Hip pain after squatting is a common experience, often signaling a need for technique adjustment or muscle activation rather than a severe injury. The location of the discomfort provides the first clue about the underlying cause. Pain felt at the front of the hip or in the groin typically relates to structures deep within the joint or the powerful muscles that flex the hip. In contrast, pain on the side or outer back of the hip usually involves the stabilizing muscles and tendons running along the outside of the pelvis. Addressing the problem starts with understanding this distinction.
Common Anatomical Causes of Squat-Related Hip Pain
Pain presenting in the front of the hip or groin is frequently diagnosed as hip flexor tendinitis or a strain in the muscles responsible for lifting the leg. This irritation often arises when the hip flexors, particularly the iliopsoas, are overused or forced to stabilize the pelvis due to weakness in the gluteal and core muscles during the squatting motion. The repetitive stress of deep hip flexion, especially when coupled with heavy loads, can cause inflammation where the tendon attaches near the pelvis.
Pain felt on the side of the hip, centered over the bony prominence of the upper thigh, often suggests gluteal tendinopathy or trochanteric bursitis, frequently grouped as Greater Trochanteric Pain Syndrome. Gluteal tendinopathy is an overuse injury of the gluteus medius and minimus tendons, which stabilize the pelvis and prevent the knee from collapsing inward. Bursitis involves inflammation of the fluid-filled sac that cushions the tendons in this area.
A sharp, distinct pinching sensation felt deep in the hip, especially at the bottom of a deep squat, may indicate Femoroacetabular Impingement (FAI). FAI is characterized by an abnormal contact between the ball (femoral head) and socket (acetabulum) of the hip joint. The deep flexion of a squat forces the thigh bone against the socket rim, causing a painful pinch. If persistent, this structural issue requires professional assessment to determine the best approach for managing the bony contact.
Biomechanical Errors in Squat Form
The mechanical execution of the squat frequently dictates which anatomical structure is stressed, making form errors a primary cause of hip pain. The choice of stance and depth is particularly influential. A stance that is too narrow or deep, especially with the toes pointed straight ahead, increases the likelihood of Femoroacetabular Impingement (FAI). This positioning forces the femur against the hip socket rim, causing the characteristic pinching sensation. Conversely, adopting a slightly wider stance with a moderate toe-out angle can provide necessary joint clearance by allowing the hip to externally rotate.
Another common flaw is knee tracking, often seen as the knees collapsing inward during the ascent or descent, a movement known as valgus collapse. This inward motion places excessive stress on the outer hip muscles, specifically the gluteal tendons and the iliotibial band (IT band), which are strained as they attempt to stabilize the pelvis. Valgus collapse is typically a symptom of weak gluteus medius and minimus muscles that are unable to maintain proper knee alignment over the foot. Observing the knees in a mirror or filming a set can help identify this instability.
Insufficient hip mobility, coupled with an inadequate warm-up, forces the body to compensate during the squat. Tightness in the hip flexors or limited ankle dorsiflexion can prevent the torso from maintaining an upright position. When the hip cannot achieve the necessary range of motion, the pelvis often tips forward (anterior pelvic tilt) or the lower back rounds. This compensatory movement places undue strain on the anterior hip structures, accelerating the onset of hip flexor pain or impingement symptoms.
Immediate Action and When to Seek Medical Attention
If pain occurs during a squat, the immediate priority is to modify the activity to eliminate the discomfort while promoting healing. Temporary modifications include reducing the load or switching to a safer variation like the box squat. The box squat limits the depth of the movement, ensuring the hip stays within a pain-free range and avoiding the deep flexion that often triggers pinching or tendinitis. Another option is the goblet squat, which uses a weight held in front to encourage a more upright torso, reducing hip compression.
For acute soreness or strain, initial management should focus on Rest and Ice. Rest involves avoiding activities that recreate the pain, though gentle, non-painful movement is encouraged. Applying ice to the painful area for 15 to 20 minutes several times a day during the first 48 hours helps manage localized inflammation. Since compression and elevation are less practical for the hip joint, the primary focus should be on temporary load reduction and utilizing ice to calm irritated tissues.
Targeted mobility and strengthening drills should be incorporated to address the underlying muscle imbalances. Glute activation exercises, such as banded glute bridges and clamshells, are specifically designed to “wake up” the hip stabilizers before a workout, ensuring they engage correctly during the squat. These exercises help strengthen the gluteus medius, which is crucial for controlling knee valgus and stabilizing the lateral hip. Avoiding aggressive, painful hip flexor stretching is advisable, as the pain may be due to tissue irritation rather than simple tightness.
Recognize when the issue requires professional medical attention beyond simple muscle strain. Consult a physician or physical therapist if you experience a sharp, stabbing pain that persists for more than 48 hours after stopping the activity. Other warning signs include a distinct clicking, catching, or locking sensation within the joint, which can indicate a deeper issue like a labral tear or FAI. Ignoring these mechanical symptoms risks further injury to the cartilage and soft tissues of the hip joint.