Have you been experiencing hip discomfort and heard about the dreaded femoroacetabular impingement? You're probably looking for clear answers about which exercises you should avoid and which ones you can do with ease to improve your condition without making it worse. Whether you've just received a diagnosis or simply want to prevent complications in your daily life due to hip discomfort, having reliable information is essential for making good decisions.
Hip impingement is a relatively common problem and can affect quality of life if not properly managed. Knowing which movements are discouraged and which can help strengthen and regain mobility is key to preventing further injury, more intense pain , or progression to more serious conditions like premature osteoarthritis. Below, I explain all the relevant information for taking care of your hips in a clear and easy-to-understand way, based on the best studies, medical recommendations, and safest exercises.
What is hip impingement and why does it happen?
Femoroacetabular impingement (often known simply as hip impingement) is a condition that occurs when, during certain movements, the head of the femur and the acetabulum (the area of ​​the pelvis that forms part of the hip joint) come into abnormal contact . This causes friction, which can damage the cartilage and labrum (a structure that provides stability and protection to the hip), leading to pain and functional limitations.
This condition can be asymptomatic in many cases, but if it progresses or worsens, it can lead to problems such as premature hip osteoarthritis . Up to 30% of the population may have some degree of abnormality without symptoms, but it is much more common among young and very active people, especially those who perform repetitive movements or high-impact sports. It can also affect adults of any age who have an altered joint morphology.
Main types of femoroacetabular impingement
There are two main variants:
- CAM Type: This occurs when there is a widening or asymmetry in the junction between the neck and head of the femur. It tends to affect men more and causes greater friction when flexing and rotating the hip.
- CLAMP type: Here, the problem lies in the acetabulum, which grows excessively, covering too much of the femoral head. This causes abnormal friction and compression during movements such as flexion and rotation.
Most patients (up to 85%) present with a mixed form, combining characteristics of both types . The most characteristic pain is located in the groin with hip flexion or rotation, but it can also extend to the thigh, lower back, or even the buttock area.
How is this problem diagnosed?
The diagnosis of hip impingement should always be made by a specialist orthopedic surgeon . This usually involves a detailed clinical interview, specific physical tests, and imaging studies.
- Bone scan: identifies bone alterations typical of CAM or PINZA.
- Magnetic resonance: helps assess labral and cartilage injuries.
- Arthroresonance: Contrast is used to accurately view tears and damage to the labrum.
- Scanner: is usually reserved for planning surgical interventions.
The goal is to confirm the type of pinching, rule out other causes, and plan the most appropriate treatment.
What are the symptoms of femoroacetabular impingement?
The main symptom is hip pain that often radiates to the groin, thigh, lower back, or buttock, especially with certain movements (flexion, rotation, adduction) . This pain can appear suddenly or increase over time and with specific exercises. It is also common to notice:
- Rigidity or loss of mobility in the hip
- Popping or feeling of joint blockage
- Functional limitation for daily activities such as walking, bending or standing
- Nighttime discomfort or difficulty finding a comfortable sleeping position
It is always necessary to rule out other conditions such as pubalgia, advanced hip osteoarthritis or bursitis with a good diagnosis.
Prohibited exercises for hip impingement
Avoiding certain exercises and activities is essential to prevent aggravating the injury and promote recovery . Although each case is unique and final recommendations should be individualized, below is a comprehensive list of exercises that experts advise against for people with hip impingement, osteoarthritis, or bursitis:
- run or jog: Repeated impact increases stress on the joint and aggravates wear on the cartilage and labrum.
- Jumps and plyometric exercises: Activities such as burpees, skipping, jumping jacks or any repetitive jump transmit excessive vibrations and loads.
- Deep squats and exaggerated lunges: especially when flexed beyond 90 degrees or when performing with extra weight. These movements strain the problem area.
- Quick turns and sudden changes of directionSports such as soccer, handball, hockey, or tennis involve violent twisting and turning that can trigger acute pain and injure the labrum.
- Heavy weight lifting exercises: Working with heavy loads, especially squats, leg presses, or deadlifts without proper technical supervision, adds unnecessary stress.
- Cycling after an acute flare-up (bursitis): In the inflammation phase, repeated gestures and sitting posture can further irritate the bursa.
- Standing for long periods of time while performing physical activities: These exercises can increase pressure and aggravate discomfort.
- Machine exercises that involve a lot of weight on the hips: hip extensions with resistance, abductors/adductors on a machine, etc., especially if there is no professional supervision.
In general, all sports or routines that involve impact, sudden movements, twists or heavy loads should be avoided until medical clearance is obtained.
Safe Alternatives: What Exercises Can You Do?
Adapted physical activity is key to conservative treatment and prevention of joint deterioration . Exercises recommended by rehabilitation specialists, physiotherapists, and sports medicine physicians include:
- Low impact aerobic exercises: walking at a moderate pace, elliptical, stationary bike (except during bursitis flare-ups) or swimming, as long as it does not cause pain.
- Exercises in the waterPool work is ideal because the aquatic environment reduces the weight on the joint. Walking in the water, gently kicking while holding onto the edge, or even gentle jogging in a therapeutic pool are very beneficial.
- Gentle and controlled stretchesMaintaining flexibility prevents stiffness and improves range of motion. It's essential to warm up before exercising, and if stiffness persists, apply local heat or a hot shower.
- muscle strengthening exercises: Strengthening the glutes, quadriceps, abductors, and core (abdominal and lumbar areas) stabilizes the hip and reduces tension in the joint.
- Adapted Pilates and Yoga routines: Consciously working on movement, alignment, and breathing helps tone without causing impact. Some effective examples include the adapted Warrior I pose, the side plank (as long as it doesn't hurt), or Pilates with resistance bands.
- Specific joint mobility exercises: such as hip circles in addition to gentle controlled rocking movements.
Practical examples of safe exercises:
- Hip abduction (standing): Holding onto a chair, raise one leg sideways without bending your torso, then slowly return. Repeat several times on each side.
- Heel raise: Stand on your toes from a standing position to activate your calves and work on your balance.
- Glute bridge with elastic bandLying on your back, knees bent and the band around them, separate your knees and raise your pelvis without lifting your feet off the floor. Hold for a few seconds.
- Static side plankWith your forearm supported and your elbow under your shoulder, raise your pelvis, aligning your shoulders, torso, and knees. Contract your abs and hold the pose.
- quadriceps stretch: Standing with the help of a chair for balance, bend one leg back and hold the ankle, keeping the body straight and the hip aligned.
Remember: exercises should always be adapted to your abilities and the evolution of the injury, prioritizing the absence of pain.
How to adapt your routine and progress safely?
It's important to start any exercise program under the supervision of a physical therapist or sports medicine doctor, especially if you have persistent pain or a confirmed diagnosis . A professional will advise you on when and how to increase the intensity, which exercises to introduce first, and which to modify or eliminate if you experience discomfort.
Some key general recommendations:
- Avoid straining or painful postures
- Warm up well before starting with gentle stretches
- Use elastic bands or body weight, advancing very little by little
- Pay attention to technique and range of motion
- Don't obsess over quantity, prioritize the quality of movement
If you work out in a pool, you can increase the duration of your workout, as the impact is much lower. Water also helps improve circulation and restore joint range of motion.
Exercises to strengthen the hip after impingement
Muscle strengthening is one of the best ways to prevent relapses and improve joint function . Here are some examples of commonly recommended circuits:
- Wall balancing exercise: Lean against a wall and stretch your uninjured leg and arm for 10 seconds. Maintain control on the affected leg. Do several repetitions.
- Forward lunges (no added weight): Take a step forward, bend your back knee, and lower your hip without touching the floor. Alternate legs.
- Glute bridge with band: : Already mentioned above, but very effective for working glutes and hip stabilizers.
- side lunges: Open the knee on the moving side to the side and bend it. Keep the other leg straight.
- Lateral walk with elastic band: Keep your hips and knees slightly bent and walk sideways, keeping tension on the band.
These exercises help improve neuromuscular control, stability, and specific strength around the hip.
Recommendations if you have bursitis or hip osteoarthritis
For people with osteoarthritis or bursitis of the hip , the guidelines are very similar to those for impingement, but extra care must still be taken with high-impact exercises:
- Do not perform deep squats or jumps: avoid movements that can increase inflammation and pain.
- Avoid running, jogging or activities that involve pounding: Impact can aggravate bursa inflammation or joint wear.
- Do not ride a bicycle (during a bursitis flare-up) or make sharp turns.: repetitive movements that can further irritate the inflamed structures.
- Prioritize swimming, gentle walks, stretching, and adapted yoga or pilates-type sports.
- Listen to your body: Any exercise that increases pain or inflammation should be discontinued and a professional consulted.
In case of an inflammatory flare-up, apply cold locally and follow medical advice to control pain before resuming physical activity.
The key to managing femoroacetabular impingement and preventing progression to more serious injuries lies in clearly identifying harmful exercises and movements and creating an individualized routine based on low-impact exercises, strengthening, and professionally guided mobility . Staying active while avoiding harmful movements reduces pain, improves quality of life, and can delay joint progression for years. Learn more about how to relieve hip pain quickly . Always consult a professional if you have any questions and opt for personalized care to take care of your hips in the long term.