Common Injuries (the hip)

It is important to understand that all bodies are different and all injuries are different. My reason for these posts is to possibly open you eyes to alternative ideas for therapy. It is NOT to diagnose YOUR injuries. If you have similar pains, you should talk to a professional to verify that there is not further damage and you will not be causing permanent injury by treating it in some way.
Crossfit has a huge potential for injury, as it does for amazing results. Be smart with your training and you will last longer as an athlete and a human.

The Problem:
So i finally converted my girlfriend to weightlifting and was immediately presented with an injury. I got so excited that i had her sqaut just about everyday. If she wasn’t cleaning or snatching she was front squatting or back squatting. She has these legs that go on forever so it is hard for her to build strength in her legs, so i figured we would just squat, and squat then squat some more.
Well, it worked, she got stronger but she also got injured.

Here is the issue.
She was having pain when she squatted (surprise!) in her hip. It was right at the crease where the hip bends to the outside of the hip. basically a hip abductor or one of the gluteus muscles.

Pain generating from the anterior capsule and joint space due to impingement from lack of lateral stability from the gluteus medius, glutes and hip ext rotators. This was complicated by over recruitment of the adductors and tightness.

A good friend of Mine, Darin Deaton of CF Fort Worth, is a physical therapist and someone we go to all of our little aches and pains. This was very helpful to me because Darin is like the 50 mile expert. he has a title and therefore more clout when it comes to healing injuries. This is especially important when it comes down to training my girlfriend (you all know the rules right??).
Darin first had Meggie quit squatting so much, down to maybe once a week depending on her pain. He also showed her a couple stretches to help loosen the associated muscles.
The first one is lying on her back take the injured leg and pull the knee to her opposite shoulder. Next she would cross her ankle of her injured leg over the other knee and pull the other leg to her. See video. The last one you will start on your hands and knees. Take the non injured leg and stretch it straight behind you, reach across the other leg and reach away from your body so you will be sitting on your injured leg. You should feel the stretch in the outside of your leg. I think its called pigeon pose in yoga.
The next step is to strengthen the specific muscles required to keep your alignment during the squat. For this specific problem the abductor (outside of leg) is weaker than the adductor (inside of leg) which allows the knee to come in when squatting. This is a very common problem. We solve this by loosening the adductor by stretching and foam rolling and strengthen the abductor with accessory exercises. For this we took some theraband and tied the ends together. We then put it around the ankles and did side steps into the squat position or a bit wider followed by an air squat with perfect form and most importantly making sure the knees tracked the toes.

Our goal was to maintain alignment of the hip knee angle in the same plane during the weakest range of the squat, the bottom. If at any time, the knee deviated medially, the squat was stopped, corrected and trialed again. If proper alignment not maintained, then go lighter or improve.

Darin also had her roll on a trigger point ball before and after training.  This helped loosen the abductor

external rotator and avoid potential impingement of the anterior joint due to malalignment

and made training and rehab easier.

The last part of this, like any injury is time.  We squatted light but with perfect form that didn’t hurt her.  Anytime there was  a little bit of pain, we stopped and moved on.  This meant lots of power movements and overhead work.

0 thoughts on “Common Injuries (the hip)

  1. Sounds pretty similiar to what I’m doing to treat ITB syndrome. Trying to build up strength in the glutes by squatting though.

  2. Sounds incredibly similar to the pain I was having. Only my pain got progressively sharper over the course of several months. The first stretch you mentioned of laying back and bringing the injured leg up, knee to the opposite shoulder is the stretch they use to do an initial diagnosis of a labral tear. Off to the MRI arthrogram and yep, torn labrum. It seems more and more crossfitters are getting these tears…mainly because instead of just calling it groin or hip pain, the root cause can be determined. I’m headed into surgery Thursday to get it repaired.

    If she is at a constant pain level of 2 to 4 even with less squatting and more stretching, get a labral tear ruled out…

  3. i know too well the problem of leg strength with long legs! i like those stretches a lot. i’m digging the common injury posts, keep them coming!

  4. The muscle you are describing is likely the tensor fasciae latae which connects directly into the IT band.

    Basically, anything involved with strains you gotta take slow and build back up much like the lower back. Proper movement is key as well.

    Most people with knee or lower back pain have problems with proper biomechanics of the hip — both lacking in range of motion, stability, and/or strength. Very important to stretch and loosen everything that is tight, and reset with proper squatting movements and strength work.

    This is indeed why I wrote the article on shoes, sitting, and lower body dysfunctions. Ubiquitous things like shoes and sitting cause problems when we don’t even know it.

  5. Pingback: Wed, Feb 3rd | CrossFit Ireland

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