One of the questions I get asked a lot is about hip pain when doing deep squats. And it is not okay. Performing a squat should not hurt. It can be uncomfortable if you add load, but should not cause pain. If you go to heavy, you will be sore, but not have pain. It is a subtle difference and I hope to address it with this blog post.
Causes of Hip Pain When Squatting
When people squat, there is no perfect squat form (we will address this in the next section). There is some things you should definitely avoid when squatting and the big one is pain. There are a few primary culprits for hip pain when squatting.
Ankle Mobility
Poor ankle mobility can cause the body to find other areas of the body to help increase the depth of squatting. If you lack the ability to dorsiflex your ankle (if you are sitting, that's lifting your toes off the ground and keeping your heels on the ground), the hips will have to have excessive movement to make up for the lack of motion. This can cause hip pain.
Hip Mobility
When you have poor hip mobility, it is difficulty to get into a proper squat position. Usually hip mobility for squats requires internal and external rotation of the hips. If these motions are restricted it can cause some disfunction in the bones, joints, or muscles leading to pain when squatting. Generally this can be addressed with some hip mobility drills and changing the position of your squats.
Midline Stability
This refers to your abdominal wall, spinal stabilizers, and pelvic floor muscles. All of these work to keep the torso, core, or midline still while you are doing squats. If one of these is not doing its job, the hips may try to pick up the slack leading to pain in the hips.
Boney Anatomy
Not everyone of you has the same bone structure. The difference in structure of your femoral head (the part of the leg that meets the pelvis) or the acetabulum (the part of the pelvis that holds the leg) can bump against each other during the squatting motion. This can lead to hip impingement (femoroacetabular impingement). This can be soothed with changing the position of your squat.
Squatting Position
Your squat will look different than my squat! The difference in squats is quite large. Some of you may need to have a wide or narrow squat stance. Some of you may have to turn your feet in or out. It is all okay. Due to boney anatomy, you may not be able to get your full depth squat without pain. And that's okay. You should work the available range of motion that your body has. If you are just starting out with squats, here are some basics to start from.
"Ideal" Squat Starting Position
Heels between hip and shoulder width apart
Feet pointed straight ahead
Knees following the second toe during descent
As stated before, not everyone can maintain this position and be pain free. Here are some ways you can play around with your positioning to make the squat less painful and more comfortable overall.
Adjusting Your Squat Starting Position
Turn your toes out equal amount - try turning your toes outward and squatting to see if that changes your symptoms
Widen your heels - try to move your heels farther apart and then squat to see if that changes your symptoms
Push knees out wide - for some squatters, pushing the knees out even wider than the second toe will relieve symptoms
Combine a few of these - play around with your squat position and find one that feels right for you.
As you read this, you may notice that the solution seems to be making a wider base for your hips to move in. For a small percentage, people will like to make their base closer together (bringing the heels closer, bringing knees together, etc.).
Everyone squats differently and it is important to be able to squat without hip pain.
BodyFix can help you learn how to squat, fix your squat, alleviate your squat related hip pain, and get you back in the gym without requiring injections or surgeries!
Reach out for a consultation: info@bodyfixpt.com or 425-202-5687