PT Exercises for Hip Pain From FAI (2023)

Orthopedics

Physical Therapy

Exercises

FAI: Femoroacetabular Impingement Exercises

By

Brett Sears, PT

PT Exercises for Hip Pain From FAI (1)

Brett Sears, PT

Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.

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Updated on February 07, 2022

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Laura Campedelli, PT, DPT

PT Exercises for Hip Pain From FAI (2)

Medically reviewed byLaura Campedelli, PT, DPT

Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults.

(Video) Hip Impingement (FAI) Pain Stretches & Exercises - Ask Doctor Jo

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PT Exercises for Hip Pain From FAI (3)

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Femoroacetabular impingement (FAI) is a condition in your hip or hips that may cause hip pain, leg pain, and limited overall mobility. The pain from FAI may prevent you from performing your normal work or recreationalactivities.

Working with a physical therapist can help you regain range of motion and strength and improve your mobility.

Strengthening and stretching exercises are vital to recovering from FAI. A physical therapist can map out an exercise routine for you. This article explains how to do seven common exercises.

Exercise as Primary Treatment for FAI

A physical therapist may offer a variety of treatments to manage your pain and movement dysfunction. Exercises will most likely play the biggest role in treating your FAI.

Research shows that exercises can help you fully recover and manage future episodes of pain from FAI. The exercises may focus on improving hip mobility and flexibility, hip strength, balance, and overall functional mobility.

You may be glad to know that these exercises are safe to do. And they will put you in the driver's seat of your recovery.

Talk with your healthcare professional before you begin any exercise program. You want to be certain the exercises are safe and appropriate for you. Then pay close attention as your physical therapist shows you how the exercises should be done.

1

Hip Flexor Stretch

Many people with hip FAI experience tightness in a muscle group called the iliopsoas. These muscles, located in the front of your hips,help flex your hip upward.

Tightness here may be one cause of the pinching feeling you get in the front of your hip when sitting or bending. Stretching your hip flexor muscles may be one part of your FAI exercise program.

Follow these steps:

  1. Get into a half-kneeling position, placing one knee on the floor. This knee should be the one with the tight hip flexor you want to stretch. Your other foot should be flat on the floor in front of you.
  2. Keep your back straight with your chest high. Shift your body forward slowly.
  3. Gently tighten your abdominals by drawing your belly button in towards your spine.
  4. Tighten your butt muscles.
  5. You should feel a gentle stretch in the front of your hip and thigh of the leg with the knee on the floor.
  6. Hold the stretch for 15 to 30 seconds.
  7. Repeat three to five times.

Stop the stretch if you feel intense pain in your hip or leg. Any mild discomfort while stretching should go away once you return to the starting position of this exercise.

2

Piriformis Stretch

Your piriformis muscle is located deep in your hip underneath your gluteus muscles. It rotates and stabilizes your hip. It may feel tight if you have hip impingement or FAI.

(Video) Femoroacetabular Impingement (FAI) | Hip & Groin Pain (Rehab | Education | Exercises)

A physical therapist may recommend that you stretch your piriformis muscle as part of your FAI rehab.

Here's how:

  1. Lie on your back with your knees bent.
  2. Cross the leg to be stretched over your other knee. Your ankle should rest on your thigh next to your knee.
  3. Grab the thigh of your leg supporting your bent leg. Gently pull it towards your chest.
  4. You should feel a slight pull in the back of your hip.
  5. Hold the stretch for 15 to 30 seconds. Then rest.
  6. Repeat three to five times.

You may prefer an alternative stretch for your piriformis.

Try this:

  1. Lie on your back.
  2. Lift your knee up toward the opposite shoulder.
  3. Grab your knee and gently pull until you feel a stretch in the back of your hip and buttocks.
  4. Hold for 15 to 30 seconds. Release.
  5. Repeat three to five times.

Stop if you feel increasing or lasting pain.

Beginner Piriformis Stretching Routine

3

Groin Stretch

PT Exercises for Hip Pain From FAI (4)

Hip FAI often triggers tightness in the inner thigh and groin. Your physical therapist may tell you to stretch your groin muscles, or hip adductors, as part of your exercise program.

Follow these steps to do a groin stretch—also called the butterfly stretch:

  1. Sit with your back straight and your legs in front of you.
  2. Bend your knees and place the soles of your feet together.
  3. Gently allow your bent knees to fall toward the ground until you feel a pull in your inner thigh and groin. You can also lean your trunk forward a bit if you want some more stretch.
  4. Hold the stretch for 15 to 30 seconds. Then release.
  5. Repeat three to five times.

Remember to stop if you feel pain.

4

Hip Strengthening

PT Exercises for Hip Pain From FAI (5)

You might have weakness around the muscles of your hip. If so, hip strengthening may be one of the goals of your exercise program.

Many exercises can build up hip strength. Ask for a demonstration and practice a few of the more common ones.

They include:

  • Ball bridges
  • Bridges
  • Clamshells
  • Hip hikes
  • Isometric hip raise
  • Lateral band walking
  • Single leg bridges
  • Straight leg raises

You can do these exercises daily. Or your physical therapist may prescribe them less often because exercising every other day may give your hip the "rest time" it needs.

5

Core Strengthening

You may benefit from doing exercises on your core since your abdominals, hip muscles, and low back muscles all attach to the pelvis.

Your pelvis houses the socket of your hip joint. So gaining control of your core and pelvis may be important to your FAI exercise program.

These exercises could help:

  • Bridging
  • Pelvic clock
  • Pelvic tilt
  • ​Prone straight leg raising

Core exercises can be done in 15 to 20 repetitions. Your physical therapist can show you how to do each exercise.

6

Balance and Proprioception Exercise

PT Exercises for Hip Pain From FAI (6)

Your FAI rehab program may include balance and proprioception training. Proprioception is your body's awareness of its position in space and how it interacts with everything around it.

Improving balance can help you gain control of your pelvic and lower extremity regions. Doing so takes pressure off your hip joint and helps relieve the pain from FAI.

Balance exercises may start out with a simple, single-leg stance: Stand on one foot and hold your balance for 30 seconds.

Make the exercise more challenging by closing your eyes or standing on an unsteady surface, such as a pillow or folded-up towel.

(Video) Hip Impingement Pain (FAI) Best Exercises, Rehab & Strengthening (How to Avoid Surgery)

Other balance exercises include:

  • Single leg squat
  • Single leg standing with a ball toss
  • Standing on a balance board or wobble board
  • Using a BOSU or BAPS board

It can be tricky to improve your balance through exercise. Your goal is to challenge your balance while remaining safe. So hedge your bets and keep something stable (to hold onto) or soft (to fall into) nearby.

Balance Exercises in Physical Therapy

7

Functional Training

PT Exercises for Hip Pain From FAI (7)

Your FAI rehab program should be geared to your specific needs. You and your physical therapist can work together to come up with the best exercise and training program for you.

You may need help:

  • Learning to jump and land properly
  • Performing single-leg hop testing and training
  • Continuing to gain balance and muscular control of your hips, pelvis, and lower extremities

Summary

Exercises to strengthen and stretch the hip muscles—as well as the core, which helps stabilize the hip—are vital for recovering from an FAI. Balance and functional training can also help relieve pain and restore function.

Your physical therapist can create a personalized exercise plan for you, show you how the exercises are done, watch you do them, and keep a close eye on your progress.

Frequently Asked Questions

  • Can you run regularly if you have femoroacetabular impingement?

    Following surgery for FAI, you should be able to run after recovery. This process can take up to a year. Managing FAI with non-surgical treatments involves a tailored physical therapy plan. In the early stages, you can continue running with proper rest, stretching, and anti-inflammatories. But if the impingement progresses, cut back on running or allow longer periods for rest and rehab.

    Learn More:How to Prevent the Progression of Arthritis

  • What type of exercises can help with hip arthritis?

    Exercises that strengthen the muscles that support the hip will take some of the load off the joint. These can include leg raises and other targeted exercises. Swimming, walking at a moderate pace, and other aerobic workouts that may be easier on your joints can also help.

    Learn More:Targeted Hip Strengthening Exercises

  • What exercises should I avoid with FAI?

    Any exercise in which the knee moves above the hip can aggravate hip impingement and should be avoided. So should exercises that require heavy weights. Also steer clear of deep squats, lunges, leg presses, and deadlifts. After surgery, return to exercise gradually. And avoid hip-straining moves at first.

    Learn More:A Guide to Physical Therapy

2 Sources

(Video) Strengthening Exercises | Femoroacetabular Impingement (FAI)

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Trigg SD, Schroeder JD, Hulsopple C. Femoroacetabular impingement syndrome.Curr Sports Med Rep. 2020;19(9):360-366. doi:10.1249/jsr.0000000000000748

  2. Pennock AT, Bomar JD, Johnson KP, Randich K, Upasani VV. Nonoperative management of femoroacetabular impingement: a prospective study. Am J Sports Med. 2018;46(14):3415-3422. doi:10.1177/0363546518804805

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(Video) Hip pain relief: top 3 tips for relief from FAI, labral tears, and hip arthritis

FAQs

PT Exercises for Hip Pain From FAI? ›

Here's how:
  • Lie on your back with your knees bent.
  • Cross the leg to be stretched over your other knee. ...
  • Grab the thigh of your leg supporting your bent leg. ...
  • You should feel a slight pull in the back of your hip.
  • Hold the stretch for 15 to 30 seconds. ...
  • Repeat three to five times.
Feb 7, 2022

Can physical therapy fix FAI? ›

Physical Therapy Treatment for FAI

The goals of PT for FAI include to improve overall hip, spine, and lower extremity ROM and strength and to decrease pain so you can return to optimal mobility. Various treatments will occur in PT to help achieve those goals.

Can PT fix hip impingement? ›

To treat hip impingement, physical therapists prescribe stretches and strengthening exercises to better balance the muscles around the hip to protect it, and use manual therapies to help restore range of motion and increase comfort.

How do you get rid of hip impingement pain? ›

Treatment for hip impingement should begin with: Resting the affected hip. Modifying your activities to avoid moving the joint in a way that causes pain. Exercising as recommended by your doctor or physical therapist to strengthen the muscles that support the hip.

Does FAI ever go away? ›

Once someone develops symptoms associated with FAI, it is unlikely that the problem will just get better and go away. However, that does not mean that surgery is always the best first line of treatment. There are a number of nonsurgical strategies that can be utilized.

Can you reverse FAI? ›

1 The pain from FAI may prevent you from performing your normal work or recreational activities. Working with a physical therapist can help you regain range of motion and strength and improve your mobility. Strengthening and stretching exercises are vital to recovering from FAI.

Does stretching help FAI? ›

Hip Impingement (FAI) Pain Stretches & Exercises - Ask Doctor Jo

Can stretching fix hip impingement? ›

While the hip impingement may be related to bone structure, the surrounding muscles can help or hinder movement and can reduce pain. Muscle release along with stretching will provide the best results.

How do you fix FAI without surgery? ›

Nonoperative management of FAI can be attempted. However, it involves a change in lifestyle from active to less active and a commitment to maintaining hip strength. A good physical therapy program focusing on hip strengthening instead of stretching may be beneficial.

How do I get rid of FAI? ›

5 Simple Exercises from The FAI Fix - YouTube

Should you squat with FAI? ›

Conclusions: Individuals with symptomatic FAI can squat to a depth comparable with controls, regardless of task design.

What happens if you don't treat FAI? ›

If left untreated, symptoms often get worse. Over time, FAI can lead to osteoarthritis (the breakdown of cartilage around the hip joint), or joint deterioration. This can be painful and limit the ability to be active. If you're noticing persistent pain in your hip joint, you may have some damage to the cartilage.

Can I do squats with hip impingement? ›

If you have a structural impingement deadlifting variations (that don't require as much hip flexion) and single-leg work for your posterior chain are great options to get your lower body strong and keep your hips healthy without squatting.

Does FAI get worse over time? ›

When you begin having pain at night or when walking on level ground, it means the cartilage cushioning the ball is breaking down — this is called osteoarthritis. If your FAI goes untreated, your symptoms only worsen over time.

Why do people get FAI? ›

Cause. FAI occurs because the hip bones do not form normally during the childhood growing years. It is the deformity of a cam bone spur, pincer bone spur, or both, that leads to joint damage and pain. When the hip bones are shaped abnormally, there is little that can be done to prevent FAI.

Does FAI lead to hip replacement? ›

Both hip dysplasia and hip impingement (femoroacetabular impingement, or FAI) are, in fact, major causes of osteoarthritis in the young adult hip and often result in the need for surgical reconstruction or replacement of the joint (a procedure called arthroplasty) at a young age.

How do you fix FAI pain? ›

Femoroacetabular impingement (FAI), also called hip impingement, is a condition where the hip joint is not shaped normally. This causes the bones to painfully rub together. This condition can be treated with corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, rest and surgery.

Does heat help hip impingement? ›

Heat and ice help decrease pain, swelling, and muscle spasms. For heat, use a heating pad on a low setting for 20 minutes, or take a warm bath. For ice, use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you place it on your joint.

How long does it take for a hip impingement to heal? ›

How long should you give conservative management of hip impingement? You should notice an improvement in pain, strength, and range of motion after about eight weeks. You should aim to return to sport in 3-6 months and be prepared to continue with independent rehab for at least six months.

What happens if you don't fix a hip impingement? ›

Hip impingement also may damage the protective cartilage that covers the ends of the bones in the joint, called articular cartilage. That can wear down the cartilage over time and eventually make it deteriorate completely — a condition known as hip osteoarthritis.

Can you live with a hip impingement without surgery? ›

Non-surgical treatment should always be considered first when treating impingement. This condition can often be resolved with rest, modifying activity behaviour to adapt to change in hip structure, physical therapy input and/or appropriate painkillers.

Does cortisone shot help FAI? ›

IA steroid injection has an important role in the treatment of FAI, which is an anti-inflammatory effect. Its anti-inflammatory effect decreases the inflammation caused by OA. This effect was explained such that patients with hip joint effusion show a better response to IA steroid injection [16].

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