If you've ever had a nip in your hip that just won’t go away that catches you at weird angles, when squatting, or getting up out of a chair, then there’s a fair chance you’ll have heard the term “hip impingement” or it’s more sexier name, “Femoroacetabular Impingement”.
After a quick look on Dr Google, you’ll come across all kinds of information about Cam Impingement (a deformity of the head of the femur) or Pincer Impingement (a deformity of the front rim of the hip socket) and you can even have a mix of the two. You can also experience impingement sensations if you have deep hip sockets.
How unlucky is that! Your bones just weren’t made right 🤷♂️
But a lot more common is tight and/or weak muscles causing your joint to move inefficiently or shifting your femur head out of the centre of the socket.
You can feel like you’re rubbing “bone on bone”, but the majority of the people I have worked with the problem (and solution) was muscular & movement based, only a handful of times has it turned out to be a bone deformity that needed a surgical intervention.
I personally dealt with impingement in my right hip for a very long time and the more I tried to train through it the more inflamed it would get - but now I am totally pain free! I love to squat and Olympic lift and don’t have to adapt my training in any way. In fact, there are many people in our SMM group who have osteoarthritis, or have had scans showing bone deformities, or even labral tears who now are either totally pain free or drastically reduced their symptoms, simply from building better mobility.
Before we get into what to do, when you are dealing with something like an impingement, remember that it is not an overnight fix, and you will most likely aggravate it along the way and that is totally normal as the muscles improve. But if you’re ever unsure you should check with your Doctor or Physiotherapist!
Think back to the first time you did a new workout, movement, or sport - how sore were your muscles were the next day? Your hip has likely not moved in a certain range for an extremely long time, and it’s going to get sore the first few times - the key thing is to rest, let it recover, then get straight back in! Not just throw in the towel at the first hurdle.
I genuinely thought I had torn something, or had given myself arthritis, bursitis, or wore away the bone… my brain panicked and went through absolutely every worst-case scenario as I was working on my hip, but now it’s totally fine. Our brains are hardwired to protect us against negative feelings, especially around our important joints, so trying to convince you that you must stop what you’re doing immediately or else you might explode is actually quite a normal response.
Rather than trying to pinpoint a particular muscle that’s causing all your problems (which is nearly impossible considering how closely all your muscles work together), just by doing these movements regularly by happy accident, you’ll catch whichever muscles may or may not be the problem!
Making things any more confusing that than will leave you going round in circles, getting stuck and probably giving up.
But… 6 things!
I only have time to do 1 movement!!
Well, my inflexible friend, you’re in luck!
You can hit a lot of these motions in one drill is the hip CAR’s drill, or the Fire Hydrant if you’re old school:
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Do this to a range that feels comfortable but challenging and keep increasing how far you go over a period of weeks! Your range of motion improve with frequency and if you are sensible enough you can do it daily.
1-3 sets of 5 slow rotations per side twice a day. Once when you first wake up in the morning and the second in the evening!
Next: Add Strength & Stability
Now that we’re working on our movement, we want to add strength & stability to our hips so the new range of motion sticks (and doesn’t become weak). Sometimes you can be doing the right stretches but if the stability is lacking, you can still have symptoms of pain!
The side plank march is an amazing way to accomplish a lot of strength, with the added bonus of link your core and hips together:
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If you cannot do this exercise at all then don’t worry – but you have some work to do! Don’t give up if you find it hard, instead accept your starting point and challenge yourself to keep practicing until it becomes a normal movement for you
A good goal is 10 marches per easily without stopping.
Aim for 2x 10 per side after your hip CARs. This eventually will be 10 unbroken, but at first it could be 10 single reps with a rest inbetween each.
Finally: Learn & Practise Deep Hip Movements
Lastly, combining range of motion with stability in a movement will build confidence in your hips and teaches your body that it is safe & strong.
For that you need exercises that include deep hip positions. I highly recommend learning the Cossack squat and to include it into your training.
Start assisted by either holding on to something or using a counterbalance weight out in front of your body to build confidence, over time you’ll be able to get deeper and deeper into the movement:
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Set a timer for 1-5 minutes (depending on how much time you have left after your CARs & Side Plank Marches) and just have a wiggle! How low can you get? Are you close, or far away? Is one side better than the other?
If the first time you try Cossacks, they feel horrible and you feel like you’ll never be able to do it… then… good! That means you’ll definitely be able to improve it and you have lots to gain from practicing it!
Just like the Side Plank March & Hip CARs, starting in a weak or bad place doesn’t mean it has to be like that forever. You are capable of changing your body, it just takes a bit of time.
Moving better is a long-term process. Remember that the time is going to pass anyway.
1-3x 5x Hip CARs per side 1-2x 10x Side Plank Marches per side 1-5 mins Cossack Squat practise (assisted or unassisted)
Commit Yourself to Improving
Remember that as you work on these things it’s normal to feel like your hips are knackered or slightly inflamed so take time off if you need.
There’s no rule for how long it will take for you to notice a change, or how often you need to practice these movements. You are the best person to know when you can push and when you need to relax, try to find that thin line between being a hero and being a wimp and hang out there. Push yourself but push yourself sensibly.
If you're at the stage where you’re considering injections or surgery, I would take this blog very seriously and really commit to these 3 exercises.
It takes daily effort to make a change and, again, it’s not a quick fix but if it leads you to have better moving hips that cause you no problems then it’s worth every second, and once they move better it’s much easier to maintain.
