Hip Impingement

[Taramisu]

Hello -

I have been a member of this board for many years but this is my first post in over a year. Just got away from it as well as my fitness routine, this was going to be the spring/summer that I was going to get back into shape. Working from home the past two years and other various factors I have really fallen off the wagon and am frankly in the worse shape I have been in years.

A few weeks ago I noticed pain in both of my hip flexors, some days worse than others but it has persisted for a few weeks now so I went to the orthopedic doctor. X-rays show no sign of arthritis which is good but they are calling it a "hip impingement" which makes perfect sense and matches all the symptoms that I have been having. Pain in the front of the leg/hip flexor, even groin area. I have been doing stretching, foam rolling which helps. I have been doing some exercise, but wanted to back off until I found out what I am dealing with as I don't want to irritate further. Based on what I have read, it's possible that I have had this for years but it didn't start causing pain until recently. Which would make sense as it just started hurting out of nowhere.

Physical therapy has been recommended, hopefully this will help, otherwise I will be looking at injections, maybe an MRI, I suppose surgery would be a last resort.

Just wondering if anyone here has experienced this. Did you get physical therapy? Did it help? Were you able to return to previous levels of fitness or did you have to permanently change the way you exercise?

I enjoy yoga and pilates so I think I will be able to continue doing those activities, though there might be some exercises/poses that I should avoid but I don't do advanced moves anyway.

I also enjoy step, but haven't done it in a long time, and if I were to start up again would probably only do once a week. I also enjoy weights which I know that I need to do but probably need to back off on most weighted standing work lower body right now. I can do squats with my ball, lunges are hard, even unweighted. So it will be floor work for lower body for a while, maybe forever.

I think of all those years I did the Firm and those tall box presses, I want to blame that but I don't know if that's the cause. But looking back now I never liked doing those on such a tall box (14 inch), I dropped to 12 and eventually 10 and like those heights much better. The Firm is lower body heavy too, so I wonder if I will be able to do those workouts again, or honestly if I even want to. I do really enjoy Cathe's intermediate workouts but she has plenty of lower body work as well. Maybe I will be able to work it back in eventually who knows.

Sorry for the long post, but if anyone has any experiences with this that they would like to share I am open to reading it.

TIA...

[Vantreesta]

In 2009 I tore my high hamstring tendon, hip labrum and other ligaments in my hip, all on the left side. It was discovered I have an impingement in both hips. I did 4 sessions of PT for the injuries and then kept up the exercises for 10 months on my own till my injuries were mostly pain free. I was never told to change activities I was doing as far as the impingements were concerned, so I haven't. The orthopedic doctor did recommend I not sit with my hips in external rotation, but I still do. I still do a lot of accessory work/prehab for my glutes, hams and hips but more bc of the injuries than anything else. I just can't say I've felt much affected by the impingements, unless it predisposed me to the injuries, but they were sustained while doing the splits so all on me being stubborn. I highly recommend the Upright Health channel on YouTube. Matt Hsu is incredibly knowledgeable about hip impingement and much more.

But here's my disclaimer. I still have pain but it's on my injured side. I have degeneration in both SI joints and both hips but I'm also 46 and from a family where pretty much everyone on my dad's side has had arthritis for decades so I have no idea how the impingements may or may not have played into it.

The orthopedic doctor told me I would most likely end up with arthritis but he was mainly talking about my injured side. He said when you start to feel arthritis pain come back and we'll give you a shot. I'm stubborn, though. I'm doing everything I can to keep my joints happy and moving freely and never even consider a shot.

My only movement modifications come when my injured side is hurting bc I've slacked off prehab or bc my high hamstring tendons are aggravated from overstretching.

But I will also say that I didn't find my primary care of the orthopedic doctor terribly helpful in any of this. My doctor at the time told me I could still run while injured, just don't do anything that hurt. I was disgusted with her advice and lost any trust I had in her. Every single thing hurt to do!! I get much better advice from my chiropractor.

Check out Upright Health for sure and learn all you can. I hope you find what works for you and moves you out of pain. If you have any questions for me feel free to ask.

[Taramisu]

Originally Posted by Vantreesta

Check out Upright Health for sure and learn all you can. I hope you find what works for you and moves you out of pain. If you have any questions for me feel free to ask.

Thank you for sharing your experience, I appreciate it.

I do have a chiropractor which I will be seeing soon, I will ask his opinion also. But I do hope that the PT will help.

Thanks again.

[yogapam]

I have early osteoarthritis arthritis in my hip & am dealing with a hip impingement from an osteophyte, aka bone spur. TBH, in my experience doctors are fine at diagnosing these things, but not always so good at treating them. I’ve been seeing a kinesiologist who has extra training in rehab. She has helped me so much! I’ve been doing a combination of strengthening exercises, joint opening stretches with a resistance band, and hip focused stretches. My glutes were weak & my quads were very tight. It’s all about balance and, although I am very active & workout pretty much daily, what I was doing wasn’t providing the balance I needed.

We are all different, but that is my experience, I have less pain, much more range of movement, and better flexibility in my hip.

ETA All PTs and kinesiologists aren’t created equal. I was fortunate to get a good one who was highly recommended by two friends who have worked with her.

[bzar]

Originally Posted by yogapam

My glutes were weak & my quads were very tight. It’s all about balance and, although I am very active & workout pretty much daily, what I was doing wasn’t providing the balance I needed.

Aloha Pam, thanks for sharing. Exactly what exercises are you doing to address weak glutes and tight quads?

i have nagging left hip pain. doctor x-rayed me last year and no issues were found. i chalked it up to an old tailbone injury from the early 90s. it doesn't always hurt, but i wish i knew why it did. right hip is fine.

[Lorelai]

Originally Posted by bzar

Aloha Pam, thanks for sharing. Exactly what exercises are you doing to address weak glutes and tight quads?

i have nagging left hip pain. doctor x-rayed me last year and no issues were found. i chalked it up to an old tailbone injury from the early 90s. it doesn't always hurt, but i wish i knew why it did. right hip is fine.

I have been struggling with my hips (usually my left) and my lower back for awhile now. I decided it was my SI joints and have been doing this rebalancing sequence daily for the past several days and it's making a big difference. I did buy a therapy belt for less than $10 on Amazon and it's been really useful... I even like it instead of a resistance band for some stretches.

https://youtu.be/Az1wKCmD52Q

I also have very weak glutes and even doing, say, side leg lifts, I've found it difficult to isolate the glutes without letting my hip flexors take over (I have stronger hip flexors but they are also tight). The same PT gives some good form tips in this video which helps me isolate and activate the correct muscles for bridge work, clamshells and side leg lifts. Also, I use the hemmhroid cushion per Classical Stretch/ Essentrics for the side leg lifts.

https://youtu.be/wpraANs3YmY

I also had a great massage and learned that I have tight pirformis (both sides) and my hips really don't like to internally rotate. So my self imposed PT is the SI joint rebalancing sequence from the first video, plus side leg lifts and clamshells. I work very hard to isolate the glutes even if I means my ROM is currently quite small. Then gentle slow Essentrics... My go to has been 1020 Back Pain Relief (all floor) which seems to work all of my problem areas. I do want to learn ways to modify the pigeon stretch to see if I can benefit more from it, but I love it for stretching my quads. I sit on at least one riser most of the time, and at the end I sit on two. Yesterday I tried the beginner posture workout on Essentrics TV. The weeks of floor work is paying off... I can see it in my plies and lunges and I feel a lot more stable.

I also have an old tailbone injury from high school, it hurt to sit for like a year, and driving for any length of time wasn't fun either. I do wonder if it's related, although I attribute most of my problems to three pregnancies and the inactivity and muscle imbalances that can be made worse during all that...

[Jane P.]

I have the same problem in my right hip. I am seeing a sports med doc next week. One thing that caused me problems was doing plie squats with fairly heavy barbell.

[Vantreesta]

I don't have time to read all the replies right now but wanted to post before I forgot again. For prehab I am mostly using Caroline Jordan videos, most frequently her 15 min glute activation workout and the two for high hamstring tendonitis. My glutes have definitely gotten stronger doing these regularly.

[Taramisu]

Thanks all for your replies, it is much appreciated. I will check out those videos.

Yes, my glute muscles are quite weak so that is likely a big part of the issue, also sitting so much especially working from home these last couple of years and that will remain the case provided I stay with this same company.

I need to strengthen some areas, but will be doing mostly floor work, bridgework, clams and exercises like that. I do have bands I can use so that will help. I also have some pilates videos that I will revisit, plus I found some YT channels that maybe I will try.

Standing work is likely out for a while, though I can do squats with my ball just fine. I actually like doing them with the ball because doing squats in recent years can be hard on my back, especially pulsing squats. I am not concerned about not doing basic standing lower body moves for a while, but would like to work them back in eventually as I feel they are important for muscle strength and bone health, so I don't want to abandon them entirely. I will speak to the PT and get their take on it. But for now pilates and yoga, walking for cardio if it ever warms up here, and I need to do weights for upper body.

I wish I knew what caused this but I don't. I don't recall having any sort of injuries that spurned it on. Looking back I was adamant about using heavy weights (15lb in each hand) for lots of lower body work (Firm) plus using the tall box at the 14 inch height. I dropped the weight to 12lbs and lowered the box to 12 inches, then 10 inches which felt much better. Perhaps I should have been doing that all along but it's really hard to speculate what did this. But doing the really heavy weights (for me) and the taller step never felt comfortable I wish I would have been wiser back then.

I will be going through my DVDs and assessing what I will do provided I heal up. I hope to get better and back to my previous level of fitness, but I don't want to reaggravate this either so I need to take that into account as well. I would rather be pain free and limit my injuries than force myself to do moves that I used to do. I would be safe about it going forward, if that makes sense.

Thanks again for reading and responding, I appreciate it.

[Vantreesta]

From what I remember reading when I was diagnosed was that it's more the shape of the joint, not smthg caused by one's activities. It has been a long time since I researched it though.