Why Do My Hips Hurt When I Squat? Femoral Acetabular Impingement: Part 4

source: www.mikemahler.com

So in part 1 we discussed what Femoral Acetabular Impingement is why it’s important to fix.  In part 2 we discussed  how the squat can be contributing to this problem and what we’ve got to do to fix it.  In part 3 we learned all about joint centration and how the hip joint is supposed to operate during the squat.  In this article we’ll try to put everything together.

Disclaimer:  I don’t intend this article to replace medical consultation or treatment.  If you’re concerned you may have a hip labral tear go see a trained medical professional.  The goal of this article series is to point out a common hip problem and ways to prevent it.

So now that we’re educated about FAI and labral tears, how should we go about training to prevent future injury?

1. Stop each set of squats before technical breakdown
2. Troubleshoot your squat mobility
3. Work within a pain free range of motion
4. Add corrective exercises to your program

1.  Stop each set of squats before technical breakdown

Remember the cues for a good squat:

1. Feet Flat – Not excessively turned out
2. Knees over toes
3. Hips back  with the hip crease below the top of the knee
4. Flat neutral spine
5. Upright torso
6. Externally rotated shoulder
7. Arms locked out
8. Bar over your center of mass

A good goal would be to try and squat more like this guy.

When our form falls apart we’re putting ourselves into a compromised position.  Over time we’re predisposing ourselves to more serious injuries such as labral tears.  Remember that bone grows when stressed and if we continuously stress our hips by ending in a poor position we might be creating a boney deformity that can’t be fixed without surgery.

Check your ego at the door.  Make sure your squat is on point and you aren’t lying to yourself when those weights start getting heavy.

2. Troubleshoot your squat mobility

It takes a tremendous amount of mobility to get into a safe and efficient deep squat.  Your goal should be to spend some time working on your mobility every time you enter the gym.

One useful tip is to try olympic lifting shoes.  Olympic lifting shoes have a heel lift.  This heel lifts acts like artificial ankle mobility and can make getting into a deep squat much more comfortable.

Remember that stretching is not the only way to get more flexible.  Getting your core more stable and strength training to your end range of motion (particularly focusing on the eccentric or muscle lengthening portion of the lift) will improve your mobility.

3. Work within a pain free range of motion

Deep squats are often the culprit to hip pain.  Until you build the prerequisite mobility to get into a safe and efficient deep squat don’t feel the need to push into a painful or inefficient position.  Feel free to modify or substitute deep squats for other exercises.  Some examples:

• More shallow squat variations
• Box Squats
• Lunge and step-up variations

4. Add corrective exercises to your warm-up

Source: jospt.org

We learned that joint centration is of the utmost importance when we get into a deep squat.  Often times muscle imbalances can lead to a poor position of our femoral head in the acetabulum.  To combat this we’ll mobilize the posterior tissues of the hip and work on strengthening the glutes while minimizing recruitment of the TFL.

Here’s the picture from JOSPT again.  Pick 2-3 of these exercises and throw them into your warm-up for a few sets.

And there you have it!  I hope this gives people a jump off point for understanding why their hips are hurting when they squat.  Let’s not become another health care statistic and wreck our hips permanently.  Although surgeons are getting better and better at hip replacement surgery I’d rather rely on my own hips for now!

Off to the gym,

Dan Pope

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