I’ve been following the BBM crew growing over the last year or so, Big fan, been running the Bridge back to back for a bit and also leaning out a little (wedding in 2 weeks, scared to get fat haha).
I’ve been having pain in my right hip on and off the entire year really but it’s gotten worse the last month or 2. I first noticed it first after a multiple day motorcycle ride in late December.
I know the whole “take some load off the bar, find motions where it doesn’t hurt” etc but my problem is that I really don’t have much pain during workouts. It’s afterwards that the hip kills me and lately it’s really starting to affect my sleep badly. (especially sleeping on my left, right hip starts killing me and pain starts going down into the knee)
I did some googling (I know, I know I shouldn’t) and the motion that really hurts is the same as the FAI test (knee to chest and then rotate foot out/knee in/internal hip rotation). I actually notice this because it’s hell sitting in a chair and then bending forward and bringing my knee in to do up my motocross boots on the right side.
Is it time to see someone? Do I see a doctor? Physio? Any ideas or info would be madly appreciated, I can deal with a bit of pain, but losing sleep is wearing on me.
What have you tried for modifications so far? As I’m sure you also saw in the google search, “FAI” has a very high base rate in the asymptomatic population and the best treatment we have for it is modification of activity to address the symptoms. As with many elective ortho surgeries, FAI surgery does not fair any better than conservative care. The “test” for FAI is not a very good one either as it has a very high false positive rate (people experience symptoms without actually having anything show up on imaging). If we can try and trouble shoot some of the modifications you are working with (this still tends to fall in the same axiom even if you are asymptomatic while training) then we may be offer to some better advice.
Honestly, I haven’t changed anything with regards to training because I don’t have any real feedback mechanism ya know? I really don’t feel any pain consistently while squatting…I don’t know if it’s even more the squat or the deadlift that may be aggravating my hip. At best I guess pain on the night of training or the day after would be my feedback??
Should I drop some weight on squats and or deadlifts for a week or 2 and see what happens?
I definitely feel more pain after spending a day on my motorcycle…But there’s not a whole lot of modification I can do for that, and there’s about as much chance of me quitting biking as there is of me quitting training.
I guess part of my question is, if someone WASN’T training and had pain symptoms like this, is there anything you’d recommend (besides training) that may help? I know we aren’t fans of “stretching” here but if there’s “one weird stretch” I can do before bed that’ll chill it out and let me sleep better, I wouldn’t see that as a waste of time (knowing it wouldn’t make me stronger or improve my squat mobility or anything…I just value my sleep )
I am also experiencing a similar problem on my right hip. I’ve been squatting for 2 years now - previous program was only 1 time per week until the bridge which I just finished 2 weeks ago and now 2 weeks in the strength program and started noticing a flare up last week in my deep front pelvis, groin area. I worked through it and ignored it through my 3 squat days last week… and by the weekend the pain was also terrible 6-7/10 just walking… I too did lots of research on it on whats going on here is what I am finding.
1st: I am extremely inflexible - tight calves, tight hammies, tight hip abductors - cant touch toes with locked legs (2 inches above when not warm). Normally it would take me 10-15 minutes of squat warm ups to get to depth OK - I stopped stretched as well when starting the bridge. However all my research I did focused my pain problem potential to me being so damn tight and inflexible. I did 1 hr of focused mobility work on Sunday. Then another 45 minutes Monday before heavy squat day - felt pretty good. Tuesday I did 45 minutes of mobility on my lower half. Then yesterday 90 minutes - and finished with a 303 x 10 x 5 sets RPE 8-9 squats. Felt AWESOME. I get to depth without pain, after the session my hip pain is a dull 1-2 of 10. Today its barely noticeable.
I’m 30 - 6’1" x 87kilos - my goals are overall health, stay lean, getting stronger, no intention or plans to compete
Here are the videos I watched and followed during my stretching - I pulled out what I felt works best for me.
I plan to have sessions totaling ~2 hrs per week of dedicated lower body mobility - honestly after only 5 days of it - I feel so much better on my lower half already. Today’s squat session only took me ~10 minutes to feel excellent and ready to handle weight without pain, or tightness.
This is just is working for me - hope it can help you as well. I want to hit my goals I listed above and will do what it takes to get there pain free.
Well, I took just over a week off of all training (got married and then a short “mini-moon” with zero access to any gym). So I haven’t done much besides lifting a beer keg or 3 haha. Pain hasn’t changed at all, i’ve tried doing stretches etc and it hasn’t helped. It does kinda go into the back of my leg/hamstring at times as well. I’m getting pretty tired of it so I’m probably going to see a biokineticist that some family members have seen recently and are very pleased with.
I’ll see what he says and let you guys know. Back to squats today though. Excited.
I had left off on week 4 of the bridge, so I jumped back into that…But man I seem to have detrained quickly!! All the beer and food I guess:o I didn’t really change anything more than going a little lighter than where I had left off (due to RPE mostly). I did feel a bit of strain in my groin during squats (same side as dodgy hip…) but I rushed my warmup so I’m putting it down to that. Feels fine this morning I am just a little stiff from the workout. I’m amazed at how much just 1 week off made such a difference to the feeling of the workout!! It was way harder than it had been before I left.
I’m seeing this biokineticist guy in about an hour and will report back what he says…if he’s even the right sorta pro to see about this. Who knows.
This whole thing has left me wondering…How do you know what pain to just accept and work through, and what pain is an indication of damage or wear and tear getting worse? Seemingly if you actually have FAI and you just carry on, it’s just going to degenerate into osteoarthritis no?
First question: What kind of training do you do? Happy about powerlifting style workouts.
Did some looking around and he actually seems to have dealt with very similar symptoms on himself. He does recommend some stretching and even gasp foam rolling, but nothing hectic and obviously no static stretching before lifting. Rather during the day or at night.
He definitely found some really sensitive spots and things that were referring to other places…It’s a lot to take in for an idiot like me but it was pretty interesting.
He also recommended some deep quad stretching and doing some lunges as warmups for squats to warm up the quads a bit more.
He checked my squat form and was happy, also said “I don’t want you to stop squatting” so in my books the dude is legit. The hip definitely feels a lot looser after the torture haha. One crazy thing was him pushing on the inner thigh (adductor magnus I think) and that shot pain straight into the hip where I usually feel it at night!
(I do have a slightly dodgy right ankle, same side as the offending hip, from various skating and bike crashes over the years. The mobility there is not too bad, but not as good as the left one, so maybe that has something to do with this whole thing.)
A few things to unpack here. To your first question, I would argue that part of the pain process is acceptance across the board. It is often a question of when to work through versus work around. “Wear and tear” is a natural part of aging. We don’t get worked up too much (hopefully) over the presence of wrinkles but small changes on imaging can cause a stir. If you live long enough (past 40) then changes are you are going to have some arthritis show up somewhere on imaging regardless. There is little correlation with that image and symptoms however. If the symptoms have been going on for a while, then it tends to fall into the work around category whether this be changing stance, changing load, or working specifically on another task with which to bring up the foundation. The only thing guaranteed to predispose you to an increased risk of OA is living another day.
As for your visit to the biokineticist (no clue what that actually is but a quick search looks like it is unique to South Africa), the problem with poking around in areas if you can almost always elicit a response and a referred pattern so it does not hold much stock from any diagnostic standpoint. There is nothing wrong with stretching (cue pitchforks and torches) so long as it is being done from sensation point of view. Doing activities that can raise the tolerance of tissue to load/movement is well warranted in the literature. Stretching just does not change any tissue structure. I am curious as to what “deep quad stretching” is however.
Thanks, your first answer makes perfect sense, I hadn’t really thought of it that way I guess. Thanks!
Interesting that the Biokineticist thing is only South African! I guess it’s very similar to physiotherapy but he seemed to take more note of what kind of working out I do, checked my squat form, some ankle ROM etc, which I’ve never had a PT do.
The quad stretches he recommended were kinda like the “warrior” yoga pose, but with the rear foot raised on a bench or similar, which I assume just makes the stretch more intense. I just put the word “deep” in there, my bad. Like so: http://howtodoyour20s.com/wp-content/uploads/2013/11/a18e9c2a67c6539858ebad6876494548.png and also some single leg box squats.
I had almost no pain the night of the appointment, but after paused beltless squats yesterday I had a bit of pain last night. I do have some DOMS from taking that week off and diving straight back in though so I’m not taking much pain seriously this week…because everything hurts right now haha.
All in all it seems to help, my medical aid plan covers it completely so I’m going to go for a couple sessions and see how it goes.
Update!
I had 3 sessions with the Biokineticist dude and I feel basically 100% better. (I asked him what’s different between him and a physio and he reckons physios treat the symptom, which he does too, but then he’s also interested in the cause or keeping the problem from returning. So his practice has a squat rack and pilates tables and shit too)
The 2nd session a few days after the first was BRUTAL. He went to town on my right quad and rector femoris. “active release” etc. It was basically just 40mins of pain and suffering. Half way through I said “Dude, I think i’ll rather just keep the hip pain thanks!” haha
But I felt way “looser” afterwards. It just felt good and mobile. I dunno how to explain it. That day, after some deads and squats everything just hurt and I was in a shitty mood because of it.
3rd session was today, a week later. I had zero pain at night after the 2nd session but I still feel it getting up after sitting a while, after squatting while walking around, but at the top of the squat, not the bottom oddly. But like a 2/10, very minimal.
He recommended foam rolling that quad every once in a while, like every 2 weeks or so. I know rolling is frowned upon but once every 2 weeks isn’t gonna kill me. Also rolling the hip flexors a bit with a ball. He had me do some side leg raise type exercises which were actually really difficult and I could barely walk around after. I guess fatiguing those muscles you lose hip stability to an extent. It felt crazy.
He also gave me some single leg deads and squats to do now and then, even as warm ups for actual squats and deads. And coached me a little on overhead squat (just something im keen to learn for the technique and have always struggled with…we just got to talking about shoulders and mobility and stuff and it came up.)
That should be the last I see of the guy for a while but all in all it was a pretty interesting and effective experience! Just losing the pain at night was entirely worth the time and money so anything beyond that is a bonus!
Thanks for the advice here. Im glad I didn’t try to go down the imaging and FAI path automatically…I’ll always try this stuff first in future, even if it may be a little “woo-woo” with regards to stretching or rolling etc.
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