Squat-, Deadlift-, and Clean- substitutions (can't flex hips 90 degrees due to FAI)

[mangoose]

This may sound like blasphemy but I would like some ideas for squat-, deadlift-, and clean-substitutions that do not require more than 90 degrees of hip flexion.

I was diagnosed with femoroacetabular hip impingement (yes, both from x-rays and the physical test) so in the event that I can't or decide not to get that fixed via surgery, I'd still like to go back to doing heavy compound exercises for strength emphasis.

I'm thinking I can do hang cleans in replacement of power cleans. Not sure what to do for the big two, though, besides trying to put together some chimera program with rack deadlifts, glute-ham-raises, cable pullthroughs, back extensions, and leg presses or something.

Thanks in advance, Rip.

[Mark Rippetoe]

There is no replacement for the full-ROM versions of the basic lifts. How did you wear out your hip?

[Steve Hill]

The first question I would have is "What does your squat / DL look like?" - because most people just plain do't set up correctly. While I recognize that everyone is unique, I've been squatting (with no symptomology) with FAI bad enough to have caused two torn labrae (labri? labrums?), one in each hip. I find that a slightly wider

The second was how exactly was it diagnosed? What was your symptomology? What kind of x-ray was done? The gold standard is typically a fluoroscope, and an injection of a contrast dye along with Novocaine. The physical test is typically some type of hip flexion to determine if the pain goes away after the injection (hence the Novocaine). I've not heard of a plain x-ray being used to diagnose, but it's been a while. And, as Rip asks above, what is causing the impingement in the first place? Cycling? Usually, except in the case of a genetic disorder, this is a case of repetitive strain / impingement that causes an osteophyte to grow on the neck of the femur, further reducing the ROM before impingement occurs.

If you have such a bad impingement that you cannot get into a proper pulling position (let alone squat), then you need to have surgery, because your future is grim (search the board for examples). As Rip pointed out, there's no substitute for these lifts, and the 3rd edition (as well as the other editions) explains why: the systemic stress developed having to move heavy loads over a large ROM is part of the benefit you get from the training. As we never, ever, ever prescribe half- or quarter-squats. A leg press over a reduced ROM would be, to my mind, even worse.

If you are unwilling to get the surgery, then the only thing I can say is that sometimes in life we don't get to do the things we'd like to do. I'd like to be a pro baseball player. I got stuck being pretty good at cycling instead - so I have to actually work for a living now instead of resting on my laurels and my fat retirement savings.

[mangoose]

There's no conclusive reason for the condition. It's either congenital and/or due to too much high impact athletics as a child. Basically I have extra bone growth on my hip socket that causes femur-hip impingement much earlier (~90 deg flexion) than "normal." http://hipfai.com/ for reference.

I saw that SteveInATL has the same condition, and was able to modify his stance to accommodate, but I've tried that and it definitely doesn't work for me. And even if I could get it to "work," it'd be a big risk of causing labral tear and early osteoarthritis.

[Dastardly]

Can you manage sumo deadlifts?

Or how about high bar or front squats?

If none of these work, then perhaps unilateral stuff?

[mangoose]

I am scheduled to get an MRI done - had to badger them to use contrast fluid - but my ortho seemed pretty confident that I had impingement and saw the overgrowth on the x-rays. The physical test was the "Hip flexion, adduction and internal rotation" test which was positive for impingement.

Honestly I've squatted for a year without noticing pain, and it was starting martial arts that started the pain, but from hindsight (and finally videorecording myself) I realize that I never got impingement pain from lifting because my lower back rounds to compensate for the impingement.

Yeah I understand there is no proper substitute for the ROM at all, and I did also read over the section in SSBBT talking about the anterior-posterior force unbalance with partial squats. But I'd like to explore all of my options before giving up, and thus my posturing of the question here.

I'm not as unwilling to get the surgery as right now I've yet to find an ortho that will agree to the surgery. The current one just says to do whatever I want and avoid extremes of ROM, doesn't even prescribe PT. Also he says that squats are bad for your knees and hips. But yeah I definitely won't push myself to do these lifts if I don't get the surgery; I agree that's a recipe for labral disaster.

[Will Morris]

There's no conclusive reason for the condition. It's either congenital and/or due to too much high impact athletics as a child. Basically I have extra bone growth on my hip socket that causes femur-hip impingement much earlier (~90 deg flexion) than "normal." http://hipfai.com/ for reference.

I saw that SteveInATL has the same condition, and was able to modify his stance to accommodate, but I've tried that and it definitely doesn't work for me. And even if I could get it to "work," it'd be a big risk of causing labral tear and early osteoarthritis.

Not that it matters much, but do you have cam or pincher type FAI?

[mangoose]

Not that it matters much, but do you have cam or pincher type FAI?

Pincer