Lateral hip pain during a squat is typically felt over the greater trochanter, the bony prominence on the side of the upper thigh. For those involved in lifting and strength sports, this discomfort signals that the hip stabilizing structures are under excessive stress. While persistent pain requires a formal diagnosis from a professional, understanding the underlying causes is the first step toward correction and relief.
Anatomical Origins of Side Hip Pain
The primary anatomical structures involved in lateral hip pain are the tendons and fluid sacs surrounding the greater trochanter. This condition is often grouped under the term Greater Trochanteric Pain Syndrome (GTPS). The pain typically arises from tendinopathy—inflammation or degeneration—of the gluteus medius and gluteus minimus tendons. These muscles stabilize the pelvis during movement and become strained or compressed during a poorly executed squat.
Gluteal tendinopathy results from repetitive overloading or compression of the tendons. During a squat, moving the thigh across the body’s midline compresses these tendons and the underlying bursa against the femur, irritating the tissue. The primary issue is usually tendon pathology, as isolated trochanteric bursitis (inflammation of the fluid-filled sac) is less common. The bursa often becomes inflamed secondary to the tendon issue due to increased friction or compression.
The iliotibial (IT) band, a thick band of connective tissue running down the outside of the thigh, can also contribute to lateral hip discomfort. Although rarely the sole cause of squatting pain, a tight or irritated IT band pulls on the hip structures. This tension increases compressive forces on the gluteal tendons and bursae. The resulting combination of tendon issues, bursal inflammation, and IT band tension creates the complex symptoms of lateral hip pain.
Squatting Technique Errors That Cause Lateral Pain
Injury to the hip structures often results directly from improper mechanics that strain the lateral stabilizers. A common technique flaw is knee valgus, where the knees collapse inward toward the midline during the squat. This inward collapse shifts load distribution, causing the thigh bone to move into adduction and internal rotation. This movement directly compresses the gluteus medius and minimus tendons against the greater trochanter, often preceded by gluteal weakness.
Stance width and foot angle significantly influence hip mechanics during the squat. A narrow stance or feet pointed straight forward limits the hip’s natural external rotation, potentially causing pinching or increased lateral compression. Turning the toes slightly outward (15 to 30 degrees) can open the hip joint, allowing for a deeper, pain-free squat and reducing knee valgus. However, an excessively wide stance can also introduce a valgus moment, requiring careful individual adjustment.
Failing to execute a proper hip hinge—pushing the hips back to initiate the squat—can result in an excessive forward lean of the torso. This shifts the center of mass, forcing the lateral hip stabilizers to work harder to prevent pelvic tilting. Latent issues in the gluteal tendons become exacerbated when the squat is too deep or the load exceeds the lifter’s stability capacity. Overloading these sensitive structures often occurs by squatting past a pain-free depth or attempting loads that cause a visible hip shift.
Immediate Pain Management and Load Modification
When acute lateral hip pain occurs during a squat, immediately cease the activity that triggers the sharp sensation. Continuing to push through the pain will aggravate the irritated gluteal tendons and bursa. For immediate relief, applying ice to the painful area around the greater trochanter for 15 to 20 minutes can help manage acute discomfort.
Temporary training modifications are necessary to allow the tissue to recover. This involves reducing the weight or modifying the exercise to a pain-free range of motion, such as performing partial or box squats. Switching to alternative exercises that do not provoke lateral pain, like machine-based movements, helps maintain strength without stressing the injured area. Avoiding activities that involve crossing the legs or sleeping on the affected side can also reduce compressive forces on the tendons.
Recognize warning signs that indicate a need for professional medical evaluation. Consult a doctor or physical therapist if the pain persists while resting, if you cannot bear weight, or if you feel a clicking or catching sensation in the hip. These symptoms may suggest a significant injury requiring a formal diagnosis and structured rehabilitation plan. Seeking help early prevents acute irritation from developing into a chronic condition.
Targeted Strength and Mobility for Prevention
Long-term prevention requires strengthening the gluteus medius and gluteus minimus. These muscles are responsible for hip abduction and stabilizing the pelvis during single-leg stance, a significant component of the squat movement. Specific exercises that isolate these lateral stabilizers are effective for building the necessary capacity.
The clamshell exercise, performed with a resistance band around the knees, is a foundational movement targeting the gluteus medius through controlled hip external rotation. Side-lying hip abduction, where the top leg is lifted while maintaining a neutral pelvis, is another direct strengthening method. Progressively loading these movements, starting with bodyweight and advancing to resistance bands, helps build the tendon’s resilience over time.
Proprioception and stability drills improve the mind-muscle connection needed during a squat. Exercises like single-leg bridges or banded walks train the glutes to activate reflexively, controlling the pelvis and preventing the knee from caving inward. Incorporating hip flexor and tensor fascia lata (TFL) mobility work helps balance the hip complex. Tightness in these opposing muscle groups contributes to altered mechanics and increased tension on lateral hip structures. A comprehensive approach combining targeted strengthening with movement control drills provides the best defense against recurring lateral hip pain.