If you have pain in hips when squating watch this video (hip impingement)

[AlanGregson]

No amount of stretching has worked until i found this video, all you need is a heavy resistance band and an attachment point, works like magic. The theory behind it is that your femur doesnt internally rotate properly when squating and you get a pinching sensation in your hips because your femur bone is colliding with your hip bone, these exercises focus on loosening the tightness in your inside groin area to establish proper internal femur rotation.

 

[Sano]

I never really had that much success using banded hip mobilisation on patients with FAI (impingement). Some people actually respond negatively to it because they keep aggravating the pain. It can be a decent tool, but it wont solve the issue for most people. Especially someone with legitimate impingement, and if we're talking cam deformities forget about it. A lot of it has to do with anatomy. The angle and size of the acetabulum (hip socket), the size of the caput (head of the femur), the angle of the collum (femur head) and so on effects your hip ROM. If you have retroverted hips you have osseos (bony) limitations in internal rotation and a band wont do much to fix that. Even with using manual traction with a belt you rarely gain more than a few inches.

Changing depth, stance width and foot angle is what gives the most relief in my experience. As well as adjusting end range volume.

 

[AlanGregson]

I never really had that much success using banded hip mobilisation on patients with FAI (impingement). Some people actually respond negatively to it because they keep aggravating the pain. It can be a decent tool, but it wont solve the issue for most people. Especially someone with legitimate impingement, and if we're talking cam deformities forget about it. A lot of it has to do with anatomy. The angle and size of the acetabulum (hip socket), the size of the caput (head of the femur), the angle of the collum (femur head) and so on effects your hip ROM. If you have retroverted hips you have osseos (bony) limitations in internal rotation and a band wont do much to fix that. Even with using manual traction with a belt you rarely gain more than a few inches.

Changing depth, stance width and foot angle is what gives the most relief in my experience. As well as adjusting end range volume.

If your femur or hip socket are literally oversized then surgery is the only option you have, if you have tight muscles in the inside groin area that inhibit proper femur rotation then this is your best bet, there shouldnt be any pain whatsoever when doing these with a band, thats why its there in the first place.

 

[Sano]

If your femur or hip socket are literally oversized then surgery is the only option you have, if you have tight muscles in the inside groin area that inhibit proper femur rotation then this is your best bet, there shouldnt be any pain whatsoever when doing these with a band, thats why its there in the first place.

I don't know what you mean about oversized. Anatomical differences are normal, and shouldn't require surgery. I know there shouldn't be any pain, but the thing is that many people with impingement cannot do internal rotation at high hip flexion angles without aggravating pain, with or without a band, which was my point. This is what I do for a living.

 

[AlanGregson]

I don't know what you mean about oversized. Anatomical differences are normal, and shouldn't require surgery. I know there shouldn't be any pain, but the thing is that many people with impingement cannot do internal rotation at high hip flexion angles without aggravating pain, with or without a band, which was my point. This is what I do for a living.

I can't do these exercises without a band because it hurts too much, once i put on a heavy band and a lot of pressure it doesnt hurt whatsoever, so there's that. If it still hurts with a band then you need to soften up the area with external pressure like tenis ball massages. Everyone should be able to do a squat without pain, unless you have some anatomical anomaly ofc, thats the way we use to take a shit ya know. The problem is that most people these days have very tight hips because of constant sitting, poor posture and lack of primal movement, which leads to other major issues in life like unexplained back pain, pelvic floor dysfunctions... Issues that are virtually non existant in parts of the world where daily exercise is a part of normal life and survival.

 

[Sano]

I can't do these exercises without a band because it hurts too much, once i put on a heavy band and a lot of pressure it doesnt hurt whatsoever, so there's that. If it still hurts with a band then you need to soften up the area with external pressure like tenis ball massages. Everyone should be able to do a squat without pain, unless you have some anatomical anomaly ofc, thats the way we use to take a shit ya know. The problem is that most people these days have very tight hips because of constant sitting, poor posture and lack of primal movement, which leads to other major issues in life like unexplained back pain, pelvic floor dysfunctions... Issues that are virtually non existant in parts of the world where daily exercise is a part of normal life and survival.

Please stop.

 

[boingyman]

I would take what Squat U says with a grain of salt.

 

[Sano]

I would take what Squat U says with a grain of salt.

I actually like some of their stuff. A bit reductionistic in their biomechanics, but some of their videos on instagram are good. For the most part anyway.

 

[AlanGregson]

I actually like some of their stuff. A bit reductionistic in their biomechanics, but some of their videos on instagram are good. For the most part anyway.

No i wont stop, pretty much everyone should be able to squat pain free, instead of giving the typical i do this for a living explain why im wrong, there's plenty of people that do things for a living yet know fuck all about the subject like idk pelvic floor specialist, chiropractors... You're on my thread by the way, make your own and post your finding and recommendations...

 

[Sano]

No i wont stop, pretty much everyone should be able to squat pain free, instead of giving the typical i do this for a living explain why im wrong, there's plenty of people that do things for a living yet know fuck all about the subject like idk pelvic floor specialist, chiropractors... You're on my thread by the way, make your own and post your finding and recommendations...

I never said that the goal shouldn't be to get people to "squat" pain free. However, that's not always the case. More importantly, a squat can vary in depth, feet position, mechanics and load. Which is exactly what I said. We are built differently, have different morphology and different injury/training history. Please do whatever works for you, and if the vid in the OP does that's great.

What you should stop is trying to lecture me on anatomy, as well as recommending specific interventions or even surgery for pathologies you don't understand. This is not an appeal to authority, because plenty of people with degrees are, as you say, not necessarily the best in rehabilitation. I don't know everything, yet I've studied anatomy, biomechanics and physiology for years. I work as an orthopeadic physiotherapist specifically in lower extremity rehab and I've treated hundreds of patients with various hip pathologies. So I definitely know that banded hip mobility isn't a cure for all with FAI, and that not everyone should squat the same way.

 

[boingyman]

I actually like some of their stuff. A bit reductionistic in their biomechanics, but some of their videos on instagram are good. For the most part anyway.

Most of his content is outdated and/or not backed up by evidence. He makes a bunch of generalized absolute statements mixed with subtle fear mongering in terms of injury and pain. A lot of nonsense about excessive mobility work and 'perfect' biomechanics in various lifts. Not saying all his content is bad, but a lot of bullshit mixed inbetween which is not right. Just like 'nutrition' experts on instagram, a lot of bullshit blended into one.

 

[Sano]

Most of his content is outdated and/or not backed up by evidence. He makes a bunch of generalized absolute statements mixed with subtle fear mongering in terms of injury and pain. A lot of nonsense about excessive mobility work and 'perfect' biomechanics in various lifts. Not saying all his content is bad, but a lot of bullshit mixed inbetween which is not right. Just like 'nutrition' experts on instagram, a lot of bullshit blended into one.

Yeah you're right. I haven't seen any of their videos touch on pain, but obviously we know that pain is a lot more than biomechanics. Then again I've only seen a handfull of their vids at random.

 

[boingyman]

Yeah you're right. I haven't seen any of their videos touch on pain, but obviously we know that pain is a lot more than biomechanics. Then again I've only seen a handfull of their vids at random.

Yeah, I'm a believer of the biopsychosocial model of pain, although at the same time I'm not an expert on either topic of pain or biomechanics so I would advise anyone to take what I say lightly and doing your own research on the topic.

 

[JimRussel]

You're on my thread by the way

You mean the thread you posted in a public forum? Just checking.

 

[sakfjgadsyukgf]

I never really had that much success using banded hip mobilisation on patients with FAI (impingement). Some people actually respond negatively to it because they keep aggravating the pain. It can be a decent tool, but it wont solve the issue for most people. Especially someone with legitimate impingement, and if we're talking cam deformities forget about it. A lot of it has to do with anatomy. The angle and size of the acetabulum (hip socket), the size of the caput (head of the femur), the angle of the collum (femur head) and so on effects your hip ROM. If you have retroverted hips you have osseos (bony) limitations in internal rotation and a band wont do much to fix that. Even with using manual traction with a belt you rarely gain more than a few inches.

Changing depth, stance width and foot angle is what gives the most relief in my experience. As well as adjusting end range volume.

So I have the cam impingement and basically had to stop squatting altogether (have experimented with the leg press a bit, and oddly that doesn't seem to bother it? But would much rather be squatting).

My issue is that a bunch of other non-squatting stuff bothers it too- including hiking (like in the mountains hiking), which I really enjoy doing. Even sumo deadlifting, to some degree. Would you recommend that I at least try this banded hip mobilization? Or should I go straight to surgery? Is the surgery even effective? Lol. (Cam impingement was found by an osto on an x ray, also had my hip looked at with MRI w/ contrast dye injection just to check for other issues too)

 

[Sano]

So I have the cam impingement and basically had to stop squatting altogether (have experimented with the leg press a bit, and oddly that doesn't seem to bother it? But would much rather be squatting).

My issue is that a bunch of other non-squatting stuff bothers it too- including hiking (like in the mountains hiking), which I really enjoy doing. Even sumo deadlifting, to some degree. Would you recommend that I at least try this banded hip mobilization? Or should I go straight to surgery? Is the surgery even effective? Lol. (Cam impingement was found by an osto on an x ray, also had my hip looked at with MRI w/ contrast dye injection just to check for other issues too)

Depends on A) How you are doing and B) How severe the cam is. If you're still able to work around triggers and generally feel good, I wouldn't suggest surgery as the first line option. However, If you do feel like it hinders you too much, talk to your doctor about post-operation prognosis, and get a professional opinion. Maybe seek out a physical therapist as well who can examine you and give you a treatment plan.

As far as the mobilizations go, sure, try them out! Be gentle with it. If they aggravate the pain stop doing them, however if you find relief keep at it. Generally the overarching points in the rehab are; Try not to aggravate the pain, modify your exercise selection to include variations without pain, strengthen your hip musculature and stretch lower body tissue.

I'd throw in the clam exercise with a band and hip bridges as part of your warmup. Also I would suggest a 90/90 glut medius stretch against the wall as part of your cooldown, like so:

Spoiler: glut med stretch

It's simular to the pigeon stretch he's doing in the video but it's much easier to control with less hip flexion and compression, which is usually more easily tolerated if you have impingement. You'll still get a posterior capsule stretch as well.

Lastly, could you elaborate your squat? What's your stance like (narrow, wide, feet forward, feet out), how heavy is the load, how deep do you go, and when during the movement do you feel pain? Better yet, record it.

 

[sakfjgadsyukgf]

Lastly, could you elaborate your squat? What's your stance like (narrow, wide, feet forward, feet out), how heavy is the load, how deep do you go, and when during the movement do you feel pain? Better yet, record it.

Ill try the mobilizations (thank you man!) All variations of the squat hurt, tends to hurt more after I cool down/the day after. I tried a few different variations including both feet out & feet forward, low bar, high bar, and front squat. I'd say it starts to feel 'weird' a bit above parallel. Originally the pain started with normal weight (say 245+ for reps)- this was 2 years ago- now whenever I try with very light weights (95 lbs.??) it feels 'weird' and then hurts the next day. I can intuitively feel that what I'm doing is bad for the hip, then the pain starts later. (And I am in love with squatting, so I don't like to experiment anymore than one wants to see their ex socially after breaking up- trying to make a clean break to spare my emotions, haha).

My build is short & stocky, short limbs, etc. (in case that's relevant). Also I'm of northern European descent (I know there was some talk about hip shape & European ancestry at one point).

If you really want I will record me squatting with like the bar or a bit of weight. I thought that with a cam deformity, squatting is basically out unless you have surgery

 

[Sano]

Ill try the mobilizations (thank you man!) All variations of the squat hurt, tends to hurt more after I cool down/the day after. I tried a few different variations including both feet out & feet forward, low bar, high bar, and front squat. I'd say it starts to feel 'weird' a bit above parallel. Originally the pain started with normal weight (say 245+ for reps)- this was 2 years ago- now whenever I try with very light weights (95 lbs.??) it feels 'weird' and then hurts the next day. I can intuitively feel that what I'm doing is bad for the hip, then the pain starts later. (And I am in love with squatting, so I don't like to experiment anymore than one wants to see their ex socially after breaking up- trying to make a clean break to spare my emotions, haha).

My build is short & stocky, short limbs, etc. (in case that's relevant). Also I'm of northern European descent (I know there was some talk about hip shape & European ancestry at one point).

If you really want I will record me squatting with like the bar or a bit of weight. I thought that with a cam deformity, squatting is basically out unless you have surgery

It depends. Sometimes people with cam can't squat comfortably with load, but sometimes they can. Some people with cam morphology don't experience any hip pain at all. Besides the anatomy, it's about the symptomatology, ie, how you feel. If you do have impingement symptoms however, most of the time the best variation is frontsquat, shoulder width or a tad wider, feet out and depth above parallel. That'll results in the least amount of internal rotation and hip flexion, and not too much abduction. Another benefit is that you can keep absolute load lighter compared to a back squat, while still working with relatively high percentages. I completely understand getting disappointed and not wanting to play around with it too much, not to mention it can be pretty painful for a little while afterwards. With that said, how does a goblet squat feel to you, especially if you cut the depth?

Yeah Nothern and Central Europeans tend to have a bit deeper hip sockets with shorter and more retroverted necks, on average (it's still highly individual). Makes us a little more sturdy, but less anatomical range of movement.

 

[sakfjgadsyukgf]

It depends. Sometimes people with cam can't squat comfortably with load, but sometimes they can. Some people with cam morphology don't experience any hip pain at all. Besides the anatomy, it's about the symptomatology, ie, how you feel. If you do have impingement symptoms however, most of the time the best variation is frontsquat, shoulder width or a tad wider, feet out and depth above parallel. That'll results in the least amount of internal rotation and hip flexion, and not too much abduction. Another benefit is that you can keep absolute load lighter compared to a back squat, while still working with relatively high percentages. I completely understand getting disappointed and not wanting to play around with it too much, not to mention it can be pretty painful for a little while afterwards. With that said, how does a goblet squat feel to you, especially if you cut the depth?

Yeah Nothern and Central Europeans tend to have a bit deeper hip sockets with shorter and more retroverted necks, on average (it's still highly individual). Makes us a little more sturdy, but less anatomical range of movement.

Hey Sano, hope you're doing well man. So, I'm back on this. If you can stand to listen to my ramblings about my hip....

I spent 3 months of Covid lockdown basically not exercising. Now that I'm trying to get back into it, the leg press is bothering my bad hip- and I was fine with leg pressing before. Seeing as there's no other reason why it should've gotten worse, my conclusion is that 3 months of no exercise and no stretching worsened my mobility around the hip capsule (?), so now it's a cranky little b*****. I am not particularly young so I'd imagine that doesn't help either.

I was working with a physical therapist a bit pre-Covid, but I can't go see him now, and anyways I moved. What would you recommend as far as good hip mobility stuff? This banded stuff? I have internal & external hip rotation stretches (butterfly for internal, a pull for external). Anything else?

 

[sakfjgadsyukgf]

I have to say, the whole field of physical fitness is surreal. Everyone I find online contradicts everyone else- if I read 20 articles, each one is saying the last guy is dumb & dead wrong. In between that and the incomprehensible language, it's just hard to understand what's true and what's false