Hip Impingement:
Anatomy, Risk Factors, and Prevention

Hip impingement, also known as femoroacetabular impingement (FAI), is a common hip condition that can cause pain and discomfort in the hip joint. In this article, we will explore the anatomy, biomechanics, and function of the hip joint, as well as what happens in hip impingement, the risk factors for this condition, and prevention measures that can be taken to avoid it.

The hip joint is a ball-and-socket joint that is formed by the femur (thigh bone) and the pelvis. The head of the femur fits into the acetabulum, which is a socket in the pelvis. The joint is surrounded by a joint capsule and is supported by ligaments, tendons, and muscles. The labrum, which is a ring of cartilage, lines the rim of the acetabulum and provides stability to the joint. The hip joint is responsible for supporting the weight of the body and allows for a range of movements, including flexion, extension, abduction, adduction, and rotation.

There are two types of hip impingement: cam impingement and pincer impingement. Cam impingement occurs when there is an abnormality in the shape of the femoral head, which can cause it to rub against the acetabulum. Pincer impingement occurs when the rim of the acetabulum extends too far over the femoral head, causing it to become trapped in the joint.

Hip impingement occurs when there is abnormal contact between the femur and the acetabulum, which can cause damage to the labrum and surrounding tissues. This can lead to pain, stiffness, and reduced range of motion in the hip joint.

Risk Factors for Hip Impingement

Hip impingement is a condition where the bones of the hip joint rub against each other, causing pain, stiffness, and limited range of motion. While it can occur in anyone, there are certain risk factors that increase the likelihood of developing this condition. Here are 5 risk factors for hip impingement.

1. Hypermobility

Excessive joint laxity or hypermobility in the hip joint can increase the risk of hip impingement. When the hip joint is hypermobile, it can lead to abnormal movement patterns and increased stress on the joint structures. Over time, this can contribute to the development of impingement. Proper management of hypermobility through targeted strengthening exercises and stability training can help reduce the risk of hip impingement.

2. Previous Hip Injuries

Individuals who have experienced previous hip injuries, such as hip fractures, dislocations, or labral tears, are at an increased risk of developing hip impingement. These injuries can alter the mechanics of the hip joint, resulting in abnormal contact between the bones and subsequent impingement. Proper rehabilitation and management of hip injuries are crucial to reduce the risk of developing impingement and its associated complications.

3. Poor Movements Patterns and Muscle Imbalances

Poor movement patterns and muscle imbalances around the hip joint can contribute to the development of hip impingement. Weakness or tightness in certain muscle groups, such as the hip flexors, glutes, or deep hip rotators, can alter hip joint mechanics and increase the risk of impingement. Addressing muscle imbalances through targeted exercises and working with a physical therapist can help improve movement patterns and reduce the risk of hip impingement.

4. Repetitive Movements

Engaging in repetitive activities or sports that involve frequent hip flexion, rotation, or extreme ranges of motion can increase the risk of hip impingement. Athletes involved in activities like soccer, ballet, hockey, or martial arts that require repetitive hip movements are particularly susceptible. The repetitive stress on the hip joint can cause wear and tear, leading to impingement. Incorporating cross-training, varying activities, and using proper technique and equipment can help minimize the risk.

5. Structural Abnormalties

Certain structural abnormalities of the hip joint can predispose individuals to hip impingement. These abnormalities include a cam deformity, where the femoral head is not round and has an abnormal shape, or a pincer deformity, where the acetabulum extends too far over the femoral head. These abnormalities can alter the mechanics of the hip joint, leading to impingement. These structural abnormalities can be present from birth or develop over time due to factors such as skeletal growth and repetitive motions.

6. Age and Genetics

Age and genetics can also play a role in the development of hip impingement. As individuals age, the natural wear and tear on the hip joint can contribute to the development of impingement. Additionally, certain genetic factors may predispose individuals to hip abnormalities or structural variations that increase the risk of impingement. While these factors cannot be controlled, early intervention, proper conditioning, and maintaining a healthy lifestyle can help manage and reduce the impact of these risk factors.

Prevention Measures to Reduce Risk
for Hip Impingement

Hip impingement can cause pain and discomfort, especially during activities that require a lot of hip motion, such as walking, running, or sitting for prolonged periods of time. While some people may require medical treatment for hip impingement, there are also steps that can be taken to prevent the condition from developing in the first place. Let’s discuss some of the best prevention measures to avoid hip impingement.

Strengthen Your Hip Uscles

Weak hip muscles can also increase your risk of hip impingement. The muscles in your hip, including the glutes, adductors, and abductors, help support the joint and reduce the amount of stress placed on it during activities. Strengthening these muscles through exercises such as squats, lunges, and bridges can help prevent hip impingement.

Practice Good Posture

Poor posture can contribute to hip impingement by causing misalignment in the hip joint. This can increase the amount of stress placed on the joint during activities, leading to pain and discomfort. Practicing good posture, such as sitting up straight and avoiding slouching, can help maintain proper alignment in the hip joint and reduce the risk of hip impingement.

Use Proper Form and Technique

Using proper technique during exercise is important for preventing hip impingement. For example, if you are a runner, make sure you are wearing the proper shoes and running on even surfaces to reduce the stress placed on your hips. Additionally, avoiding exercises that involve excessive hip flexion or rotation, such as deep squats or leg presses, can help prevent hip impingement.

Maintain a Healthy Body Weight

Being overweight or obese can increase your risk of developing hip impingement. This is because excess weight places additional stress on the hip joint, which can cause damage to the joint over time. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce your risk of hip impingement.

Don't Sit For Too Long

Sitting for prolonged periods of time can also increase your risk of hip impingement. This is because sitting places the hip joint in a flexed position, which can cause the femur and acetabulum to rub against each other. Taking breaks and standing up to stretch or walk around every 30 minutes can help reduce the amount of time your hip joint spends in a flexed position and prevent hip impingement.

Prevention Exercises for Hip Impingement

Hip impingement occurs when the bones in the hip joint rub against each other, causing damage to the soft tissues and cartilage. Hip impingement can be caused by various factors such as overuse, injury, and genetics. Fortunately, there are exercises that can help prevent hip impingement. Here are the top 5 exercises to prevent hip impingement.

If you feel discomfort or pain consult a medical professional and do NOT exercise!

1. Hip Flexor Stretch

Hip flexor stretches target the muscles at the front of the hip, including the psoas and the iliacus. Begin in a kneeling lunge position, with one knee on the ground and the other foot positioned forward. Keeping your torso upright, gently push your hips forward until you feel a stretch in the front of your hip. Hold the stretch for 20-30 seconds, then switch sides and repeat.

Tight hip flexor muscles can contribute to hip impingement by pulling the femur into an anteriorly tilted position, increasing the risk of bone-on-bone contact. Regularly stretching the hip flexors helps maintain proper muscle length and balance, reducing tension in the front of the hip and promoting optimal hip mechanics.

2. Clamshells

Clamshells are a great exercise for targeting the gluteus medius, a muscle located on the side of the hip. Start by lying on your side with your knees bent and your feet together. Keeping your feet touching, lift your top knee while keeping your feet in contact with each other. Slowly lower your knee back down to the starting position. Perform 10-12 repetitions on each side.

The gluteus medius plays a crucial role in hip stabilization and maintaining proper alignment during movement. Weakness in this muscle can lead to compensatory movements and increased stress on the hip joint, potentially contributing to impingement. Clamshells strengthen the gluteus medius, promoting hip stability and reducing the risk of hip impingement.

3. Hip Abduction

Side-lying leg raises target the hip abductor muscles, including the gluteus medius and minimus. Lie on your side with your bottom leg slightly bent for support. Keeping your top leg straight, lift it upward, leading with your heel. Hold the top position briefly, then lower your leg back down. Aim for 10-12 repetitions on each side.

Strengthening the hip abductors is important for maintaining stability and control of the hip joint. These muscles help prevent excessive inward collapse of the hip joint during activities like walking, running, and jumping, which can contribute to hip impingement. Side-lying leg raises target and strengthen the hip abductors, improving their ability to stabilize the hip joint and reducing the risk of impingement.

4. Glutes Bridge

The glute bridge exercise targets the gluteal muscles, including the gluteus maximus, which is the largest muscle in the buttocks. Start by lying on your back with your knees bent and feet flat on the ground. Engage your glutes and lift your hips off the ground, forming a straight line from your shoulders to your knees. Hold the top position for a few seconds, then lower your hips back down. Repeat for 10-12 repetitions.

The gluteus maximus plays a significant role in hip extension, which is essential for activities like walking, running, and squatting. Weak gluteal muscles can lead to compensatory movements and increased stress on the hip joint, potentially contributing to impingement. The glute bridge exercise strengthens the glutes, promoting proper hip mechanics and reducing the risk of hip impingement.

5. Squats

Deep squats are a fundamental exercise for improving hip mobility and strengthening the muscles surrounding the hip joint. Begin by standing with your feet shoulder-width apart. Slowly lower your body into a squat position, ensuring that your knees track in line with your toes. Aim to achieve a deep squat where your thighs are parallel to the floor. Hold the position briefly, then rise back up to the starting position. Repeat for 10-12 repetitions.

Deep squats promote hip mobility by stretching the hip flexors and increasing the range of motion in the hip joint. Additionally, this exercise targets the glutes, quadriceps, and hamstrings, which are essential for hip stability and proper alignment. Strengthening these muscles helps to distribute forces more evenly across the hip joint, reducing the risk of impingement.