Understanding Hip Impingement Femoroacetabular impingement (FAI) occurs when there is abnormal contact between the femoral head (ball) and acetabulum (socket) during hip movement. This abnormal contact pinches soft tissues, causing pain and limiting range of motion. The condition affects the labrum and articular cartilage over time. Three types exist: cam (bony bump on femoral head), pincer (overcoverage of socket), and combined. Pain typically occurs in the groin with hip flexion, internal rotation, and activities like squatting, sitting for long periods, and athletic movements. Research from the British Journal of Sports Medicine shows that exercise therapy improves pain and function in hip impingement. A randomized trial found that structured physical therapy produced similar outcomes to arthroscopic surgery at 2-year follow-up for many patients. Conservative treatment should be the first approach for most cases. (PubMed) Contributing Factors Bony morphology: The structural shape of the hip joint affects how the bones interact. This cannot be changed without surgery but can be accommodated. Hip muscle weakness: Weak hip muscles, particularly the deep stabilizers, allow poor joint mechanics. Movement patterns: Activities that repeatedly move the hip into impingement ranges aggravate symptoms. Posture: Anterior pelvic tilt and prolonged flexed positions increase impingement loading. Start your 14-day free trial to access hip impingement programs. Hip Mobility Exercises These exercises improve hip range of motion in directions that do not provoke impingement. Hip Circles JME 144 For stability, hold onto your chair or desk with one hand. Follow the movement of your leg to the diagram very specifically. Ultimately, you are making a big circle with your knee. You want to be finding your end range of motion at each point. Be slow and controlled - this isn't a race. Find what works for your joints. Hip Extension JME 124 Holding onto a wall or your chair, extend one leg back. Hip External Rotation JME 149 Either sitting or standing, straighten and extend one leg forward. Rotate that leg left and right and find your end range of motion each way. Stay slow and controlled. Standing Hip Work JME 127 Holding onto the wall or your chair, lift one leg to 90 degrees, return to the ground, then do the same with the other leg. Hip Strengthening These exercises build the muscular control to optimize hip mechanics. Hip Abduction JME 125 Holding onto a wall or your chair, extend one leg to the side. Glute Activation JME 146 Either with your hands above your head or holding onto your chair, lift one leg up to 90 degrees. Then, bend at your hips to rotate your upper body toward the floor. Single Leg Balance JME 140 Standing, while maintaining a 90 degree bend at your knee, lift your leg to find your end range of motion. Once found, return to the floor and do the other leg. Hip Control JME 145 Standing, with your knee bent at 90 degrees, lift your leg up to find your end range of motion. Each rep, try to find more space to move your leg higher - but don't force anything. Listen to your body and find what works for you. Movement Modifications Squat stance: Wider stance with toes turned out reduces impingement. Avoid deep squats that provoke pain. Hip hinging: Emphasize hip hinge movements that load extension rather than deep flexion. Sitting position: Avoid prolonged sitting with hips below 90 degrees. Use a wedge cushion to raise hips higher than knees. Sleep position: Avoid sleeping with hip flexed and internally rotated. Use a pillow between knees if side sleeping. Common Mistakes Aggressive stretching: Forcing hip flexion and internal rotation worsens impingement. Avoid stretches that provoke pain. Ignoring symptoms: Continuing painful activities accelerates cartilage damage. Modify activities to reduce pain. Deep squatting: Full-depth squats often provoke impingement. Work in ranges that do not cause symptoms. Neglecting strengthening: Mobility work without strengthening does not improve joint control. Include both. Activity Guidelines Activities that involve repetitive hip flexion past 90 degrees with internal rotation are most provocative. This includes deep squats, certain yoga poses, and some sports movements. Modify or avoid these during symptomatic periods. Running on flat surfaces is often tolerated better than activities requiring deep hip flexion. Posture Considerations Anterior pelvic tilt positions the hip socket in a way that increases impingement. Working on neutral pelvic alignment can reduce symptoms. This involves hip flexor stretching and glute/core strengthening to support neutral position. When to Seek Help If symptoms persist despite 8-12 weeks of appropriate exercise, if there is significant loss of range of motion, or if symptoms significantly limit daily activities, consult an orthopedic specialist. Imaging can clarify the structural component. Some cases benefit from surgical intervention. Progress Expectations Symptom improvement typically begins within 4-6 weeks of consistent exercise and activity modification. Significant improvement takes 3-6 months. Some structural issues create ongoing limitations that require permanent activity modification rather than complete resolution. Start your 14-day free trial and manage hip impingement with simplmobility.