This is part II of a three-part series. If you haven’t read part I yet, check it out as I explain my two biggest reasons for not getting surgery after being diagnosed with FAI. In this article, I’ll dive into the main strategies I utilized that helped me get out of hip pain.
It is important to note that every “body” is different. What worked for me will not necessarily work for someone else. However, the information below can be useful to give you some ideas on where to start. Another crucial component to remember is that pain is just a signal to you that something somewhere is not functioning properly. The main goal is to improve your movement function, not necessarily the isolated joint that is bothering you. By consistently working toward the goal of improving movement function, pain will inevitably subside.
Below are three strategies that helped me the most during my recovery:
(1) Stretching the Hip Flexors
Guess what happens when you sit in flexion all day long – your hip flexors get tight! There are approximately ten muscles that are involved in hip flexion and if you have a sedentary desk job, there is a likely chance that some, if not all, of these muscles are tight and shortened. If these shortened muscles are not given the attention they need, it is very possible that pain and/or dysfunction in the hip will be present.
For me, I found that my adductors were the tightest out of all the muscles involved in hip flexion. I never even knew how bad they were until I started troubleshooting different muscles to see what ranges of motion I had. Matt Hsu at Upright Health has a great video demonstrating a very efficient adductor stretch over at his website.
If you have a sedentary desk job, I would highly recommend starting here. The key is to get your hip in extension to counteract all that flexion the hips are in all day. One of my favorite hip flexor stretches is known as the “runner’s stretch” – here is a tutorial I recorded of the stretch:
(2) Joint Mobility Drills
The next crucial step in my recovery was discovering joint mobility exercises. I did some research and found out that one of the most highly-respected strength and conditioning coaches, Steve Maxwell, had a video series called the Joint Mobility Library. Moving the joints therapeutically adds synovial fluid to the joints providing more range of motion. One of these videos was solely dedicated to hip mobility and I memorized all the different drills within days. Here is a teaser from YouTube showing a few drills from the series. Once I added joint mobility to my daily regimen, I began noticing even less pain in my hips.
A few years later I discovered MovNat and learned a few more amazing hip mobility moves that are part of their program. These are not meant for rehabilitation per se but instead, they are natural human movements that all of us should be able to do. What I’ve found however is that these movements are also excellent at mobilizing the hip joint and alleviating any stiffness that may be there. One of my favorite movements is the side bent swivels which I still use every morning.
(3) Posterior-Chain Strength Training
This may have been the most important part of my FAI rehabilitation. The posterior chain – and more specifically – the glutes and hamstrings are often neglected in recreational exercise. In terms of hip health however, there may not be two more important muscle groups in the body. A good way to start is to simply learn how to recruit these muscles.
For the glutes, the first step may be to simply stand straight and see if you can contract each glute. Then you can work on some easy exercises where you actively contract the glutes (i.e. hip bridges, quadruped arm leg raise, side leg lifts). I like the quadruped arm leg raise because it also gets you in a very natural human movement which is the set-up position for MovNat crawling drills. Here is an example:
In respect to the hamstrings, the best way to get these contracting is to work on the hip hinge. You may notice that when you perform a proper hip hinge, a very strong stretch in your hamstrings appears quite quickly. If that’s the case, which it was for me, the hamstrings are weak and tight. Here is a great video from Upright Health showing proper activation of the hamstring muscles and how to progress into more challenging movements.
Once I got the hamstrings and glutes contracting better, I started adding more intensity to really gain some strength in those muscles. Good options to increase posterior strength include Romanian Deadlifts, One-legged Romanian Deadlifts, Goblet Squats, Barbell Deadlifts and Barbell Squats to name a few. These are more challenging movements however and I would encourage individuals to seek out an experienced trainer before adding more intensity.
These are some specific strategies you can use to start getting some pain relief immediately. If these don’t work in your situation, don’t lose hope! As I explained, we all have very different anatomies and there may be something out there that I never needed but would be a gamechanger for someone else. The key is to explore your body and see what works for you.
Next week in part III, I’ll go over some important lifestyle changes I made during my FAI recovery that were as much, if not more, important than the exercises I discussed above.
Did any of these exercises work for you? Something else you can recommend to those struggling with FAI out there? Let us know in the comment section below.