One Highly Effective Hip Impingement Exercise (Femoroacetabular Impingement)
Key insights: 60-second read
- FAI treatment often focuses on bony abnormalities - but we can't remodel bone overnight. We can, however, influence how the joint functions.
- Hip joint capsular stiffness is the hidden piece - improving mobility here increases joint "slack" and buffers against bony impingement.
- A specific hip capsule stretch is highly effective - it targets the deeper stiffness that muscle stretching alone misses.
- Local + telehealth support available - personalised physio assessment in Port Macquarie or via video consult.
Femoroacetabular Impingement (FAI) can be a tricky condition for many to handle. The pain can debilitate even the best athlete once it progresses to a certain point.
Interestingly, our focus with FAI is often on the bony abnormalities and its impact on our joint structures. As a result, we try to buffer these bony abnormalities with strength and muscular stretching. And while this is obviously very important to do, it doesn't necessarily change the deeper mechanical dysfunction going on.
We may not be able to remodel our hip anatomy in an instant, however, we can influence its function. And a great way to do this is by improving any deeper hip joint stiffness.
Clinically, a strong focus on hip joint capsular mobility can be hugely advantageous by increasing the amount of slack in the joint. This potentially adds a greater buffer against these bony abnormalities and subsequent joint dysfunction.
On this page
Video: The Hip Capsule Stretch for FAI
In today's video, I demonstrate how to perform a hip capsule stretch. It's highly effective at treating the underlying stiffness associated with hip impingement and should be a staple of any FAI treatment program. I also discuss the bigger picture that's often overlooked when trying to understand the cause of Femoroacetabular Impingement.
What is Femoroacetabular Impingement (FAI)?
Femoroacetabular Impingement is a condition where extra bone develops along one or both of the bones that form the hip joint - the femoral head (ball) and/or the acetabulum (socket). This bone overgrowth causes the bones to rub against each other during movement, rather than gliding smoothly.
There are three main types:
- Cam Impingement: The femoral head is not perfectly round, creating an irregular shape that rubs inside the socket.
- Pincer Impingement: The acetabulum (socket) has extra bone coverage, causing the femoral neck to pinch against it.
- Combined Impingement: Both cam and pincer types are present.
FAI can lead to pain, reduced range of motion, and eventually damage to the labrum and cartilage if left unaddressed.
The Hip Capsule: The Missing Piece
The hip joint capsule is a strong, fibrous sleeve that surrounds the entire hip joint. It provides stability and contains the synovial fluid that lubricates the joint. Importantly, it also influences how much movement is available at the joint.
In many cases of FAI, the hip capsule becomes stiff and restricted. This stiffness reduces the "slack" in the joint, meaning the bony abnormalities have less space to move without impinging. The result is pain and dysfunction even with relatively minor bony changes.
Conversely, a more mobile capsule creates more slack. This extra space allows the joint to move further before the bone-on-bone contact occurs, effectively buffering against the impingement. This is why addressing capsular stiffness can be so impactful - it changes the functional environment of the joint, even if the bony anatomy remains the same.
The Hip Capsule Stretch: How to Perform It
The video demonstrates this stretch in detail, but here's a summary of the technique:
- Get into position: Lie on your side with the affected hip facing up. Bend both knees to about 90 degrees.
- Use a band (optional but recommended): Anchor a resistance band to something sturdy and place it around the front of your hip joint, just below the hip bone. This helps "distract" the joint, allowing for a more specific capsule stretch.
- Rotate your leg: Keeping your knees together, rotate your top leg outward (external rotation). You should feel a stretch deep within the hip joint, not just in the muscles.
- Apply PNF technique: Once you feel a comfortable stretch, gently contract the muscles by trying to rotate your leg back inward against resistance for 5-10 seconds. Relax, and you should be able to rotate further into the stretch. Repeat 2-3 times.
- Repeat on both sides: Even if only one hip is symptomatic, both sides may benefit from this mobility work.
The key is to feel the stretch deep within the joint, not just in the superficial muscles. This indicates you're targeting the capsule itself.
Related: The Couch Stretch: How to Do One of the Best Exercises for Knee Pain, Hip Pain & Back Pain - another powerful exercise for hip mobility.
Helpful equipment for this video
- Power Band - for the banded hip capsule stretch
- Lacrosse Ball - for additional soft tissue work around the hip
Please note: These are affiliate links. I may earn a small commission if you purchase through them, at no extra cost to you.
With this information I hope you find the missing piece to your FAI rehab puzzle. It's OK if you feel a though things are progressing slowly, as long as there is progress!
If you found this video useful, please leave a like and let me know in the comments! Also, please consider subscribing to the Your Wellness Nerd channel for more helpful information.
- Grant
Frequently Asked Questions
Can you fix FAI without surgery?
Yes, absolutely. While surgery is sometimes necessary, many people manage FAI successfully with conservative care. This includes addressing capsular stiffness, strengthening supporting muscles, improving movement patterns, and modifying activities. The goal is to create more space and better mechanics within the joint.
How often should I do the hip capsule stretch?
Daily can be very helpful, especially in the initial stages. The hip capsule is dense tissue that responds slowly, so consistency is key. Even 5-10 minutes a day can make a significant difference over time. As symptoms improve, you can reduce frequency to a few times per week for maintenance.
Will I still need surgery if I have significant bony abnormalities?
Not necessarily. While significant bony changes can't be reversed without surgery, improving capsular mobility and muscular control can often create enough functional space to make surgery unnecessary. Many people with substantial bony abnormalities live pain-free by optimising their joint mechanics. A thorough assessment with a physio can help determine the best path for you.
One key insight
"We can't remodel bone overnight, but we can influence joint function. Improving hip capsular mobility adds slack to the joint, buffering against bony abnormalities - even if the bone itself doesn't change."
Struggling With Hip Pain or FAI?
If you'd like help uncovering the underlying cause of your hip pain - whether it's capsular stiffness, bony impingement, or something else - a thorough assessment can help. Learn more about our hip pain physiotherapy services in Port Macquarie.
Want personalised guidance?
If you'd like help with your FAI or any other persistent issue, you can book with Grant either in Port Macquarie or via an online telehealth consultation.
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