There are a few types of hip fractures, depending on where the pop occurs, Popkin says.
- External hip closure it most commonly happens when the iliotibial band (a thick band of tissue on the outside of your thigh that runs from your hip bone to the top of your shin) slips over the greater trochanter (a bony bump on the side of the hip).
- Internal hip closure it most commonly occurs as the iliopsoas (a group of three muscles that join at the top of the thigh bone) slides over bony structures inside the pelvis or femur.
Dancers, runners, football players and weightlifters are particularly prone to hip impingement. “Anyone who performs repetitive and extreme ranges of motion with their legs can be vulnerable,” says Popkin. Because they’re constantly putting their hips into flexion and then extension—bringing the knees closer to and away from the chest—combined with twisting, the muscles and tendons in that area can become strained and tight, he says.
The key to controlling hip impingement is to modify your activity, as well as strengthen and stretch.
Popkin suggests starting with your core, which will take pressure off your hip joints, as well as your glutes and hip abductors, which tend to be weaker in people with hip fracture syndrome.
Try the following to boost:
Abdominal braces
Focus on the transverse abdominis, which is one of the deep core muscles. “These are the fundamental muscles that help stabilize your trunk and help it move in proper alignment,” says Popkin. To help you engage these muscles so you can fire them when needed, perform an abdominal brace: Lie on your back with your knees bent. Inhale, then as you exhale, try to pull in your lower abs, engage your pelvic floor muscles and straighten your back on the floor. Don’t suck or push, just keep breathing steadily. Do two to three sets of 10 repetitions with five to 10 second holds.
Buttock bridges
- Lie on your back with your knees bent and feet firmly planted on the floor about shoulder width apart.
- Perform an abdominal brace to maintain a neutral spine.
- Squeeze your glutes and imagine your heels moving toward your bottom.
- Starting the movement from your buttocks, push through your heels and lift your hips until your body makes a straight line from your shoulders to your hips to your knees.
- Pause at the top for a few seconds as you keep your glutes tightly squeezed. Don’t use your back muscles with this move.
- Slowly lower your hips down and release your glutes.
- Do two to three sets of eight to 10 repetitions.
Bypassing
- Get into a mini squat position by pushing your butt back with your knees slightly bent.
- Step your right leg out to the right, then follow with your left leg.
- Make sure your knees don’t give out and the movement comes from the glutes.
- If you want to challenge yourself further, place a resistance band around your knees.
- Do two to three sets of five to 10 steps each time.
Lateral leg raise
- Lie on your right side with both legs straight, the left leg stacked directly on top of the right. Check that your ears, shoulders, hips, knees and ankles are in a straight line.
- Keeping your left leg straight, lift it off the right leg until you feel a stretch in your core or lower back. Make sure you are not leaning forward or backward. (Keep your hips stacked like bookshelves.)
- Lower the left leg back to meet the right leg. You want to make sure you feel it in your outer glute on the side of your hip. You don’t want to feel this in the front of your hip.
- Do two to three sets of eight to 10 repetitions on each side.
Try the following moves to stretch your hips. All of this can be done during the day if your hips are too tight.
Half kneeling hip flexor stretch
- Start by kneeling on the floor.
- Bring your right leg in front of you so that your right thigh is parallel to the floor, with your knee bent at a 90-degree angle and your foot on the floor.
- Place your left knee on the floor, making sure your shin is pointing straight back (not to the left or right).
- Place your hands on your hips, tilt your pelvis to keep your spine in a neutral position, and squeeze your glutes.
- With your back straight, shift your weight forward until you feel a stretch in the front of your left thigh and groin. Don’t lose your neutral spine as you do this weight shift.
- For an even deeper stretch, reach your left arm overhead and slightly to the right.
- Hold for 20 to 30 seconds. Do three to five times on each side.
Stretch Iliotibial Band Stretch
- Stand up straight and cross your right leg in front of the left at the ankle.
- Raise your left arm overhead and reach to the right side. If you don’t feel stable, lean your left side against the wall or hold on to a chair or piece of furniture with your right hand. You should feel a stretch along your left hip.
- Hold for 20 to 30 seconds. Do three to five times on each side.
Figure 4 Stretching
- Sit in a chair and place both feet on the floor. You can also do this on the floor starting with your legs straight.
- Lift your right leg and place your right ankle directly over your left knee. If you are on the floor, place your hands on the floor behind your back for support and keep your chest lifted.
- Gently lean forward while keeping your back flat. You should feel a stretch in the right glute.
- Hold for 20 to 30 seconds.
- Sit on your back, return your right leg to the floor so you’re back in neutral, and repeat the exercise with your left leg.
- If the forward bend is too much, you can gently push your knee down with your hand to do the same stretch.
- Do three to five times on each side.
Popkin also recommends plenty of foam rolling, a type of self-massage that can help loosen tight areas. Focus on the sides of your hip, quadriceps (in the front of the leg), glutes, IT band (along the side of the leg), and adductors (inside your thigh).
If you still feel snapping after trying these stretches and strengthening exercises, see a physical therapist. They may perform an assessment and use additional techniques such as exercise prescription, activity modification and hands-on therapy.
