Guilty: Femoral Anterior Glide Syndrome

Written on July 6, 2007 at 12:05 pm, by Eric Cressey

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.

Eric Cressey

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Fixing Leg Imbalances

Written on June 12, 2007 at 5:07 pm, by Eric Cressey

Q: I have an imbalance – one leg vs. the other. Do you suggest doing 100% unilateral leg-work for a while to cure the imbalance?

A: This is a tough one to answer; it’s never as simple as “right and left.” Generally, you’ll see muscles on each side that are a bit stronger or weaker. For example, in right-handed individuals, they’ll typically be stronger on lunging movements with the left leg forward. The left ITB/TFL, right quadratus lumborum, and right adductors will be tight, while the right hip abductors, left adductors, and left quadratus lumborum will be weak.* There are more complex ramifications at the ankle and foot, too. Often, the best way to address the unilateral imbalance in a broad sense is to figure out where people are tight/weak and address those issues. I’ve seen lunging imbalances corrected pretty easily with some extra QL work or pure stabilization work at the lumbar spine. The tricky thing about just doing extra sets on one side is that your body will often try to compensate for the imbalances. You might get the reps in, but are you really doing anything to even yourself out if you’re just working around the dysfunction?

This is just some stuff to consider. I don’t think doing more on that side will hurt, but it won’t always get you closer to where to want to be.

Eric Cressey

Boxers or Briefs

Written on June 11, 2007 at 3:06 pm, by Eric Cressey

Q: I am a strongman competitor and am thinking about incorporating squat briefs into my training. I talked to a powerlifter buddy of mine and he said he would recommend briefs for max effort squats and deadlifts to keep the hips healthy. What do you think about this?

A: Well, my first observation is that you’re not going to be using the briefs in competition, are you? Specificity is more important than people think; what’s specific for a powerlifter won’t necessarily be specific for a strongman.

However, given the nature of the training you’ll be doing (powerlifting-influenced), I wouldn’t rule the briefs out right away. It depends on whether you’re regularly box squatting and/or squatting with a wide stance. If you are, I’d say that they’re a good investment, and you could use them 1-2 weeks out of the month.

I would, however, caution against using them as a crutch against poor lifting technique. There are a lot of guys who just throw on briefs because their hips hurt, not realizing that it isn’t the specific exercise that is the problem; it’s the performance of that exercise that gives them trouble. For example, hamstrings dominant hip extension/posterior pelvic tilt allows the femoral head to track too far anteriorly and can cause anterior hip pain. If the glutes are activated appropriately, they reposition the head of the femur so that this isn’t a problem. Unfortunately, a good 80% of the population doesn’t have any idea how to use their glutes for anything except a seat cushion.

Eric Cressey

Efficient Athletes will always be Better Athletes