Hip pain during squats

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My hip hurts when I squat.

Post by Sam Donaldson, APA Sports & Exercise Physiotherapist

Why does my hip hurt when I squat?

Hip pain during squatting is a frequent complaint with many gym goers and can be a big frustration. It can cause people to shift body weight, change exercises, avoid squatting, lose motivation and sometimes even discontinue gym-based exercise all together. 

Squatting related hip pain falls under a category of anterior hip pain that relates to a dysfunction of the hip as it moves into a flexed position. The hip itself is a complex ball in socket joint, with labral tissue increasing the ‘socket’ component, and muscles that control movement in all planes of motion.

There can be several anatomical, morphological, or motor control causes for the hip to move in a way that might cause pain.
Typically, what we see is that the tissue around the superior edge or anterior edge of the acetabulum (hip socket) becomes irritated either through direct compression or through excessive load. 

The compression may be caused by bony growth from the neck of femur, or even from the acetabulum (cam or pincer type lesions). This can cause the labral tissue, capsule or muscular attachments to become ‘pinched’ or otherwise irritated when the hip moves into the flexed position during a squat.

There are several reasons that this might be happening, and therefore several solutions. These may include:

  • Reduced ankle range of motion
    • Joint restriction
    • Calf muscle tightness
  • Retroverted femoral torsion
  • Retroverted acetabulum
  • Weak deep gluteal muscles
  • Poor abdominal and trunk muscle control
    • Excessive lumbar extension
    • Anterior pelvic tilt in motion
  • Inherent or developed posterior laxity of the capsule

Importantly, there is a solution once the contributing factors are evaluated. So, it is important that you don’t give up! Seek help by talking to someone who can assess your squat and consider how your body moves as one system to achieve the movement you are after.

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