Hip Impingement: Exercises and Treatment for Pain-Free

Hip impingement, also known as femoroacetabular impingement (FAI), is an increasingly recognised condition among active Malaysians. It causes a pinching sensation in the front of the hip, especially during squatting, lunging, or sitting cross-legged. Understanding this condition can help you modify your training and manage symptoms effectively.

What Causes Hip Impingement?

FAI occurs when the bones of the hip joint are shaped in a way that causes them to rub against each other during movement. There are two main types: cam impingement (extra bone on the femoral head) and pincer impingement (extra bone on the hip socket). Many people have a combination of both.

The condition is partly genetic, meaning the shape of your hip bones predisposes you to it. However, certain activities and training habits can worsen symptoms. Deep squatting, aggressive hip flexor stretching, and high-volume running are common aggravators.

Recognising the Symptoms

Common signs of hip impingement include:

• A pinching or catching sensation in the front of the hip
• Pain that worsens with prolonged sitting, especially in low chairs common at Malaysian kopitiam
• Discomfort during deep squats or when bringing your knee to your chest
• Stiffness after sitting cross-legged on the floor during family gatherings
• A feeling of limited range in one hip compared to the other

Exercises That Help

Glute Activation and Strengthening

Strong glutes help control the position of the femur in the hip socket, reducing impingement symptoms.

• Glute bridges: Lie on your back, feet flat on the floor, and drive your hips upward. Squeeze at the top for 3 seconds. Perform 3 sets of 15.
• Lateral band walks: Place a resistance band around your ankles and walk sideways with a slight squat stance. Perform 3 sets of 15 steps each direction.
• Single-leg glute bridge: Progress to this once regular glute bridges become easy. Perform 3 sets of 10 per leg.

Hip Mobility Work (Within Pain-Free Range)

Focus on movements that improve rotation without forcing the joint into impingement.

• 90/90 hip switches: Sit on the floor with both knees bent at 90 degrees. Gently rotate from one side to the other. Stay within your comfortable range.
• Quadruped hip circles: On hands and knees, lift one knee and draw small circles. This gently works the hip through its available range.
• Half-kneeling hip flexor stretch: Avoid aggressive stretching. A gentle stretch held for 30 seconds is sufficient.

Core Stability

A stable core reduces compensatory movement at the hip joint.

• Dead bugs: Lie on your back with arms extended and knees bent at 90 degrees. Slowly extend opposite arm and leg while maintaining a flat back. Perform 3 sets of 8 per side.
• Pallof press: Use a cable machine or resistance band. Press outward from your chest while resisting rotation. Perform 3 sets of 10.

Training Modifications

You do not need to stop training with hip impingement, but some modifications are necessary.

• Squats: Limit depth to just below parallel or slightly above. Use a wider stance and turn your toes out slightly. Box squats work well as they provide a consistent depth.
• Deadlifts: Sumo deadlifts may be more comfortable than conventional. Elevating the bar using blocks can also reduce hip flexion demand.
• Lunges: Reverse lunges are generally better tolerated than forward lunges. Keep your torso upright.

Professional Help in Malaysia

If symptoms persist, consult a sports medicine doctor or orthopaedic specialist. A diagnostic injection, available at hospitals like Pantai or Sunway Medical Centre, can confirm whether the hip joint is the source of your pain. Physiotherapy sessions typically cost RM100 to RM200 in major Malaysian cities.

Surgery is only considered when conservative treatment fails after 6 to 12 months. Most people manage their symptoms successfully through exercise modification and targeted strengthening.