At New York Bone and Joint, we strongly encourage our patients to consider non-surgical treatment for their bone and joint conditions whenever possible. While many orthopedic injuries can be surgically repaired, we’ve consistently found that if it’s possible, non-invasive treatment greatly reduces the risk of complications while promoting quicker recovery, resulting in better long-term outcomes.
Since hip impingement responds particularly well to physical therapy, we highly recommend that you practice gentle stretching and strengthening exercises under the supervision of a qualified physical therapist (PT), who can devise an appropriate plan for you after evaluating your gait, your current range of motion, the severity of pain in the affected hip, and the strength of the surrounding muscles.
Here are a few of the common exercises that your PT might recommend:
Hip Flexor Stretch
Hip impingements often affect the hip flexors, which are the muscles responsible for standing and walking. Any impingement can cause significant tenderness and weakness in these muscles, limiting your ability to walk. Fortunately, these symptoms can be easily managed by regularly stretching the hip flexors. The most common stretch is outlined below:
- Place the knee with the impinged flexor on the floor while keeping the other foot flat on the floor.
- Slowly move your body forward while straightening your back and holding your chest high.
- Flex your abdominal muscles by drawing them in toward the spine.
- Contract your gluteal muscles.
Maintain this position for fifteen to thirty seconds, and repeat for three sets. If you’ve performed the exercise correctly, you should experience a gentle stretch in the front of your hip and thigh.
Piriformis Stretch
Located beneath the gluteal muscles, the piriformis stabilizes the hip and is responsible for rotating it. Regularly stretching it should help you regain your range of motion. The most common stretch is outlined below:
- While lying on your back, bend your knee.
- Bend the knee with the affected hip and cross it so that the ankle is resting above the other knee.
- Pull the bottom leg towards your chest.
Maintain this position for fifteen to thirty seconds, and repeat three times. If you’ve performed the exercise correctly, you should experience a slight pulling sensation in the back of your hip.
Bridges
Since hip impingement can weaken the muscles in your lower back, you’ll need to rebuild them to ensure a complete recovery. A common strengthening exercise is outlined below:
- Lie down on your back with your knees bent and the soles of your feet on the floor. Your arms should lie at your sides.
- Reach towards your heels with your arms.
- Raise your hips by pushing down on the soles of your feet.
- After raising your hips, rest your back on a sturdy surface so that your sacrum touches it.
Maintain this position for several minutes, then remove the surface on which your back is resting and slowly lower your hips to the ground. You can repeat the exercise as many times as you like.
Leg and Thigh Lifts
Your inner and outer thighs can be affected by hip impingement, making proper stretching of the muscles within them crucial. The most common stretch for the inner thigh is outlined below:
- While lying on your side, keep your bottom leg bent in front of you and extend your top leg.
- Bend your bottom arm upwards to support your head with your hand.
- After placing your top hand on the floor in front of you, bend the arm.
- Raise your top leg by six inches before returning to the starting position.
After three sets of ten reps, repeat the exercise on the other leg.
The most common stretch for the outer thigh is outlined below:
- While lying on your side, extend your bottom leg.
- Bend your top leg as you raise your knee towards the ceiling.
- Position your foot in front of you with the sole of your foot planted on the floor in front of your bottom thigh.
- Bend the bottom arm to support your head with your hand.
- Place your top arm alongside your body.
- Raise your bottom leg by at least five inches before returning to the starting position.
As with thigh lifts, perform three sets of ten reps on each side.
Exercises to Avoid
Before you hit the gym for an intense workout, it’s important to remember that not all exercises are suited for patients with hip impingement. In particular, squatting, plyometric workouts, and any exercises involving significant hip flexion with internal or external rotation should be avoided, since these exercises can aggravate the impingement.
