Are you, or someone you know, dealing with hip pain? Perhaps due to a prior injury, an insidious (unknown) and gradual onset during activity or due to trauma?

Hip pain, as nagging and uncomfortable, is also very common. In most cases, an individual can be walking around day to day life with a mild labral tear and not even know it. That is because some cases of changes in the hip do not show symptoms. However, this is for those of you who do experience pain and who do not feel like relinquishing workouts and daily movement.

To start, find a provider, like your trusty providers at Urban Wellness Clinic, to help explain your overall movement patterns and explain compensatory patterns that could be contributing to your hip pain. Secondly, learn to move properly so that when you are not with your practitioner or trainer, you know how to move the body in a healthy way and avoid further damage and pain.

The good news is, you can start to train with strength moves from home that you can safely do when dealing with hip impingement or a mild labral tear. And the even better news is that you SHOULD be doing them to help support the joint with strong tissue!

What is hip impingement?

Hip impingement, more formally known as Femoroacetabular Impingement (FAI), is brought on when there is wear and tear to the ball and socket joint. The ball and socket joint refers to the type of joint where the head of the femur (ball) sits inside the half moon shaped (socket) in the ilium.

The ball and socket joint allows for a wide array of movements, such as: flexion, extension, adduction, abduction, circumduction and rotation. A layer of cartilage between the two bones allows for smooth movement in all of these directions. Therefore, when there is injury, trauma or repetitive load to this joint, there is a lack of smooth glide within the aforementioned movements. What follows is dull to sharp pain and decreased range of motion.

Hip impingement (FAI) is most commonly due to damage to the cartilage from repetitive movements that put strain on the joint if done poorly, ie. sports such as baseball, golf, dancers and runners.

Common symptoms include, but not are limited to: pain in the groin, pain with hip flexion, low back pain and pain along the groin while at rest. The pain can either be dull or sharp depending on severity and level of movement.

What is a labral tear?

The ball and socket joint I just talked about also includes the labrum, which is a thin layer of cartilage that lays along the hip socket and provides the hip the ability to move smoothly in multi-axial directions. A tear in this layer of cartilage can also lead to pain in the front of the hip and along the groin.

Labral tears can be brought on similarly to hip impingement such as direct trauma or repetitive movements that create torsion. Examples of torsional movements include those in golf, hockey, soccer and dancers.

Once again, a mild labral tear can be present in one’s body without the onset of symptoms; however, in the event that you are dealing with severe pain and your provider has assessed you, you may also be advised to obtain imaging, such as an MRI, to gain more insight into how severe the damage is.

What strength moves are safe to do?

After we have taken a look at your movement patterns both in standing and in motion, checked your ranges of motion and specific orthopedic testing, we can confidently provide you with the right treatment program. You likely will be able to incorporate strength moves to supplement your in-office care! What are some go-to moves?

Hinge for hip pain

Learning to properly hinge at your pelvis is important not only for strength moves but for daily life. How many times do you bend down to pick something up in your home or at work? Knowing how to hinge at the hip joint is crucial so that you are activating your posterior chain muscles (the muscles that run along the back of your body.) It is essential to activate muscles, such as your glutes and hamstrings to help drive the power from your lower body rather than using your low back or applying asymmetric pressure on one hip.

Deadlifts are a great way to build strength throughout the whole body, but also teach your body that it is not about flexing your low back or putting force into your painful hip, but powering through your glutes and balancing the weight into both of your feet.

Squat for hip pain

That’s right, more glute strength, but I can’t stress this enough. The glute max muscle is the biggest and most powerful one in your body. The likelihood that you are using another muscle in place of it for movement is high if you are experiencing hip pain of any kind.

Start off easy with a bodyweight squat and then work your way up to incorporate a load. Keep your stance wide and point your toes out to 11 and 1 for a wider base of support as you master the form. Remember, form trumps load! Don’t add weight to a movement that doesn’t feel stable and pain free.

Lunge for hip pain

A lunge stance, whether done in place or as a walking lunge, is important when it comes to hip pain. You are likely experiencing pain on one side. Why? The way your body learns to compensate over time typically leads you to overcompensating to one side of your body; therefore, unilateral movements are important to incorporate. Strengthening the side that is weaker can help create more balance in your body and allow for more awareness of muscles that may be inhibited due to your pain.

How else can you care for hip pain?

Anatomy In Motion (AIM)

Here at Urban Wellness Clinic we are trained to incorporate AIM assessments and exercises to help remind your body how to move properly. We see where the weight and focus is being placed all the way down into your feet and then treat up the kinetic chain to help break poor patterns and help your body relearn the right ones. As we have seen with a lot of prior hip conditions, the compensatory patterns the body has learned over the years need to be rewired so that your joints are moving in the direction they are meant to without pain.

Dynamic Neuromuscular Stabilization

This is a tried and true treatment at UWC as we understand that the body cannot function properly by just focusing on the area of pain. We incorporate breathing techniques while putting you through corrective exercises so that you continue to build a strong core. If the center of your body or your “movement brain” as I like to call it, is not strong, then other corrective exercises will not stick. Learn to breathe better in rehab and through your strength moves to avoid more injury!

Active Release Technique

This is a manual technique utilized by your provider to help break down scar tissue and unravel tight and dysfunctional muscles. When dealing with hip pain and dysfunctional movement patterns (which is the body’s way of trying to avoid more pain) other muscles tend to get tight. For example, if your glute muscles are not strong enough or turning on when you need them to, then it is possible that your deep 6 muscles (the rotators of the hip) are being overworked. ART is a great way to loosen these muscles with specific contact and movement.

Regardless of whether you are able to come in for an in person session or would like to have an assessment done virtually, we will be able to help! The goal is to get you out of pain and one of the best ways to do so is by strength training and waking up the muscles that should be supporting the load we place on our joints.

Having hip pain or want to be assessed by a provider? Give us a call at 212-355-0445 or email us at hello@urbanwellnessclinic.com. Let us help you move better, get stronger and show your pain who’s BOSS!

Yours In Health,

Dr. Monisha Mallik, D.C.