Squat question - Pain in right hip crease

Hi All,

I appreciate any advice and insight that can be provided. A bit of background, I've attempted to do the program a few times, twice under the tutelage of a SSC, both were very helpful, but no matter what has been attempted I've been unable to squat successfully. It doesn't seem to matter what the weight is (it can be just the bar) and the next few days I have trouble walking. Like literally. I've attended a seminar, I've tried seemingly everything I and others can think of (shimming a shoe, switching to high bar, etc. etc.) but nothing has allowed me to successfully progress or squat. I often appreciate the mindset displayed by so many on SS in terms of sticking things out, finding solutions, etc. and I'd like to be one of those individuals (as I've tried over the past few years), but as one SSC said, "there's no need to be dogmatic about it, maybe you have to use the deadlift as the driver of your strength." I agree with that, if that really is the case, but I'd like to make one last push and see whether anyone has other ideas or "fixes" that may allow me to squat.

Here's a video of me squatting 185x5. I know it's not much and to reiterate, it could be a video of me squatting 65lbs. The days that follow I literally struggle to walk with tightness. I would look 20 years older trying to walk, it's not a great sight. I've had MRIs (unremarkable), done countless hours of PT (no lasting benefit in regards to THIS issue), tried all kinds of other modalities (blah blah blah), but I haven't seen any results. It's been an expensive, frustrating and time consuming process to say the least. I'll spare you my self analysis from reviewing Netter's anatomy book and other efforts since they've proven fruitless and leave it up to the experts.

I'm happy to provide any additional information. Thanks.

YouTube

Hey Swyou22,

The link on your youtube is not working. For people who have persistent problems with this issue to the point where it becomes debilitating, I decrease squatting frequency to 2x/week for three sets of 5 reps on a linear progression and start with front squats. Once that starts to get hard, I back off 10-20 lbs and start another LP with a high bar. Once that starts to get hard I backoff 10-20 lbs and start another LP with low bar. Over the years, I've used this successfully with many people who suffered from very persistent anterior hip pain that was not responsive to stance and technique alterations. It has not worked for everyone, but there have been many successes.

I've found that one of the contributors to his problem is a sensitivity to end-range hip flexion. That squat progression does an excellent job of grading your exposure back in this context. Still, you need to take in a bigger picture to get rid of this. When I am managing these cases, I also control for any other activity that spends time in that area. Typical examples here include rowing, situps, biking (especially spin classes clipped in), and grade those exposures back using the same kind of principles.

More specific advice than this is in consult/rehab coaching territory, but hopefully, this gets you started.

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Originally Posted by Nick D'Agostino

Hey Swyou22,

The link on your youtube is not working. For people who have persistent problems with this issue to the point where it becomes debilitating, I decrease squatting frequency to 2x/week for three sets of 5 reps on a linear progression and start with front squats. Once that starts to get hard, I back off 10-20 lbs and start another LP with a high bar. Once that starts to get hard I backoff 10-20 lbs and start another LP with low bar. Over the years, I've used this successfully with many people who suffered from very persistent anterior hip pain that was not responsive to stance and technique alterations. It has not worked for everyone, but there have been many successes.

I've found that one of the contributors to his problem is a sensitivity to end-range hip flexion. That squat progression does an excellent job of grading your exposure back in this context. Still, you need to take in a bigger picture to get rid of this. When I am managing these cases, I also control for any other activity that spends time in that area. Typical examples here include rowing, situps, biking (especially spin classes clipped in), and grade those exposures back using the same kind of principles.

More specific advice than this is in consult/rehab coaching territory, but hopefully, this gets you started.

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Thanks, Nick. I believe I've fixed the Youtube link. I tried to edit my original post, but I don't appear to have that functionality. I reviewed the edit post page in the FAQs, but it's likely I'm overlooking something.

YouTube

I appreciate your recommendations. I do cycle, but the hip issue persists even after taking extended time off (6+ months). Please let me know if the updated video gives any additional insight. Thanks, I really appreciate it.

https://youtu.be/irRz2MexbE0

Nick, can you define "persistent anterior hip pain" any more specifically?

Do you think there is a possibility the sensitivity to end-range hip flexion may be connected to the functioning of the gluteus minimus and medius?

Thanks, Nick. I found the link you referenced about squatting and the knees. Knee Position in the Squat | Starting Strength Coach Development

Your analysis and the video are very helpful. Thanks.

I really hate to interject in someone else’s injury thread, so my apologies. This thread did catch my eye because I’d been dealing with the exact same injury (up until pre-COVID). My body style (height, weight) is nearly identical to that of the OP and I also rode bikes up until I started my NLP. I suck at squatting and was about to sign up for a SS seminar when COVID happened.

One thing I noticed is that by moving the foot of the bothersome side forward about a half inch or maybe an inch, my depth got better and I was having far less pain. And, yes, I struggled mightily with depth. Then COVID happened.

It seems to me like moving the foot forward a smidge is very similar to having a shim in one’s shoe? Mentally, the geometry seems about right, but I feel like I’m probably not understanding things correctly.

Again, I hate to interrupt, but I really got a lot out of this thread and just thought it might add to the discussion. Thanks.

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Originally Posted by Yngvi

Nick, can you define "persistent anterior hip pain" any more specifically?

Do you think there is a possibility the sensitivity to end-range hip flexion may be connected to the functioning of the gluteus minimus and medius?

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I do not have a definition for you. I do not think the sensitivity at end-range hip flexion has to do with glute function. I think it is simpler than that with a significant contributor being too much time under load in a new position. This idea is why I believe various other activities are additive (biking), and I suggest modifying them as well in management.

Quote:

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Originally Posted by Swyou22

Thanks, Nick. I found the link you referenced about squatting and the knees. Knee Position in the Squat | Starting Strength Coach Development

Your analysis and the video are very helpful. Thanks.

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You're welcome! I hope it was helpful.