Exercises for Hip Injuries
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HIP INJURIES
Common in sports and activities like cycling, gplf, running and snowboarding.
WHAT CAUSES HIP INJURIES?
The hip is one of the most mobile joints in the body, designed to rotate almost a full 360 degrees.
Due to the hip’s inherent ability to move in so many directions, it’s not uncommon to see injuries to the hip after awkward falls or collisions. Hip injuries often occur due to structural imbalances, direct impact to the hip area or biomechanical inefficiencies. Injuries to the foot and ankle can also greatly impact the hip.
COMMON HIP INJURIES IN SPORTS
FEMOROACETABULAR IMPINGEMENT (FAI) SYNDROME
FAI is typically broken down into two classifications.
Structural FAI
Structural FAI involves a change how bone or cartilage around the hip joint develops and grows.
In some cases the head of the femur that sits inside the the acetabulum (the hip capsule) is misshapen, making it difficult to move. Another type of FAI involves extra bone growth at the tip or rim of the acetabulum, whereby some hip angles can cause pinching on the femoral head.
Functional FAI
Functional types of FAI occur due to muscular imbalances that over time change the way the hip sits and moves inside the socket.
With FAI, the hip tends to sit anteriorly (forwards) in the socket. This can happen due to sitting posture, weakness of the muscles surrounding the hip, and tightness from overcompensating muscles.
Individuals with FAI tend to feel a pinching pain inside their hip, that may radiate to the groin, upper thigh, or side of the hip.
HIP BURSITIS
A ‘bursa’ is a fluid-filled sac that functions to reduce friction between two surfaces. In the hip the bursa lays between thick muscles, tendons, and fascia, and the bone.
Bursitis occurs when the bursa becomes inflamed. This can be due to a direct blow to the bursa, or it can be due to too much friction or compression around the area that causes irritation over the bursa.
Hip bursitis is often accompanied with a dull, achy, burning pain on the side of the hip, which can be made worse with walking, running, stair climbing or laying directly on the painful side of the hip.
SNAPPING HIP SYNDROME
‘Snapping hip syndrome’ is also known as coxa saltans. It is the sensation and feeling of an audible snap in the hip joint, usually reproducible with a specific movement.
There are 3 different types of snapping hip syndrome:
External - IT band snapping over the greater trochanter of the femur
Internal - Psoas tendon snapping over bony prominence of the pelvis
Intra-articular - a flap tear in the hip cartilage or a loose bony body inside the hip.
The snapping feeling usually indicates a tendon rolling over another structure, such as a bone or another tendon, and may or may not be painful.
It is important to consult a healthcare provider if snapping does become painful.
The underlying cause of the snapping is usually due to instability of a joint above or below the place where the snapping is felt, alongside a general lack of core and hip stability. Similarly, the ‘cure’ for such instability involves exercise designed to strengthen and stabilize the core and hips (see ‘Exercises and Stretches for Hip Injuries’ section below).
EXERCISES AND STRETCHES FOR HIP INJURIES
PSOAS MARCHES
If you feel like your hip flexors are always tight, they may actually need to be strengthened rather than stretched. The Psoas March is a great rehab exercise to target the hip flexors and increase stability of the front of the pelvis and hips.
You’ll need a resistance band for this exercise.
Exercise instructions:
Lie flat on your back with a resistance band looped around your feet.
Lift your knees so that both your knees and hips at at 90° while bracing your core (so as to prevent your lower back and rib cage extending upwards toward the ceiling).
Extend the uninjured leg horizontally, while maintaining the other injured leg’s position and resisting the pull of the band.
Hold for 3-5 seconds.
Bring your extended leg back to the start position and repeat the ‘march’.
Tips on technique:
Try to control the downward motion by resisting the pull of gravity.
Suggested workout:
3 sets of 10 repetitions
For each repetition, aim to spend 3 seconds extending out and 3 seconds flexing back.
SINGLE-LEG DEADLIFT WITH KICK STAND
The single-leg kickstand deadlift is an exercise to improve posterolateral hip stability and strength.
It is an excellent exercise for those that have trouble balancing on one leg, as the back leg (the kick stand) helps to maintain the proper position.
Exercise instructions:
Stand with the affected leg in front and the back leg about 30cm (1ft) behind in a staggered stance (similar to a walking stride.
Keeping your back flat, perform a ‘hip hinge’ motion by pushing your butt backwards and bending from the hips (not the knees).
Return to the starting position while keeping you back in a neutral position and pulling the hips inwards.
Tips on technique:
Aim for placing 90% of your body weight on your front leg and the remaining 10% on the leg behind you - lightly touching the ground to aid balance. More weight can be shifted to the back leg if balance is an issue.
You should feel the muscles working in the front-leg hamstring and the glutes.
Suggested workout:
3 sets of 12 repetitions
SINGLE-LEG GLUTE BRIDGE WITH HIP ABDUCTION
The single-leg glute bridge is a popular exercise for the glute and hamstring.
By adding hip abduction to the bridge with the leg in the air it creates a lateral force imbalance to add increased difficulty to the hip and core.
Exercise instructions:
Lay face up on your back, with one knee bent and the corresponding foot flat on the floor.
Push through the ground to lift your hips and straight leg off the floor, keeping this leg straight throughout.
Once your straight leg reaches its maximum height, push it outwards and hold for 3 seconds.
Lower the hips, bring the straight leg slowly back to midline, and repeat.
Tips on technique:
Try and keep the back and core braced throughout the entire movement to prevent movement through the lumbar spine.
Suggested workout:
3 sets of 8-12 repetitions.
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