Case Study: Hip Pain During Squats - Your Technique Matters
- Anterior hip pain during squats
- 24 years old
- Personal trainer
Blake is a healthy and active young man that came in to see us for the pain he felt at the front of his hip, particularly when performing heavy squats. He’d previously had an MRI, which did not show any hip joint injury.
Blake suspected that his restricted right ankle was related to his hip pain. We had seen Blake years earlier for prescription orthotics to help optimise the biomechanics of his right ankle joint. The orthotics had done a good job of keeping the ankle controlled.
WE EXAMINED BLAKE
Our examination included:
- Visual gait analysis
- Range of motion testing
- Muscle testing
The final piece of the puzzle was that a front squat caused no symptoms. What this meant was that at the bottom of his squat, his leg length and bar hold were creating a large amount of hip flexion. Coupled with his narrow stance and very large musculature, Blake had a significantly increased risk of anterior hip impingement. This was exactly what was causing Blake’s pain.
While the low bar squat was causing this painful impingement, Blake’s front squat, in which maintains a much more upright torso and relatively smaller hipflexion angle, did not cause this impingement and exhibited no painful symptoms.
The first step was explaining to Blake the effect that his morphology and technique were having on his hip function - and pain. We then worked with Blake on some alternative techniques and ensured he understood the movements correctly.
Specifically, we recommended a high bar carry and a slightly wider and out-turned stance. This will decrease Blake’s hip flexion demand, and free up space for the soft tissues at the bottom of the squat to prevent impingement.
EDUCATION IS THE KEY TO PREVENTION
One of the first steps in any treatment plan here at The Podiatrist is to ensure that our patients understand exactly what is going wrong and how it is caused. We believe that by the end of our initial appointment, our patients should be able to confidently describe what has caused their symptoms, and what the plan is to alleviate the problem and keep it gone long-term.
One month after Blake started his new squatting technique, he reported an improvement in his hip pain, and more importantly for Blake, a safe return to back squats.
We gave Blake more advice around his muscle balance - namely his Quadriceps and Hamstrings strength and length and strategies he could start implementing immediately to address these identified discrepancies.
At his last review, 6 months after his first visit, Blake was doing well and had returned to full training without pain or discomfort.
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