Hip flexor pain when squatting

Hip flexor tendonitis can develop due to a form problem that often occurs in the low bar back squat. You didn't say if you were squatting low bar or not. If you are, you need to check your forward knee travel.

The knees should only travel forward for the first third to half of the descent. When they reach the furthest point forward, you need to sit back and stay tight in the hole. If your knees move forward at the bottom of the squat, you have relaxed your hamstrings. At this point, tension is put on the hip flexors at the point where they attach proximally (that means at the hip, or the ASIS). They get pulled on pretty hard, and you can develop tendonitis there. Once you have it, it's hard to get rid of, but over time, squatting properly will itself rid you of this issue.

Other people with this issue have reported that they had a great result when they found a good ART practitioner. (Active Release Technique - in other words, a vicious massage).

Bump...didn't hubs talk about this the other day?

I've been lifting for about a year, but only started squatting heavy multiple times a week (Stronglifts) back in January. So perhaps this is an overuse injury, but I'm looking for info/experience in case it's a matter of form/flexibility or something else entirely.

Anyway! I'm having sharp hip flexor pain during squats. The pain is significant, and it's there whether I do front, goblet, BB or even bodyweight squats, normal or sumo squat, parallel or ATG. I'm extremely flexible - hypermobile, in fact - so it's not a matter of my calves/ankles/hips lacking a full ROM. I have changed my stance several times over the course of the last few months, trying to find the position that will allow me maximum glute activation since I'm naturally more hamstring-dominant. I've been very conservative with the weight progression - currently lifting 60kgs for 5x5 in a wide sumo stance.

I was having some back pain that I thought was twisted vertebrae, but when I saw my PT about it two days ago, she said that my right glute was extremely tight and that it was causing a chain reaction of tightness up my spine. I'm wondering if this is somehow related to the hip flexor pain, since it's all in the same area and both problems started around the same time.

Any thoughts? Thanks!

Have you tried a Crossfit site for info? They are extremely helpful and have a lot of blurbs and info about these kind of things - or find a crossfit gym in your area and go and have a chat with them for some personalised service! They will show you the hip flexor stretches and things to help increase muscle stability in that area. My Crossfit gym contains a mini super power lifing pocket rocket by the name of Georgina - she is awesome with info, and does olympic powerlifing. You might find someone similar there. Just a thought!
Luck **

Is the pain very local and sharp, almost like a pinch, or needle poke?

To me, it sounds like you have femoroacetabular impingement (FAI), or a hip impingement.

This is a good test to diagnosis the problem. You'll feel a sharp pain at the 0:55 mark if you have a hip impingement.

http://www.youtube.com/watch?v=XA1VSK5NBCk

Exactly my thought too when I read the initial post.

Oops...diagnose*


Foam rolling and some glute activation exercises should help!

Foam rolling and glute activation exercises are not going to do anything for FAI. Both cam and pincer FAI are pathomorphologies of bone shape.

bump for great responses

Oops...diagnose*


Foam rolling and some glute activation exercises should help!

Foam rolling and glute activation exercises are not going to do anything for FAI. Both cam and pincer FAI are pathomorphologies of bone shape.

I'm not suggesting that foam rolling and glute activation is going to reverse anything, but it will HELP stop the progression and relieve pain.

The femur isn't traveling properly which causes the pinching sensation during internal rotation and flexion. Stabilizing the hip should give the head of the femur some more room to travel, at the bottom of the squat.

While I'm sure some people have a disposition for FAI, I believe 90% of it is a result of poor hip position.

The femur isn't traveling properly which causes the pinching sensation during internal rotation and flexion. Stabilizing the hip should give the head of the femur some more room to travel, at the bottom of the squat.

FAI is due to contact between the femoral neck and the acetabular rim, and the pain is caused by crushing or pinching of the acetabular labrum. You cannot make more room for hip flexion by stabilizing the hip. FAI symptoms in deep hip flexion (bottom of the squat) are due to this impingement. People with FAI should avoid deep squatting and other activities that elicit pain, as the pain is due to labral deformation. Repeated deep squatting will result in labral tears and eventually cartilage delamination around the periphery of the acetabulum.

You should of spent more time searching Google before posting this...

http://posturalrestoration.com/media/pdfs/Hip_Impingement_2.pdf
http://www.ericcressey.com/hip-pain-in-athletes-the-origin-of-femoroacetabular-impingement
http://www.pureperformancetraining.com/blog/FAI

To be clear, coach, my knowledge does not come from google. I have a PhD in bioengineering, and my research is focused on musculoskeletal biomchanics. Part of my research targets the study of the biomechanics of hip pathology. I also happen to have FAI.

http://mrl.sci.utah.edu/

Best of luck trying to correct skeletal deformities with foam rolling and glute activation exercises.

My 2 cents for the FAI discussion (getting my Doctor of Physical Therapy in August) -

Agree with you jaweiss that you can't correct skeletal deformities without surgery. However having treated a lot of patients with FAI, snapping hip, and hip flexor tendonitis (all of which the OP could have, hard to tell without physical exam), there are definitely ways to decrease pain and improve function. Myofascial release such as foam roller and glut activation could help, tho I would recommend a more individualized program based on specific impairments (strength, myofascial restrictions, tendonitis, etc). Surgery, for true correction of skeletal deformities, is usually the very last option in my book based on the long and highly restricted recovery.

Also OP just clinical experience/personal experience wise I have noticed a link between pelvic alignment problems and aggravation of FAI. It's possible that your glute tightness is causing an alignment problem, sacral or iliac, which is aggravating present FAI symptoms. It's also possible if you have an FAI or an alignment problem, that is causing the tight glute Kind of a chicken or egg thing there.

Anyway OP glad you are seeing a specialist, hopefully it all works out for you and you can get back to squatting soon! Just FYI if it is FAI and you end up considering surgical options, it is a very long recover time so make sure you talk to your physician about all of that. Some of my patients still come in surprised that they have to be on crutches for months. Update us after your appointment!

I have FAI and labral tears in both hips. I had a regular MRI and then a MRA. I'm having surgery on the left hip in a couple of weeks. Doc said a long rehab of about 4 to 6 months on each side.