The Worst Exercises for Hip Impingement? Why Personalized Hip Therapy Doesn't Work

Let's take a deep dive into a hip impingement physical protocol with some of the worst exercises for femoroacetabular impingement I've ever seen. These are exercises for FAI used as an alternative to surgery in two randomized controlled trials - and they are TERRIBLE.

RESEARCH LINKS

HELPFUL LINKS

---

---
At Upright Health we give you strategies and research to get your life back.

With principled functional training, we believe everyone can beat chronic pain and get strong, mobile, and resilient.

Our home training programs help you troubleshoot and train your body safely. We help you tear down fear and build up muscle. We help you think right, move right, and feel right.

Matt Hsu's own battle with chronic pain from the age of 16 in his feet, knees, hips, back, shoulders, elbows, forearms, wrists, hands, and head gives him a uniquely thorough understanding of musculoskeletal pain, the ways in which it can undermine an entire life, and the mental and physical hurdles that keep people from getting out of it.

When not filming videos, he's working out in the living room, surfing, learning dance or gymnastics moves, or riding a bike with his son in tow.

ENDING CREDITS MUSIC

ABOUT THIS VIDEO
This is a deep dive into the Personalized Hip Therapy protocol which was used in the UK's FASHION Trial for Hip Impingement. This physical therapy protocol was designed by an orthopedic surgeon and several physical therapists to be used in randomized controlled trials to compare physical therapy with hip surgery. Because the PHT protocol has poor exercise selection, bad advice about pain killers, and a focus on the cam and pincer bone shapes, it fails to provide any real benefit for patients. As a result, the nonsurgical FAI treatment failed to do better than hip surgery (even though hip surgery did poorly too). Sadly, this hip impingement physical therapy protocol is used in the UK to treat patients with hip pain.

#FemoroacetabularImpingement #FAI #HipImpingement #HipImpingementExercises #uprighthealth

CHAPTERS
00:00 Intro
03:22 Study Overview / Methods
04:39 Patient Sessions
05:42 Exercises (and Preparation for Failure)
07:11 Deep Dive into PHT
08:37 4 Major Problems with PHT
09:59 Patient Mis-education
11:13 Exercises Weren't Chosen to Help
13:53 First Draft of PHT
15:15 Co-existing Conditions
17:15 The Idiotic Exercises
23:28 My FAVORITE Exercise for the VMO
24:50 Would PHT help your hip pain?
26:16 Push-ups Analogy
28:46 How to approach hip pain
29:23 FAI bone shapes and flexibility
29:57 Summary on PHT
30:35 PHT vs. Surgery (the truth)
31:23 Fake Surgery vs. Real Surgery
32:39 Who can you trust?
34:32 How to help yourself out of hip pain

[Uprighthealth]

What did you learn from this video? Got more questions? Drop me a comment! 🤙

[asiainNC]

Matt, last year I barely walked. First, I was told I needed a shot, then an arthroscopy procedure for the FAI and, finally, I was told I needed a hip replacement. I learned so much from you and the FAI fix. I stopped going to see any new doctors and now I'm walking and going to the gym. I can't run yet but, most importantly, I don't think anymore that "my life is over". I was also severely depressed. I'm not exaggerating if I say you saved my life. Thank you.

[cynthiasymons]

I couldn’t help thinking, while I was listening, that I suddenly understand why you are concerned about censorship. Big pharma and surgeons do not want people to hear this message. Thanks for teaching us—and for your courage.

[tinacarson]

19:20 YES YES YES!!! That is exactly what caused my low back pain: anterior pelvic tilt! And they kept telling me to do it more and more, and I got worse and worse....until one day the surgeon "entered the scene"....He stated, "I only have 3 tools in my tool box: PT, injections, and surgery. Therefore since the exercises didn’t help you, and neither did the injections, then you have to have surgery on your lumbar spine."
I went to the orthopedic clinic originally with severe HIP pain, not back pain. But the PT only gave me exercises that put me in APT. He never gave me exercises for my hips. The clinic definitely had me on the road to surgery from the moment I entered the building. And I'm sorry to say it took me $5k and 2.5 months to figure that out.
The good news is, I refused the surgery, and began looking for ways on YouTube to help my hips. And that's when I found your videos on APT.
Thank you, Matt!!🎉
Now I'm always thinking muscles.
And I'm telling all my friends.

[BlueSkies]

Matt, coming across your videos changed the course of my declining hip and knees. In a fairly short time, my pain, weakness and limitations have improved so much! It truly sucks that the “professionals” in this field have us doing all the wrong things..it’s crazy!! Thank you again for your wisdom, kindness and insight! 💪

[brianm]

I am 40 years old, I started having major hip pain in 8th grade football. After that I would frequently feel the need to reduce my hip, much like people feeling the need to crack there knuckles. When I was 25 I went to a sportsmedicine surgeon. I was diagnosed with fai. I was skeptical so I tried to get by without it for a few years. Then I decided to do the surgery since I couldn't improve the situation. My range of motion was immediately better and I didn't have the need to reduce or crack the hip joint. I had surgery on the other hip too. My range of motion dramatically increased on both hips. Eventually after playing alot of basketball my groin hurt so I went back to get more physical therapy. This new round of physical therapy was very beneficial. Once I addressed the asymmetry in my body I felt sustained dramatic improvement. Here is a link to describe the therapy I did. These are great videos and I am glad you are discussing in such detail. It took me a lot of time and patience to fully understand the mechanical problems I was dealing with so being patient is key

[tara]

Sending warm supportive thoughts your way
I hope your journey with the aging elders in your life lends itself to moments of serenity and understanding ❤

[BourneFighting]

This video was absolutely brilliant. I've known how B.S. the industry is when it comes to foot, knee, and hip pain and you put everything into words perfectly. So much oversight of such simple solutions. Use the muscles!

[truestory]

You are seriously amazing! Your family is blessed to have you as are your patients and YT viewers. You've taught me so much as well as keeping me motivated to continue through my hip issues...

[eveliaroman]

I want you to be my physical therapy. You are who gave me hope not to get surgery . Thanks to your encourage

[megancarberry]

I really appreciate your radical transparency; your approach is refreshing and truly needed. The incessant and relentless wave of biased advice in the Orthopedic realm, where chronic pain suffers like me often suffer; is in dire need of more professionals like you.

[janeking]

Love your videos! We need more people like u in the world? So honest and transparent...with calmness and grit!!!

[Nowheredeb]

Oh wow. I had a PT that gave me some of those exercises, told me that I was not allowed to lunge, squat, stand on one leg etc. etc. I was also told that I would never be able to do much and that I would also be in constant pain because my "knee is crooked". Well, I am still on the road to full movement with a new PT and I can do anything. The new PT tells me the sky is the limit!

[cathyjennings]

Thanks SO MUCH for your knowledge and time & research to SHARE WITH US !!! 👍👍👍👍👍👍👍👍👍👍👍🥰🥰🥰😍🤩😊😊👍

[jkjayhawk]

My N=1 experience with FAI arthroscopy and multiple rounds of physical therapy with a diverse set of therapists and protocols contradicts your insinuation that surgery is worthless. Surgery helped me make a step change in pain and performance. I’m glad I listened to my docs and not my parents. To anyone reading, be skeptical of “do your own research / contradict the medical consensus / listen to my overlooked trick” type of medical self help. It’s often grifting.

[zeezoe]

I have been formally diagnosed with all the hip ting'abob...but have a lit if hip pain.. you have explained a lot.. luv Mr. Skeleton's feedback.

[christinelewis]

I really love your thinking, thanks so much.

[puggirl]

This is so depressing. After 6 months of fighting for a diagnosis and in that time before diagnosis I was wasting time in PT for an undetermined problem. Finally got the MRI that showed the hip impingement in both hips, a torn hamstring attachment, deteriorated labrum and deep hip sockets what ever that is. Since I'm a Medi-cal patient they actually don't want to give me surgery so it's back to PT for me. I am hypermobile so can do any and all of these exercises. At 61 I'm not as strong as I used to be but still pretty strong as my work is very physical. The pain is terrible. I'm in the system that uses HPT and I can see that it's not going to help me. Sure I can demand surgery but I can't demand better PT. My only thought is to learn how I walk and move and try to change my gait, my posture and ways in which I move that don't let me heal. That's why I watch your videos and a few others. It's a good education about many things but so far hasn't been helpful for figuring out what to do. Thanks for the relevant content.

[AllThingsConsidered]

So glad for this video- been having increasing issues with my right hip and mentioned it to my dr and he mentioned possible FAI which may be likely as I used to be a long distance trail runner before my health was decimated by tick diseases and indoor molds.

He said the standard tmts include PT, steroid injections and possible surgery.. that doesn’t sound so right to me esp since I am a bodyworker who has been training in the jean-Pierre barral methods of visceral and neural manipulation and we have done work on the nerves as well as the muscles & ligaments of the hip and pelvis including the pelvic bowl.

I am always curious what the mainstream medical community recommends for different things and I have been pretty discouraged and sickened by how little they actually help with so many things.

Thankfully I grew up with a lot of medical people in my family and they all say don’t go to Dr unless you’re dying lol.

Unfortunately tho, the closest therapist who does the manual therapy that I know will help most is 2 hrs away.. so that’s 4 hrs of driving and $125 for an hour apt… but it’s worth it to avoid this slippery slope of crap..

I believe my current dr really does care and wants to help but i also believe he is very misinformed and misled. I will take the next apt and let him test my hip as I’d like to see what that entails and also see what the X-rays show.. but I will also be making an apt with the private practice PT who is 2 hrs away who has been trained in these methods that I believe will be most helpful.

I also do this bodywork and it’s important for me to know what my clients are dealing with physically and how their drs may recommend dealing with their conditions so then I know how these other treatments may be more beneficial.

Again, thanks so much for this info and thanks boney for your input and questions lol, great stuff!

[stephm.]

I felt very validated by this video. I have been doing physical therapy prescribed by my doctor for a couple of years, and the protocol is always the same. A physical therapist works on me for 15 minutes and then sends me to an 18-year-old who tells me to do exercises that I could be doing at home. No advice on functional movement. I have been to several physical therapists in the last couple of years, and it is always the same. I am sure there are some good ones out there who do more than this, but I can't find one. I hope to find someone who specializes in this area and that is covered by insurance! Thank you for this video. I look forward to seeing your others. 🙂 Could you direct me some videos that you might have about what stretches and exercises might help this situation? Thank you!!