What Is Hip Pinching?
Pinching in the front of the hip, often described as an anterior hip impingement, typically occurs due to a combination of overuse of the anterior hip muscles and decreased space for these muscles to operate. This can lead to the labrum (the cartilage that lines the hip socket) or other surrounding tissues being compressed and irritated. The sensation can vary from a dull ache to a sharp, intense pain.
Common Causes
Hip Labral Tear: The hip labrum is a ring of cartilage that helps stabilize the hip joint. A tear in this cartilage can cause pain, especially during movements that involve flexing the hip.
Femoroacetabular Impingement (FAI): This condition occurs when there’s an abnormal contact between the femoral head (the ball of the thigh bone) and the acetabulum (the socket of the hip bone). This can lead to irritation and pain.
Hip Flexor Strain or Tendon Overuse: The hip flexors are a group of muscles that allow you to lift your knee and bend at the waist. Overuse or strain of these muscles can cause increased inflammation, a further decrease in anterior hip space, and an eventual pinching or pulling sensation.
Bursitis: Inflammation of the bursa (a small, fluid-filled sac that reduces friction between tissues) in the hip can also contribute to discomfort and pinching.
Identifying the Issue
To determine the exact cause of hip pinching, consider the following steps:
Assess Your Symptoms: Pay attention to when the pain occurs. Is it during certain activities or movements? Does it improve with rest?
Evaluate Your Movement Patterns: What happens to your hip during uphill hiking or yoga? What muscles turn on during specific lifting techniques? Can you feel an imbalance in muscle strength and activation from one side to the other?Â
Consult a Professional: A physical therapist can conduct a thorough assessment to diagnose the underlying issue to help determine if the issue is originating from a lack of mobility, a lack of muscle control, or both.Â
Solutions and Treatments
To alleviate symptoms of pinching in the front of the hip, it's crucial to address both the mobility and muscle control of the hip joint. Here’s how you can manage and reduce discomfort through targeted interventions:
1. Joint Mobilizations
Joint mobilizations aim to improve the movement and alignment of the hip joint, which can reduce pinching. These techniques can help restore normal range of motion and decrease pain:
Hip Flexor Mobilization: Gently pulling the hip joint backward away from the irritated area can help reduce pressure on the front of the hip. One way to achieve this is by practicing gentle hip flexor front to back oscillations with a thick strap or band pulling the femoral head posteriorly. Even just 60-90 seconds of this can make a dramatic difference in symptoms.Â
Hip Capsule Traction Mobilizations: Other techniques such as gentle, controlled distraction of the hip can create beneficial stretching and movement for all sides of the joint and decrease pain while improving muscle control. One way to do this is to lay on your back with a strap on the foot and gently pull the body away from the anchor point and feel a pull in the deep hip.Â
2. Stretching
Effective stretching can help alleviate the tightness in the hip flexors and front of the hip, which often contributes to pinching:
Hip Flexor Stretch: Kneel on one knee with the other foot in front, creating a 90-degree angle at both knees. Gently push your hips forward while keeping your back straight. Hold the stretch for 20-30 seconds and repeat 2-3 times on each side.
Adductor Stretch: Sit with your legs spread wide and gently lean forward, keeping your back straight. Or with legs in a wide stance shift your hips toward one foot to perform a Cossack Squat. Both of these ideas can help release tension in the inner thigh area, indirectly benefiting the hip joint.
3. Strengthening Exercises
Strengthening the muscles at the back of the hip can help balance the forces acting on the hip joint and reduce the sensation of pinching. Focus on the following exercises:
Glute Bridges or Barbell Hip Thrust: Lie on your back with your knees bent and feet flat on the floor. Lift your hips toward the ceiling, squeezing your glutes at the top. Hold for 10-20 seconds before lowering back down. Perform 2-3 sets of 15-20 repetitions.
Hip Extensions or GHD Extensions: With a band around your ankles, stand with one hand on a support for balance. Extend one leg straight back, keeping your knee straight and your core engaged. Perform 2-3 sets of 15-20 repetitions on each side.
4. Integrate Proper Movement Patterns
Incorporate exercises and techniques that emphasize proper alignment and movement patterns to prevent further strain:
Entry Level Control = Pelvic Tilts: Practice pelvic tilts to improve control and awareness of your pelvis. This exercise helps engage the core and align the hips properly.
Higher Level Control = Step Ups:Â Perform a step >16 inches to challenge the hip into a potentially irritating position. While performing the step focus on glute and back of hip muscle activation to redistribute muscle use from the front of hip toward the back.Â
Conclusion
By focusing on joint mobilizations, stretching, and strengthening the muscles around the hip, you can effectively address the pinching sensation in the front of the hip. These strategies help balance the forces acting on the hip joint, improve mobility, and alleviate discomfort. If symptoms persist or worsen, consider consulting with a healthcare professional for a personalized treatment plan.
For more insights and support, feel free to reach out to the Rise-RSP team. We’re dedicated to helping you overcome challenges and enhance your physical well-being!