Hi BBM crew,
I’d like to start by saying I greatly appreciate all of your content. Your information on back pain helped me get through a 3 year stint of pretty nasty back pain, and your general pain information has helped me push through patellar and quad tendinopathy a few times.
I’ve been dealing with a weird hip issue for 5 or so months now. Your material has helped me get past many aches and pains in the past, but this one has been trickier.
At the time, I was following Greg Nuckols SBS 5x RTF programming. My lower body E1RMS were around 600 pound high handle trap bar deadlift, 525 conventional deadlift, 355 high bar squat and 305 front squat at 185 pounds body weight.
The pain is in my right hip, and basically occurs during any movement involving hip external rotation and abduction. So, the bottom of the squat is quite painful, and where most of my woes are coming from. Squatting with a very narrow stance feels better (not pain free but better), but I have incredibly long legs and this squat form basically has me horizontal in the bottom. Squatting with a band around my knees makes it worse. I can also generate the pain by using the cue “screw your feet into the floor”. During these types of movements, the pain kind of radiates through the entire hip, which initially made me think it was an adductor strain. I can also generate this pain by flexing and externally rotating my right hip as if I was putting socks on. However, if I use my hands manually move my leg through this ROM, there is zero pain.
Possibly unrelated, but there is also a feeling of “tightness” in my right lateral hip (near the TFL). If I stand in a wide stance and bend towards my right leg, it feels “locked up”, and is quite uncomfortable. This is also reproducible by sitting in a “pancake” position. Benching with an arch/leg drive causes this tightness as well, but no pain.
I have modified my training the past 5 months or so while I’ve been trying to deal with this. At first, I added in some direct isolation work (banded clamshells, single leg RDLs and copenhagen planks). The copenhagens were slightly painful in the “lockout” position, but the rest of the work was relatively pain free. I also massively reduced the load on my primary squat to 3x12 303 tempo work, and here even 45 pounds was painful at first. I swapped my secondary squat to Bulgarian split squats for sets of 12 as well, and raised the reps/lowered the RPE of my deadlift training (deadlifts only really hurt near maximal weights as this time). I had small amounts of success with this, but even after 2 months, I was still in pain squatting 115.
After this point, I further experimented with box/pin squats and sumo deadlifts. I found that box squats were substantially more painful, and sumo deadlifts don’t hurt, but rather just feel tight and uncomfortable. My lower body training has now looked like the following:
Day 1 -
High Bar Squat - 3 sets of 12. Right now I can tolerate up to about 135 pounds before significant pain sets in. Can’t rate rpe here.
Banded clamshells - 3x20
Day 2 -
Sumo Deadlift - 10 @ 6, 10 @ 7, 10 @ 8 - generally pain free, just general hip tightness/discomfort
RDL - been doing 3x8 at 255 here. Going above 275 causes some pain. Can’t rate RPE here.
Day 3 -
Front Squat - 3 sets of 12. Right now I can tolerate up to about 135 pounds before pain sets in. Can’t rate rpe.
Reverse Nordic - 3 sets of 12. Doing these as I suspect there may be some hip flexor involvement (read the point about benching causing hip tightness). Pain free
Day 4 -
High Handle Trap Bar - 1 @ 8, 5x5 @ -25% - I can push these without pain, so this has been my “heavy” movement.
Copenhagen Raises - 3x12-15 - only the last few reps will be painful, and near the lockout position.
My main concern is that my hip function/pain free ROM has not improved at all in the past 5 months. Any external rotation hurts, and I still cannot bring my foot to my chest (think putting on a sock) without substantial pain. I’ve tried isolating this directly by laying on my right side on a bench, letting my right shin hang off and externally rotating my hip, but this causes tremendous pain.
If it is any help, there is zero contact pain in the greater throchanter region, and sleeping posture is not affected (unless I roll over and use my hips to do so).
If you guys have any advice for me regarding my symptoms and rehab approach, it would be greatly appreciated.