Hip and Knee Pain from Squats

I have been having really bad hip and knee issues. I do a lot of olympic lifting, squatting, deadlifts. The pain bothers me the most when I squat and high bar back squats are the worst. The pain in my knee is at the patellar tendon. The hip pain is in both hips, but it is way worse on the left side. It is primarily in the front of the hip, but it hurts deep at the joint as well.

I had X-rays done and there is no impingement. The chiro did some ART and said my psoas, hip flexors and hamstrings were tight. I started working on mobility religiously while taking it easy with the weights. I started doing Agile 8 before lifting and doing a gradual and prolonged warmup while working out with the light weights. Things finally got a little better, and I started my olympic lifting regimen again.

A month into it the knee and hip pain starting flaring up again bad. I’ve put a few videos of my back squat since this is the movement that makes it hurt the worst. Any tips? Anything I could be doing to prevent this issue?

Thanks a lot.

Do you hip flexors get sore from squats and when you get to the bottom of the squat do you feel like the front of your hip is limiting you at the bottom even though X-rays show you have no structural impingement?

Yes and yes

I think we have Femoral Anterior Glide Syndrome and its also more significant on my left hip as well and it doesn’t like hip flexor stretches like the couch stretch.

I’ve been thinking of adding an accessory day where I strengthen glutes and my other weaknesses to get rid of this problem.

I have recently run across this as well. I will say that couch stretches make my hip flexor feel a lot better, but I still feel limited in the front at the bottom position of the squat. Is the pain in your hip limited to just the hip flexor? Every time I’m in flexion, any type of internal or external rotation hurts pretty bad around the capsule. It’s probably due to the femoral head being incorrectly positioned. Just wondering if you felt this at all?

Dumb question, but aren’t high bar back squats supposed to strengthen your glutes? The reason I put this video up here was because I originally thought I had Fem. Ant. Glide Synd. because I was squatting incorrectly and was looking for help on squat form. Do you see anything in the video that would be inhibiting glute activation?

Thanks for the replies. Hopefully some glute and core strengthening and stretching in some areas will help.

The pain is mainly in the front part of the capsule when my leg is in flexion in either external/internal rotation but I think my hip flexor tightens up a lot on that side so I wouldn’t go into hip extension and potentially bang up my front hip capsule.

I haven’t squatted in a while but in my last leg workout(on Wednesday) I was able to generate external rotation from my glutes at the bottom of the leg press from doing some glute activation stuff the day before and when it activated the bottom range of motion/hip flexion felt much more comfortable and consequently my left glute is sore today.

When standing I can only get 90 degrees of flexion for my hip while Kelly Starrett says I should be able to get 120ish. How much ROM? | Feat. Kelly Starrett | MobilityWOD - YouTube
I haven’t done this and it may help with range of motion for hip flexion(I haven’t found a strong enough anchor point for the band) but I think strengthening the glutes is imperative as well as well as generating external rotation from them in hip flexion.
Hip Impingement: AIS | Feat. Kelly Starrett | Ep. 161 | MobilityWOD - YouTube