Walking is generally considered safe for individuals with Femoroacetabular Impingement (FAI), provided specific modifications are made to the walking pattern. This condition, also known as hip impingement, involves an abnormal shape of the hip joint bones that causes friction and pinching during movement. By understanding the biomechanics of FAI and adjusting your gait, it is possible to maintain activity levels and strengthen supporting muscles without aggravating the joint. The goal is to move the hip within a pain-free range, transforming a potentially irritating activity into a beneficial form of exercise.
Understanding Hip Impingement and Movement
Femoroacetabular Impingement is a structural disorder where the ball (femoral head) and socket (acetabulum) of the hip joint have extra bone growth, leading to premature contact when the hip moves. These bony irregularities are categorized as cam (excess bone on the femoral head-neck junction), pincer (excess coverage of the socket), or mixed (a combination of both). This abnormal abutment can pinch and damage the labrum and the articular cartilage over time.
The biomechanical issue with walking stems from the natural gait cycle, which requires the hip to move into flexion, internal rotation, and adduction. These movements are the exact positions that cause the bony structures to collide and pinch in FAI. During walking, the hip flexes and extends, which can cause the bony structures to rub. Individuals with FAI often naturally compensate by walking with a reduced range of motion, particularly less hip extension, to avoid painful impingement.
Walking Safely: Specific Modifications for FAI
Successfully walking with FAI depends on controlling the hip’s movement to avoid painful ranges of motion. The most effective modification is to shorten your stride length, which directly limits the degree of hip flexion and extension required during the gait cycle. A shorter stride means the hip does not travel as far forward or backward, keeping the joint away from the end-range motions where impingement occurs.
Maintain a slower, more deliberate walking pace than a fast or power walk. Increased speed naturally leads to longer strides and greater momentum, which can push the hip into the painful impingement zone. Walking on flat, level ground is strongly advised, as inclines introduce significant hip flexion (uphill) or increased impact and hip extension (downhill), both of which aggravate the joint.
Attention to foot placement can further protect the hip. Avoid turning your feet excessively inward (toe-in) or outward (toe-out), as these positions can translate into internal or external hip rotation, increasing friction within the joint. Ensuring the movement is smooth and controlled reduces the force transmitted through the hip joint during the push-off phase.
Recognizing Pain Signals and When to Stop
The presence and quality of pain are the most reliable signals that walking is causing irritation or damage to the hip joint. A sharp, catching, or stabbing pain in the groin or the front of the hip is a clear warning sign of active impingement and means the activity should be stopped immediately. This sensation indicates that the bony structures are colliding and potentially damaging the labrum or cartilage.
A dull ache that develops after walking or prolonged activity can signal inflammation but may not require immediate cessation if it is mild and resolves quickly with rest. However, any symptom that involves mechanical sensations, such as clicking, locking, or the feeling of the hip giving way, suggests mechanical obstruction and necessitates stopping the activity. If these warning signs occur, it is important to rest the hip and consult with a physical therapist or healthcare professional to reassess your activity modifications.
Alternative Low-Impact Exercises
When walking causes pain, low-impact alternatives allow for continued cardiovascular fitness and muscle strengthening without high-impact forces or deep hip flexion. These exercises enable you to maintain muscle strength around the hip, which helps stabilize the joint and reduce strain during daily activities.
Swimming and water aerobics are excellent choices because water buoyancy makes them virtually non-weight-bearing, minimizing joint compression. Stationary cycling is another good option, provided the seat height is adjusted to prevent the knee from rising too high, avoiding excessive hip flexion and impingement. An elliptical machine offers a low-impact, gliding motion, but ensure the machine’s path does not force the hip into extreme ranges of motion.