Chronic, migratory groin issues

[rorywatts]

Basic information: Male, 34 years old, 183cm (6'0), 82kg (highest was 94kg around June 2022)
Lifts: Squat 140kg, Deadlift 160kg, Bench 95kg, Press 70kg - all of which were around June at my heaviest.

I was looking for a little guidance on how to manage my groin injuries.
Basically I'm getting frustrated at feeling debilitated, and would like to be more systematic with how I treat, and prevent these injuries.

Basic Overview:

• Apparently highly flexible for a 34 year old, and for a male (not marfanoid)
• History of left hip injuries,
• some imaging suggestive of left labral tear,
• xray suggestive of abnormal left hip anatomy (can't remember if cam or pincer morphology) leading to impingement during hip flexion (can hear an audible snapping if I flex hip to waist height)
• (side note, sports doctor recommended to avoid squatting to depth due to anatomy)

Longer History
I have been managing a series of hip issues since May 2022, which saw improvement during Oct and Nov, but have come back again.
This is the second occurrence, with the first occurrence being in April 2020, but which resolved with squats.
Initially, I thought the issue was a labral tear (due to some damage shown on MRI), but the symptoms don't seem to be consistent with a labral tear.
Instead, it seems a combination of: lateral hip issues (maybe trochanteric bursitis or a tendonitis) + medial groin injury (some adductor I think).
The pain improves with antiinflammatories (e.g. ibuprofen, naproxen)
It's often the case that one flares up, then as it resides, the other flares up (e.g. lateral pain, then medial pain).

From June I basically fell off any strict programming, and just focussed on doing some training, which often consisted of box squats + rack pulls (deadlifts exacerbated the groin injury).
In October, I started training squat again, got back to 100kg, before having another flare up, which is what I currently have.
I might have been too ambitious with training, and i'm prone to rushing.
I also had a night out on the town, and the dancing seems to have exacerbated the hip.
Originally, the combination of long walks, and squatting seemed to do a lot of good, but now it's difficult as i've got an injury in the right knee (feels like a tendonitis too, but had sustained an injury to the knee when I was young).
I've gone back to box squats for the moment, as it feels irritating and painful to be in the bottom position of a squat at load

Question
I suppose I'm wondering, given this history, what the best approach to managing this injury is?
Box squats until ...? Good girl / bad girl machine? 3 x 5 or modified?

Thanks for your time

[Mark Rippetoe]

You are 40 pounds underweight. Muscle mass supports injuries, can make them basically go away. But this may be a situation where surgery is the only way out, if your hip joint geometry is the cause.

[rorywatts]

You are 40 pounds underweight. Muscle mass supports injuries, can make them basically go away. But this may be a situation where surgery is the only way out, if your hip joint geometry is the cause.

Thanks Mark. I'll consider my options (surgery included, if labral tear is a chief contributor, if it's just hip morphology, i'm not so eager).
In the interim, would you suggest anything on top of box squats to keep training?

[Mark Rippetoe]

Eating.