Doing lots of squat (especially weighted ones) may lead to some discomfort thanks to muscle soreness, but if you have hip pain while doing this popular lower-body move, something is wrong. The muscles, ligaments and tendons that surround your hips may be too tight or out of balance.
Carmyn Barnes, an accredited exercise physiologist, explains what exactly is going on when hip pain flares up during squats, as well as tips to help avoid and manage the pain, without having to avoid squats altogether.
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You're Experiencing Hip Impingement
Exercises that involve the movement of the hip joint can highlight an impingement, which feels like a pinching pain that's likely to get worse when you squat.
Also known as femoroacetabular impingement (FAI), this occurs when the ball and socket of the hip joint don't fit together cleanly, resulting in friction and possibly pain, stiffness and a clicking sensation.
Stretch the muscle groups around your hip joints to help reduce the tightness and pinching that occurs in a squat, Barnes says. Pick ones that work on your piriformis, hip flexors and groin muscles to help stabilize your hip joints and reduce tightness. Here are three Barnes recommends:
Move 1: Piriformis Stretch
- Lie on your back and place one foot on top of a stability ball. Cross the other foot over your knee.
- Slowly move the stability ball toward you with the heel of your foot, while pressing your crossed knee away from you until you start to feel the stretch in the back of your hip.
- Hold this stretch for 30 seconds and repeat on the other side.
Move 2: Hip Flexor Stretch
- Kneel on the ground, placing your right leg in front of you and bending the at a 90-degree angle.
- Slowly shift your body forward and squeeze your glutes.
- Raise your left arm and stretch to the right until you feel a stretch in the front of your pelvis.
- Hold this stretch for 30 seconds, then switch and repeat with your left leg.
Move 3: Butterfly Stretch
- Sit with your back straight and your legs comfortably out in front of you.
- Place your feet flat on the floor, bend your knees, and rotate your thighs out toward the floor, finishing with the soles of your feet touching each other.
- Slowly push your knees to the floor until you feel a stretch in your groin.
- Hold the stretch for 30 seconds, rest and repeat.
A December 2016 review of femoroacetabular impingement treatments published in the journal Sports Medicine and Arthroscopy Review shows that if non-surgical management of FAI fails, then surgery is the next option.
The good news is that surgical treatment for FAI shows positive results and many FAI surgeries are done arthroscopically (a minimally invasive procedure).
Your Hips Are Tight
If your hip muscles — specifically the hip flexors at the front of your hips — are too tight, you may experience pain when squatting, Barnes says. Tight hip flexors may also result in poor posture and pain in the lower back, according to the International Sports Sciences Association.
And when hip flexors are tight, individuals see less gluteus maximus activation when squatting, according to a study published in the International Journal of Sports Physical Therapy in December 2015. Meaning that in addition to some hip pain, you might not even be reaping the full muscle-building benefits of your squats.
“Prevention of hip pain can be simple and easy: stretch regularly and strengthen and maintain your muscles appropriately, especially before attempting to add significant weight onto your squat,” Barnes says.
Preparing your hip flexors before squatting could save you a lot of pain and let you focus on working your thighs and glutes. Try one of these stretches:
Move 1: Simple Hip Flexor Stretch
- Kneel down and place your left foot in front of you, bending the knee and placing your foot flat on the floor.
- Press your hip forward, pushing your pelvis down while keeping your shoulders back until you feel a stretch in your hip.
- Hold the stretch for 30 seconds.
- Repeat with your right foot and do the set again.
Move 2: Quadriceps Stretch
- Stand straight and hold on to a table or chair.
- Bend one knee and grab the top of your bended-knee ankle with your same-side hand.
- Pull your foot toward your butt until you feel a stretch in your quads.
- Hold the stretch for 30 seconds and release.
- Repeat this stretch on the other side and do the set again.
Your Hips Are Out of Alignment
Pain in your hips during squats could also be the result of your hip joints becoming misaligned, which is made worse when the hip ball and socket joint moves during a squat.
Most commonly, this is a result of prolonged sedentary positions while at a desk or driving, which can shorten the hip flexors and alter the way the hip joints move. But squats themselves could also lead to hip misalignment, Barnes says. Exercises that occur through a singular plane of motion can cause a muscle imbalance if repeated too often.
Muscle imbalances and hip misalignment can be addressed with simple changes to your daily routine and additional stretching.
First, ensure you take breaks throughout the day to stretch during prolonged periods of sedentary activity. And second, make sure to incorporate occasional movements through other planes while squatting (rotating, punching, kicking or leg lifts), Barnes says.
Here are some stretches Barnes recommends:
Move 1: Runner's Lunge
- Stand up straight and take a large step forward with one leg, settling into a comfortable position.
- Slowly bend the front leg forward while keeping the back leg straight.
- Tuck your tailbone under and keep pushing the front leg forward until you feel a stretch in the front part of your back leg.
- Hold the stretch for 30 seconds and repeat on the other leg.
Move 2: Seated Wide-Legged Forward Fold
- Sit on the ground with a straight back and your legs directly in front of you.
- Spread your legs while keeping them flat on the ground, creating V shape.
- Gently lower your upper body out in front toward the ground until you feel a stretch in your upper legs.
- Hold the stretch for 30 seconds.
If you still feel pain after trying these stretches, Barnes recommends "visiting a health professional, such as a physiotherapist or sports physician, who is able to diagnose. They may provide some strengthening or stretching exercises, or in worse cases, they may recommend a scan as a next step."
- Sports Medicine and Arthroscopy Review: "Femoroacetabular Impingement: A Review"
- International Journal of Sports Physical Therapy: "EFFECT OF RESTRICTED HIP FLEXOR MUSCLE LENGTH ON HIP EXTENSOR MUSCLE ACTIVITY AND LOWER EXTREMITY BIOMECHANICS IN COLLEGE-AGED FEMALE SOCCER PLAYERS"
- International Sports Sciences Association: How to Identify and Correct Tight Hip Flexors
- American Academy of Orthopaedic Surgeons: Femoroacetabular Impingement