Hip Pain During Squats: Why Does My Hip Hurt When I Squat?

Hip pain during squats is a common and frustrating problem.

Some people describe a deep ache in the groin. Others feel a sharp pinch at the front of the hip as they reach the bottom of the squat. For some, it only occurs under heavy load. For others, simply sitting into a deep squat is enough to reproduce it.

The immediate temptation is often to assume something is being “pinched” inside the joint.

Sometimes hip joint structures are relevant, but front-of-hip pain during a squat is not a diagnosis by itself.

There are several possible contributors, and the most useful question is usually:

Why is this particular hip uncomfortable during this particular squat?

At RHP, our Hip & Groin Physiotherapy assessments consider the hip itself, squat mechanics, available movement, strength, training load and other possible sources of pain rather than assuming every painful deep squat is hip impingement.

Why Does the Front of My Hip Hurt When I Squat?

A squat takes the hip into progressively more flexion as you descend.

At the bottom of a deep squat, the thigh moves relatively close to the trunk and the hip joint is placed in a position that can become provocative for some people.

Pain in this position may relate to several different structures or conditions, including:

• Femoroacetabular impingement syndrome.
• Hip labral irritation or injury.
• Iliopsoas or hip flexor-related pain.
• Adductor-related groin pain.
• Hip joint irritation.
• Early or established hip osteoarthritis.
• Less commonly, stress-related bone injuries or other pathology.
• Pain referred from the lumbar spine or surrounding regions.

That is why simply saying “my hip pinches when I squat” does not tell us exactly what is causing the problem.

What Does a Hip “Pinch” During a Squat Actually Mean?

People often use the word pinching to describe a sharp sensation at the front of the hip or groin when the hip reaches deeper flexion.

It is a useful description of the symptom, but it should not automatically be interpreted literally.

You cannot reliably determine which structure is painful simply from the sensation that something feels pinched.

The sensation may come from the joint itself, surrounding soft tissues or a combination of local sensitivity and mechanical compression.

An assessment therefore looks at the full pattern:

• Where exactly the pain is located.
• How deep into the squat it begins.
• Whether changing stance alters it.
• Whether the pain occurs with sitting, running or other hip-flexion tasks.
• Whether hip range of movement is limited.
• Whether strength or other functional tasks reproduce symptoms.

Is Hip Impingement Causing My Squat Pain?

Possibly, but the term requires some care.

Femoroacetabular impingement syndrome, or FAIS, describes a clinical condition in which hip symptoms are associated with particular clinical signs and characteristic hip morphology on imaging.

Two commonly discussed bony shapes are:

• Cam morphology: additional bone or reduced concavity around the femoral head-neck junction.
• Pincer morphology: greater acetabular coverage of the femoral head.

These shapes can influence how much movement is available before the femur and acetabulum come into contact.

But an important point is often missed:

Having cam or pincer morphology does not automatically mean you have a problem.

These anatomical variations are seen in many people who have no hip pain at all.

The diagnosis of FAIS therefore cannot be made from an X-ray or MRI alone.

Your Hip Anatomy Influences How You Squat

Not everyone is built to squat in exactly the same way.

The orientation of the hip socket, shape of the femur, length of the femoral neck, femoral version and the proportions of your limbs all influence the positions that feel comfortable.

This is one reason giving everyone the instruction to:

“Put your feet exactly shoulder-width apart and point your toes straight ahead”

does not make much sense.

One person may feel comfortable with a relatively narrow stance.

Another may naturally prefer a wider squat with slightly more toe-out.

Neither is inherently better.

The squat should fit the person rather than forcing every person into one predetermined squat shape.

Squat Depth Changes Hip Demand

The deeper you squat, the more hip and knee flexion is generally required.

If your hip only becomes uncomfortable at the final few centimetres of a very deep squat, temporarily reducing depth can be a useful modification.

That does not mean shallow squatting is the permanent solution.

It simply gives us a way to maintain training while reducing the amount of time spent repeatedly provoking the painful range.

Over time, the depth may be increased if symptoms and capacity improve.

Changing Your Stance Can Change Hip Pain

The squat is highly modifiable.

Small changes can alter hip, knee and ankle demands.

If your hip hurts when squatting, useful variations to trial can include:

• A slightly wider stance.
• A slightly narrower stance.
• Allowing a little more toe-out.
• Reducing squat depth temporarily.
• Changing trunk angle.
• Elevating the heels.
• Using a box or target to control depth.
• Using a different squat variation.

The purpose is not to discover one universally perfect squat technique.

It is to determine whether a different strategy lets you train comfortably while still achieving the purpose of the exercise.

Can Limited Ankle Mobility Cause Hip Pain During a Squat?

Ankle movement affects squat strategy.

If the ankle has limited dorsiflexion, your body may compensate by changing foot position, trunk angle, squat depth or movement elsewhere in the lower limb.

That does not mean restricted ankle dorsiflexion directly causes hip pain.

But it can influence the movement options available to you.

If ankle range is clearly limited and changing it affects the painful squat, then it may be relevant.

Heel elevation can also be useful because it changes the amount of ankle movement required and modifies squat mechanics.

Are Weak Glutes Causing My Hip Pain?

Not necessarily.

“Weak glutes” have become an easy explanation for almost every lower-limb problem.

People with hip pain can have strength deficits, and strengthening the gluteal muscles is commonly useful in rehabilitation.

But finding a weaker muscle does not prove that weakness caused the pain.

A better assessment looks at strength across the hip and lower limb and asks whether any deficits are actually relevant to the tasks you want to perform.

That may include testing:

• Hip extension strength.
• Hip abduction strength.
• Hip rotation strength.
• Adductor strength.
• Quadriceps strength.
• Single-leg strength and control.

Our Sports Physiotherapy approach uses strength and functional testing where it helps answer these questions rather than assuming every hip problem needs the same set of glute exercises.

Does Anterior Pelvic Tilt Cause Hip Impingement?

This is another common oversimplification.

The pelvis naturally moves during a squat.

There is no universally correct pelvic position that everyone must maintain from the top of a squat to the bottom.

Your lumbar spine and pelvis are also allowed to move.

Trying to rigidly brace the trunk and lock the pelvis into one position can sometimes make a squat less comfortable rather than more comfortable.

Movement pattern changes may still be useful for some people, but they should be based on whether the change improves symptoms or function.

Could the Pain Be Coming From My Back?

Yes.

Not all pain felt around the hip originates from the hip joint itself.

The lumbar spine can refer pain into the buttock, groin or upper thigh, and neurological symptoms may occasionally be perceived around the hip region.

If your hip discomfort is accompanied by:

• Lower back pain.
• Pain extending further down the leg.
• Numbness or tingling.
• Changes in strength.
• Symptoms that change significantly with spinal movement.

then assessment of the spine may be appropriate as part of the examination.

You can read more about our approach to Lower Back Pain Physiotherapy.

Do I Need an MRI for Hip Pain When Squatting?

Usually not as the first step.

For many people, the history and physical examination provide enough information to begin appropriate management.

Imaging may become useful where:

• The diagnosis remains unclear.
• Symptoms are persistent despite appropriate rehabilitation.
• Significant joint pathology is suspected.
• There has been substantial trauma.
• Symptoms suggest a bone stress injury or other condition requiring further investigation.
• Surgical opinion is being considered.

Importantly, scans commonly identify anatomical findings that may not be responsible for the pain.

That is particularly relevant for cam and pincer morphology and labral changes.

Should I Stop Squatting if My Hip Hurts?

Not necessarily.

Complete rest is often not required.

The better approach is usually to determine what amount and type of squatting your hip currently tolerates.

You may temporarily adjust:

• Depth.
• Load.
• Volume.
• Stance.
• Tempo.
• Exercise variation.

For example, if a deep back squat is painful but a shallower squat or split squat is comfortable, you may be able to keep training your legs while rehabilitation continues.

Maintaining training where possible is usually much more useful than removing all lower-body exercise without a clear reason.

What Exercises Help Hip Pain During Squats?

There is no single exercise that fixes every painful squat.

The program should address the findings that are relevant to you.

That may include:

• Hip strengthening.
• Adductor strengthening.
• Quadriceps strengthening.
• Single-leg exercises.
• Trunk strengthening.
• Hip mobility where a meaningful restriction exists.
• Ankle mobility where relevant.
• Gradual exposure to deeper hip flexion.
• Progressive return to heavier squatting.

Current clinical guidelines for non-arthritic hip pain support a multimodal rehabilitation approach that includes activity modification, strengthening of the hip and lower limb, and movement-pattern training where appropriate.

Can You Improve Hip Mobility?

Sometimes.

But first we need to understand what is limiting the movement.

A restriction created by muscle stiffness may respond differently from a restriction influenced largely by the shape and orientation of the joint.

You cannot stretch your way into changing the bony architecture of the hip.

And you do not necessarily need to.

Sometimes the better strategy is to find a squat position that suits your anatomy rather than relentlessly trying to force additional range.

What If I Only Have Hip Pain in a Deep Squat?

This is a very common presentation.

If your hip is comfortable during everyday activity and only becomes painful at the very bottom of a loaded squat, that tells us something important about the threshold at which symptoms appear.

The solution may involve:

• Temporarily training above that depth.
• Trying a different stance.
• Reducing load while deeper flexion is reintroduced.
• Building hip and lower-limb strength.
• Gradually exposing the hip to the provocative range.

You do not earn extra health points for forcing yourself into the deepest possible squat if that position consistently hurts.

Depth should reflect your goal.

What If Squats Are Important for My Sport?

If deep hip flexion is important to your training or sport, the goal changes slightly.

A weightlifter may genuinely need a very deep squat.

A footballer, runner or netballer may need strong legs but may have no particular requirement to barbell squat to maximum depth.

Rehabilitation should therefore consider what you actually need to get back to.

Our Sports Physiotherapy team uses the demands of the athlete’s sport and training to determine whether a particular movement needs to be restored or whether another strength exercise can achieve the same purpose.

When Should Hip Pain During Squats Be Assessed?

An occasional mild sensation during training does not always require treatment.

Assessment becomes more worthwhile when:

• The pain keeps returning.
• You have progressively lost squat depth.
• The pain is becoming more intense.
• You are shifting your weight significantly away from one side.
• You have stopped lower-body training because of the hip.
• The hip catches, locks or gives way.
• You have significant loss of movement.
• The pain occurs outside the gym as well.
• You are unsure whether the problem is coming from the hip, groin or lower back.

A good physiotherapy assessment should identify more than the painful movement. It should help establish what is likely contributing to the pain and what you can continue doing while it improves.

How We Assess Hip Pain During a Squat

At RHP, an assessment may include:

• Your training history and recent changes in load.
• The exact location and behaviour of your symptoms.
• Hip range of movement.
• Hip and lower-limb strength.
• Assessment of the lumbar spine where relevant.
• Your unloaded and loaded squat.
• Different squat depths and stance positions.
• Single-leg tasks.
• Other movements relevant to your sport or gym program.

The purpose is not to find every asymmetry in your body.

It is to determine which findings actually change your symptoms or help explain why the squat has become difficult.

Hip Pain During Squats Usually Has More Than One Possible Solution

If your hip hurts when you squat, you do not necessarily need to stop training.

You also do not necessarily need to force yourself through the pain, stretch harder or completely rebuild your squat technique.

The useful questions are:

• What structure or region is most likely contributing to the pain?
• At what depth and load do symptoms begin?
• Can the squat be modified to make it more comfortable?
• Are there useful strength or mobility deficits to address?
• What squat depth do you actually need for your goals?
• How do we progressively restore the capacity you need?

For many people, the solution is a combination of sensible loading, targeted strengthening and finding a squat strategy that suits their individual anatomy.

If you are experiencing persistent front-of-hip pain, groin pain or pinching when squatting, our Hip & Groin Physiotherapy team can assess the problem and help you continue training while working towards a more comfortable squat.

Author in the know

Sam Donaldson

Director, APA titled Sports and Exercise Physiotherapist. Sam loves to treat athletes with lower limb injuries and has a special interest in knees of all ages; adolescent knee pain, athlete with knee pain, ACL injuries, ACL rehabilitation, Knee Osteoarthritis and Knee Replacement recovery. He is a Dad, Football enthusiast and loves to move. BAppSci (HMS), MPhtyStudies, MPHTY (Sports)