Eric Tannenbaum, MD

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Hip Impingement & Labral Tears

For many people with hip impingement or a labral tear, a structured strengthening program focused on the hip and core improves symptoms. Physical therapy-led care is a recommended first step before considering hip arthroscopy, and it also prepares you well if surgery is needed later.

Prepared by Dr. Eric Tannenbaum, MD · Board-certified orthopedic surgeon, Southern Indiana Orthopedics

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Use this program for

  • Femoroacetabular impingement (FAI)
  • Hip labral tears
  • Groin pain from the hip joint in active adults

Before you start

  • Check with Dr. Tannenbaum or your physical therapist that this program fits your condition.
  • Warm up with 5 minutes of easy movement.
  • Move slowly and with control. Quality matters more than speed.
  • Use the pain guide below to decide how hard to push.
0 to 3 out of 10Safe. Keep going.
4 to 5 out of 10Acceptable if it settles by the next morning. Otherwise ease off.
Above 5, or worse the next dayToo much. Reduce the reps, range or weight.

Phase 1: Control

Weeks 0 to 3

Strengthen without pinching the front of the hip.

1Bridge

  1. Lie on your back with knees bent and feet flat.
  2. Tighten your stomach and squeeze your buttocks.
  3. Lift your hips until your body is in a straight line from shoulders to knees, then lower slowly.

3 sets of 10 to 15, hold 2 to 3 seconds at the top, once a day

Progress to a single-leg bridge when 15 feel easy.

2Clamshell

  1. Lie on your side with hips and knees bent and feet together.
  2. Keep your feet touching and lift the top knee.
  3. Do not let your pelvis roll backward. Lower slowly.

3 sets of 10 to 15, once a day

Add a band around the knees to progress.

3Bird dog

  1. Start on hands and knees with your back flat.
  2. Reach one arm forward and the opposite leg back until both are level with your body.
  3. Hold, then switch sides.

2 to 3 sets of 8 to 10 each side, hold 3 to 5 seconds

Imagine a glass of water balanced on your low back.

Phase 2: Strengthen

Weeks 3 to 8

Build hip and core strength.

4Side-lying leg raise

  1. Lie on your side with the bottom knee bent for balance.
  2. Keep the top leg straight and slightly behind your body, toes pointing forward.
  3. Lift the leg toward the ceiling, then lower slowly.

3 sets of 10 to 15, once a day

Lead with the heel. If the toes turn up, the wrong muscle is working.

5Side plank from the knees

  1. Lie on your side propped on your elbow, knees bent.
  2. Lift your hips so your body is in a straight line from shoulder to knees.
  3. Hold without letting the hips sag.

3 to 5 repetitions, hold 15 to 30 seconds each side

Progress to straight legs when 30 seconds feels easy.

6Standing leg lift backward

  1. Stand tall holding the back of a chair.
  2. Keep the knee straight and squeeze the buttock to lift the leg backward.
  3. Do not arch your low back. Lower slowly.

3 sets of 10 to 15 each side, once a day

Small and controlled is better than big and swinging.

Phase 3: Function

Weeks 8 and beyond

Improve control for sport and daily life.

7Single-leg balance

  1. Stand near a counter for safety.
  2. Lift one foot and balance on the other leg, keeping your pelvis level.
  3. Progress by closing your eyes or standing on a pillow.

3 to 5 repetitions, hold 30 seconds each leg, once a day

Keep a slight bend in the standing knee.

8Step-up

  1. Stand facing a step or stair.
  2. Step up with the sore leg, pushing through the heel, and bring the other foot up.
  3. Step down slowly with the other leg first.

3 sets of 8 to 12 each side, once a day

Keep the knee in line with the second toe. Use a lower step to make it easier.

Avoid for now

  • Deep squats and deep hip bending
  • Sitting in low chairs or with your knees higher than your hips
  • Pivoting and cutting sports until pain settles
  • Stretching into a pinching feeling in the groin

When to move ahead

Keep exercises out of the deep, pinching range. Advance when exercises are comfortable at 3 out of 10 or less.

Stop and call our office at (812) 376-9353 if you have

  • Pain that is getting worse week to week, or severe pain at night
  • New numbness, tingling or weakness
  • Significant swelling, redness, warmth or fever
  • A joint that locks, gives way or will not move
The research behind this program
  1. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN). Lancet. 2018;391(10136):2225–2235.
  2. Griffin DR, Dickenson EJ, O'Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50(19):1169–1176.

Need more help?

Work with our physical therapists

Our physical therapists at the SIO Physical Therapy & MRI building, 745 Schnier Street in Columbus, work alongside Dr. Tannenbaum and can tailor this program to you.

Request an appointmentCall (812) 376-9353

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