Anterior Pelvic Tilt: Pain While Squatting

[rafsanjaniii]

[quote]alexus wrote:
I actually think that the worrying thing in this whole situation is how much we are in agreement…

But the osteo is focused on stopping your squatting and increasing your lower back mobility.

Personally… My priority would be ‘I want to squat pain free’ and so not squatting (unless it is a temporary measure) is not an option. I’m not going to be replacing squats with cat-camel stretches!!

You say they pain isn’t ‘that pronounced’ when doing bodyweight squats… One take on rehab is to find a version of the movement that produces discomfort (but not really pain) and use that as a rehab exercise. The idea is to (this is all scientific) figure out how to do the movement without producing pain.

What happens if you hold a 5kg plate out front like a zombie looking through the hole. Then squat down slowly (say, take 3 or 3 and a half seconds for your descent. Then pause for a one-two count. Then try and use your glutes to push your hips forwards / up as explosively as you can. Does that produce pain? I’d love to see a vid… Side on so we can see whether you are holding your arch too hard or whether you have tail tuck at the bottom (so you lose the tension in your posterior chain which makes it hard for you to recruit it properly for your ascent)[/quote]

Woah woah woahhh… things are getting so heated up and technical here lol.

Anws, I’ll post up a vid of me doing squats later on today, currently at work now and posting this using my phone.

And yeah you’re right, I was kinda upset when she just told me to stop squatting altogether, which kinda lead me to postjng here for other alternatives lol. Really appreciate all the discussion in this thread tho, really helpful info.

Btw, would it be beneficial for me to strengthen my glutes, hamstrings and core, to reduce the APT? Or should I just focus on stretching out the lower back first? I’ll post up a vid of my squats later today and hopefully give you guys a clearer picture on my situation.

[BHOLL]

[quote]rafsanjaniii wrote:

[quote]alexus wrote:
I actually think that the worrying thing in this whole situation is how much we are in agreement…

But the osteo is focused on stopping your squatting and increasing your lower back mobility.

Personally… My priority would be ‘I want to squat pain free’ and so not squatting (unless it is a temporary measure) is not an option. I’m not going to be replacing squats with cat-camel stretches!!

You say they pain isn’t ‘that pronounced’ when doing bodyweight squats… One take on rehab is to find a version of the movement that produces discomfort (but not really pain) and use that as a rehab exercise. The idea is to (this is all scientific) figure out how to do the movement without producing pain.

What happens if you hold a 5kg plate out front like a zombie looking through the hole. Then squat down slowly (say, take 3 or 3 and a half seconds for your descent. Then pause for a one-two count. Then try and use your glutes to push your hips forwards / up as explosively as you can. Does that produce pain? I’d love to see a vid… Side on so we can see whether you are holding your arch too hard or whether you have tail tuck at the bottom (so you lose the tension in your posterior chain which makes it hard for you to recruit it properly for your ascent)[/quote]

Woah woah woahhh… things are getting so heated up and technical here lol.

Anws, I’ll post up a vid of me doing squats later on today, currently at work now and posting this using my phone.

And yeah you’re right, I was kinda upset when she just told me to stop squatting altogether, which kinda lead me to postjng here for other alternatives lol. Really appreciate all the discussion in this thread tho, really helpful info.

Btw, would it be beneficial for me to strengthen my glutes, hamstrings and core, to reduce the APT? Or should I just focus on stretching out the lower back first? I’ll post up a vid of my squats later today and hopefully give you guys a clearer picture on my situation. [/quote]

both lol

[Sentoguy]

[quote]BHOLL wrote:

[quote]Sentoguy wrote:

[quote]alexus wrote:

[quote]Sentoguy wrote:
I disagree with the notion that the reason people injure their backs has anything to do with them having the ability to move their spine through a full ROM. [/quote]

Where did I say this?

Oh… I didn’t.

Again, if you LACK the mobility to move from anterior to posterior pelvic tilt then you probably want to gain this mobility. BUT IF YOU CAN DO THIS then doing EXTRA work for lumbar mobility is most probably not the best use of your time.

I agree completely with the idea of putting more work into thoracic and hip mobility. And with glute recruitment on squats.

[/quote]

Sorry, wasn’t trying to imply that you had said that. It was more of a retort to the popular notion these days that moving the spine through it’s normal range of motion is going to ipso facto cause injury; which seems to be the theory that the OP was questioning when he started this thread.

We are in total agreement it seems.[/quote]

What are you considering the spines normal ROM?[/quote]

It’s of course going to vary somewhat depending on a person’s proportions as far as exact degrees of movement, but essentially:

Flexion: being able to create a smooth curve beginning from hips (which are in a strong PPT) to the neck, or being able to lay the torso on the legs while keeping the legs locked straight and together. Yes, this also requires a lot of hamstring flexibility, but it is also impossible without good back flexibility.

Rotation: being able to rotate the pelvis at least 90 degrees to the shoulders

Extension: being able to perform a bridge with straight arms and straight legs (which also of course requires significant shoulder flexion ROM and Hip Extension ROM)

This doesn’t mean that everyone needs to achieve these natural limits of ROM, but until you start to exceed these ROM’s, I don’t buy into there being any danger in gaining flexibility (again with the caveat that you also need to be building the ability to control these ROM’s and gain the ability to prevent movement as needed).

If I could post pics (on phone ATM) it would be much easier to explain what I mean.

[rafsanjaniii]

okay guys, i finally did some squats today, but i started off really really light so that i wont aggravate my hip flexors. this are low bar back squats btw. only doing 3 sets of 5 reps today, but i only got the first and last set on video.

so this is my first set.

Wan squat 40kg 1st set

This set felt kinda good, no pain in my hips whatsoever. lower back felt a lil tight tho, but i think thats just normal in squats, no?

This is my 3rd set of squats

Wan squat 3rd set 40kg

In this set, from the 2nd or 3rd rep onwards, i could actually feel the pain in my hips when im about to burst upwards from the squat. the pain isnt as unbearable as before, but its just a mild yet uncomfortable pain that i could grind out, but its definately there.

P.S i did a lot of stretching before the workout, including hip flexor and lower back stretches, and i also ensured that i opened up my hips with just normal squat stretching.

will appreciate any assistance and feedback from you guys!

[alexus]

They actually look pretty good. Which would usually be a good thing. But here it isn’t such a good thing, because it makes fixing it so much harder…

You don’t lose your lumbar arch - which is good. I see a little bit of wobble - like your body is starting to think about it - but you have trained yourself to stop your descent about there - yeah? Which is good.

If you weren’t experiencing pain I’d say your squat looks pretty good. But the fact that you are experiencing pain means you need to change something…

So… The pain is like a pinching or stretching in your hip flexors at depth? Does that seem right?

I used to get a pain like this sometimes… The fix for me was to replace squats (temporarily!) with unweighted squats / front loaded plate squats / squats with just the barbell. 5x5 kind of rep scheme. Every 2nd day. It gave me the chance to work on my form and really grease the groove with it. It also (without load) gave my flexors the chance to recover. The movement was pain-free - that is important! But doing it with full concentration… Is kind of mentally fatiguing.

I think… That you are stopping your descent at the point where you start to be in danger of losing your lumbar arch. Which is good - that is what people are usually told to do. What isn’t so good is that you cant’ get a little more depth out. Another couple inches would really give your glutes so very much more work to do - which would be a terrific thing for someone with anterior pelvic tilt.

So… I’d work on getting your squat a little bit deeper. I think that you will find that that (along with glute activation drills) will stretch out your hip flexors appropriately and they will start to chill out as you get the opportunity to get much better at really using your glutes to initiate the drive out of the hole (your hip flexors can actually relax on the way up).

How do do this?

I’m a HUGE fan of front loaded plate squats for a whole bunch of reasons. The idea is to take a good 3 to 3 and a half seconds on your descent. Really try and hold your lumbar arch and ‘sit into’ your hip flexors / ‘pull yourself into it with your hip flexors’ (I think you get this) to to really push a little more depth. Then pause for a couple seconds (sometimes a gentle bounce helps push a little more depth). Then try and initiate the ascent with the glutes.

If I understand you right… This is how I managed to rehab a similar / perhaps the same problem. But I’m sure there are other ways… And I’ll admit my anatomical knowledge isn’t so good.

[alexus]

At least… Give the front loaded plate squats a try. The idea is… There is good pain when it comes to squats… Pain that should be ignored and pushed through. And there is bad pain when it comes to squats. That pain that you are regarding to be problematic: It is problematic. ‘Discomfort’ associated can be used to help rehab - to turn discomfort into comfort then things that were painful become uncomfortable etc…

But don’t push through this kind of pain. When you feel the pinching stop it. Then try and find something unfomfortable - but not painful. The aim is to make it comfortable (you helped) not painful (making things worse)

(It cracks me up how you have to explain this shit to guys sometimes)

[VTTrainer]

Try squatting with your feet pointing straight, with your stance at various widths. Test the closer stance with both knees forward, and spread out How’s everything feel then? Your feet are pointed out fairly wide, just an observation.

[Sentoguy]

Front loaded plate squats (or just regular front squats or Zercher squats) would be a good method of keeping you more upright (thus not needing to go into as severe of an APT during your squats), which should help. Even just switching a high bar/Olympic squats would help somewhat with getting depth and keeping the torso more upright.

Low bar squats mandate a greater forward torso lean and greater hip flexion than High bar (in order to keep the bar over the center of the feet/center of gravity), and definitely more than Front, front plate loaded, or Zercher squats, thus placing greater shearing/radial forces on the spine and greater pressure on the hip joints. For some people this might serve their purposes well, but seeing as you are experiencing pain with this movement, switching to a more vertical torso variation would likely help to alleviate some of the pressure/discomfort you are experiencing.

Some other things to make sure that you are doing would include:
-keeping the weight slightly towards the outsides/pinky sides of your feet to maintain your arches
-spreading the floor with your feet/pressing the knees outwards throughout the entire movement
-keeping the weight over your arches or slightly towards your heels (this will change somewhat depending on squat variation, but you should never shift your weight towards your toes, which you don’t appear to be doing anyways, just putting it out there in case)

[BHOLL]

[quote]alexus wrote:
At least… Give the front loaded plate squats a try. The idea is… There is good pain when it comes to squats… Pain that should be ignored and pushed through. And there is bad pain when it comes to squats. That pain that you are regarding to be problematic: It is problematic. ‘Discomfort’ associated can be used to help rehab - to turn discomfort into comfort then things that were painful become uncomfortable etc…

But don’t push through this kind of pain. When you feel the pinching stop it. Then try and find something unfomfortable - but not painful. The aim is to make it comfortable (you helped) not painful (making things worse)

(It cracks me up how you have to explain this shit to guys sometimes)[/quote]

mmm thats good, but only if its a chronic tendonopathy. In this case, I’d recommend avoiding pain just to assure that it isn’t impingement which can ultimately result in bony deformity. All the other points are well said

I just think you need to create less hip flexion during your squats, I think sento’s point of maintaining an upright torse will help you acheive this.

[rafsanjaniii]

[quote]BHOLL wrote:

[quote]alexus wrote:
At least… Give the front loaded plate squats a try. The idea is… There is good pain when it comes to squats… Pain that should be ignored and pushed through. And there is bad pain when it comes to squats. That pain that you are regarding to be problematic: It is problematic. ‘Discomfort’ associated can be used to help rehab - to turn discomfort into comfort then things that were painful become uncomfortable etc…

But don’t push through this kind of pain. When you feel the pinching stop it. Then try and find something unfomfortable - but not painful. The aim is to make it comfortable (you helped) not painful (making things worse)

(It cracks me up how you have to explain this shit to guys sometimes)[/quote]

mmm thats good, but only if its a chronic tendonopathy. In this case, I’d recommend avoiding pain just to assure that it isn’t impingement which can ultimately result in bony deformity. All the other points are well said

I just think you need to create less hip flexion during your squats, I think sento’s point of maintaining an upright torse will help you acheive this. [/quote]

i already sent an email to my osteopath, and she replied stating that there was nothing to indicate that there is any fracture in my hip. And also she stated that i’m not presenting with any common symptoms of hip impingement from the tests that she ran through with me, so i think we could safely rule out hip impingement i guess.

[quote]alexus wrote:
At least… Give the front loaded plate squats a try. The idea is… There is good pain when it comes to squats… Pain that should be ignored and pushed through. And there is bad pain when it comes to squats. That pain that you are regarding to be problematic: It is problematic. ‘Discomfort’ associated can be used to help rehab - to turn discomfort into comfort then things that were painful become uncomfortable etc…

But don’t push through this kind of pain. When you feel the pinching stop it. Then try and find something unfomfortable - but not painful. The aim is to make it comfortable (you helped) not painful (making things worse)

(It cracks me up how you have to explain this shit to guys sometimes)[/quote]

okay just to confirm, do front loaded plate squats look like this?

Plate Loaded Front Squat

i might give these a try soon, but how should i build my workout around them? the rep ranges, the progression, and also how many days and for how long actually should i stick to these squats? at what weight would it be good enough for me to proceed to normal back squats?

[quote]alexus wrote:
So… The pain is like a pinching or stretching in your hip flexors at depth? Does that seem right? [/quote]

well…not really when its at depth. i mean its okay when i just stay down there during the 2 second pause, but it hurts the moment i start the initial push from the squat. and its not a stretching kinda pain, somewhat of a sharp pain i guess?

[quote]Sentoguy wrote:
Front loaded plate squats (or just regular front squats or Zercher squats) would be a good method of keeping you more upright (thus not needing to go into as severe of an APT during your squats), which should help. Even just switching a high bar/Olympic squats would help somewhat with getting depth and keeping the torso more upright.

Low bar squats mandate a greater forward torso lean and greater hip flexion than High bar (in order to keep the bar over the center of the feet/center of gravity), and definitely more than Front, front plate loaded, or Zercher squats, thus placing greater shearing/radial forces on the spine and greater pressure on the hip joints. For some people this might serve their purposes well, but seeing as you are experiencing pain with this movement, switching to a more vertical torso variation would likely help to alleviate some of the pressure/discomfort you are experiencing.

Some other things to make sure that you are doing would include:
-keeping the weight slightly towards the outsides/pinky sides of your feet to maintain your arches
-spreading the floor with your feet/pressing the knees outwards throughout the entire movement
-keeping the weight over your arches or slightly towards your heels (this will change somewhat depending on squat variation, but you should never shift your weight towards your toes, which you don’t appear to be doing anyways, just putting it out there in case) [/quote]

[quote]VTTrainer wrote:
Try squatting with your feet pointing straight, with your stance at various widths. Test the closer stance with both knees forward, and spread out How’s everything feel then? Your feet are pointed out fairly wide, just an observation. [/quote]

actually i started getting this sharp pain in my hips when i first started squatting high bar 4-5 months ago. during that time i kinda changed from low bar to high bar, and thats when i first encountered this pain in my hips. and during the whole time i was suffering from this hip pain, i was squatting high bar throughout on and off lol, so i guess high bar didnt really allow me to squat pain free? only recently i changed back to low bar again, and im kinda hesitant to go back to high bar.

[Sentoguy]

Then to me that sounds like something is off on your form for high bar (most likely hip mobility, but potentially could also be ankle mobility or core strength). How about Front squats? Have you tried those yet?

[alexus]

Okay. So you need to see if there is a way you can hold yourself (so to speak) so you can initiate the ascent out the hole without that painful sensation. That is what the plate loaded front squats are for. Except in your case the point is to figure out how to activate muscles so you don’t get that painful sensation. I reckon you can probably get a bit deeper than him, too.

I’m thinking that you aren’t really initiating the ascent with your glutes / posterior chain. I personally find the transition hard. When I squat I need to focus on ‘sitting into’ my hip flexors or actively pulling myself down into the squat. I really feel things in my hip flexors / the front of my legs. I find it quite hard to transition from this feeling to feeling the tension in my glutes / posterior chain and really driving up using those muscles.

I am wondering whether the same thing is going on for you.

I suggested 5x5 because Ripptoe said it was a good rep range in the trade-off for impeccable form, strength, volume, and I profited from it. I’d stick with the plate until you have 1) Greased the groove on a comfortable / pain free squat pattern. 2) Managed to eek out an inch or two extra depth. But that pinching pain feeling isn’t acceptable. Don’t push through it. The whole point is to learn to squat without that feeling… I’d spend a couple weeks on it. Then after the groove is well and truly greased… See how things feel with the bar (if all goes well the transition will be easy). If you transition too quickly you might be quicker to return to old squat patterns… I guess I’d spend a couple weeks… Then reassess

[alexus]

At least… It seems fairly low risk. You aren’t pushing through pain (to make tendinopathy worse). If you have injured your hip flexors a bit then this will provide a gentle stretch for them and they will get a couple weeks to recover.

The front loading will help you use your posterior chain. It works as a bit of a counter-balance to help you hold a more balanced anterior / posterior tension in your legs. That is how it feels to me, anyway, when I do it. The loading makes it easier than an unweighted squat - and that is the whole point here. Developing a pain-free squat pattern. I’m around 70kg and I find a 5kg plate is about right for me. Experiment with the weight if you need - but I’m pretty sure I’ve seen most guys use a 5kg plate, too.

[BHOLL]

[quote]alexus wrote:
At least… It seems fairly low risk. You aren’t pushing through pain (to make tendinopathy worse). If you have injured your hip flexors a bit then this will provide a gentle stretch for them and they will get a couple weeks to recover.

The front loading will help you use your posterior chain. It works as a bit of a counter-balance to help you hold a more balanced anterior / posterior tension in your legs. That is how it feels to me, anyway, when I do it. The loading makes it easier than an unweighted squat - and that is the whole point here. Developing a pain-free squat pattern. I’m around 70kg and I find a 5kg plate is about right for me. Experiment with the weight if you need - but I’m pretty sure I’ve seen most guys use a 5kg plate, too. [/quote]

I agree with trying front squats as a progression from the video you posted.

Its probably one of the tendons snapping over the femur, idk if light stretching by squatting is the way to mobilize it but everyones entitled to their opinion. I just thinks there’s easier less stressful ways to achieve it.

[alexus]

the point isn’t ‘to mobilize it’. the point is to squat pain free.

[BHOLL]

[quote]alexus wrote:
the point isn’t ‘to mobilize it’. the point is to squat pain free.[/quote]

lol, no crap sherlock

sure sounded like it>>>>>“If you have injured your hip flexors a bit then this will provide a gentle stretch for them and they will get a couple weeks to recover.”

[alexus]

ok. it is just that sometimes people get side-tracked or distracted into doing a lot of different mobility drills or stretches when they might well be better off focusing on greasing the groove on their squats.

[Sentoguy]

[quote]alexus wrote:
ok. it is just that sometimes people get side-tracked or distracted into doing a lot of different mobility drills or stretches when they might well be better off focusing on greasing the groove on their squats.[/quote]

Sure, sometimes that happens.

The counter argument though is that greasing the groove only helps if you are greasing the correct groove. In other words “practice does not make perfect, it only makes permanent. Only perfect practice makes perfect.”

If there is something off about the OP’s mechanics, then continuing to groove those mechanics will in and of itself not likely solve his problem. In that case he might be well served to perform some mobility or flexibility work to allow him to fix his mechanics. Then once he is capable of performing the movement correctly, grooving it will absolutely be beneficial for him.

One of the good things about mobility exercises is that they can isolate certain movements or illustrate to you if you have deficiencies in certain ROM’s which may not be evident from just squatting.

[alexus]

One of the good things about mobility exercises is that they can isolate certain movements or illustrate to you if you have deficiencies in certain ROM’s which may not be evident from just squatting.

If that is your aim - go nuts. If your aim is to squat pain free then perhaps it would be better to focus on the goal. People would rather do all kinds of stuff than do their 5x5 front loaded plate squats slow and controlled…

I like front loaded plate squats because they are incredibly hard to fuck up. You saw the OP squat in the vid. If there is a problem with his movements it is a subtle problem.

I’m… Not so much into arguing for arguing sake…

Focus on the goal.

[Sentoguy]

[quote]alexus wrote:

One of the good things about mobility exercises is that they can isolate certain movements or illustrate to you if you have deficiencies in certain ROM’s which may not be evident from just squatting.

If that is your aim - go nuts. If your aim is to squat pain free then perhaps it would be better to focus on the goal. People would rather do all kinds of stuff than do their 5x5 front loaded plate squats slow and controlled…

I like front loaded plate squats because they are incredibly hard to fuck up. You saw the OP squat in the vid. If there is a problem with his movements it is a subtle problem.

I’m… Not so much into arguing for arguing sake…

Focus on the goal.[/quote]

Focusing on the goal is all well and good, but sometimes it’s difficult to see the details when looking at the whole picture, especially if you aren’t sure exactly when you are looking for or what the big picture is supposed to look like.

Just like listening to a symphony and trying to figure out which instruments are off key or out of rhythm is a lot harder to do than listening to each group of instruments individually, trying to pay attention to all parts of a squat and picking out exactly which details you are missing or performing incorrectly (especially when you don’t know which to focus on) can be a very challenging endeavor. Performing mobility drills and activation techniques to isolate all associated components of a squat can help someone to more easily evaluate and identify what may not be performing properly.

No one is saying not to focus on the end goal, just that breaking it down into smaller more isolated parts can make it easier to evaluate what may not be working in the goal movement.