Are you having pain and pinching in the front of your hip when performing your squat workouts? Hip pinching, clicking, clunking, and groin pain can be indicative of either a structural or functional hip impingement. So what causes this and how do we fix it?
Structural vs. Functional Causes of Impingement
Structural causes are causes that can’t be “fixed.” These are anatomical variations that have always existed as apart of your unique make-up. These include structural variations of hip socket positioning, most notably, hip retroversion in which the sockets point outward. This causes more coverage of the femoral head and less room for the motion required for squatting. Another structural cause is Femoral Acetabular Impingement (FAI). In FAI, bony growth occurs at the hip socket or at the femoral head called a CAM lesion. In some cases, a combination of both can exist, but regardless, the excessive bony growth causes pinching when bending or flexing the hip.
The truth is, more and more people are being discovered for having FAI, but no symptoms. Just because a structural variation exists, doesn’t mean it’s causing your symptoms. Whether your symptoms are due to a structural cause or a functional imbalance, the first line of treatment should be the same.
So Let’s Look At the Functional Causes…
It’s all about hip position! If the head of the femur sits more forward in the socket, the more likely it is to pinch. So what will cause this? Here’s a few causes of hip impingement due to poor positioning:
- Anterior pelvic tilt (think arched lower back) in standing and squatting (causing stress on anterior capsule)
- Posterior pelvic tilt (think tucking your pelvis under you) in sitting (causing stress on anterior capsule)
- Tight posterior hip capsule (due to prolonged anterior positioning causing further anterior positioning)
- Weak and “tight” hip flexors (causing micro instability with movement)
- Poorly activated core and hip extensor muscles (inability to control position of the femur and pelvis)
So How do We Fix It? Let’s Break it Down into 3 Parts.
ONE: Postural Modifications
Seated changes: Slightly arch lower back and engage your core. Your shoulders roll slightly back, feet planted firmly underneath your knees.
Standing changes: Tuck your pelvis slightly underneath you and feel your core engaging with shoulders just slightly back.
The most important postural modification you can make is the amount of time you spend in a position. Joints respond well to change- changes in position, changes in stress, changes in load. Don’t allow yourself to spend extensive amounts of time in just one position.
TWO: Squat Variations
A pinchy squat isn’t the end of the world. Or the end of your workout. Variations can and should be made. Here’s a few to get you started:
- Stand with your feet wider apart and toes pointing slightly outward
- Decrease the depth of your squat
- Get your trunk upright
- Accommodate your ankles
- Practice pelvic awareness
THREE: Supplementary Exercises
Squatting is a fundamental movement that may require a few accessory exercises. Try adding these prior to starting your squat routine:
- Lateral hip opener with posterior capsule mobilization
- Eccentric Hip Flexor Isolator
- Hip Thrusters
In most cases, whether structural or functional, a pinchy hip can be helped! It just requires a proper understanding of your own mechanics and the adjustments that need to be made!
If you are currently experiencing a painful hip when squatting, reach out to us on our contact page. We help a lot of lifters with their squat and would be happy to discuss ways to improve yours as well!
References:
Prevalence of Abnormal Hip Findings in Asymptomatic Participants: A Prospective, Blinded Study
Treating Hip Impingement in the fitness athlete
Microinstability of the hip—it does exist: etiology, diagnosis and treatment
Physical therapy for hip pain with squatting in Columbia and Baltimore, Maryland
If you have hip pain while squatting reach out to our office today!
