Do you feel sore and tight if you sit too long or if you try and do high reps at the squat rack? Do you continue to be physically active but somehow you are struggling with hip pain and stiffness?
Do you feel you are too young to have a troublesome hip?
Well, not all hip pain can be explained away as arthritis and not all hip pain is equal. Hip impingement or FAI is when the shape of the femur (top of your thigh bone) or the acetabulum (the socket) doesn’t match together well and this causes you pain.
So basically, you either get a little bit more bone on the neck of the femur (CAM) or more bone on the hip socket (Pincer) or if you are really interesting you can potentially have both. Now this might all seem very scary, but this type of increased bone is very normal and is really a sign of how your hip was loaded through those years when your skeleton was maturing. Actually, having these increased bony bits is very common and in a vast majority of the population it causes no issues at all.
FAI is when these extra bony prominences irritate or impinge (butt together) the hip and it becomes painful and movement may become limited and hip weakness may develop over time.
So How Does the hip usually become irritated?
- Hip Bending:
Deep squats, deep lunges or sitting in a low chair when your knees are higher than your hips all can impinge the hip which drives your pain.
2. Crossing legs:
Sitting with your legs crossed at the computer or when watching TV pushes the hip into a position where it becomes impinged
3. End range rotation:
In standing pivoting or turning towards the sore hip can cause pain, often with “stretching out the tight hip” and yoga (ineffective for this problem as you can’t stretch out bone)
So now we know what it is and what agitates it. How do we ‘fix it’?
FAI is a movement related disorder. Get better at recognising, avoiding or reducing these aggravating positions and you reduce the irritation. For instance, if prolonged sitting bothers you a simple yet effective use of a wedge cushion to open up the hip allows you to sit with less discomfort. Or if you are a gym fanatic and the back squat is causing you discomfort modify the depth of your squat or look at your overall weekly volume of squats and try and scale back.
There is only so much you can do on your own. Rehab needs to be specific, progressive and challenging. Reach out to the highly skilled team at Active Physiotherapy Solutions who can guide you through a hip strengthening program specific to demands of your hip.
Remember it’s all about finding the balance between what you want to do and what you need to do to keep your hip happy!