Anterior hip pain is pretty common in powerlifters, however, this blog isn’t designed to diagnose what the issue with your or your athletes hip is. I want to talk about our experiences at Strength Culture with people who experience hip pain whilst powerlifting and more specifically, squatting. As a strength/ powerlifting coach there are some big rocks that can be attacked when athletes complain of hip pain in the big lifts, some low hanging fruit:
1) Controlling Extension Bias
Heavy squat, bench press and deadlift programs with large amounts of per session and weekly volume adds up over time. This consistent exposure to un accounted extension driven movement can lead to a pretty consistent stream of ‘overuse’ lifting injuries, anterior hip pain being one of the most prominent.
When you dump a pelvis into an aggressive anterior tilt you close off the space available for hip flexion articulation of the femoral head moving inside the acetabulum, the ball inside the socket. This reduced space often leads to a ‘pinching’ feeling at the front of the hip in deep bilateral hip flexion (squatting). More often than not, this ‘pinching’ can be resolved by neutralising the lumbo-pelvic region by controlling the bias to extension patterns.
We take our athletes through a series of proprioceptive motor control and breathing drills to help manage this extension bias that arises from heavy barbell training and help to create a better understanding of what a neutral lumbo-pelvic relationship feels like:
- 90/90 Hip Lift
- Dead Bug Progressions
Once our athletes have created context for what a neutral lumbo-pelvic position feels like we apply that to the squat itself, ensuring our athletes maintain the new found ‘neutral’ position throughout the entirety of the squat.
2) Create Proximal Stability
It is well understood that proximal stability leads to better functioning shoulders from both a stability and mobility standpoint. The same applies to the hips, when they have a strong foundation supporting their actions, the hips work better!
Intra-abdominal pressure (IAP) is pressure created inside the abdominal cavity through diaphragmatic breathing. When the diaphragm draws down through inhalation it reduces the space inside the abdominal cavity, hence, increasing the pressure. This pressure helps to stabilise the entire lumbo-pelvic position. However, the diaphragm really only functions in its entirety when the rib cage is ‘down’ creating a zone of apposition (ZOA). This ZOA is sub optimal in an extended position so if you are yet to address the lifter’s ‘extension bias’ refer back to point 1 of this blog.
At Strength Culture we create context around IAP through the plank, an extremely basic core exercise that offers a lot of teaching points for controlling the sagittal plane.
Correct IAP and bracing helps to hold and maintain the neutral position that has been created by point 1.
3) Core Strength and Endurance
This point is pretty simple, once neutral positions have been understood and are maintained with IAP it’s important to strengthen the musculature holding the rib cage and pelvis in alignment. We program core and bracing drills daily for our lifters. Any combination of anterior, lateral and transverse core drills progressed with both external loads and timed drills work wonders! Our favourites:
- Plank Progressions
- Dead Bug Progressions
- Cable Chop Progressions
- Loaded March Variations
4) Foot and Ankle Stability
The feet provide contact with the floor, where our global stability starts in ground-based movements like squatting. If the feet are unstable we begin to see upstream form break down, more often than not resulting in internal rotation and adduction of the hip (knee valgus). The glutes, which are responsible for external rotation and abduction at the hip, directly oppose this knee valgus movement, meaning sub optimal glute recruitment, leading to reduced stability within the hip joint and potentially hip pain.
We coach that classic ‘tripod foot’ teaching at Strength Culture, big toe, little toe and heel all working together to create a strong and stable arch.
These fundamentals of human movement will be covered comprehensively in our upcoming Squat and Deadlift Seminar on April 28th. Tickets available through the button below!