Psoas Tendonitis

Hi Austin and Jordan. First off, a great thank you for the work you do for the fitness community.
So, I’ve been dealing with psoas pain/inflamation/tendonitis (still not 100% sure, not even physiotherapists no accuretly) for the last year. I particulary hurts on squats, deadlifts are just fine. I followed the same protocol three times now: Get off squats all toghether (comp low bar squats are the worst for pain) for a month, just do bulgarian split squats and leg press which don’t hurt. Then I slowly introduce front squats which don’t generate pain, and I very slowly add weight throughout the weeks, after, a month, when I’m at a decent weight (and no pain) with my front squat, I start High Bar squatting, same process till I low bar squat, and after 2-3 weeks of low bar squatting, same pain starts again, still with very submaximal loads.

Since I’m a competitive powerlifter I can’t just ditch the low bar squat, cause my high bar is waay weaker. Any ideas? I’ve had other tendonitis cases before and it was just a matter of time, but it’s been a year since my Squat has barely increase anything at all (from 150kg to 160kg in a year where I gained 6 kg of weight). My deadlift is way outperforming my squat

What does the rest of your training program look like? Could you elaborate on your symptoms and mechanism a little more?

I’m currently squatting x2 a week, 1 front squat session working up to a single @7 and 2x2 backdowns, 1 high bar squat session with the same scheme. Both with a pause since I find it better on my hips, and volume is low since I found I dealt better with the pain that way. As long as I’m not above RPE 8, higher loads don’t feel particularly worse, but if I’m doing 5 sets, I’d usually feel worse as the sets go by.

Regarding the symptoms, is not a huge deal of pain but it’s been consistent for a year (when I stop low bar squatting for a couple of weeks, I can get to it again with no pain, but after a couple sessions it starts again), so that’s why I’m worried. I feel it in the inside part of my right iliac crest, semi superficial and a little bit lower aswell. I never got it during the descent or pause, when I get the pain is usually when initiating the concentric phase of the lift, and as I said, I feel it the most when Low Bar Squatting, less on High Bar and barely at all in the Front Squat.

The issue is, I know Front Squats may be the way to go programming wise, but I expect to compete 2-3 times a year and I can’t be front squatting in competition (not even High Bar), and it’s been going on for a while now. Thanks!

Correction: Sartorius tendonitis