Hip pain/instability, suggestions on where to go from here?

Pain & Rehab Forum [Moderated]
1

All,

About two weeks ago I was getting out of a car when my left hip felt like it was going to buckle underneath me–super unstable, like I couldn’t put any weight on it, though only a little bit painful. Since then I’ve had the same thing recur about 1-2x/day, usually while moving somehow (getting up from a seated position, twisting, side-stepping, though none of these movements reliably reproduce the sensation). I’ve also noticed intermittent pain in the same hip since then, not very painful but noticeable, right in the area of the inguinal crease. Any suggestions for workarounds/avenues of attack?

Background: male, 27, 5’11", 190, 33" waist. Summer was mostly hiking and manual labor with easy jogging and intermittent lifting, usually some combination of FSQ/OHP/chins/rows/pull variant, usually about 1-2x/week and keeping RPE fairly low. Been trying to move into off-season programming, pretty much the same thing but slightly increased volume and frequency. I hadn’t front squatted regularly before this summer and thought it would be a good opportunity to learn the lift.

Goals: build strength, endurance, and running durability between now and about April/May and transition to more outdoor-specific training about then.

More info: not wedded to squatting but I felt like front squatting in particular was helping me hike heavy loads up steep hills, and it’d be nice to get back to it. Sometimes it seems like the hip is fine with front squatting, sometimes not–it’ll twang on the walkout, or fine for the first couple of sets but then start hurting. Before I started noticing this pain and instability I’d notice some anterior hip tightness during warm-ups (usually goblet squatting 54lb x 10r x 2s or so, since I had a hard time getting a good rack with the empty bar), but it would go away and I’d front squat without any trouble. Experimenting with high handle trap bar pulls in heeled shoes, which seem like they might be OK but a little soon to tell. The hip podcast mentioned high box squats and single-leg work, which I may also try. Running is OK during the run but maybe feels a bit worse the next day, not entirely sure. Long hikes and kettlebell swings/snatches/cleans seem to be about the same deal as running.

2

Hey man, instances like this can certainly be frustrating. Most often this is something that does resolve with time but there are some ways with which we can work to expedite the process. Any time it is a getting out of the car and feels unstable event it would get classified as hip flexor related pain. I would recommend starting to run some split squats/rearfoot elevated split squats in place of squats for a few sessions. Odds are you’ll feel the exercise right in the area you are talking about and it will start to resolve. Squatting is fine, but I wouldn’t recommend continuing to do the thing that pisses off your hip. Using a box or pins to work through tolerable range is likely a better approach where you can track gainzz in weight and gainzz on depth of pins.

3

Thanks much, Derek. Out of curiosity (and subject to the usual caveats about structural/biomedical accounts of pain), I gather that tears of the hip labrum can sometimes present pretty much like what I’m experiencing, with the instability and the getting-out-of-the-car symptoms in particular–what says “hip flexor” rather than “hip labrum” to you here and would your recommendations be any different if you thought it was a labrum?