In today’s post, we will share our go-to exercises for someone with femoral acetabulum impingement (FAI) or hip impingement (hip pinch).
We’ll also cover the reasoning behind why we’ve chosen to include each exercise in the program. The goal of this blog is to serve as a resource for you to integrate into your approach with your physical therapist.
If you need a refresher on why movement and strength intervention should be your first focus for improving FAI, check out our earlier blog post All About Femoral Acetabulum Impingement
In most FAI cases, movement and strength will improve the situation enough to not warrant surgery. And in the rare instances in which surgery is the only option, all the work you put in to improve your strength and movement now will make the surgery recovery smoother.
Manage load and modify activities
Even the greatest rehab training program is unlikely to work if the hip and groin area are constantly painful and inflamed. As with most musculoskeletal issues, the first steps in FAI rehab are managing your load and modifying your activities.
You will likely need to reduce the weights you’re lifting or were lifting before the FAI symptoms started. It might also mean having to stop doing the activities you enjoy. Bummer, I know, but this is an example of needing to regress to progress.
You don’t necessarily have to eliminate exercises altogether
The aim is to find alternative ways to get the best training effect without aggravating your symptoms. That way, you don’t lose as much of your strength and fitness during rehab and can return to your usual activities and sports quicker.
For example, staying away from the deep hip flexion in squats and deadlifts and opting for box squats and rack pulls often works. And instead of high step-ups or pistol squats, try split squats.
If your FAI really limits what you can do, you can use single-leg exercises to only train the opposite leg. Which will then help your FAI leg maintain some of its strength.
As a general rule, choose loads and activities that keep your FAI pain under 2 or 3 out of 10. Not everyone has the same tolerance and relationship with pain, so your pain scale might be slightly higher or lower.
Mobility exercises for femoral acetabulum impingement
1. STANDING HIP FLEXION PAILS AND RAILS W/ BAND
We’ve chosen this standing exercise to start by creating space in the posterior hip capsule to increase movement in the front of the hip.
2. ELEVATED HIP EXTERNAL ROTATION (W/ PAILS AND RAILS)
We then move on to PAILS and RAILS to improve the hip’s internal and external rotation in a pain & pinch-free range of motion.
3. KINSTRETCH CLASS- HIP INTERNAL ROTATION WITH BLOCK
A quick 15-minute class using a block to help you with your hip rotation.
4. KINSTRETCH CLASS- HIP INTERNAL ROTATION SIDE-LYING
A short 10-minute class in a side-lying position.
5. HIP CARS TO STRENGTHEN THE OUTER RANGES
These are daily recommendations for anyone. Stay within the range that is pain-free.
You can do the above exercises as a part of your warm-up and sprinkle them into your off days. Be consistent and get at least 5 reps a day every day.
We want to create long-term change at the hip which requires consistentcy.
You can do your hip C.A.R. from standing, side lying, or quadruped. Find a pinch-free setup you can be consistent with and put in the work.
Strength exercises for FAI
Most people with FAI symptoms have suboptimal hip strength and single-leg balance. Based on that, most of our FAI strength exercises are unilateral.
Pick exercises that work best for you as an individual avoiding any aggravation of symptoms. We have an entire program on systematically building hip strength.
Adding this Campo deadlift to your warm-up is going to be a huge help.
This will shift your center of max back and open up the back of the hip promoting internal rotation. Do 3 sets of 10 as directed in the video before your next strength day.
For bonus points superset 5 hip CARs with it and notice how well you get into your hips for your lunge, deadlift, and squat variations.
FAI is not a death sentence
Most FAI cases resolve with load management, activity modifications, and intelligent movement and strength training. Give them at least 3-6 months before considering surgery. We recommend contacting a qualified movement therapist to individualize your rehab.
And if you do need surgery, doing this strength and movement work now will speed up your post-surgery recovery.
If you are having trouble and want some personal guidance, you can work with Ian individually.
References:
https://pubmed.ncbi.nlm.nih.gov/27301577/
