It all started a few months ago. It was max day and you were about hit your highest weight ever for a back squat. You unrack, step back, squat down, and push… push… push…. and boom. You crushed it. You’re a beast and just upped your max by 20lbs. But as you walked away from the rack, something felt off. You felt a little twinge and pinch in the front of your hip during the squat. “Whatever,” you think. It doesn’t hurt that bad and you’re on cloud nine after what you just accomplished.
Fast forward to now. That pinch never went away. In fact, it’s gotten worse. Now it feels like your hip bones are just smashing together at the bottom of every squat. You can’t even finish a workout of body weight squats. Even simple leg raises hurt.
What the hell happened? You are now dealing with what many people call a hip impingement.
What is Hip Impingement?
First of all, despite it feeling like your hip bones are crashing into each other, it is NOT your bones pinching together. Your bones do not touch. What really happens is the soft tissues and structures in the front part of your hip get a little more compressed than normal, which still creates that uncomfortable, pinchy pain.
As your leg flexes up, or your hips sink down in a squat, those structures come closer and closer together, and if you really try to push through a full range of motion, that’s when you have that painful pinching.
But Why Does This Happen?
For the majority of people, the root cause of this pinching is the position of the pelvis. Under normal circumstances, the pelvis should be able to roll backwards slightly in order to create room in the front of the hips for the leg to move so the structures don’t compress together. In people with hip impingement, the pelvis is stuck in more of a forward position. What many people call anterior pelvic tilt. This positioning already places the structures in the front of the hip closer together, so as you try and flex your leg up or squat down, there is less room to even begin moving through.
For a visual representation and further explanation, watch this video.
How Do You Fix It?
The good news: because this pain is due to a pelvic position problem, you can get rid of this pain by improving the position of your pelvis. All it takes is getting out of that anterior pelvic tilt, and learning how to better tuck your pelvis “underneath you”, or in more of a posterior pelvic tilt. This repositioning can be done by strengthening the muscles that help pull your pelvis into that tucked position: your hamstrings and abs.
This exercise targets both of these muscles directly, in a position that allows you learn how to properly contract them:
If you especially have a difficult time contracting your abdominals correctly, this exercise may be a better option for you:
Once you have mastered these exercises and how to properly contract these muscles, you can begin integrating these same concepts into the exercise that has been giving you trouble, i.e. the squat. This variation below will help you better learn how to utilize your hamstrings and abs to allow for a proper pelvic tuck during the squat:
These exercises shown above and the ability to control the positioning of the pelvis is something every single person should be able to do, but this is especially true for those of you dealing with hip impingement. However, it is important to note that every human body is incredibly complex and no two are alike. While positioning and control of the pelvis is incredibly important in getting rid of hip impingement related pain, there may be other factors involved as well depending on each individual. An assessment by a qualified practitioner is necessary to determine exactly what you need to get out of your pain. If you are currently dealing with hip impingement and wanting to return to squatting or any other activities pain-free, then call us at (469)626-7254 to schedule an assessment with one of our Doctors of Physical Therapy who will determine the right plan for you.