Background: 31 y/o male, life long athlete, began training around age 18 with some breaks in between, with no gaps in training since 2017.
Summary:
Have been experiencing an onset of anterior/lateral hip pain over the course of the past month.
First experienced symptoms 4 weeks ago with a “pinching” sensation felt in anterior/lateral left hip at the bottom of heel elevated back squat. While I have previously experienced low back and shoulder pain, the hip pain is brand new. I mitigated at first by narrowing my stance, which seemed to work for the first 2 weeks. I already train with a ‘heavy and slow’ approach implementing strict tempos on all my exercises (Poliquin style programming). I still continued to add load to the bar, maybe not the best idea, but symptoms seemed to be steady rather than getting worse. No lasting symptoms outside of the squat itself.
In addition to 4x/week strength training, I’d also been running 2x/week on non-lifting days (one day of longer ‘steady state’, one day of 10 sec sprint intervals). I experienced no symptoms during or after running, until last week (week 4). I’m not a competitive or serious runner, but do enjoy it for conditioning during the warm weather months as a way to train outdoors.
Since week 4, symptoms have gotten slightly worse. Completed last week of the block with squats, and none of the sets/reps felt great. Continued to increase load rather than back off up to this point. After the week 4 steady state run, symptoms worsened from the initial pain felt only in squats, to something I would describe as a dull tingling and weakness running down my calf and felt in my foot. It’s woken me up a few times at night, but subsides if I take ibuprofen (something I’m ultimately trying to avoid doing).
Ever since week 4, I’m feeling symptoms just in normal daily activities. A dull ache in the front/side of my hip accompanied by the tingling, which comes and goes. Felt mostly while working at my desk / sitting for long periods of time. The tend to feel better when I go for a walk. The symptoms seem to align most closely with FAI or tendinopothy, though, I’m not sure it really matters what the “diagnosis” is.
Since then, I’ve switched programming to do a heel elevated front squat with significantly less load. Still felt some of the pain at bottom of squat but focusing on controlling the ROM seemed to help. I’ve cut out the sprints for now. I did leave in the steady state, and modified by lowering the intensity (pace, duration). Felt some symptoms after by not necessarily worse.
I’m very familiar with your philosophies on pain / load management, and those have helped me keep a positive outlook. Plus I’ve read/listened to all your hip pain related articles and podcast.
Questions:
Are the tingling symptoms cause for concern / red flags?
Should I cut out running until symptoms subside, and instead program a different modality for conditioning?
I am leaning towards conservative care based off what I know from your free content. I’ve been on the fence about scheduling a consultation, because I’ve already spent a good amount of money on physical therapy for a shoulder issue earlier this year (which honestly did more harm than good imo). I’m not opposed to a consultation if I need to, but money isn’t abundant and just doing my best to take control for myself.
I appreciate your time reading this long post and for any advice you may be able to provide.