Squatting Without Hip Pain

Squatting with hip pain is one of the most common issues that we treat at our physical therapy office.  With this type of pain, pinching is often found at the front of the hip joint.  Common diagnoses associated with hip pain include hip impingement, hip arthritis, and hip bursitis.

To obtain an accurate diagnosis, an examination would be needed.  Although there are differences in how we treat each of these conditions, we’ve found that common limitations exist when it comes to squatting and hip pain.

In many cases, imbalances at the ankle, trunk, and buttock muscles can result in a tilted pelvic girdle. 

This can alter normal mechanics of the hip joint when standing, walking, and exercising.

Moving with this type of hip imbalance may cause hip pain as you descend deeper into a squat.  If this is combined with weakness of the core and spinal muscles, a sensation of pinching, tightness, and irritation may result.  This can be further complication by bony abnormalities of the ball and socket of the hip.  In physical therapy, we refer to these abnormalities as cam or pincer lesions. 

Considering that hip pain with squatting is multi-factorial, the only way to know what is contributing to these symptoms is to perform a full body movement assessment.

Once we know what the specific limitations are, our first recommendation is to take a break from the aggravating activity for a period of time.  For example, if squats are painful at the hip, it makes sense to substitute hinge movements (e.g. deadlifts, swings) until pain subsides.  This will create an environment for irritation to subside.  While taking a break from squatting can help with pain, we know for our patients to get back to squatting without pain, we have to address the root of the issue.

When pain and stiffness is found via our assessment, our approach includes manual mobilization to alleviate pain and improve mobility.  Pain improvements can be made very quickly with soft tissue mobilization of the hip muscles and manual distraction of the hip joint.  In addition, if ankle mobility is optimized,  squat technique will directly improve and offload sensitized tissues.

If weakness is found, we teach activation exercises to help our clients better engage muscles that are not firing well.  Strength of the hip flexors and extensors must be developed to squat with good technique.  Once we engage these muscles properly, we must be able to use them at the same time while we squat.  This can be tricky without having good feedback and coaching while performing a squat movement.

Once pain is controlled and movement and mobility is restored, our next step is developing strength and durability with load.  When performed with the right technique, goblet squats, back squats, front squats and other squat movements can develop strength and durability of the entire lower quarter.

When addressed with a thorough physical therapy assessment and plan of care, squatting without hip pain is possible.  Ignoring symptoms, on the other hand, may lead to atrophy, deconditioning, or a more serious problem.  If you have hip pain with squatting, the physical therapists at Movement Solutions would be glad to be a resource for you. 

We have a free guide on recovering from athletic injuries that can give you further insight into these type of problems and help kickstart your recovery.  We are available for a free 15-minute phone consultation to talk about how your pain is affecting you and discuss your treatment options.

If your concerns warrant an in-person consultation, we offer a limited number of free Discovery Visits at our office.  This type of appointment of for those who are interested in working with us and resolving their hip pain.  It is an opportunity to ask questions, obtain clarity, and develop confidence that we can help.  If you have hip pain with squatting and unsure about what your next steps should be, call us at (864) 558-7346 and ask how we can help.

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