Tailoring your exercise routine: Physiotherapy for active individuals with Hip pain

Travis Kluckhenn
by Travis Kluckhenn
Hip impingement, also known as femoroacetabular impingement (FAI), is not only painful, but can be super frustrating for those trying to lead an active lifestyle. Whether you’re a runner, powerlifter, or just enjoy a HIIT or Pilates class, addressing hip impingement pain early is critical to staying active. Here are some simple tips to help you get on top of hip pain, and keep performing at your best without pain.

Understanding Hip Impingement

Firstly, it’s good to understand why you’re getting pain. You can find out more about why hip impingement occurs in THIS BLOG, but to keep it simple, hip impingement occurs when there is excessive and early contact between the hip ball and socket, leading to irritation to the tissues around the hip joint. This can cause pain to the front of your hip, down the front of your thigh, or to your groin, with pain also occasionally located on the outside of your hip. 

The First step to hip impingement pain relief – avoid aggravating it!

If you’ve only just started experiencing hip discomfort, the first step is to identify which movements, positions, or activities are triggering it.
Common causes often include new exercises, tasks at work or home, or gardening activities that involve deep squatting or kneeling. These actions bring the hip and ball socket together and, if done more frequently or for longer durations than usual, can cause excessive rubbing in the hip joint, leading to irritation.
If this discomfort is new, simply stopping these activities, reducing how often you perform them, or modifying them slightly may be enough to prevent your discomfort from progressing to full-blown pain.
However, avoiding these movements isn’t always possible. For instance, if you’ve recently started a new job that requires frequent squatting to pick up heavy objects or kneeling to roll out carpet, avoiding these movements might not be an option. In such cases, it’s essential to focus on improving your hip mobility and strength.

Mobility exercises for hip impingement 

Improving hip mobility can be really helpful for managing hip impingement pain. Enhanced mobility can alleviate discomfort, increase range of motion, and prevent further injury by ensuring that the hip joint moves smoothly during activities. Mobility exercises focus on loosening tight muscles and improving joint function, which will help the majority of people experiencing hip impingement.
Below is a simple hip mobility routine to help manage hip impingement pain, that will only take you 10 minutes, and can be performed every day.

1. Hip Flexor Stretch

• How to Perform:
  1. Kneel on one knee with the other foot in front, forming a 90-degree angle with both legs.
  2. Push your hips forward gently until you feel a stretch in the front of your hip and thigh.
  3. Hold this position for 60 seconds, then switch sides. 
• Benefits: This stretch helps lengthen the hip flexors, reducing tightness and improving hip extension.

2. 90/90 Hip Stretch

• How to Perform:
  1. Sit on the floor with one leg bent in front of you at a 90-degree angle and the other leg bent behind you at a 90-degree angle.
  2. Keep your torso upright and hinge forward slightly over the front leg to deepen the stretch.
  3. Hold for 60 seconds, then switch sides.
• Benefits: This exercise targets the internal and external rotators of the hip, enhancing overall hip mobility.

3. Hip Internal Rotation Stretch

• How to Perform:
  1. Sit on the floor with your knees bent and feet flat on the ground.
  2. Let both knees drop to one side, keeping your feet in place, and hold the position for a few seconds.
  3. Return to the starting position and repeat on the other side.
  4. Perform 10 repetitions on each side.
• Benefits: This stretch focuses on improving internal rotation, which is often limited in individuals with hip impingement.
While a good mobility routine will help in the majority of cases, sometimes when there is excessive bone growth to the ball of the hip, the hip simply won’t move. If this is the case, these exercises are unlikely to help at all, which means that strengthening is going to be your best bet.

Strength exercises that help hip impingement 

Strengthening the muscles around the hip is essential for stabilizing the joint, reducing pain, and preventing future injuries. Strong hip muscles support proper alignment and movement patterns, which can alleviate the stress on the hip joint caused by impingement. Incorporate the following strengthening exercises into your routine to help manage hip impingement pain effectively:

1. Glute Bridges

• How to Perform:
  1. Lie on your back with your knees bent and feet flat on the floor.
  2. Lift your hips towards the ceiling, squeezing your glutes at the top of the movement.
  3. Hold for 2-3 seconds, then lower your hips back down to the starting position.
  4. Perform 15-20 repetitions.
•Benefits: Glute bridges strengthen the gluteus maximus and hamstrings, promoting hip extension and stability.
•Too easy? Progress to a Single leg bridge, or add a barbell to perform a Hip Thrust!

2. Standing Hip Abduction

• How to Perform:
  1. Stand with your feet hip-width apart, holding onto a chair or wall for balance.
  2. Lift one leg straight out to the side, keeping your toe pointing directly in front of you, and your body upright.
  3. Slowly lower your leg back to the starting position, but stop before you touch the ground.
  4. Perform 10-15 repetitions on each leg.
• Benefits: Standing hip abductions strengthen the hip abductors, enhancing lateral stability and control during movement.
• Too easy? Add a cuff weight or an exercise band around you outer leg.

3. Standing Hip Adduction

• How to Perform:
  1. Stand with your feet hip-width apart, holding onto a chair or wall for balance if needed.
  2. With an exercise band looped around your leg closest to the leg of a heavy dining table or couch, cross one leg in front of your standing leg, keeping it straight and your foot flexed.
  3. Slowly bring your leg back to the starting position.
  4. Perform 10-15 repetitions on each leg.
• Benefits: Standing hip adductions target the hip adductors, which are essential for maintaining balance and stability during lateral movements. Strengthening these muscles can help improve overall hip function and reduce the risk of injury by providing better support and alignment for the hip joint.
• Too easy? Try a copenhagen sideplank, or a shortened adductor sidpelank

4. Single-Leg Romanian Deadlifts (RDLs)

• How to Perform:
  1. Stand on one leg with a slight bend in your knee, holding a weight in the opposite hand or with both hands.
  2. Keeping your back straight and core engaged, hinge at the hips to lower the weight towards the floor while extending your free leg straight behind you.
  3. Lower until you feel a stretch in your standing leg’s hamstring, then return to the starting position by driving through your heel and bringing your hips forward.
  4. Perform 10-15 repetitions on each leg.
• Benefits: Single-leg RDLs are excellent for strengthening the hamstrings, glutes, and lower back. This exercise also improves balance, stability, and hip control, which are crucial for managing hip impingement. By focusing on one leg at a time, single-leg RDLs can help address muscle imbalances and enhance overall hip function, reducing the likelihood of injury and pain.
• Too easy? Simply increase the weight, or step into the gym and progress to barbell deadlifts. 

These fundamental strength exercises are a great place to start, and can be easily progressed as you get stronger. However, if you do get pain with any of the above exercises, it may be due to the shape of your hip. So if you’re finding it difficult to exercise without aggravating your pain, or if you’re able to do the exercises but your pain isn’t going away, book in to see a Physiotherapist specializing in treating hip impingement pain. They will be able to perform a thorough assessment of your hip, create a treatment plan that tailored to your needs, which may involve an individualised strengthening program.
Looking for other tips to relive your hip pain? Check out this blog which explains how you can sit better to avoid aggravating your hip.
Call (03) 97522368 or BOOK ONLINE to see one of our Physiotherapists and get a treatment plan to overcome your hip pain today.