How To Fix Hip Impingement (WITHOUT SURGERY!)

The Science Behind Fixing Hip Impingement

First, let's talk about the science of fixing your hips without surgery.

Back in 2013, a group of researchers systematically reviewed the literature on nonoperative treatments for femoroacetabular impingement.

Their conclusion?

"Research supports a non-operative approach to treating FAI."

In other words, we CAN heal our hips without surgery!

Fast forward several years and another group of researchers gave us the specific roadmap to hip rehab in a 2021 paper titled Therapeutic Exercise Approaches to Nonoperative and Postoperative Management of Femoroacetabular Impingement Syndrome.

In this paper, they recommend 4 specific types of exercise to help heal our hips:

 The 4 Magic Steps for Fixing Hip Impingement: 

1. Postural exercises
2. Core exercises
3. Hip strength exercises
4. Flexibility and mobility exercises

They are magic because of how effectively they can alleviate pain and improve mobility – almost like magic!

In fact, I remember the 1st time I discovered 1 of these magic steps or exercises from the "flexibility and mobility" category. It was 2012, and I learned how to do deep, targeted massage on my glutes with a little device called the Jack Knobber 2.

Before I used this device, I used to get intense, stabbing pain in my hip whenever I would lay on my back and open my leg out to the side.

After 2-3 minutes of deep, targeted massage on my glutes with the Jack Knobber, the pain disappeared – like magic! But even before this magic massage works, there are faster and easier fixes to make your hips feel good ASAP.

STEP 1: Postural Exercises for Hip Impingement

To see how posture affects hip impingement, try this simple test:

1. Lay on the ground, arch your back, and pull your knee to your chest. Feel that ouchy, pinching sensation? That's your femur having a car crash with your acetabulum - aka hip impingement!
2. Now, get your pelvis in a more neutral position by slightly flattening your back to the ground.

Pretend you are squishing a rose petal beneath your back. Now, pull your knee to your chest. Less pinch? Congrats! You just learned how pelvic posture influences hip impingement.

The take-home message is this:

Anterior pelvic tilt = more impingement
Neutral/posterior pelvic tilt = less hip impingement.

So what do you do with that information?  You learn to MASTER your pelvic position!

Here are 3 ways to start to do that: (check the video above for more details) 

1. Lying pelvic tilts
2. Seated pelvic tilts
3. Standing pelvic tilts

After you master these basic movements, you need to learn how to use them in complex activities—things like squatting, deadlifting, lunging, sprinting, playing sports, and more.

Check out this video for more ways to train your core to heal your hips:

14 years ago, In my journey out of hip impingement, my mentor helped me master these pelvic control exercises. He did so by meticulously coaching me to do them with perfect technique. His OCD-like attention to detail helped me big time. Thanks to this phase of my rehab, I never got surgery for my hip impingement, labral tear, and bone cysts.

In fact, I’ve still got these same “bad bone shape,” labral tears, and cysts today! However, I learned how to control my pelvic posture with these exercises.

This led me to Step #2, which is...core exercises!

STEP 2: Core Exercises for Hip Impingement

If you have more core strength and endurance = you will have less pain and more range of motion.

Build your core, save your hips!

There are dozens of core exercises for hip impingement and progressions/regressions for all of them. For a comprehensive approach to core training for hip impingement, check out TheFAIFix.com program.

For now, let's cover the 4 essential core exercises:

• Planks: help you build core endurance and strength.
• Side planks: train your obliques.
• Deadbugs: help activate your deep core muscles, like the transverse abdominis, while your limbs move. 
• Pallof Presses: help build rotational stability.

Altogether, they help you stabilize your trunk and hips, giving you more freedom and less pain.

STEP 3: Strength Exercises for Hip Impingement

The next step on your hip recovery journey is strength & stability. AKA, hell yeah, brah! It's finally time to build some muscle! But don't worry, I'm not talking about turning you into the Hulk Hogan. The focus here is on strengthening the muscles around the hip to give your hip joint better support and stability.

Why is this important? Imagine your hip joint is like a king sitting on a throne. The muscles around the hip are the loyal knights protecting the king. The stronger the knights, the safer the king. Similarly, the stronger (and smarter) your muscles, the safer your hip!

When I work 1-on-1 with my hip impingement students, I have them do the “3 “I’s” progression:

First, we Isolate, then we Integrate, then we Improvise.

What that means is first, we isolate individual muscles to develop a strong mind-muscle connection with weak or underactive muscles. 

Then, we integrate those muscles into more complex movement patterns (like squats, deadlifts, and lunges). 

Finally, we improvise by challenging the hips with more unstable/chaotic movements—things like playing your sport, trail running, or various movement challenges and games. 

Check out this video for more step-by-step ideas: 

STEP 4: Flexibility & Mobility Exercises for Hip Impingement

The 4th and final step is flexibility & mobility exercises for hip impingement. This step is critical to fix pain and heal hip impingement without surgery.

Unfortunately, it's also one of the steps that most physical therapy protocols get wrong.

I know from direct experience because I went to over 30 physical therapists and healing professionals in my hip recovery journey. After spending over $26,000 with them, I started to see a pattern. I was getting the same generic and unhelpful advice over and over.

For example, if the PT prescribed self-myofascial release work, it was usually very basic and never progressed beyond simple foam rolling. 

If they prescribed stretching, it was almost always a 15-30-second stretch that irritated my hip.

For example, the PT prescribes a hip flexor stretch, which can help some people and cause anterior femoral glide and PAIN in others.  

What I needed instead was: 

1. Better tissue work/self-massage BEFORE the stretching 
2. Better instructions and VARIATIONS of hip flexor stretching 
3. Instructions about how to build strength at every length while stretching (rather than just passive/relaxed stretching) 
4. Other stretching options if hip flexor stretching didn’t work.

Even though my experiences with the flexibility and mobility exercises prescribed by generic PT were disappointing – don’t get it twisted – there ARE many amazing flexibility and mobility exercises for hip impingement. For example:  

Some of the most effective are:

1. Deep tissue massage on the quads
2. Deep tissue massage on the glutes
3. Deep tissue massage on the adductors and hamstrings
4. Improved stretching for the hip flexors and quads
5. Band hip distraction exercises in various positions and directions WITH super precise instructions on how to position the body
6. Glute/hamstring and adductor stretching that doesn't lead to more pain or pinchiness in the hips

Of critical importance here is the fact that you can’t do deep tissue work without a few special massage tools. If you want to unlock your hips, you need the right tools. After all, a car mechanic CAN work on a car with only a wrench, but he can do a whole heck of a lot more with more specialized tools.

Similarly, a foam roller can do a few things on your body. But specialty tools can do even more. 

Conclusion & Two Ways to Heal Your Hips Faster

So there you have it!

The 4 magic keys to fixing hip impingement without surgery are:

1. Postural exercises
2. Core exercises
3. Hip strength exercises
4. Flexibility and mobility exercises

If you master these 4 areas, your hips will be doing the cha-cha in no time!

Two Ways to Help Heal Your Hips Faster

✅ If you want personal 1-on-1 help with a hip pain specialist who's dealt with the exact same problem as you, visit GotROM.com/VIP to apply for my VIP mentorship program. 

✅ If you want a "DIY" approach to fixing hip pain, please visit TheFAIFix.com

And remember, you're just 1-step away from building or re-building your perfect body.

See you soon!
 

                                     GET 1:1 HIP HELP NOW

About The Author

Shane Dowd, CES, CMP, is the owner/founder of GotROM.com. He is also a sports performance & mobility coach specializing in injury prevention and flexibility for athletes.