article ‘9 Effective Resistance Abductor Exercises With Bands‘.  

This goes into detail about the importance of strengthening the hip abductors as well recommending some great exercises using a resistance band.  

If you’re unsure as to the cause of your hip pain, it’s worth consulting with a healthcare professional, such as an orthopedic specialist or a sports medicine physician, for an accurate diagnosis and personalized treatment plan.

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