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Hip Impingement Pain (FAI) Best Exercises, Rehab & Strengthening (How to Avoid Surgery)
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- เผยแพร่เมื่อ 1 ส.ค. 2024
- #hipimpingement #painfulhip #femoroacetabularimpingement
Femoroacetabular Impingement, more commonly known as hip impingement is a bony issue within the hip socket involving the femur and pelvis. These changes are more commonly seen in athletes and can lead to groin pain, potential labrum and subchondral bone issues.
There are two main types, CAM (changes to the femur, thigh bone) and PINCER (changes to the acetabulum, pelvis). In this video we will go into detail about all of this and best ways to manage this condition, including what role imaging plays and when surgery is recommended.
Timeline:
Anatomy: 00:05
What causes it? 00:22
Clinical Presentation: 00:40
Diagnosis: 00:54
Exercise Recommendations: 01:39
Sports with Hip Impingement: 09:03
Other Conditions: 09:16
Timeline: 10:00
Imaging: 10:24
Surgery 10:51
Related Videos:
Piriformis Syndrome: • Persistent Buttock Pai...
Hip Osteoarthritis: • HIP OSTEOARTHRITIS. B...
Gluteal Tendinopathy: • How to FIX Lateral Hip...
Snapping Hip Syndrome: • Snapping Hip Syndrome ...
Gluteal Bursitis: • GLUTEAL BURSITIS. BEST...
Tight Hip Flexors: • Tight Hip Flexors?!? ...
Adductor/Groin Pain: • Groin/Adductor Pain, B...
Hp Impingement Comprehensive Rehab: • HIP IMPINGEMENT PAIN. ...
References:
ishasoc.net/wp-content/upload...
pubmed.ncbi.nlm.nih.gov/23333...
pubmed.ncbi.nlm.nih.gov/30733...
pubmed.ncbi.nlm.nih.gov/22773...
pubmed.ncbi.nlm.nih.gov/33989...
pubmed.ncbi.nlm.nih.gov/29443...
www.jospt.org/doi/full/10.251...
www.ncbi.nlm.nih.gov/pmc/arti...
pubmed.ncbi.nlm.nih.gov/27301...
journals.sagepub.com/doi/abs/...
pubmed.ncbi.nlm.nih.gov/30262452
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Disclaimer
The information provided in this video is intended as general information and not a substitute for individual medical advice regarding your medical condition. To the extent permitted by law, neither Performance Sport & Spine, nor any of our officers, employees, agents or related bodies corporate will be liable in any way (including for negligence) for any loss, damage, costs or expenses suffered by you or claims made against you through your use of, or in connection with, this video or information supplied or offered to be supplied on this video. Although we use our best efforts to provide accurate information and other materials on this video, the video is provided “as-is”. To the extent permitted by law, all warranties, conditions and representations provided about or by this video are excluded. Redmond, WA Chiropractic
I’ve been to physical therapy and pain clinic. But the exercises you just showed are helping more than the ones the hospital gave me. I want to just say thank you so much for making this video. You just helped this veteran.
So happy to hear you found it helpful. Thank you for letting us know. Keep up the great work!
Most thorough, detailed breakdown of different exercises. Kudos to ya!
Glad you enjoyed it! Thanks for the comment.
Love u fin
Very valuable information,thank you !
Glad it was helpful! Thanks for watching.
Thank you very much for these tips. Great exercises. I already feel more mobility in my mild FAI issue..
You are most welcome! That's great news that you are feeling more mobility.
Great video, thanks!
Glad you liked it!
Thanks for this.
Yep! Hope its helpful.
Excellent video, really Appreciate
So nice of you! You are most welcome.
Thank you very much, I need this!!!!!!!!
You're welcome! Thanks for the comment,
FANTASTIC!
Thank you! Cheers!
Thanks for your exerçises
My pleasure!
Tried it. Best help!
Great job! Thanks for watching
Awesome ‼️
Thanks for watching
I like the honest info on the efficacy of surgery. Really good run-through of those exercises!
Thank you, appreciate the comment!
Sir, but what is the honest truth regarding surgery? If it comes to arthroscopy, after a year of physiotherapy I've been recommended to consider arthroscopy. On top of that, arthroscopy, according to PubMed showed superiority to physiotherapy. Is surgery really a bad option I should avoid (given a 17% success rate), or I can benefit from arthroscopy after failing in exercises?@@PerformanceSportSpine
God bless you brother 🤝
You are most welcome!
Thanks again 💖💖💖
You're welcome
Great video!
Thanks! Appreciate the comment
I've been grappling in my mid 20s and I've started developing impingement symptoms. Online the general consensus has been that surgery is the only hope. I'm going to try these exercises out for a couple months and I hope they help 🙏🏻
Sorry to hear you have gotten that consensus. Be reassured the evidence says differently, a lot of people have great success with rehab/exercises. Please let us know if you have any questions along the way. Also here is another video with some different/more advance exercises.
th-cam.com/video/EHk4_tcEX28/w-d-xo.html
feedback?
Did they help
Wow, best video on impingement I have seen. Great job
Wow, thanks! Really appreciate the comment.
@@PerformanceSportSpine Could you help me to separate the exercises for strengthening, and the ones that help in the short term when the pain is the greatest? I tried the second exercise and my impression is that it _immediately_ helped somehow, the pain seems gone. Maybe because it is not only strengthening, massageing - by the ground - my problematic hip side?
@@Fricsak Yes we can, can you be more specific about what you mean by separating them? Often it is about finding the right entry point for the exercise (intensity, duration and frequency) and then gradually increasing over time. Allowing time to recovery and adapt. Pain is extremely complex, so if one helped immediately it is most likely for a variety of reasons.
Miglior video che abbia mia visto sei bravissimo e preparatissimo ieri ho iniziato a farli e lo sento li farò con costanza almeno per un mese
Si vede che oltre alla preparazione c’è tanta esperienza dietro
Really good video! I actually understand more why I can’t internally rotate my hip. Thank you
Happy to hear it helped! Thanks for the nice comment
You're doing god's work. Clear, helpful, concise. Thank you.
Thank you for the kind words. We hope people find these videos helpful!
How important is stretching the hip flexors in addition to strengthening? Thank you! Great video!
Great question. With FAI impingement the tightness or loss of range of motion is caused by bony changes, not a loss of flexibility. So stretching them isn't normally that important. However, if you find they you like stretching, then continue to do so. Just be carefully in not over stretching at end-range
Had an arthroscopy for this. Wish I saw this video earlier. It's perfect
Hope the surgery helped! Thank you for the kind words. Hope the exercises & content help.
I had surgery also
@@rokometer8 did surgery help you?
@@orevelickovic7619 yes it helped a lot, I mean im still on recovery period
@@rokometer8 Hows the current condition?
Amazing video! My hip pops out of the socket and I think I need to strengthen hip flexors and psoas. Physical therapy, doctors and chiropractors have but been any help. But I think this will help me. Thank you!!
Thank you very much! Glad to hear it gives you a new course of action. Thanks for watching and let us know if you have any questions
thanks alot for this video. I am a bit confused because you counted from tier 1 to 5 then releated again.
It is for different muscle groups, hip abductors, adductors, flexors etc.
Excellent video, I played rugby from the age of five to nineteen as well as surfing always been active. Diagnosed with osgoodschlatters disease at thirteen and FAI at forty. Be interesting to know the correlation between both.
Thank you! Hope this video helps. If we come across anything explaining a correlation we will pass it along.
@performance sport & spine ...can the regular use of "kneeling chairs" have any impact on the fixing the hip impingement? I imagine it can balance the lower back/spine and pelvic in correct position and help improve the pelvic & femoral ball interaction ?
If that position is more comfortable than it most likely is a helpful strategy. However, it won't fix the issue of hip impingement as this is caused from bony changes to the femur and/or pelvis, not a incorrect position
It would’ve been nice to see a different color band used in your demonstration as it was hard to see..
Will do that next time, thanks!
Amazing video! I have FAI and got surgery for it. Everything was fine for 2 years and now the symptoms are kicking back.... what is the next move???
Thanks! Start doing these exercises. Also if you have been less active than normal, slowly add activities/exercises that you like to do. If you have been more active than normal, TEMPORARILY reduce them, let things calm down, then add them back in.
Does this apply to psoas snapping in the low back as well, can this even be fixed?
This is different. As for the psoas snapping (popping), strength exercises for the hip flexor may reduce the snapping.
Thank you for sharing this
My only concern are the jumping exercises. I have osteoarthritis and heard I should avoid any kind of impact exercises. Any comments ?
Of course, thanks for the comment!
As for jumping, I would argue it depends. Osteoarthritis is much more than a "wear n tear" disease and often moderate exercise is protective, not destructive. As for hip oa, in general (can't say specifically to an individual without a personal assessment) if it is mild to moderate and the person is a healthy weight they should be able to add impact exercises in over time. Noting that dosage matters here, and they will need to find the right Entry Point and gradual increase in volume, allowing the body time to adapt.
I bought a resistance band and did the exercises suggested in this video. I will reply to this comment every 7 days to report my improvement.
Great job! Keep up the good work and we can answer any questions when you post next.
homie, we are waiting for the feedback. where r you at bro?
@@Nick-bm5jj What is your question? Happy to provide feedback
@@PerformanceSportSpine I was wondering how Morcys improved with his regular exercises. It's great that you have also replied though! Thanks for the great and detailed explanation. But I still do not get it how strength and stretching exercises may help with this condition. I mean, whether its cam or pincer - the bone structure will remain like this forever, it can only get worse due to the constant scratching
@@Nick-bm5jj Gotcha. Great question. Basically pain is more complicate then just what is happening to the bones or what we can see on an image. First, how long the bony changes take to form matters, if these changes happen over weeks (more likely) or more slowly over years (less likely). And exercises help by increasing the threshold you experience pain., i.e. giving you more buffer between activity and pain. The higher the line (threshold) is above what you level of activity is, the less likely you are to have pain. Hope this helps some.
Thank you . I am 20 years old and a good football player. I injured my right leg when kicking the ball hard 10 months ago. You are lost now. I have neglected my leg and I cannot return to training. What do you advise me to do? Should I go to a doctor to get an MRI or take your own exercises? 🙏🏻
Sorry to hear that. Yes go to a sports med doctor, if you have this condition these exerises will help.
@@PerformanceSportSpine thanks 👍🏻
Hello, thanks for the video. I play football and I felt the pain of groin since the end of March, so that is almost 6 months. The doctor confirmed FAI Impingement. It's been 2 months when I started cycling regularly and it helped out a bit. Do you think that I am gonna return into trainings without problems, eventually when?
Thanks a lot!
You are welcome! Have you start rehabbing or just cycling? Most people improve with progressive strength training, unfortunately we can't predict specifically the time line for you.
@@PerformanceSportSpine I don't perform the rehabs but cycling helps in my case. What do you mean by "progressive strength training"? Thanks a lot for your quick response, I really appreciate it
@@StepanBezdek it means increase the weight or intensity over time, increasing the strength of the tissues. Yep anytime, hope it helps. Keep up the good work!
@@PerformanceSportSpine thanks a lot
What if you have a bone spur on your femur head neck junction due to FAI? I can't do any adductor exercises without extreme pain. :(
Hard to say for certain, but often with that you have to work around the pain and the bony changes. With the adductor exercises, have you tried isometrics at a really low intensity? Have you consulted an ortho yet?
Hello! Do you recommend performing one tier per category, based on your ability? Thanks for your help
Hi! Yes, then progress up the tiers to increase the difficulty. Often certain catergoires will be easy or hard and adjust the progress accordingly.
@@PerformanceSportSpine great, thank you. Hopefully I get results. I'll be sure to come back and thank you again if so
@@DJM3KS It is a process, but if you are consistent you will!
Hello , I am 29 years old and have been diagnosed with FAI and anterosuperior labral tear with associated thinning of the articular cartilage of the right acetabulum , my FAI is mixed. I had an x-ray and Hip MRI after I started feeling pain in my right buttock that starts there and stops on my knee ,( I also feel pain in my knee and slightly above it on the thigh when I sneeze or cough , even though I underwent an EMG test and it was normal) My MRI report also showed subsequent degenerative changes of the right hip joint demonstrated by joint hip narrowing predominating posteriorly, subchondral sclerosis and erosive changes of the right acetabulum and spur formation of the femoral head. Moreover , I have tendinopathy of the right gluteus tendons at their insertion on the greater trochanter as well as a small trochanteric bursitis on the right . My orthopedic recommended surgery because he said I might be developing osteoarthritis that might lead with age to hip replacement. I haven't started physical therapy or strength training yet, but I would like to know you opinion on my case if possible because I am not very convinced about the surgery (hip arthroscopy). Your reply is highly appreciated !
Happy to help any way we can. First off, we almost never recommend surgery prior to several months of high-value, evidence-based PT/rehab has been tried and failed.
Secondly, surgery normal increases the risk of long term OA, rather than decrease (think cutting & shaving out). Now there is an increase risk after injury, regardless of course of action, but don't let the potential long-term implications dictate your treatment in regards to OA.
I will have you ask you some questions. Did you play sports as a kid? For the hip/buttock pain, what makes it worse/better? Is the pain from the buttock radiating to the knee, or two separate spots? Has some assess your low back/lumbar spine?
This video will give you all you need and more to resolve the Gluteal Tendinopathy issue:
th-cam.com/video/l5Me8a1Hui4/w-d-xo.html
@@PerformanceSportSpine Thank you for the reply.
I played a bit of football(soccer) and basketball when I was a kid but not religiously. As for the hip/buttock pain, sometimes it feels radiating and connected through thigh pain but most of the time it feels separated, sitting for a long time or walking for a long time triggers the pain . Prior to my hip MRI, I did a lumbar MRI and everything appeared normal with no disk.
@@ejelia You are most welcome! Does stretching or loading your hamstring irritate the pain? And sprinting really hurt?
@@PerformanceSportSpine When I used to want to do the prone leg curl machine, I remember that as soon as I wanted to lie down I felt sharp pain in my thigh only, like tearing pain , hard to describe it , for the whole workout duration but never knee or hip pain. As for sprinting im not sure because i dont usually run, only walk. Now it's been almost a month since i stopped going to the gym , i'll be meeting a physical therapist in the next couple of days to discuss my rehab journey , but i am really confused because as far as i know FAI and labral tear don't cause thigh pain or knee pain alone, especially not when coughing or sneezing.
@@ejelia I agree, that description doesn't not sound like FAI. Sciatica or Piriformis would be on the top of my differential. Glad you are meeting with a PT, just make sure they don't tell you some outdated theory, like your pelvis is rotated, weak core and some mythical firing pattern. Basically like every profession, not all PT's are equal, so getting a good one is paramount.
If you care here are links to our Sciatica and Piriformis Videos:
Sciatica: th-cam.com/video/Uw5PxVn5o4o/w-d-xo.html
Piriformis: th-cam.com/video/MtcbW1rDEbs/w-d-xo.html
I am not saying you have theses, just that they need to be ruled out.
I’m 15 just recovered from a torn hip labrum could this be why I’m feeling this pain. My range of motion is fine tho it’s just pinching in my groin and pelvis and I can’t move laterally quickly
Sorry to hear that, fortunately we dedicated rehab and exercise most people can make a fully recovery!
These 2 videos may also help you.
Hip Labrum: th-cam.com/video/goQ2A0JD57Q/w-d-xo.html
5 Most Common Causes of Groin Pain: th-cam.com/video/9YeyecaxEGw/w-d-xo.html
Hi when i do functional training my pain increases. Is it because my legs are week? What should i do?
Unfortunately we can't give medical advice on that without a personal assessment.
Do you do this on both sides jusy the sore hip?
Do both sides
Doc... Good Stuff! It would be better if you slowed down ..... just a bit. Thanks!
Thank you, will do!
I love your video
What bands are you using
What sizes
I want to buy t gf same ones
Thank you!
Here are the band links:
a.co/d/9dKF72H
a.co/d/hZOVwtr
Thank you for this video. I'm a 36 year old male who used to be heavy into squatting and deadlifts, but have slowed down over the last two years. At first, I could work out legs 1-2 times a week, then it slowed down to one time a week. And just recently it's been sharp pain throughout most of the day, I can't walk without pain. It's gotten pretty bad, and there's no reason why? I'm 6ft and 200lbs, 15% body fat, eat clean. I don't know why I have hip pain? Would you consider this FAI? Thanks for your help!
Thank you! Sorry to hear about your hip pain. Happy to try and help. Is it one hip or both? Where on the hip exactly does it hurt? Besides walking, what other activities/exercises cause hip pain? Typically FAI pain is worse with things like deep squats or cutting in sports
@PerformanceSportSpine Thank you for responding! It's only in my right hip. It's a very sharp pain throughout the day, and the pain resides mainly in the front of my leg and I occasionally feel it radiate to the right side. Pain is about 6 out of 10 when resting, upwards to a 9 out of 10 when moving. I am unable to squat, deadlift or do anything other than leg curls as the pain is so bad. Recently I have a similar sharp pain in my left foot. It's bizarre to be because I don't really over exert myself since this injury. I have been taking rest most day and low activity, and sometimes the pain gets worse. I do have a history of psoriasis years ago, which has been well managed. I'm leaning towards Rheumatoid arthritis as the root of this pain. Any insights would be incredibly helpful and a life saver! Thanks Dr.!
@@Wolverich Of course! As I read your description psoaris or rhematoid arthritis were my first two thoughts. Have you had blood work and/or imaging done? Unfortunately this is a little out of my wheel house, but I will do some research and see what I can find.
@@Wolverich Did you get any confirmed diagnosis? I have tried these stretches partially and some self modified versions where I can feel the muscles stretching and a gap creating. I have clear diagnosis of FAI 4 years back based on symptoms and MRI, which actually came clean other than bone on bone. Only one leg hurt. Now as of 2023, MRI and CT scan have confirmed scar tissue, CAM+ PINCER Impingement on both legs. and ever since I tried physio and theraband stretching suggested in some other videos with heavy bands, I started to hurt a lil more. Keep sharing your fight with this terrible situation with your hips
Hi, why would a bony response to load in adolescence suddenly progress at age 25-35 years to cause symptoms? The literature proposes the bony adaptation occurring in adolescence is due to growth plates being softer relative to matured skeletal frames and thus more prone to bony changes. Are you suggesting over time the bony abutment wears the soft tissue down to a point in a person's mid to late 20's they will feel pain/dysfunction? Bearing in mind these bony changes have likely been around for 15-20 years?? Seems hard to believe...
Because these bony changes over time can increase the stress and altered kinematics of the hip joint and start to irritate/damage the cartilage. It is a risk factor so it does not mean that everyone that has FAI will get it, only that it increase the change. And it doesn't happen sudden, the pain may start suddenly, but the underlying condition builds over years and/or decades
I think I have this. I feel pain in the front of my hip, realy close to my private region. Is that possible?
Yes it can. For this diagnosis there needs to be three things:
1) Positive bony changes on imaging
2) Appropriate symptoms, think popping, clicking, snapping, physical impairments
3) Signs of FAI, think reduced ROM & hip strength, gait alterations, poor trunk control
Hope this helps!
Can we do weights while doing these exersices? Or should we wait until we reacj the last Phase ?
Yes you can lift weights during. And modify as needed
I have a cam type impingement on thr both hips, can i do this exercises ?
And if theses exercises have bad effect on my hips?
yes you can. Just start slow with the level 1 exercises and progress gradually.
I had partial diagnosis of FAI 4 years back based on symptoms and MRI, which actually came clean other than bone on bone. Only one leg hurt. Now as of 2023, MRI and CT scan have confirmed scar tissue, CAM+ PINCER Impingement on both legs. My main concern is I had Grade 3 Fatty Liver. I was 108 KGs last year and dropped 17 KGs in 6 months just by walking. Now even the walking hurts after 10-15 minutes. Glutes have started to hurt. And sleeping can be messy at times. whenever i rest for 5-10 days, I feel better. But moment I try heavy theraband excercise for lateral distraction of hip joint, I feel instant relief but it starts to hurt in back and other places after couple of hours. My question: My physio told that I have extremely weak muscles in legs (even though my calves due to 2-3 hours of walking everyday are pretty cut). Do i need to loosen up all my leg muscles and then try stretching? or I can do the basic ones in this video(which I already tried and they helped in 10% increased motion). My ultimate Goal is to just walk pain free every day for 2 hours. My MRI also should calcium deposits and early stage arthritis... Please guide. Pain right thigh(pelvis). Both Glutes. Left Side laying hurts right thigh and groin. Right side laying hurts right side lateral.
You don't need to loosen up your muscles before you start strengthening them, you just need to find the right dosage to start with. Also if you have impingement you definitely don't want to stretch or distract the hip at end-range as the loss of mobility (range of motion) is d/t bony changes not muscle tightness. If you can walk that far you don't have weak muscles. If you have already seen a 10% improvement, we would recommend continue the exercises and gradually increase (Be patient it will take time with this condition).
@@PerformanceSportSpine thanks for responding. I will try to do the easy ones for a week and probably start using light theraband ones 3rd week onwards and gradually increase the band strength and be patient like you suggested
@@techBuffy you are welcome! Please let us know if you have any questions
@@PerformanceSportSpine I finally had surgery in Aug last year. I still have pain, my ROM has improved, tightness has improved, leg feels lighter, my external rotation is slowly improving. But I still have pain. And my Lumbar spine is a mess
@@techBuffy Thanks for the update. Are you working with someone to do post-op rehab?
Great video.
I only have 2 questions
When would you recommend to start with plyometrics?
And also individually :
I am advanced in my rehabilitation in strength (can do almost all level 4 exercises) and my range of motion is back to normal except for my hip flexors (strength lvl. 1 and the Thomas test shows the hip flexors are shortened). What can I do to improve my psoas?
I already train it 3-4 times a week and stretch it 3-4 times a week but increasing difficulty in the exercise causes immediat and lomgterm(2-3 days) pain
Thank you for advice in advance :)
Thanks, appreciate the comment!
We typically recommend being in level 3 or higher to start ballistics, can't say for certain but it seems you should be good to start, just start slow and see how the hips/body respond.
As for the hip flexor questions, without doing an assessment this video is the best we can recommend.
th-cam.com/video/cawtGfQ0STc/w-d-xo.html
Please let me know if you have additional questions.
@@PerformanceSportSpine thank you very much!
I watched the video and it is very helpefull already.
I only have 2 additional question
How strong is the resistent band you used?
Also should I isolate the strength training for the hip flexors instead of doing it with the other exercises? I am a little bit scared to have the painful symptoms again because the psoas is also working during other exercises I do for example squats.
@@florianw.ii.9044 For the resistance bands, we recommend getting this package that goes from extra light to heavy so you can adjust to your current level. The green band in the video is extra light.
Link:
www.amazon.com/Fit-Simplify-Resistance-Exercise-Instruction/dp/B01AVDVHTI/ref=sr_1_1_sspa?crid=2GBTGT1D8W2CM&keywords=pt+resistance+bands&qid=1671635993&sprefix=pt+resistance+band%2Caps%2C522&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUExNVpNVk9TQVJUVlYmZW5jcnlwdGVkSWQ9QTA4MTg4ODgxQlQxWjI4TEY3WkVXJmVuY3J5cHRlZEFkSWQ9QTA3Mzg0MzYxRjhTQ1BLMFhHODVHJndpZGdldE5hbWU9c3BfYXRmJmFjdGlvbj1jbGlja1JlZGlyZWN0JmRvTm90TG9nQ2xpY2s9dHJ1ZQ==
Yes, do them isolated and try to find a entry point for the dosage that doesn't flare up the issue. Usually there is some trial and error, but if you are consistent for several weeks with gradual progression, I think you will start to see some significant improvement.
Also here is another video with a lot of exercises for hip impingement with progressions. In case you want to take a look.
th-cam.com/video/EHk4_tcEX28/w-d-xo.html
@@PerformanceSportSpine thank you very much!
I think in the long run this is going to help a lot.
Today I did 4 sets of the level 3 exercise (band around mid foot) unfortunately it flared up the issue and I think I will have to rest a few days again. But I will try to find the sweet spot for me.
The wierd thing is doing the exercise feels easy. But a few hours later the pain comes.
Is these exercise completely done in one session? Or do any one or two is enough?
One or two is enough. It's designed so you can pick 1 level of each type of exercise, then progress over time.
Hi, so I have slight discomfort at the bottom of my squat and I am unable to externally rotate my knee/thigh outward? If that makes sense, if I try to then I feel a very slight discomfort in my right hip joint. It feels like my hip joint isn't allowing me to fluidly rotate outward. I've only experienced this in the past two weeks. And it's not constantly there, only happens during squatting or if I try to externally rotate my thigh, like a sumo stance or so. Can I still perform these exercises?
Any idea what caused the discomfort? Specific incident or change in training volume/activity? It's really hard to say if an exercise is safe or not without an assessment.
@@PerformanceSportSpine I never specifically felt anything was off and no incident took place as such, it just appeared out of nowhere. I feel weighted squats could be a problem, because I noticed recently (I've lowered the weight) That on my way down during back squats, in my left leg i can feel it in my quads etc. Where as the right leg (the troublesome one) I dont feel it in my quads, instead I feel the pressure in my hip which is weird. I guess i had been squatting with wrong form. Basically my knee wasn't aligned with my toes so I feel this could be an issue? I tried to align my knee as much as i could and reduced my squat depth and it took off the pressure off my hips
I do feel like my joint is limiting me, could it be an external impingement? Or could it be weak support muscles? Glute medius/glutes. Because I didnt pay attention to my core/glutes since I resumed training three months ago
@@vaibhavbhasker2579 Try tinkering with your squat stance and see if that helps. Here is a video that can help.
th-cam.com/video/McgbY3lvddM/w-d-xo.html
Stop if the pain increases. Let me know how it goes.
I can play split squat without weights?
Yes you can. You have to limited the depth of how far you go down, but you'll have to assess how it feels
Hi there.. I hope you can provide some guidance for me.. I was diagnosed with hip impingement after experiencing pain while back squatting. I denied surgery, so I’ve been trying to heal it myself. However the exercises you show here are extremely easy for me (even the top tier ones) since i am a weight lifter and do all these movements consistently with weights. I can still do them, but experience the discomfort form the impingement. I guess my question is.. what would you suggest I do if i can do all these, and do them
all the time, but the impingement never gets better? thanks your time!!
Hi! Here is another video with more high level hip impingement exercises.
th-cam.com/video/EHk4_tcEX28/w-d-xo.html
Does the hip pain happen with certain movements? Such as squats?
I was diagnosed with fai on both hips but the low back muscles on the left side are chronically tight, so much that at the beginning of the symptoms (5 years ago) i couldnt even bench press the bar alone without it giving me pain. The pain started roughly 1 year after i added deadlifts into my workout, and i was out of the gym for 3 years because it would start with basically any exercise. I also have a L5 S1 protrusion but never had any pain in the legs or in the groin. I got the fai diagnosis with an orthopedist and he said thats the reason of the low back pain and tightening, is it possible that its weak muscles? Because the majority of the pain is on the left side of the low back and not on the joint itself. Also i stopped doing squats and leg press because those seem to be the exercises that make it worse, like a sharp pinch, the same pain that comes sometimes for bending for like 1 second than i go trough days of pain untill it stabilizes again.
Was the FAI diagnosis from an image (x-ray), or did you have signs/symptoms, positive clinical test and imaging findings? From the description you wrote, it seems more like a back issue, then the FAI (usually presents with single leg movements and hip/groin pain). Sounds more like overloading, than weak muscles, what the pain worse when you arch/extend your spine? Can't say for certain but with what you wrote this video is very likely to help you. Please let us know if you have additional questions.
th-cam.com/video/5Fgzf455Wm8/w-d-xo.html
@@PerformanceSportSpine Yes i got the diagnosis from an x-ray. The pain gets worse when i sit for long periods of time or stand for long periods of time, but its always a tightening on the lower back, on the left side, sometimes extends to the glutes, not the joint itself. There was also this one time i felt that sharp pain while doing side lateral shoulder raises, so no bending was involved, even tough the other times i felt i was either bending or going past 90 degrees with moderate weight in squats or leg press. I also work in pizza delivery pretty much everyday, i dont know if its making it worse. Im also starting physical therapy soon to see if it helps, thanks
@@HYCbruno Glad to hear you are starting PT, yes hopefully it will help!
Can this hip impingement cause some discomfort back . . Pls
Yes it can.
If you get the surgery will you affect your height growth??
We have not read anything that suggests that.
Should I be concerned that my physical therapist has never heard of pincer deformity?
Yes, you should be very concerned about that
👍
Thanks!
Hello sir! I appreciate your content.
Well I am an 18 years old basketball player who is about to sign his first contract and I discovered that I have hip impingement... The doctors told me to undergo a surgery whenever I decide to but I am really confused I dont know if a surgery is going to affect my game and if its better to undergo the surgery at the end of my career... Basically my question is if am going to recover fully after the surgery and reach my fullest athletic potential.
I have had this issue with my hips for years but I thought it was just my height(200cm) and I am still able to play basketball like before.
The pain didn't get worse it is on the same levels but I have just went to the doctor for a check up and told me all these...
Hello, and thank you for the kind words! Sorry to hear you are dealing with this. Those are good questions, unfortunately the answers depends on a variety of factors. First do you have for hip impingement syndrome you need 3 things. 1, FAI Symptoms (hip/groin pain, sometime clicking/snapping) , 2) Clinical Signs (positive ortho test & often limited ROM), & 3) Radiographic Findings. do you have all 3 of these?
@@PerformanceSportSpine Thank you for the response sir! Yes I have all 3 you mentioned and I am diagnosed by an orthopedic...
@@charalambossava3219 How much does the hip currently impair you? have you done any rehab and if so how extensive was it?
@@PerformanceSportSpine The pain I feel is not that bad. I would say its more of a discomfort and it occurs when I am sitting for prolonged hours(2 hours of driving), plus I can't squat without feeling a stretch to the groin area and my maximum depth its about 80 to 90 degrees. Also when I deadlift I set my feet in sumo stance in order to get the bar off the ground. Otherwise there is a pain in the groin and I can't get any lower.
Would you say a right rotated pelvis would cause hip impingement on the left hip going into abduction?
The main factor for hip impingement is excessive loading of the hip joint during adolescents (i.e. competitive sports). If the pelvis was in a position that caused the ball/socket to have more force placed on it, this is theoretically possible. However, the pelvis only moves in 3 degrees in anyone plane, the SI joint is one of the strongest joints in the whole body. The asymmetric is due to the difference in shape of the bones, rather then them being rotated.
@@PerformanceSportSpine thanks for the reply, I've seen 8 PTs and they all said custom insoles or strengthen the glutes or lower abs.
I race bicycles competively and after some right SI pain, I had a pro fit done and the saddle I was using was too skinny. So my right leg hiked backed to compensate hence the pelvis rotated to the right. And my left leg is the stronger one. 4 years 20k miles it took to get here haha.
I'm hoping bringing my right pelvis more forward will fix the right leg length discrepancy and the left upper quad/hip flexor pain with abduction on that left side.
@@carboncrank2250 You are most welcome! Did the exercises/insole the PT's prescribe help? How large is the leg length discrepancy?
@@PerformanceSportSpine actually the PT did not do anythin besides showing me how to pop the SI joint. The discrepancy was about 1cm. Right foot was always supinated which lead to my right SI joint paint.
My bike fitter helped more. 2 cleat wedges for the right shorter leg and a wider seat but I'm down to one wedge fixing things now just focusing on bringing the right pelvis more forward in hopes it will clear things up. Crazy how the body adapts.
I have power meter pedals and I can see I put more work on thr left that the right so need to subconsciously aim more work on the right.
@@carboncrank2250 Yes, the body is pretty amazing. Glad to hear the bike fitter was able to help. As for the difference force production of left compared to right. have you tried single leg knee extension and/curls? If not they maybe a helpful option to help improve the right side
I don't get it, why the surgery may increase cartilage degeneration if it removes the bone deformity ? Should it be the opposite?
Because with surgery that is an invasive procedure and when they are shaving away the bone, there is likely some damage and irritation to the surrouding tissue, i.e cartilage
Thanks, another question.
For "clinical hip OA 40+ year old", do you mean a premature degeneration or an end stage OA which requires a Hip replacement surgery ?
I got diagnosed FAI after I felt some pain, (with the rehab is going great btw), an RX showed low joint degeneration, but I stopped running and playing baskeball cause I am too concerned about OA.
I just do martial arts twice/y
Thanks you
@@lukino0o0 means anyone that is dealing with hip oa, from mild, moderate to severe. Sounds like you have done a good job modifying and figuring out what works for you body. I appreciate the insightful questions
Is returning to basketball/soccer actually doable with CAM fai without surgery?
It is definitely possible. Rehab can take many months, but more than half of people can return to pre-injury levels.
@@PerformanceSportSpine How long would you say is long enough before surgery? I’ve currently been rehabbing for about 7-8 months and I’ve progressed to running without an issues. However still get the actual pain in my adductor hip and also struggle to do basketball type movements . I can do the movements such as cutting and explosive movements but it just doesn’t feel “right”.
If at 7-8 months you don't feel the hip is right and have felt like the rehab has evidence-based and progress appropiately, we would recommend a surgical consult, if you haven't already done it.
@@PerformanceSportSpine I’m seeing a surgeon in a few months. So is my slow progress a worry? I have progressed since the injury as I said but it’s been slow.
@@PerformanceSportSpine also me playing with cam fai does that pose any damage to my hip for the future ? Will I tear my labrum? It currently isn’t torn
When I squat the pinching pain gets increasingly worse as the weight goes up, why is this?
There is more load into the tissues that is causing the pain as the weight goes up.
A couple of things you can do:
1) Wear lifting shoes/elevated your heels
2) If the pain is at the bottom, reduce the ROM (i.e. box squat)
3) Tinker with you squat stance (width, turn toes out)
This video may also help:
th-cam.com/video/McgbY3lvddM/w-d-xo.html
@@PerformanceSportSpine thanks a lot for reply I appreciate it!
@@versi9573 You're most welcome!
Surgery for something like this should be avoided at all costs. There are lots of other videos in education out there that indicate focusing on muscles and physical therapy are far superior to an invasive expensive surgical procedure... Especially when the success rate quoted here is about 50% only.
No, surgery definitely has a time and place with this condition. Blanket statements like this show a lack of understanding of the complexity and nuance these conditions bring. Context, goals and other factors all have to be consider when deciding the best cross of treatment
guys i tried everything and couldn't avoid surgery don't wast time trying
Nope, research shows about 50% of people can improve with rehab only. This is a classic of someone not knowing what they are talking about and extrapilating their experience to all people.
It’s all good with hip replacement till it’s not and revision is a bear so is prosthetic infection
i did not do hip replacement the surgery is called (FAI) femoroacetabular hip impingement you can search and see what's the surgery and there us no way you can avoid it because you extra bone on your hip and whatever you do tge bonea will keep hitting each other this caused my labrum to tear wich made it more painfull
did not help
They do if done correctly
All great up until the jumping exercises. WORST thing you can do with a diagnosed FAI. Anything that causes impact is out. Surprised this was recommended in an FAI video.
Nope, nothing to support that jumping is harmful for people with FAI. Almost every one can get back to it safely.
@@PerformanceSportSpine I just had an appointment with a specialist in FAI yesterday and he works extensively with FAI patients. He said no impact, no running, .no jumping with this condition. It's permanent and it's all about avoiding making it worse. I'm 48, fit, but not getting younger. Can't afford to do serious damage. I'll go with his explanation and expertise.
If your hips are impinged
You most likely have TIGHT QUADRICEPS…. Loosen those and your hip and LOWER BACK PAIN WILL GO AWAY
WRAP A TOURNIQUET AROUND BOTH THIGHS right below hips WHILE STANDING… get it as tight a possible and try bending over
Immediate relief
No, hip impingement is caused by bony changes, not tight muscles
And NO ONE should every put a tourniquet on for the purpose you describe
@@PerformanceSportSpine ok 👍🏼
You’re saying tight quads don’t cause pelvic tilt???? BONY CHANGES? Where did you go to school????it’s called FEMOROACETABULAR IMPINGEMENT…..
For anyone with low back pain and hip issues give it a try… you have to wrap BOTH legs NOT one a time.
Don’t wrap the TOURNIQUET SO TIGHT TO CUT OFF CIRCULATION
JUST TIGHT ENOUGH TO COMPRESS THE MUSCLE.
Trust me it FEELS GREAT….
Stretch your QUADS
@@PerformanceSportSpine where did you get this technique?
from some other TH-cam video
I have asymptomatic cam lesions/fai. Im 38. Ive no pain and good mobility. Based on this info, do you think I'll ever have issues with my hips? I train smarter, not harder now as well.
Seems very unlikely. Just keep doing what you are doing with smart training/exercising. Very probably those changes have been there for a long time.
@@PerformanceSportSpine thank you for the response! Very much appreciated
@@sheldor73 Of course!