Core Principles
Hip impingement (femoroacetabular impingement) flares when the hip is forced into end-range flexion combined with adduction and internal rotation — the position that jams the femoral head against the acetabulum. Three principles guide every exercise choice:
- Stay Out of the Pinch Zone: Avoid deep hip flexion with the knee drawn inward across the body, especially under spring load.
- Prefer Extension and External Rotation: Patterns that open the hip — extension, abduction, and external rotation — unload the joint.
- Screen for Pain, Not Just Range: Groin pain, catching, or a sharp pinch at the front of the hip is the signal to stop and shorten the range.
Apparatus-Specific Precautions
Feet in Straps: Frog, Leg Circles, Scissors, and Bicycles
All four take the hip through wide flexion-rotation arcs. Keep the arc small, the hip in the pain-free zone, and the pelvis anchored; cut the range before cutting the exercise.
Side Kicks, Side-Lying Leg Lift, and Side-Lying Leg Press
Side-lying abduction work is generally friendly — keep the leg in the pain-free arc and reduce the height of the kick if the front of the hip pinches.
Single Leg Bridge
Keep the pelvis level and the lifted leg long, in line with the hip — no crossed or internally rotated positions.
Carriage Hamstring Stretch
A deep hip-flexion stretch. Keep the hips level and limit the depth to the pain-free angle; never force the leg toward the chest.
Safe Alternatives
Prone extension work (Swan, Breaststroke), footwork with a neutral hip, standing work, and quadruped patterns keep the hip out of the pinch zone while building the muscles that stabilize it.
Teaching Cues for This Population
- Cue the knee and thigh in line with the hip — no crossing, no internal rotation under load.
- Keep the pelvis anchored and level in every single-leg pattern.
- Move within the pain-free arc; range is a goal for later, not a demand for today.
- Stop and reassess on any catching, clicking with pain, or groin pinch.
Programming Notes
Start with extension- and abduction-biased work, add flexion patterns only in small, supported arcs, and progress range gradually over weeks, not in a single session. Document the pain-free arc each visit.