Pain under hip/top of quad from squatting?

[Cerpin Taxt]

Recently I've ramped up my squatting (and deadlifts, too) a bit and I think I've developed some type of injury. It's located right under the front side of my hip bone -- a little bit on both sides (right & left hip) but moreso on the left.

I've continued squatting with the pain since it doesn't seem to be too severe -- initially I thought it was simply DOMS-related. When the rest of the soreness in my legs subsides, however, this pain does not diminish entirely. I suspect it may be some slight tendinitis.

My question is: what is the proper course of action to do away with this pain/injury? Should I cut back my leg workouts? How much? Cease entirely? What might be some good stretches to do? Any comments/suggestions welcome.

See illustration:

 

[Pantlegz]

Probably lack of flexibility in your hip flexor.. Google for stretches for it

 

[wheresmybacon]

Hip flexor strain probably. If you're squatting heavy, I'd probably take some time off. If you want to try to train through the issue, make sure you listen to your body. Pain exists for a reason.

 

[SociallyChallenged]

Well, let me ask you this first - do you ever notice a pinching sensation in the front of your hip (at that spot) when you get into the bottom of a squat? This is important because, rather than a hip flexor strain, you may be trying to work through femoral acetabular impingement (hip impingement), which increases your risk of tearing the cartilage in the joint. There are ways to work around this, but you need to not squat into the pain.

 

[Cerpin Taxt]

Well, let me ask you this first - do you ever notice a pinching sensation in the front of your hip (at that spot) when you get into the bottom of a squat? This is important because, rather than a hip flexor strain, you may be trying to work through femoral acetabular impingement (hip impingement), which increases your risk of tearing the cartilage in the joint. There are ways to work around this, but you need to not squat into the pain.

Yes, I do feel the pain at the bottom of the squat. I do not feel it at all if I do a half or 3/4 squat, for example.

After some googling on hip impingement and squats I suspect it may be due to improper positioning of my knees, i.e. my feet/legs are too parallel to eachother and not angled outward enough. I agree this may be characteristic of my squat form. I will have to pay attention to it better.

What should I do to recover so that I can squat full loads again?

 

[Pantlegz]

Well, let me ask you this first - do you ever notice a pinching sensation in the front of your hip (at that spot) when you get into the bottom of a squat? This is important because, rather than a hip flexor strain, you may be trying to work through femoral acetabular impingement (hip impingement), which increases your risk of tearing the cartilage in the joint. There are ways to work around this, but you need to not squat into the pain.

Squatting through pain is what makes you a man!

But really, I squat though pain all the time. Is it really that bad? Lately it's been my lower back on the right side, just at the top of my pelvis. It's been confirmed it's not my spine or a spine related issue.

 

[SociallyChallenged]

Yes, I do feel the pain at the bottom of the squat. I do not feel it at all if I do a half or 3/4 squat, for example.

After some googling on hip impingement and squats I suspect it may be due to improper positioning of my knees, i.e. my feet/legs are too parallel to eachother and not angled outward enough.

To be perfectly honest, you should be able to squat pain free with your feet shoulder width apart to sufficient depth. Of course, squatting with your feet out further can help with symptoms, they won't address the problem itself. A lot of the time, it tends to come due to tight hip flexors, tight posterior hip capsule, and weak external rotators of the hip. Consider that, if you don't address the issue and keep squatting, you're still at increased risk of labral tear, bone spur formation, chronic inflammation, arthritis, etc. If you see a physical therapist about it, they can mobilize your hip hip, teach your stretches, and strengthening exercises. I'd suggest that, if it becomes too much of a problem.

Also, you should note that this isn't a hip flexor strain. That's good though because you should be able to more aggressively stretch the hip flexors to gain hip extension.

 

[Cerpin Taxt]

To be perfectly honest, you should be able to squat pain free with your feet shoulder width apart to sufficient depth.

...and I have been able to do precisely that for years. As far as I can tell, nothing about my squat form has changed, I've just increased the frequency from about once a week to more like 3x per week (well, more like every 3rd day, so 3x per 9 days). That's what inclined me to believe it was some kind of strain or tendinitis or something.

Of course, squatting with your feet out further can help with symptoms, they won't address the problem itself. A lot of the time, it tends to come due to tight hip flexors, tight posterior hip capsule, and weak external rotators of the hip. Consider that, if you don't address the issue and keep squatting, you're still at increased risk of labral tear, bone spur formation, chronic inflammation, arthritis, etc. If you see a physical therapist about it, they can mobilize your hip hip, teach your stretches, and strengthening exercises. I'd suggest that, if it becomes too much of a problem.

Thanks, I will heed this advice.

Also, you should note that this isn't a hip flexor strain. That's good though because you should be able to more aggressively stretch the hip flexors to gain hip extension.

What would be unique about a hip flexor strain that leads you to believe it isn't what I'm experiencing? I'm not doubting your assessment as much as I am my ability to communicate my sensations. For example, I wouldn't originally have described the pain I feel at the bottom of my squat as a "pinch," exactly, but I'm not sure the best way TO describe it.

 

[IHateMyJob2004]

Pantlegz,
I think your issue is muscle pain. The OPs issue seems to be more joint related.

All,
I was keeping my legs parallel with each other when doing hack squats (no cage thus no back squats). I eventually developed knee pain. I reallized a major and minor mistake with my form. The major mistake was that my feet were not actually shoulder width. I was imagining that the center of my heal should be in line with the center of my shoulder joint. By human error, I was actually a few inches narrower than that. Now, I make sure that the heals of my feet are atleast centered with the outside of my shoulders (outside defined as skin). That helped a ton. I also angle my feet out a bit. Each foot is about 10 degrees out of parallel (the feet themselves would measure a 20 degree angle relative to each other). These basic changes fixed my knee pain.

As an aside. At one point, I just stood up and did a squat with no weights. And it seemd like my body naturally wanted my knees to flare outward as I squated. So, the 20 degree foot angle makes sense (I've read 45 degrees is "proper"). The shoulder width issue is needed to make sure that my legs bend propely at the knee joint.

Not sure if this relates to hips at all but I thought I'd throw it in there. I guess the point is that Cerpin seems to have form issues similar to the ones I had but with different symptoms (his hip vs my knee).

 

[SociallyChallenged]

...and I have been able to do precisely that for years. As far as I can tell, nothing about my squat form has changed, I've just increased the frequency from about once a week to more like 3x per week (well, more like every 3rd day, so 3x per 9 days). That's what inclined me to believe it was some kind of strain or tendinitis or something.

Thanks, I will heed this advice.

What would be unique about a hip flexor strain that leads you to believe it isn't what I'm experiencing? I'm not doubting your assessment as much as I am my ability to communicate my sensations. For example, I wouldn't originally have described the pain I feel at the bottom of my squat as a "pinch," exactly, but I'm not sure the best way TO describe it.

That sounds about right for impingement. You may not have complete hip ROM, which causes pathological joint movement to occur. Every joint requires some form of rolling, gliding, and spinning to occur. If you lack any one of those movements, then the hip will respond. In most cases at the hip, this is because you don't have enough posterior glide which causes the hip to come foward, ride up, and create stress on the rim of hip and femur. As a result, you get bone deposition there from the forces (Wolf's law). Even if you were asymptomatic before, it's just continually getting worse to further and further bone being put down in a bad place.

A hip flexor strain should hurt throughout the squat, if you're engaging them correctly. In addition to this, it should hurt when you're stretched into hip extension, and when you try to actively flexor your hip (the best way to distinguish this is an isometric contraction in a position that's not maximal hip flexion). Essentially, I'm saying you would feel it in more movements than just the squat, which is frequently the only high hip flexion movement that lifters will complete. If you had a hip flexor strain, it would likely hurt with walking, running, jumping, even bench pressing (if you have a more power-lifter oriented form).

 

[coreyb]

video of squat form?

 

[IHateMyJob2004]

video of squat form?

Rippe[size=+1]T[/size]oe's Starting Strength vide[size=+1]O[/size]s a[size=+1]R[/size]e awesome. Now, I can not say whe[size=+1]R[/size]e th[size=+1]E[/size]y are onli[size=+1]N[/size]e bu[size=+1]T[/size] they can be found. 5 exercises reviewed I think. 20-30 minutes for each.

Cliff notes:

 

[Cerpin Taxt]

So I've been trying to work this out, lately.

I do think I have real impingement issues, but I also think I have some type of hip flexor strain as well. I say that because I do this stretch:

...and I definitely feel a sore tightness at the front of my hip and down the front of my thigh for a good 4-6 inches below the hip bone. It hasn't seemed to improve much despite my efforts to stretch it, and even as I sit here idly I can feel some aching soreness in that area. Could this be simply that this area is "irritated" from getting pinched at the bottom of my squat? Or could also have a strain or some kind of tendinitis? I guess I should just give in and go see a damn doctor -- it's been bothering me for over two weeks now...

 

[SociallyChallenged]

Impingement can happen both in extreme flexion and extension. Even if it's the impingement affecting the labrum, it will refer pain to almost the exact same area as a hip flexor strain.

Personally, I'd say go visit a physical therapist. You may have to visit a doctor to get a prescription for PT, but a typically doctor will just run a ton of unnecessary imaging on you (x-ray, MRI) that likely won't show anything. Hip impingement is functional and won't show up on standard imaging - only on functional tests.