Pain Below Hip running down to outside of knee

Hey Docs,

Some background:

Currently running NLP, with plans to begin bridge when I can no longer progress linearly. And will eventually go on to intermediate programming from your templates after that.

Male/Age 27

Height/Weight 5"6’/163 up from 147
Squat 215 up from 135
DL 255 up from 135
BP 140 up from 95
OP 90 up from 45

Some more background: My right leg has a minor defect that’s had no effect on me throughout my life so far (except my mother says I had a corrective base on my leg when I was around 2 years old). Basically my right leg naturally rotates slightly inward.

Also, I have had a left ankle sprain that is virtually recovered at this point, since the beginning of my training.

I’ve been progressing fine in all my lifts with the exception being this pain below the outside of my right hip on my thigh that flares up on heavier weight when doing squats. The pain did not come on suddenly during a training session. It was just something I noticed one day, and has progressively been getting worse. Some training sessions its manageable, others its debilitating. I usually feel a dull pain outside of my right knee when the pain below my hip flares up but the main location of the pain is definitely on the outside of my thigh below my hip. Advil seems to make the pain go away temporarily but its becoming increasingly more painful to squat at heavier weights. Today the pain was horrible during squats and I could hardly walk after my first 2 work sets so I took 40 pounds off the bar for my 3rd set, which also was done in immense pain. I find it really difficult to describe the way the pain feels during/after squatting. I’d characterize it I suppose as a burning/stinging/intense cramping sort of pain. At times the pain also resembles that of a muscle pull or strain, but I’ve never injured this area of my body before and I don’t have medical training so there can only be so much accuracy to the way I’m categorizing it.

I’m wondering if this sounds more like an IT Band issue or TFL issue or something else… Also wondering what I can do to work through the pain and continue to advance in my lifting, while keeping the pain at a manageable level. I’m familiar with your philosophies on pain as discussed in detail during recent VLOGs

I’ve sought advice on your facebook group as well as from friends of mine who powerlift. Some have suggested go right to the Bridge and begin working with RPE. Others have suggested stay on LP considering I’m able to continue to put weight on the bar if it wasn’t for this pain. I’ve also heard suggestions to adjust range of motion to a level that manageable with the pain, and another suggestion has been to not squat for a while or deload. I’ve also heard it suggested to try variations rather than a traditional low-bar squat.

The past few days I have been experiencing a dull pain below the hip upon awakening on mornings after training specifically. I’ve been using advil pretty much daily, and I’m not a person who likes using medicine for anything really. The fact that advil relieves me pretty much completely, for a period of time, of the pain within a half hour or so of ingestion every time leads me to believe the pain is an inflammation of sorts. But I am not a doctor and I’m surely open to any and all corrections.

Any feedback would be much appreciated.

Thank you in advance.

Hey, sorry to hear about the hip issue.

Overall, this sounds like a load management issue.

Our typical approach in these scenarios, in order based on symptom response:

  1. Decrease external intensity (load being lifted)
  2. Alter range of motion to tolerable levels of symptoms
  3. Sub in variants of exercises to maintain activity

You may also benefit from a consult with us: Contact Us | Barbell Medicine.

The premise isn’t to train pain free but rather with tolerable levels of symptoms (individualistic to you).

How long have you been running the NLP? I highly advise to begin using RPE.

@Michael_Ray ive been on NLP for about 6 weeks. This morning in the gym wasn’t as painful but was still pretty bad. I only worked up to 135 pounds for my work sets but couldn’t do a 3rd set because the pain sets in worse after I put the barbell down. It’s not the type of pain I’m used to as I can’t gauge how bad it feels til after each set.

Gotcha. Yeah, I’d recommend decreasing load as much as necessary before altering range of motion. However, if you find yourself at an empty barbell and symptoms still aren’t tolerable then modifying range of motion with a box squat would be appropriate to allow training with tolerable levels of symptoms.