Squat, Click, Snap & Ouch - Just another hip pain thread, please help.

[Manuel Solimano]

[WARNING] This is a desperate utter from a newbie experiencing hip issues, so if you've had enough of this feel free to leave. I don't need bad vibes.


Hello everybody, what's up? what's new?
A 19 years old boy, 1.85m tall and a 71kg bodyweight here.
As I've detailed in my log(please read it fully), my first attempt to weight training began around May 2016 and it went on really well until a sharp pain hit my left hip. The pain became very acute when I tried to squat 5x90kg. A permanet pain settled in and I could feel as I moved on bed at nights. I first thought it was just the "interesting" ASIS tendinitis described in Mark's book caused by sliding knees but it seems to be more to it. What I didn't say in the first post on my log is that I had a preexisting condition on the hips. Earlier that year I felt a pinching pain in my RIGHT hip just before starting my long postponed training plans. So I went to one of the best traumatologist in the country, who examined my X-ray and MRI images and determined I had a FAI lesion of the CAM type. He showed me a really noticeable bulge on my right femur head and little one in my left femur. However, my labrum was far from damaged so I didn't need surgery or anything. Besides, the pinching pain went away on its own. I also asked him about a funny snapping noise that my left hip did when taking my leg from flexion to extension. The doc said not to worry about that and gave me the clear to start my training, if I made sure to avoid excessive internal hip rotation.

I was in heaven. I'd finally get stronger and fit. It was just a matter of time, dedication, well eating and determination. But my hip proved me wrong. About August 2016 I had to quit trainig because of the pain.

After three weeks of rest, I started to follow a chiropractic therapy. The man was not only an expert in the field but also a MD, unlike most chiropractors. Altough he wasn't very acquainted with strength training.
The therapy took seven sessions. After the second one, he told me to resume squatting and to be very carful with technique. I did, and started to videotape myself in every movement on every rep on every workout. I discovered my squat form was horrible, no wonder why I got injured!Indeed, video feedback helped a lot, and I actually could see how my squat form was improving. I used the TUBOW, pasted marks on the floor to stare at, repeated myself the hip drive thing, and all the other tricks. By the time my therapy finished, I was squatting almost painless and the snapping noise was clearly fading away. Every now and then I took a generous deload and some HI-RICE method whenever my hip started to ache.

In resume, literally all roses until I reached my old mark on the squat (90kg, a very humble one, though). Now I must confess the pain reappeared even two workouts before hitting that weight, so it's my fault I pushed through the edge. Anyway, the pain was not as bad as the first time as I could walk and move barely feeling my psoas soreness but this time it was in BOTH hips. This is a video of myself squatting the very set after wich the pain came back.
I quitted training on Januay 25th and the pain soon went off, but the snapping hip noise is louder than ever and it's seems to be growing worse. This added to new noises and cracking from my knees and a nice varicocele that suddenly appeared when I tried to lift a night table. During the holidays (February) I've tried daily mobility drills and stretching exercises as well as foam rolling and lacrosse ball massages but to no avail. I'm now looking forward to pay a new visit to my traumatologist.

Thankfully, not everything is that crappy. Looking the full half of the cup I can say I've gained 5 kilograms in this turnaround and finally crossed the 70 kg barrier. Cheers to me.

Now, a few questions whose answers I'd love to know:

Q0. What to do next?
Q1. Has any of you experienced similar (or worse) problems and solved them?
Q2. To what extent can I blame my all-day-sitting habits outside the gym for being responsible of this issue and what methods do you advise a college student for spending less time sitting?
Q3. To what extent can I blame my poor technique for being responsible of this issue and how can I improve it?
Q4. How much related can the pain and the snapping be?
Q5. Wich merits my attention the most, flexibility or mobility?
Q6. Wich are the pros and cons of surgical therapy in before some other kinds of therapy?
Q7. In what cases is a better option to accept your limits, give up, and stay a painless weakling rather than struggling to get stronger?

Million of thanks in advance!

Best Regards,
Manuel

PS.: Please be kind. Don't get angry if you find any inconsistency, grammar mispell or anatomy mistake in my tale. I stress this because I've seen a lot of unfriendly users on this board. Also respect the fact I'm not a native English speaker.

[chrisd]

For the questions.

1) Get rid of the pain. We train to live better, not to suffer.
2) Yes, around 85kg. The pain was there at every squat and then all day and all night. I honestly though I had broken a bone. A physiotherapist diagnosed a weak piriformis and gave me exercises that made the pain much worse. He suggested accupuncture, I said "Why not?" it did nothing at all. I stopped squatting for a month. The pain got less. I fixed my form, the pain has not come back like that. I get some warning pains, I check my form.
3) It's probably all technique.
I am not an SSC. I can see.

You are looking straight ahead.
Your back is quite upright.
Your stance may be narrow. Shoulder width is a starting point. Some people need a wider stance, some people need a narrower stance.
Knees seem to be a long way forward.
I think your knees are still travelling throughout the squat. You should touch the roller in the first third of the squat and you knees should stay there.

4) Maybe not very much. When I squat, people run and hide because there is so much noise from my joints that they think there is gunfire.
5) You seem perfectly mobile and you can get into the squat position. You really don't seem to need more of either.
6) No idea
7) You got rid of the pain before. I think that if you fix your form, you can go ahead without getting it back.

Rip says in the book that hip problems often occur for novices after about three months of training. From issues are allowed to develop as the weights get heavier. From errors and heavy weight produce problems.

[Nate9]

I have the same snapping and had knee slide with related asis soreness like you.
Fixed my form and asis soreness went away, snapping is still there and gives me no pain so I just ignore it. I looked around for snapping hip syndrome and from what I can tell it's not related to hip impingment, at least that's what I can tell from my own experience, also I never got it checked by a doctor so who knows, I am fine with it as long as it doesn't limit my training.

Stop stretching.

How does impingement feels like?

[Manuel Solimano]

Thank you!

Honestly, I think you are right chrisd, at least I hope so. I agree that my squat form is still very far from decent and it would be great if that is the only problem to adress. However, it is a hard thing to internalize corrections after all. I could perform a rep fairly well and then spoil the next one and then just go on even if the video doesn't convince me entirely. Perhaps I should have never tried to self-teach me the movements, altough I've really tried to get a "gym bro" with no results, let alone a coach (I can't even afford that!). The sole task of finding a well-equipped gym took me ages and the one I found is light-years away of my place.

How does impingement feels like?

- The FAI impingement doesn't hurt anymore. When it did it was a localized sharp pain in the internal hip/groin area. Total internal rotation made me see stars. There were a few days in wich walking was painful. The symptom vanished magically after a few weeks around April 2016.
- The ASIS soreness (or whatever it was) was completely different, and in a different hip. It felt more or less like a mild wrist tendonitis but in the hip and it was more intense during squats. Walking was not a problem but sometimes getting up from sitting or sleeping on one side will trigger it again. The pain didn't spread through the leg nor the low back. Very slow to go away, I still feel it 5 weeks after my last workout.
- The snapping pop, also in the left hip, feels like a thick bass string being pulled off on the left posterior side of my pelvis near the hip joint, like a coarse pizzicato on what I guess is part of the iliopsoas complex. Standing up, I raise my left knee and then lower it again: The left hip will pop 99% of the time. Adduction, abduction, squatting and other movements can also trigger the snapping. The right hip sounds much less often. The overall snapping frequency will increase if the ASIS soreness is present. I don't call it painful but sometimes produces a subtle discomfort that spreads through the low back.

In this moment I'll probably stay away from the barbell for a bunch of more weeks. Then I'll start from zero hopefully monitored by a coach and switch to the SS novice routine (will 3x5 make the difference?), I'll keep you updated.
Lots of thanks, again,
MS.