PT on the Net Research

Impingement During Squats


Question:

I work as a personal trainer in England, and I have a little problem with a client. When my client performs squats with even a moderate weight (15-20kg), he will experience a slight burning sensation in the upper section of both sets of adductors. This will last off and on for one to two days after performing the exercise and will also go into very slight pins and needles. I am starting to think maybe we have an impingement issue or perhaps some kind of circulatory problem. Are there any conditions that affect this area, and if so, how can I test for them? I have given him a stretch routine to follow, but this has made no difference. Please help!

Answer:

Based on your description, your client is experiencing a possible peripheral genitofemoral nerve entrapment at the psoas. The genitofemoral nerve passes through the psoas at the level of the mid to lower spine. It may become entrapped at this level, but it often does not cause local symptoms. Symptoms are usually more distal (which is what you describe). This is often difficult to locate and will require a trained soft tissue expert. For the time being, assess the ability for the foot/ankle, hip to function in all three planes of motion. I would strongly recommend looking at Gary Gray’s Functional Video Digest to learn about Functional Manual Reaction of the Hips. By releasing the soft tissues of the hips and getting the iliofemoral joints to work with the rest of the body, you will not waste time. In addition, review Gary’s DVD on Squatology for the myriad of “tweaks” to assess what plane and/or range your client CAN squat - possibly without symptoms. The best therapist to find for this type of nerve entrapment is an active release doctor/therapist. For more information on this type of practitioner and to find a therapist near you, visit www.activerelease.com. Reviewing the above will take time, but your client will love you for it, and you will learn a lot. Good luck!