Healthy Hips - Fixing The Hip Impingement


Today we're going to discuss the basics of hip impingement. 

What are they? 

What are they caused by?

How can we fix them? 

I'm going to explain the two most common types of hip impingements, kind of what causes them and then how to treat them. 

So what is an impingement? An Impingement is a painful condition caused by rubbing or pressure on the tendons, nerves, or maybe just a socket by adjacent structures. Impingements are usually caused by overuse injuries, very common in swimmers, so, again, a very repetitive motions, like in swimming, we would usually get impingement in our shoulders. The way this normally happens, muscle fibers primarily run in one specific direction. When we have overuse injuries, we usually won't get a buildup of collagen connective tissue. and essentially, it has no rhyme or reason. So, again, if muscle fibers are running in a specific direction and you've got this big clump, basically spider web of collagen and all these other gross fibers, of course, they're there for protection, they're there to kind of help cushion the area, but when you have too much of a buildup, it can impede our range of motion and sometimes causing impingement. 

Now, this can apply really anywhere in most joints like the elbow or shoulder. But today, we're going to be covering our hips. 

So the two most common impingements that we're going to be seeing are anterior Impingement, so meaning towards the front of the hip, and lateral impingement, or meaning towards the side of the hip. If we have pain in the front of the hip, especially when we get to the bottom position of our squat, we may have an anterior impingement. On the other hand, if we have pain on the outside of the hip or that lateral portion of the hip we may have a lateral impingement of our hip.

If we have an anterior Impingement, that means when we come down in our squat, the head of our femur is going to be hitting just the front of that hip socket versus if we have a lateral impingement, when we come down in that squat, the head of that femur is going to be hitting just on that lateral portion of that hip socket. 

Now we know a little bit about hip impingement. I'm going to show you all the ways to treat both of them. Let's get into talking about how to treat the anterior hip impingement out in the front of the hip. If we're getting a pinching sensation towards the front, that means that we need to be pulling that femur a little bit further back in that hip socket. The way that we're going to do this is going to be a banded pigeon stretch.  We're going to want a strong band and we're going to want to attach it to something that's nice and sturdy. Take it up our leg as high as we can. Now that we have this band secured here, we're going to get into a modified pigeon stretch here. 

So I like to come down to a half neal. I'll take my front foot and come across my body and drop down, elongating that back. And right here, if you need a little bit more tension, just scoot forward just a tad. Now that we're in this position here, the band is pulling my femur just slightly from the back into that socket. So this way I can have an optimal range of motion when I get back into that squat. Continue to hold this position for about a minute. 

This may be one of the very few mobility exercises, I'm going to say, unless we have this on both sides. We're not going to be doing both sides. So only treat the affected side. We're going one minute on that anterior impingement. 

So now getting into that lateral impingement, the side of the hip here, again, that impingement just kind of tells us that that femur is going to sit a little bit too far laterally on that socket. So we're getting a little bit of a pinch towards that side, which means that we need to take that femur and pull it a little bit more immediately towards the body. We're going to take that band and lift this leg through it again, taking it high up on my thigh, and we're going to walk it out and give it some attention, coming down to a half kneel here. 

When we come down to a squat, the natural motion of the knee is to be moving outwards. That's exactly what we want to do, to protect the knees, the hips, all that good stuff. So, we're going to do that exact motion. We're going to push me out and relax this anyhow, back to neutral. We're going to do this about 10, maybe 15 times. This is going to help pull that femur more medially and get us again into that optimal range of motion. 

Just like with any mobility, we want to test our squat before and after to feel the improvements. 

All right, guys, I hope we learn something new here and remember, this is always a conversation, so go ahead and leave a comment down below!

-Coach Alex

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