Physical Therapy Exercises for Hip Impingement

FAI: Femoroacetabular Impingement Exercises

Femoroacetabular impingement (FAI) is a condition in your hip or hips that may cause hip pain, leg pain, and limited overall mobility. The pain from FAI may prevent you from performing your normal work or recreational activities.

Working with a physical therapist can help you regain range of motion and strength and improve your mobility.

Strengthening and stretching exercises are vital to recovering from FAI. A physical therapist can map out an exercise routine for you. This article explains how to do seven common exercises.

Exercise as Primary Treatment for FAI

A physical therapist may offer a variety of treatments to manage your pain and movement dysfunction. Exercises will most likely play the biggest role in treating your FAI.

Research shows that exercises can help you fully recover and manage future episodes of pain from FAI. The exercises may focus on improving hip mobility and flexibility, hip strength, balance, and overall functional mobility.

You may be glad to know that these exercises are safe to do. And they will put you in the driver's seat of your recovery.

Talk with your healthcare professional before you begin any exercise program. You want to be certain the exercises are safe and appropriate for you. Then pay close attention as your physical therapist shows you how the exercises should be done.

1

Hip Flexor Stretch

Many people with hip FAI experience tightness in a muscle group called the iliopsoas. These muscles, located in the front of your hips, help flex your hip upward.

Tightness here may be one cause of the pinching feeling you get in the front of your hip when sitting or bending. Stretching your hip flexor muscles may be one part of your FAI exercise program.

Follow these steps:

  1. Get into a half-kneeling position, placing one knee on the floor. This knee should be the one with the tight hip flexor you want to stretch. Your other foot should be flat on the floor in front of you.
  2. Keep your back straight with your chest high. Shift your body forward slowly.
  3. Gently tighten your abdominals by drawing your belly button in towards your spine.
  4. Tighten your butt muscles.
  5. You should feel a gentle stretch in the front of your hip and thigh of the leg with the knee on the floor.
  6. Hold the stretch for 15 to 30 seconds.
  7. Repeat three to five times.

Stop the stretch if you feel intense pain in your hip or leg. Any mild discomfort while stretching should go away once you return to the starting position of this exercise.

2

Piriformis Stretch

Your piriformis muscle is located deep in your hip underneath your gluteus muscles. It rotates and stabilizes your hip. It may feel tight if you have hip impingement or FAI.

A physical therapist may recommend that you stretch your piriformis muscle as part of your FAI rehab.

Here's how:

  1. Lie on your back with your knees bent.
  2. Cross the leg to be stretched over your other knee. Your ankle should rest on your thigh next to your knee.
  3. Grab the thigh of your leg supporting your bent leg. Gently pull it towards your chest.
  4. You should feel a slight pull in the back of your hip.
  5. Hold the stretch for 15 to 30 seconds. Then rest.
  6. Repeat three to five times.

You may prefer an alternative stretch for your piriformis.

Try this:

  1. Lie on your back.
  2. Lift your knee up toward the opposite shoulder.
  3. Grab your knee and gently pull until you feel a stretch in the back of your hip and buttocks.
  4. Hold for 15 to 30 seconds. Release.
  5. Repeat three to five times.

Stop if you feel increasing or lasting pain.

3

Groin Stretch

woman doing groin stretch

Sporrer / Rupp Cultura / Getty Images

Hip FAI often triggers tightness in the inner thigh and groin. Your physical therapist may tell you to stretch your groin muscles, or hip adductors, as part of your exercise program.

Follow these steps to do a groin stretch—also called the butterfly stretch:

  1. Sit with your back straight and your legs in front of you.
  2. Bend your knees and place the soles of your feet together.
  3. Gently allow your bent knees to fall toward the ground until you feel a pull in your inner thigh and groin. You can also lean your trunk forward a bit if you want some more stretch.
  4. Hold the stretch for 15 to 30 seconds. Then release.
  5. Repeat three to five times.

Remember to stop if you feel pain.

4

Hip Strengthening

Photo of a woman running with hip pain.

Yuri_Arcurs / Getty Images

You might have weakness around the muscles of your hip. If so, hip strengthening may be one of the goals of your exercise program.

Many exercises can build up hip strength. Ask for a demonstration and practice a few of the more common ones.

They include:

  • Ball bridges
  • Bridges
  • Clamshells
  • Hip hikes
  • Isometric hip raise
  • Lateral band walking
  • Single leg bridges
  • Straight leg raises

You can do these exercises daily. Or your physical therapist may prescribe them less often because exercising every other day may give your hip the "rest time" it needs.

5

Core Strengthening

You may benefit from doing exercises on your core since your abdominals, hip muscles, and low back muscles all attach to the pelvis.

Your pelvis houses the socket of your hip joint. So gaining control of your core and pelvis may be important to your FAI exercise program.

These exercises could help:

  • Bridging
  • Pelvic clock
  • Pelvic tilt
  • ​Prone straight leg raising

Core exercises can be done in 15 to 20 repetitions. Your physical therapist can show you how to do each exercise.

6

Balance and Proprioception Exercise

Photo of a wobble board.

Rollover / Getty Images

Your FAI rehab program may include balance and proprioception training. Proprioception is your body's awareness of its position in space and how it interacts with everything around it.

Improving balance can help you gain control of your pelvic and lower extremity regions. Doing so takes pressure off your hip joint and helps relieve the pain from FAI.

Balance exercises may start out with a simple, single-leg stance: Stand on one foot and hold your balance for 30 seconds.

Make the exercise more challenging by closing your eyes or standing on an unsteady surface, such as a pillow or folded-up towel.

Other balance exercises include:

  • Single leg squat
  • Single leg standing with a ball toss
  • Standing on a balance board or wobble board
  • Using a BOSU or BAPS board


It can be tricky to improve your balance through exercise. Your goal is to challenge your balance while remaining safe. So hedge your bets and keep something stable (to hold onto) or soft (to fall into) nearby.


7

Functional Training

Photo of an athlete doing a box jump.

John Fredele / Getty Images

Your FAI rehab program should be geared to your specific needs. You and your physical therapist can work together to come up with the best exercise and training program for you.

You may need help:

  • Learning to jump and land properly
  • Performing single-leg hop testing and training
  • Continuing to gain balance and muscular control of your hips, pelvis, and lower extremities

Summary

Exercises to strengthen and stretch the hip muscles—as well as the core, which helps stabilize the hip—are vital for recovering from an FAI. Balance and functional training can also help relieve pain and restore function.

Your physical therapist can create a personalized exercise plan for you, show you how the exercises are done, watch you do them, and keep a close eye on your progress.

Frequently Asked Questions

  • Can you run regularly if you have femoroacetabular impingement?

    Following surgery for FAI, you should be able to run after recovery. This process can take up to a year. Managing FAI with non-surgical treatments involves a tailored physical therapy plan. In the early stages, you can continue running with proper rest, stretching, and anti-inflammatories. But if the impingement progresses, cut back on running or allow longer periods for rest and rehab.

  • What type of exercises can help with hip arthritis?

    Exercises that strengthen the muscles that support the hip will take some of the load off the joint. These can include leg raises and other targeted exercises. Swimming, walking at a moderate pace, and other aerobic workouts that may be easier on your joints can also help.

  • What exercises should I avoid with FAI?

    Any exercise in which the knee moves above the hip can aggravate hip impingement and should be avoided. So should exercises that require heavy weights. Also steer clear of deep squats, lunges, leg presses, and deadlifts. After surgery, return to exercise gradually. And avoid hip-straining moves at first.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Trigg SD, Schroeder JD, Hulsopple C. Femoroacetabular impingement syndromeCurr Sports Med Rep. 2020;19(9):360-366. doi:10.1249/jsr.0000000000000748

  2. Pennock AT, Bomar JD, Johnson KP, Randich K, Upasani VV. Nonoperative management of femoroacetabular impingement: a prospective study. Am J Sports Med. 2018;46(14):3415-3422. doi:10.1177/0363546518804805

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.