Femoroacetabular impingement (FAI), commonly known as hip impingement, is a condition characterized by extra bone growth along the femoral head or hip socket. This abnormal bone shape can cause bones to rub during movement, leading to discomfort. Sitting often triggers pain for individuals with hip impingement. This article offers practical strategies to help sit more comfortably and reduce pain.
Understanding Hip Impingement and Sitting
Sitting can aggravate hip impingement because it places the hip joint in specific angles that cause bony abnormalities to pinch soft tissues or cartilage, such as the labrum. When seated, the hip is typically in a flexed position, meaning the thigh moves closer to the torso. Deep hip flexion, or bringing the knees too close to the chest, can increase compression within the joint, leading to pain. Similarly, internal rotation or adduction of the hip, such as crossing legs or allowing knees to fall inward, can induce impingement by forcing the femoral head against the acetabulum’s rim. Understanding these mechanics is helpful for adopting sitting postures that minimize joint compression.
Core Principles for Hip-Friendly Sitting
Minimizing hip impingement while sitting involves adhering to several fundamental principles that promote an open hip angle and balanced joint loading. A primary guideline involves maintaining an open hip angle, ideally with the hips positioned at or slightly above the knees. This helps prevent deep hip flexion, which can increase pressure on the hip joint. Keeping the knees at approximately a 90-degree angle, or slightly greater, with feet flat on the floor, supports this open posture.
Another important principle is to avoid positions that involve hip adduction and internal rotation, such as crossing the legs or letting knees drift inward. Maintaining the knees apart and aligning the hips and pelvis in a neutral position helps distribute weight evenly across both hips. Moving frequently and taking regular breaks from sitting are also beneficial, as remaining in any single position for extended periods can lead to stiffness and discomfort.
Practical Sitting Strategies for Daily Life
Applying these core principles to everyday situations can significantly improve comfort for those with hip impingement.
At Your Desk or Office
When using a desk or office chair, adjust the chair height so your feet are flat on the floor and your hips are slightly higher than your knees. Using lumbar support can help maintain a neutral spine, which indirectly supports proper hip alignment. Periodically incorporating a standing desk can provide welcome changes in posture and reduce prolonged hip flexion.
While Driving
For driving, consider reclining the car seat slightly to increase the hip angle, avoiding a sharp 90-degree bend. Adjust the steering wheel distance to allow for a comfortable reach without leaning forward excessively. Carefully entering and exiting the car, avoiding twisting motions, can also prevent strain.
On Couches and Soft Seating
When sitting on a couch or soft seating, use firm pillows or cushions to elevate the seating surface and support the back. Sitting closer to the edge of the couch can help maintain a more open hip angle compared to slouching into the seat.
On Public Transport or Airplanes
On public transport or airplanes, try to create as much personal space as possible. Reclining the seat back, if available, can help open the hip angle. If possible, avoid sitting with legs crossed or tucked underneath the seat. For long journeys, getting up and moving around the cabin when safe and permissible can help alleviate stiffness.
Transitioning from Sitting to Standing
When transitioning from sitting to standing, scoot to the front edge of the chair, lean forward from the hips, and use leg muscles to push up, minimizing strain on the hip joint.
Enhancing Sitting Comfort and Support
Various tools and conscious habits can further enhance sitting comfort for individuals with hip impingement. Supportive aids like wedge cushions are useful as they naturally tilt the pelvis forward, opening the hip angle and reducing impingement. Donut cushions can help relieve pressure on the tailbone and surrounding areas.
Lumbar rolls or small pillows placed behind the lower back provide support and encourage a neutral spinal position. Footrests can be beneficial by ensuring that the knees are at the correct height relative to the hips, promoting the desired open hip angle and proper foot placement. Cultivating mindful posture by regularly checking and adjusting hip and pelvic positioning throughout the day can prevent the adoption of problematic postures. Paying attention to early signs of discomfort and adjusting position immediately is important to prevent pain from escalating. These strategies primarily offer symptom management, and persistent pain warrants consultation with a healthcare professional for comprehensive evaluation and guidance.