A hip impingement occurs when the femoral head of your upper leg fits too tightly within the acetabulum, or hip socket, potentially damaging the cartilage that lies between the two structures and limiting your range of motion. Surgery is often necessary to correct the condition, followed by physical therapy to increase your flexibility and strengthen the surrounding muscles. Consult a physical therapist to develop an individualized exercise program.
Static Stretching
Static stretches, which involve holding your muscles and connective tissues in a lengthened position for a specific period of time, can help increase your hip-joint range of motion. A rehabilitation program for a hip impingement should include stretches for the hip abductors, adductors, extensors and flexors. An exercise for the hip abductors, for example, requires bending one knee from a seated position, crossing your foot over your opposite knee and pulling your leg toward your chest. The American College of Sports Medicine recommends holding static stretches for at least 10 seconds, but not more than 30 seconds per repetition.
Dynamic Stretching
Dynamic stretches may be more practical than static stretches because they involve repeated shortening and lengthening muscle contractions, mimicking normal daily movements more closely. The butterfly stretch, which targets the hip adductors on the inside of your thighs, is one example. Sit upright with your knees flexed and the bottoms of your feet together in front of your groin, then press your knees apart and and bring them back together repeatedly, progressively increasing the range of motion with each repetition. Perform each stretch for the same amount of time that you hold static stretches.
Isometric Strengthening
Isometric-strengthening exercises involve pressing against a stationary object so your muscles develop tension without shortening and lengthening. Include them in your physical therapy program if moving your affected hip through normal ranges of motion causes pain. The bridge, which targets the hip extensors -- the gluteus maximus and hamstring muscles -- is one example of an isometric exercise. Lie on your back with your knees flexed and feet flat on the floor, about 6 inches apart, then press into the floor to elevate your hips and hold for at least 10 seconds. Avoid isometric exercises if you have high blood pressure.
Dynamic Strengthening
Consistent with the theory that dynamic stretches are more practical than static stretches, dynamic-strengthening exercises are likely more practical than isometric-strengthening exercises because they work your muscles through a full range of motion. Strengthening the hip-flexor muscles dynamically, for example, requires flexing and extending your hips repeatedly against external resistance. Place your knee under a padded lever that's attached to a stack of weights, then thrust your thigh upward to lift the lever and let it back down slowly, using your hip flexors as the primary mover during the upward-movement phase of the exercise and to control the speed of descent during the downward-movement phase. Include dynamic exercises for your hip abductors, adductors and extensors as well.
References
- Mayo Clinic: Hip Impingement
- "Essentials of Athletic Injury Management"; William Prentice and Daniel Arnheim; 2008
- "Medicine and Science in Sports and Exercise"; ACSM Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults; Michael L. Pollock, et. al., June 1998
- ExRx.net: Hips
- "Basic Biomechanics"; Susan J. Hall; 2007
