fysiotherapie Amsterdam Oost

Fixing the squat and deadlift with hip pain.

Managing Hip pain in CrossFit and weightlifting. 

People with hip problems tend to have a painful or restricted amount of hip flexion or bending of the hip. Often times going through (deep) flexion can keep a hip painful in initial stages of rehab or with conservative care.

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In order for “irritated" hips to settle the amount of flexion in daily living and sports needs to be reduced to ideally no more then 90 degrees of bending

So how do you do this and keep training at the same time?

When we look at CrossFit or weightlifting the most common moment of hip flexion is with the squat, hip hinge variations (deadlifts, kb swings etc), Split squats/lunges, box jumps and leg/knee raises. 

For this article we focus on the squats and deadlifts. 

A simple management strategy is to regress to other squat variations that put less flexion demand on the hip.  Ideally this wil give you less pain during or after training sessions. This will allow for fysio rehab to progress or for you to manage your situation through conservative care.

Here are 5 squat examples in order of most to least amount of hip flexion. The angle is viewed between the bottom half of the vertical line and the horizontal line. As you can see the angle gets slightly less with each variation. The Low bar back squat gives the most hip flexion and the box/bench squat (when the hight is priorate for the length of the trainee) has the least. 

Low Bar Back Squat - highest amount op Hip bending

Low Bar Back Squat - highest amount op Hip bending

High Bar Back Squat

High Bar Back Squat

Front Squat, a good place to start when regressing from the back squat

Front Squat, a good place to start when regressing from the back squat

Goblet Squat, slightly less hip bending then the front squat.

Goblet Squat, slightly less hip bending then the front squat.

Bench squat. The least amount of hip bending and therefore the safest.. Can be loaded with a barbel or Goblet. Preferably you want to have an external stop at 90 degrees. So here we would want a slightly higher bench.

Bench squat. The least amount of hip bending and therefore the safest.. Can be loaded with a barbel or Goblet. Preferably you want to have an external stop at 90 degrees. So here we would want a slightly higher bench.

So for instance: if you find yourself having hip pain in the high bar back squat you regress to the front squat for a month.   You should immediately or within a week feel a difference in pain during the session or in sensations of pain of stiffness in the next day. If this is not the case regress to a different version with less hip flexion.

Once you are pain free and happy with your training you progress one level at a time in difficulty and train that for 3-4 weeks. For instance: from front squat to high bar back squat. Then after 3-4 weeks progress to the low bar back squat. This is an example, how quickly adaptation takes place completely depends on the person, severity of injury and fitness levels.

For the deadlift its a bit easier. As you can see on the below images the amount of hip flexion on a conventional deadlift is more then 90 degrees. So in order to reduce the amount of bending we regress the deadlift to the hang position. (slightly lower then the next image) 

Conventional deadlift with over 100 degrees of hip flexion

Conventional deadlift with over 100 degrees of hip flexion

RDL, about 90 degrees of flexion. Normaly you go slightly lower.

RDL, about 90 degrees of flexion. Normaly you go slightly lower.

With KB swings: let the bell swing between the knees, so that the torso does not bend  more then 45 degrees forward.   This should take care of excessive knee or hip bending.

If you have some hip and groin problems give this a try, but remember that it is advised to always seek the help of a physiotherapist for a good assessment if you have not done so!