Reduce "Pinching Hip" During Squats
Anterior hip impingement, or "pinchy hip" as I like to call it, is probably one of the most common things that I get asked about via email and direct message. While there are a variety of potential causes, I do think there are a few exercises that tend to be effective for most right away. Then, if needed, we can assess a bit further and figure out what else is going on and what else needs to be done.
OVERVIEW:
Step 1: Test your Hip Mobility and Adjust Your Squat Stance
Step 2: Mobilize Your Hips to Reduce Pain and Create Space
Step 3: Improve Joint Centration/Position (aka Centering the Ball and Socket)
Step 4: Improve Coordination of the Hip Flexors and Core
Step 5: Increase Glute and Adductor Strength for Bottom of Squat Stability
Step 6: Adjust Your Squat Set-up for More Comfort.
More interested in watching me talk through and demonstrate this entire 6-step process? Check out the YouTube Video HERE
Step 1: Test your Hip Mobility and Adjust Your Squat Stance
In order to find more comfort with your squat, you can do a simple hip flexion mobility test. This test will show you where hips like to be positioned in order to get the most hip flexion. You can use the results from this mobility test to help decide how to set up your squat stance. Learn how to test your hip flexion mobility in THIS VIDEO.
Step 2: Mobilize Your Hips to Reduce Pain and Create Space
When it comes to pain at the front of the hip, this Posterior Banded Hip Distraction exercise is a great way to initially reduce pain, and potentially increase range of motion. The pressure from the band will help to "calm down" the musculature at the front of the hip by stimulating specific nerve endings that respond to sustained pressure, by reducing tension.
Additionally, the band can create a mild "distraction" force, which will help create space in the joint and stretch the deeper joint tissues like the capsule and surrounding fascial and ligaments. The theory here is that if we can create some space within the joint, and stretch the supportive tissue, then we will have more room to go deeper into hip flexion, thus allowing for a more comfortable or deeper squat. I am not sure that I 100% believe that the improved mobility and/or reduced discomfort is coming from "stretching" going on at the hip capsule and supportive tissue, as much as it is coming from sympathetic inhibition (relaxation) and improved proprioception (body awareness). Nonetheless, this stretch works. It will take you some time to find the most comfortable set-up for you, so give it a chance!
Step 3: Improve Joint Centration/Position (aka Centering the Ball and Socket)
The hip joint is known as a "ball and socket" joint. The big leg bone (femur) has a ball at the end of it, which sits inside of a socket on the pelvic bone (acetabulum). The ball of the femur rolls and slides inside that socket, which allows our hip to have all of the potential range of motion and freedom that it does. The hip joint moves the smoothest when the ball is centered in the socket. This is called joint centration.
Now, over time the the ball may become "off center" due to tightness or weakness somewhere around the joint, OR due to postural changes. This can be transient, depending on posture and position, and doesn't necessarily mean you'll automatically have pain or limitation. When the hip is not maintaining a generally "centered" position as you move through repetition motions (like the squat), there is a chance of creating irritation. In the case of a pinchy hip, the ball may be sitting too far forward in the socket as you squat, which means it will not have as much room to bend into flexion (sink into a squat).
This Modified Pigeon Pose is a simple way to stretch the posterior capsule (back side of the joint), which may help to bring the ball into a more centered position. The effects will likely be temporary when you first introduce this exercise. Over time you should see longer-lasting effects, as you combine this stretch with some of the other techniques discussed in this article.
Step 4: Improve Coordination of the Hip Flexors and Core
When most people say hip flexors, they are referring to the iliopsoas muscle group. This is a pair of muscles that are partially responsible for flex ion of the hip. The iliopsoas plays a role in core stabilization because of its proximity to the pelvis, spine, and abdomen. One potential reason that pinchy hip pain arises is that the iliopsoas is playing too big of a role in stabilizing the spine/hips, as compensation for lack of coordination/control and the other supportive musculature, such as the abdominals, obliques, and spinal erectors.
This Dead Bug exercise is a great way to improve overall core strength, stability, and endurance and teach the body how to disassociate the hip flexors (iliopsoas) from the other core musculature listed above. In other words, the Dead Bug will help you relearn how to let the core do its thing and the hip flexors do their thing. This will help to prevent the hip flexors from getting too tense and taught as you sink into a squat.
Step 5: Increase Glute and Adductor Strength for Bottom of Squat Stability
As you know, the squat is a booty builder. But what you may not have known is that the squat also heavily targets the adductor muscles (inner thigh/groin). This is because the gluteal and adductor muscles (in concert with many other muscles) lower you to the bottom of the squat, by lengthening to allow the hips to flex. For various reasons, you may have weakness or poor control of some gluteal and/or adductor muscles, which may result in the hip flexors (iliopsoas) compensating by tightening up to create more stability around the hip, as well as "pulling" you into the bottom of the squat.
Use this Heel-Tap Step Down exercise to re-train your gluteals and adductors to be in more control of your hip. Focus on going down slowly, to really challenge the gluteals and adductors eccentrically. As you feel stronger, progress by increasing the height of the box. If you begin to feel some pinching or discomfort at the front of the hip, then you've progressed too quickly and need to reduce the height a bit. This is a sign that the hip flexors are trying to compensate for the lack of control or strength at the gluteals, adductors, and/or core.
Step 6: Adjust Your Squat Set-up for More Comfort.
As you work through some or all of the techniques discussed in this article, you will likely still be dealing with some hip discomfort. Adjust your squat to reduce irritation and increase comfort, which will allow you to move properly and load up your squat nice and heavily.
Here are 3 ways to adjust your squat to reduce hip pinching and pain:
6A: Elevate Your Heels using a pair of thin plates, wedges, or weight-lifting shoes. The heel elevation changes the angles and mechanics of your squat, allowing your hips to sit over your center of gravity, requiring less anterior pelvic tilt, and potentially less pinching at the front of the hip. This is also a great way to "workaround" any ankle mobility limitations, which can also cause pain at the front of the hip.
6B: Reduce Squat Depth by squatting to a box. This will keep you out of those deeper ranges of hip flexion that are currently irritating and allow you to still get after some heavy squats. Over time, as your hip pain goes away, you will reduce the height of the box, and progress back to free squats.
6C: Add a Miniband around your legs, for the first few sets. This will help to bring more attention to your hips as well as improve how well you are activating and controlling the gluteals. The idea here is that after a few sets with the miniband, you can remove the band and have a deeper, less-irritating squat, due to the improved coordination, body awareness, and hip stability.
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This is meant to guide you on how to approach pinching or painful front hips during squats. I highly recommend going through this article step-by-step, utilizing each exercise or technique as it sees fit for you. Should the hip discomfort persist, we should schedule a time to discuss your situation in more detail. CLICK HERE to set up a free 15min call.
Good luck!
