Hip impingement? Hip flexor tendinopathy? What next? Newbie needs help

[cmorales954]

I have begun experiencing increasing pain near the forward crease of my hip / groin during my squats (left side). It has gotten worse during the past 2 weeks, but has been there in very mild levels since almost the beginning, and today got bad enough that I didn't feel comfortable continuing my squats. It does not effect my DL. The pain is fairly acute and does not travel -- its pretty much right in the fold.

I am approximately 6 weeks into SS, late 30s, and weigh 152lbs (I've gained about 12-14lbs since I got on SS and have doing my best to up my protein/calorie count).

Here are some single clips from me today trying different stance widths, foot angles, and back angles (I have additional ones, even some with less weight, but they are all fairly similar). These were all singles as the pain was too much to do much past 1 or 2 without a reset. You can see it impacting me the most on the ascent, about 2/3 up I make a weird move. It also causes me to lift my left foot on my ascent and in deeper positions, involuntary twisting my hips trying to avoid the pain.

YouTube
YouTube

Some other points:

• Thomas test is negative along with 'hip flexor strain' tests.
• Different stance widths and foot angles doesn't seem to really help all that much (I spent today doing working set singles all with different angles; none offered relief)
• More back angle helps, but I have to straighten out for a straight bar bath, thus the pain returns (however, if I do an air squat and keep my back bent 45 degrees almost immediately, the pain is much improved)
• Avoiding anterior pelvic tilt helps a bit
• It does not get worse with more load; the empty bar hurts as much as my working set weight (currently 145)
• I can trigger the pain most easily by sitting on a chair, and squeezing my fists in between my knees -- when I RELEASE, the pain appears very briefly and is stronger than when I squat. I do not feel the pain when I am actively squeezing my knees together -- only for a second when the tension is released.
• Standard lunges, without weight, also trigger the pain when I go to take a step and alternate the forward leg/foot. I also detect a bit of a pain in my right hip as well when I do this, but the left is far more severe.

Looking at my form, I fear I've been dropping too fast. Have I created a tendon strength imbalance/inflammation by neglecting my negatives/eccentrics?

I had a similar issue a few years ago with tennis elbow due to overloading concentric motions from body weight exercise, and the eccentric exercises cleared them up in a couple of weeks.

Would focusing on eccentrics with less load on concentric help? I.e., lunges inside a rack where I support myself when I stand up, but allow for a slow un-assisted eccentric on the way down? Are there ways to do only eccentric squats? I am planning to see how the pain is affected with box squats and leg presses.

I will be attending a SS training camp with Pete Troupos in January, in Orlando. Would hate to be there with this pain unaddressed, as I cant really perform multiple working sets. That session cant come soon enough, however! Very excited for it.

Thanks!

[Will Morris]

I have begun experiencing increasing pain near the forward crease of my hip / groin during my squats (left side). It has gotten worse during the past 2 weeks, but has been there in very mild levels since almost the beginning, and today got bad enough that I didn't feel comfortable continuing my squats. It does not effect my DL. The pain is fairly acute and does not travel -- its pretty much right in the fold.

I am approximately 6 weeks into SS, late 30s, and weigh 152lbs (I've gained about 12-14lbs since I got on SS and have doing my best to up my protein/calorie count).

Here are some single clips from me today trying different stance widths, foot angles, and back angles (I have additional ones, even some with less weight, but they are all fairly similar). These were all singles as the pain was too much to do much past 1 or 2 without a reset. You can see it impacting me the most on the ascent, about 2/3 up I make a weird move. It also causes me to lift my left foot on my ascent and in deeper positions, involuntary twisting my hips trying to avoid the pain.

YouTube
YouTube

Some other points:

• Thomas test is negative along with 'hip flexor strain' tests.
• Different stance widths and foot angles doesn't seem to really help all that much (I spent today doing working set singles all with different angles; none offered relief)
• More back angle helps, but I have to straighten out for a straight bar bath, thus the pain returns (however, if I do an air squat and keep my back bent 45 degrees almost immediately, the pain is much improved)
• Avoiding anterior pelvic tilt helps a bit
• It does not get worse with more load; the empty bar hurts as much as my working set weight (currently 145)
• I can trigger the pain most easily by sitting on a chair, and squeezing my fists in between my knees -- when I RELEASE, the pain appears very briefly and is stronger than when I squat. I do not feel the pain when I am actively squeezing my knees together -- only for a second when the tension is released.
• Standard lunges, without weight, also trigger the pain when I go to take a step and alternate the forward leg/foot. I also detect a bit of a pain in my right hip as well when I do this, but the left is far more severe.

Looking at my form, I fear I've been dropping too fast. Have I created a tendon strength imbalance/inflammation by neglecting my negatives/eccentrics?

I had a similar issue a few years ago with tennis elbow due to overloading concentric motions from body weight exercise, and the eccentric exercises cleared them up in a couple of weeks.

Would focusing on eccentrics with less load on concentric help? I.e., lunges inside a rack where I support myself when I stand up, but allow for a slow un-assisted eccentric on the way down? Are there ways to do only eccentric squats? I am planning to see how the pain is affected with box squats and leg presses.

I will be attending a SS training camp with Pete Troupos in January, in Orlando. Would hate to be there with this pain unaddressed, as I cant really perform multiple working sets. That session cant come soon enough, however! Very excited for it.

Thanks!

You are not tight at all when you go down into the squat. You set-up before the rep leaves a lot to be desired. Your knees are soft the entire time. You do not control your knees coming out, you do not control your knees through the rebound, and you do not control your knees collapsing inwards. I'd agree that you could do a lot for yourself by slowing the descent down, but maybe more so just because your squats are very sloppy. You would likely get some good return on your investment by focusing more on staying in control of your body on the way down. There is so much to start with just cleaning up your technique that I don't think it is necessary to even begin to start looking at this like an orthopaedic issue.

[cmorales954]

Thank you for the direction. I'll try to focus on that more during my next session. I find the squat incredibly overwhelming, and trying to think of all the cues has been difficult while doing this program solo (I have driven by wife insane with all of the starting strength form videos I watch, and how many times I have read through the book and try to discuss it).

From a tightness perspective, I have been focusing almost entirely on my upper body and not on my legs/knees. The videos were also shot at a point of extreme frustration where I was just doing single reps with slight variations in a bid to isolate why I was having the pain (or to find combos where the pain was manageable), so my mind is even LESS on tightness (if that was even possible, apparently, LOL).

Hopefully the session in a few weeks with Pete will help me apply the above direction better.

I greatly appreciate you taking the time to respond. Thanks again.