Q: I've been getting a bit of pain in the front of my hips when squatting. I'm not sure whether it's the hips flexors or something else. Squats with a stance around shoulder width are fine, as are any hip flexor exercises that work my legs in line with my body.
It's only when I squat with a slightly wider stance or do overhead squats that my hips are bothered. It's only when I do leg raises with my legs apart, making a “Y” shape with my body, that I really feel the irritated muscle working. Although these do seem to help it rather than cause it pain.
Do you have any idea what this could be? Or, tips on how to strengthen the area to avoid it? Thanks for any insight you can offer.
A: Femoral anterior glide syndrome is a classic problem in people with poor lumbo-pelvic function (overactive hamstrings and lumbar erectors coupled with weak glutes). The hamstrings don’t exert any direct control over the femur during hip extension; their distal attachments are all below the knee. So, as you extend the hip, there is no direct control over the head of the femur, and it can slide forward, irritating the anterior joint capsule. This will give a feeling of tightness and irritation, but stretching the area will actually irritate it even more.
The secret is to eliminate problematic exercises for the short-term, and in the meantime, focus on glute activation drills. The gluteus maximus exerts a posterior pull on the femoral head during hip extension, so if it’s firing to counteract that anterior glide caused by the humerus, you’re golden. We outline several excellent drills in our Magnificent Mobility DVD ; when handled correctly, you should see almost complete reduction of symptoms within a week.
Lastly, make sure that you're popping your hips through and CONSCIOUSLY activating your butt on all squats, deadlifts, good mornings, pull-throughs, etc. Incorporate some single-leg work as well. For now, though, keep your stance in for a few weeks, stay away from box squatting, and get some foam rolling done on your adductors, quads, hip flexors, ITB/TFL, and piriformis.