Fixing Hip Impingement with your Squat

Hip impingement, also known as Femoroacetabular Impingement (FAI), can be a significant hurdle for athletes, active adults, and fitness enthusiasts, particularly when it comes to squatting. This condition often manifests as a pain or pinching sensation in the front of the hip when going into a deep squat position. However, with the right approach focusing on mobility, strength balance, squat mechanics, and programming, you can overcome this challenge. As a leading performance physical therapy business in Jupiter, FL for Active Adults, CrossFit Athletes, Paddle-boarders, and functional fitness enthusiasts, Hercules Performance and Physical Therapy is here to guide you through this process.

1. Mobility

Mobility is a crucial aspect of overcoming hip impingement. It's about more than just flexibility; it's about the ability to move your joints through their full range of motion. For those dealing with hip impingement, hip mobility exercises can help alleviate the pain and improve function almost immediately. These exercises aim to increase the flexibility of the hip muscles and improve joint mobility, reducing the risk of impingement during squatting. Here are two exercises in the video below that will help clean up that stuck hip and improve your pinching sensation in the Squat almost immediately. 

2. Strength Balance

Strength balance is another key factor in managing hip impingement. Often, muscle imbalances can contribute to hip impingement, with certain muscles becoming overactive while others are underactive. An individual strength balance program program can help correct these imbalances. The common imbalances include glutes, glute meds, core, and Single leg strength imbalances especially in SL RDL and SL step ups. Include in your training, single leg strengthening including step ups and RDLs to improve the side to side strength difference to allow for a more even squat pattern, decreasing the likelihood for that pinching sensation in the squat. 

Also for strength balance, spending time in the position is huge for improving strength balance. Often we bounce out of the bottom of squat and spend maybe less than a second in a key position for hip health, squatting performance, and reducing hip impingement. Follow the routine below to improve your strength balance for hip impingement in the squat. 

•  For Barbell Back Rack Step Ups: Aim for 1-2 x a week of 3-4 sets of 12-15 reps at 40-50 % of your back squat 12 rep max. 

•  For Barbell RDLs: Aim for 1x a week of 3-4 sets of 8-12 reps at 35-50% of deadlift 8 rep max.

•  Sandbag or Kettlebell Bottom Squat Hold: 3x a week in your warm up, aim to hold the bottom of squat at about 15-20% of 1 rep max with a kb or sandbag for 20-30 sec x 3-4 sets. Relaxed breathing in this position. 

3. Mechanics of Squat

The way you squat can either alleviate or exacerbate hip impingement. Proper squat mechanics involve maintaining a neutral spine, engaging the core in a 360 pattern, and ensuring the knees track over the toes with proper heel to heel spacing for your hip anatomy. A performance movement coaches at Hercules  can provide personalized advice on squat mechanics, helping you to squat safely and effectively despite hip impingement. If you'r on your own, film your squat from the front and sides to make sure you'r checking off the list below. This is not an exhaustive list, but a great head start! 

•  Neutral spine

•  Engaging the core in a 360 pattern like a soda can

•  Ensuring the knees track over the toes from front angle and over the toes from the side angle

•  Proper heel to heel spacing for your hip anatomy. ( This tends to be about shoulder width apart)

•  Engage squat at the hips and then sit straight down with a brace in the core

•  From side view, look for shin angle and low back angle to be about the same in a back squat. (Mechanics change a bit for the front squat) 

4. Programming for Squatting with Hip Impingement

Finally, the right programming is essential for squatting with hip impingement. This involves a gradual approach, starting with pain-free exercises and slowly increasing intensity and volume as your hip mobility, strength balance, and mechanics improve. It's also important to include rest days to allow for recovery and to avoid exacerbating the impingement. To keep the hip impingement or pinching away, you must build back stronger and more mobile than you were prior. This involves progressive individual programming to keep this problem from rearing its ugly head again especially if you are a CrossFit athlete, Paddle boarder, or function fitness enthusiast in Jupiter, FL. 

In conclusion, hip impingement doesn't have to mean the end of your squatting routine. With a focus on mobility, strength balance, proper squat mechanics, and smart programming, you can continue to squat safely and effectively. If you're in Jupiter, FL, and need help managing hip impingement, our performance physical therapy team is here to help.

If your active adult, Cross-Fit athlete, functional fitness enthusiast, dealing with hip impingement or pain and need more of an individual approach in the Jupiter, Juno Beach, Tequesta, FL area, call Hercules Performance and Physical Therapy at (561) 320- 1602 or Schedule a Free 15 Min Discovery call.

-Dr. Alec Spano, PT, DPT, CSCS, Cert DN, PN1