If you’ve been experiencing pinching pain at the front of your hip or groin area with sitting, squatting, climbing stairs, or with sports movements, you may be dealing with hip impingement.
Hip impingement, medically known as femoroacetabular impingement (FAI), is a condition that affects a significant number of individuals, causing pain and discomfort in the hip region. It often presents as a deep “ache” and a loss of range motion. In some cases, you may even feel a catch or pull at the hip that affects your ability to walk or squat.
In the early stages of hip impingement rehab, it can be hard to know what makes the condition worse and what makes it better. Since hip impingement can be quite painful at times, knowing what is making the pain worse and avoiding those actions are the essential first steps in recovery.
What is Hip Impingement (FAI)?
Femeroacetabular impingement is a mouthful to say, so for the rest of this post, we will use the abbreviation “FAI.”
FAI is a structural hip disorder characterized by abnormal contact between the femoral head (the ball-shaped top of the thigh bone) and the acetabulum (the socket in the pelvis). This interaction can lead to friction and pinching of the hip joint’s soft tissues, including the labrum, cartilage, and ligaments. There are three primary types of FAI:
- Cam Impingement: In this type, the femoral head is not perfectly round, resulting in a non-spherical shape that can bump against the hip socket during hip movement.
- Pincer Impingement: Pincer impingement occurs when there is excessive coverage of the hip socket over the femoral head, causing an abnormal collision between the two.
- Mixed Impingement: This combines elements of both cam and pincer impingement, resulting in a combination of abnormalities in both the femoral head and hip socket.
FAI is often diagnosed through a comprehensive medical examination by an orthopedist or physical therapist and confirmed through an x-ray. In most cases, FAI is treated conservatively without surgery with good results.
Now that you know what FAI is, let’s dive into the all-too-often overlooked triggers that make hip impingement worse.
The Movements That Make Hip Impingement Worse
Even though you’ll most likely feel FAI pain when you squat, climb stairs, or play sports, there are other everyday movements that could be sabotaging all your efforts in rehabilitation. These “silent assassins” don’t often hurt while you are doing them but affect the joint and prolong inflammation and pain.
1. Sitting With Crossed Legs
One of the seemingly harmless habits that can worsen hip impingement is sitting with crossed legs. This posture, although great for relaxing, can create a pinch and inflammation in the hip joint. When you cross one leg over the other and lean back in a chair, you inadvertently flex and rotate your hip, bringing the ball and socket of the hip joint closer together. Over time, this can lead to discomfort and pain.
To alleviate this issue, opt for a more hip-friendly sitting position. Instead of crossing your legs, place them flat on the ground or on a stool to maintain a neutral hip position. By avoiding crossed legs, especially during acute stages of hip pain, you can reduce irritation and discomfort.
Having FAI doesn’t mean you should never cross your legs; it only means that in the acute painful stage, you should limit or avoid it to reduce inflammation and jumpstart your healing.
2. Sitting With A Low Chair
Your choice of seating, whether at your desk or in your car, plays a crucial role in hip impingement prevention. Sitting in a low chair or a car bucket seat where your knees are positioned higher than your hips can increase pressure on your hip joint. This elevated pressure can push the ball and socket closer together, exacerbating impingement.
To counteract this, adjust your seat height to ensure that your knee and hip are at the same level, or ideally, with the knee slightly lower than the hip. This simple adjustment can significantly reduce hip compression and discomfort during prolonged periods of sitting, such as during your daily commute or work hours.
3. Reconsidering Your Stretching Routine
Stretching is a common practice for relieving hip tightness and discomfort. However, certain stretches, like the figure four stretch, can inadvertently exacerbate hip impingement during the acute stages of pain. The figure four stretch involves crossing one leg over the other and sitting back onto your hip, which compresses the hip joint.
During the initial stages of hip pain, it’s advisable to avoid this stretch, as it places additional compression and body weight on the hip joint. While it may be beneficial in later stages of rehabilitation, it’s best to steer clear of it when hip pain is acute.
4. Check Your Squat Form
Squatting is a common exercise that can either alleviate or aggravate hip impingement, depending on your form. Two key factors to consider when squatting are knee alignment and pelvic tilt.
Firstly, ensure that your knees do not cave inward during a squat. This inward movement, called adduction or internal rotation, can bring the two bones in your hip joint closer together, resulting in hip pain. To prevent this, use cues like spreading the floor with your feet or turning your feet outward to engage your glutes and maintain proper knee alignment.
Secondly, avoid excessive anterior pelvic tilt, which involves tilting your pelvis forward or creating a sway in your lower back. This posture can cause the hip cup to tilt forward, increasing pressure on the hip joint. To counter this, maintain a neutral spine throughout your squat, especially as you reach the lower portion of the movement.
5. Avoid the Drop Bars In Cycling
For cyclists, hip impingement can manifest as sharp or stabbing pain, particularly when riding in certain positions. When cycling in the drop hoods or down bars, you create a forward-leaning posture that can increase hip pressure, especially during the top portion of your pedal stroke.
To mitigate this, consider riding with your hands on the crossbar or hoods, as it reduces compression on the hip joint. While this adjustment may be temporary, it can provide relief during periods of hip discomfort.
Conclusion
As you can now see, hip impingement can often be aggravated by seemingly insignificant daily habits. These “silent assassins” can undermine your efforts to alleviate hip pain, even if you are diligently performing exercises and stretches to address the issue. By recognizing and modifying these behaviors, such as avoiding crossed legs, adjusting seat height, reevaluating your stretching routine, squatting with proper form, and adapting your cycling posture, you can take significant steps toward managing and reducing hip impingement pain.
