T Nation

Hip Impingement


#1

I've been to a couple doctors, and they seem to agree that I have a mild hip impingement. However, I have no bone spurs. The only type of hip impingement I can find from googling is FAI, but that involves bone spurs. Does anybody know what else could be causing hip impingement? Orthopedic surgeons are incredibly profit-driven, so they hurried me out the door before I completely understood.


#2

Could you give a little bit more information about where in your ROM its impinged? Is there pain? How long has it been bothering you? When do you notice it most?


#3

Maybe Femoral Anterior Glide Syndrome. Strengthen your Glutes.


#4

It's impinged right around parallel when squatting, and has been this way for years. When I first starting squatting I didn't have this problem, but I didn't get much depth at that time either. As I continued to squat I kept working on getting more depth. I'd say about 5 or 6 years ago I started getting close to parallel, and I can't recall ever not having the impingement. There might not have been an impingement for the first year or two. I'm not completely certain.

If I never squatted, I'd probably barely notice the impingement. My competitive athletic career appears to have come to an end recently (mainly for academic reasons), so it's not the end of the world if I never squat again, but if I have an issue with my body, I'd like to take care of it.


#5

This + your TFL is probably tight as well. I find lying on my side and digging into it with a 20kg plate works wonders.
Hip capsule stretching may help as well.

See a physio for other exercises/diagnosis


#6

to say you have hip impingement is just to say that your mobility is restricted. which you knew already lol.

there could be a bunch of reasons ranging from the shape of your bones (the ball shape of the head of the femur, the shape of the pelvic socket) to something to do with the cartilage to something to do with the ligaments to something to do with the muscles.

forget about squatting like you are supposed to squat with weights. what happens if you just gotta squat yourself down (unweighted). i mean... forget everything you have ever been told about how you are 'supposed' to squat... and just duck down there like a brick will hit you in the face if you don't.

then take a look. what is going on? are your heels on the ground or up in the air? what if you wiggle them to the ground? do you fall over backwards or what? do you have stabby pain in your hips? how is your ankle mobility etc...

i used to get stabby pain in my hips. felt to me like i'd imagine torn cartilage would feel. grippy kinda and painful. also felt like bone was jamming on bone... took me years to figure... but now... my hips are the best they have ever been. and i credit that to working out my squat.

a vid front on and side on of your trying to do it might help.


#7

I can really feel it when I roll a lacrosse ball over my TFL, so I'm guessing you're right on that one. What do you guys suggest I do for strengthening my glutes?

Also, every doctor I've been to has done several movements with my leg to see what causes pain. The only movement that does is when they lift my knee, push my knee inward, and pull my foot outward. I can really feel it in both hips.


#8

This is the test I'm referring to.


#9

Look up Bret Contreras for Glute stuff and Kelly Starrett for Hip capsule stuff that will increase your hip flexion and hip external rotation.

I personally was doing modified Couch stretches(Kelly Starrett) before I did Rack Barbell Hip Thrusts followed by a lot of hip abductor machine and cable pull throughs, I noticed instant increases in hip flexion after I did stuff like that more than the Hip Capsule stuff alone though.


#10

That means you are lacking in hip flexion and internal rotation, not sure how to improve internal rotation but I bet it improves with improved hip flexion.


#11

So, Joab, you're saying that the stuff in the Kelly Starett vid you linked didn't help, but the barbell hip thrusts and cable pull throughs and hip abductor machine did help? What reps range weights were you doing on the barbell hip thrusts? Could one get the same effect just doing bw hip thrusts?

I had done barbell hip thrusts in the rep range of 10-15 reps (good form) before for a period of a year and a half, but noticed no reduction in anterior pelvic tilt or hip impingement during this period. Does it just take much longer than that - ie. you need to be doing barbell hip thrusts for a solid decade before you start noticing any changes?


#12

It did help but I really didn't have a place to anchor the bands with that much tension in my house so I wasn't able to use it that much. What I really noticed helped about the hip thrust(whether body weight or weight added) was getting the end range motion and having the hip go into hyper extension using the glute. My hip flexors are pretty tight so I had to stretch them before I could do that. If you have AP you would have to make sure you don't get the extra movement from you lower back arching even harder. I don't have AP because my hamstrings are so much stronger and tighter than the rest of my leg muscles how that contributes to AFGS was that they were bowstringing the head of my femur against the front structures of my hip where I would get a jabby motion restricting pain in the front of my hip whenever I was in hip flexion(bottom of squat or leg press).

I would find it weird for someone with AP to have AFGS but if you do have it with AP I would work on both Hamstring and Glute strength doing a lot of couch streches.

My last glute workout from some time ago.

Rack Barbell Hip thrusts
4x155lbx15
Hip Abduction Machine Leaning Forward
2x110lbx15
4x130lbx15
Cable Pull Through(weight stack said 90lb but I believed it to be what I wrote due to pulleys)
4x45lbx15


#13

FAI can sometimes be confused with Coxa saltans, as they have similar symptoms

Just a thought


#14

Thats a hip labral test/Impingement test, it checks if there is abnormal contact between the labrum and head/neck junction of the femur. Impingement is exacerbated with hip flexion and internal rotation. The cause is either an abnormal shaped femoral head (CAM) or acetabulum (pincer).

You should be squatting with lots of abduction and external rotation.

also strong bump from august