Squat hip pain, soon to start beginner phase 2

Pain & Rehab Forum [Moderated]
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Hey everyone! Big fan of your work and recently started getting my teeth into the podcast.

I recently posted in an old thread about a question I had but I guess the thread is still buried so here goes. It’s a bit of a long one, sorry!

Background
Fluffy 22 year old male, otherwise healthy.

After doing my own thing workout-wise for a number of months, I’ve recently been advised by Jordan to lose weight/waist size and start on phase 2 of the beginner template.

Problem at hand
Main problem is hip pain during the squat. There are two components to this:

Bilateral anterior hip pain/pinching a few inches inferior to the ASIS occurring during the descent of the squat, around parallel. I believe this has been present ever since I started squatting, maybe partly due to overuse as, aside from workouts, I used to constantly do bodyweight squats and practise reaching depth during the day. Pain is not severe enough to stop me from training but does cause annoyance and distraction. It is present from the first warmup set. I believe this can be made tolerable with a narrower stance.

Ache in the anterior hip, radiating all the way into the distal quads. This worsens as weight is added to the bar and reaches a solid 5/6 on the pain scale after set ~2 of squats. It makes it very difficult for me to exert myself properly during subsequent sets.

I do not suffer from any functional or radicular deficits of any kind and I am asymptomatic in day-to-day life, although my hips can be a bit sore and ‘stiff’ the day after a particularly painful workout.

So, given that I will be starting the beginner program in a calorie deficit and don’t want to just detrain, should I:

Remove the painful part of the ROM (pin squats or the like) and slowly look to reintroduce it. This still allows the muscles to be trained.

Substitute in the leg press - it is the only similar movement that causes no pain at all. Then try to progress eg → front squats → high bar → low bar. This similarly allows the muscles to still be trained.

Do something entirely different

Again, apologies for the length, just tried to include everything!

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If there’s a way you can modify your stance and ROM to make the symptoms tolerable for a gradual progression back to normal, that would be a reasonable starting approach.

If not, I’d do option number 2 with the leg press.

It sounds like you have the right idea overall, though!

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Hey Austin, thanks for the response

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Hey Austin, thanks for the response

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Hey Austin, thank you for the reply!

I made some further form adjustments and lowered the load. I was able to titrate up to 100kg squats with tolerable pain (3/10) and completed the next couple of exercises and the prescribed GPP fairly normally.

The general idea I get from Dr Ray and yourself is to work with weight that is tolerable pain-wise rather than assuming that training should be completely pain free. With this in mind, I was planning to continue to squat in this ~3/10 pain range and re-assess in a month or so.

I just wanted to make sure I haven’t perhaps misinterpreted BBM’s general advice here as I am okay with substituting the squat or deloading further to a weight that causes even less pain, if that is what you guys typically recommend.

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Correct. If you’re able to train with tolerable symptoms, and the symptoms don’t get significantly worse in the next 24-48 hours after training, that’s usually OK. If symptoms get markedly worse after training, the dose of training stimulus may be a bit too high.

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Cool. Thanks for the help, doc. I’ll carry on with weight that doesn’t cause grossly disruptive amounts of pain during or after the session.

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Little update for anyone reading. I know I looked up loads of these threads myself so hopefully someone finds this useful.

I still have hip discomfort from squatting but the deload and form adjustment has drastically reduced the pain and I can train more productively, now. My squat is back on the uptick and I no longer dread the lift.

Progress with the symptoms has not been linear as, for example, even the leg press exacerbated my hip a bit and made it achey for a couple of days afterwards. Nonetheless, I further tweaked my form and squatted heavy today and it actually helped my symptoms.

Key helpful points so far:

Keeping a positive attitude
Not obsessing over the symptomology during or between workouts
Improving relationship with pain
Not avoiding the squat out of fear
Keep trying to progress within tolerable pain levels - the beginner template has been super useful in helping me honestly push myself while still autoregulating the weight on the bar
Engaging in hobbies and life outside the gym

BBM’s info is a game changer. I wish I’d found these guys years ago when I had a ‘bad shoulder’ and wasted years on bio mechanical solutions and ideas.

1 Like